The Uses of Placebo

— Not long since I was a convalescent, in that comfortable stage which takes an amiable and patronizing interest in the therapeutic measures employed to effect coy Health’s return. In a professionally unguarded moment, and replying to my expressed conviction that the conspicuous flavor of a certain medicine was its essential element of efficacy, “ No,” said the good physician; “it is merely a placebo.” So, then, the great factor of my cure, as accredited by me, had nothing to do with the cure. I had been the victim of an insinuating deception, and it had been thought necessary to deal with me as with the querulous child for whom the displeasing but wholesome remedy must be disguised! On the other hand, I asked myself, Why quarrel with that which indulgently might be counted as among the little graces of pharmaceutics, — as the final æsthetic touch given by the artist chemist to his studious concoction for my benefit ? “ I-will-please ” had indeed ingratiated itself with me, and who could say that it did not have its own potency in the vague and spacious province of “ mind-cure ” ?

With the rambling license permitted to the convalescent, I ran over some cases that seemed to have a near or remoter likeness to my own. Rather, first of all, I reviewed repeated instances in which I had myself been the patient successfully treated by the placebo method. What memories of childhood’s tasks set by my elders, — tasks ingeniously flavored with play or dramatic impersonation ! What vista of school-days tinctured with contests and prizes ! Later on, what phases of experience rendered tolerable only by an adventitious sweetening with imagination ! Did not Orestes call his triad of tormentors the Eumenides, and was there not honey as well as opiate seeds in the cake which the sibyl threw to Pluto’s grisly watch-dog?

Socially, when reproof is to be administered, the use of some sort of placebo seems absolutely necessary. I recalled the admirable sagacity of my next-door neighbor, who, being much annoyed by the trespassing of school-boys, had the humorous and kindly tact to put her premises in charge, seriatim, of each marauding band or individual offender, and thus, by a dexterous appeal to each to keep the others in order, turned petty miscreancy into protective rivalry. Encouraged by the success of her example, I had, not long after, applied the same principle, with fair results ; for, in a jostling crowd of hobbledehoys at the ferryhouse, at the request, “ Gentlemen, please do not crowd,” there had been a considerate falling back, and a murmur of deprecation for their rudeness. I also remembered the pathetic case of the small dusky handmaid, who came to me in a flood of tears at the unkindness of certain white children. “ They said I was a little black nigger! ” “ Well, but you know you are not,” I answered, with less of reflection than of exasperation with her tormentors. But, sooth to say, the little handmaid dried her tears with an alacrity that could scarcely have been greater had my words effected a total annihilation of her color.

In conclusion, the illustration of the placebo principle that most pleased my convalescent fancy was drawn from a friend’s reminiscences of travel in Spain. In that land of romance, the muleteer, when he has exhausted all the usual means of spurring on his rarely opinionated and resolute beast, drops the use of oaths and lash, and, in wheedling tones, begins to compliment longears by calling him a horse ! Singularly enough, this flattery has usually the happy effect of persuading the obstinate animal to resume his journey. . . . Thus meditating, I fell asleep, and dreamed that a distinguished expert had found a placebo equally applicable and efficacious in all eases of social balking incident to the human family.