Placebo and the New Physiology of the Doctor-Patient Relationship

Abstract

Modern medicine has progressed in parallel with the advancement of biochemistry, anatomy, and physiology. By using the tools of modern medicine, the physician today can treat and prevent a number of diseases through pharmacology, genetics, and physical interventions. Besides this materia medica, the patient's mind, cognitions, and emotions play a central part as well in any therapeutic outcome, as investigated by disciplines such as psychoneuroendocrinoimmunology. This review describes recent findings that give scientific evidence to the old tenet that patients must be both cured and cared for. In fact, we are today in a good position to investigate complex psychological factors, like placebo effects and the doctor-patient relationship, by using a physiological and neuroscientific approach. These intricate psychological factors can be approached through biochemistry, anatomy, and physiology, thus eliminating the old dichotomy between biology and psychology. This is both a biomedical and a philosophical enterprise that is changing the way we approach and interpret medicine and human biology. In the first case, curing the disease only is not sufficient, and care of the patient is of tantamount importance. In the second case, the philosophical debate about the mind-body interaction can find some important answers in the study of placebo effects. Therefore, maybe paradoxically, the placebo effect and the doctor-patient relationship can be approached by using the same biochemical, cellular and physiological tools of the materia medica, which represents an epochal transition from general concepts such as suggestibility and power of mind to a true physiology of the doctor-patient interaction. I.WHAT I. WHAT IS A PLACEBO RESPONSE? A. Placebos Were Introduced to Validate the Efficacy of Medical TreatmentsAncient physicians have always used bizarre and odd treatments to cure their patients, with scarce, if any, knowledge of anatomy and physiology. As the anatomical and physiological details of both the animal and the human body started emerging, the need of a scientific explanation of many medical treatments became an imperative objective of physicians and the scientific community. An important historical period whereby scientific skepticism emerged about the efficacy of some medical remedies is approximately in the second half of 1700 and involved treatments like mesmerism, perkinism, and homeopathy (178).To take mesmerism as an example, this was introduced in the second half of 1700 by Franz Anton Mesmer, who claimed to have discovered a healing fluid which he called animal magnetism. To assess the very nature and the efficacy of mesmerism in treating many diseases and symptoms, Louis XVI appointed a commission that was headed by Benjamin Franklin. This commission performed what can be considered one of the first blind assessments and sham (placebo) interventions in the history of medicine. Some women were blindfolded and asked where the mesmeric energy was being applied. As reported by the members of the commission th...

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The Framework of a Mathematical Model of the Autonomic Nervous System and Physiological Systems: Using the Neuroregulation of Blood Glucose as an Example

“…This is further evidence that our ability to recover from a disease or medical condition can be influenced by the data flow from our environment e.g. (i) whether the attitude of the carer projects a positive or negative message to their patient, (ii) if the doctor gives a positive or negative message to the patient [165], (iii) if the nurse(s) have a caring demeanour [166][167][168][169][170][171], and (iv) if the environment in which the patient is being treated is able to stimulate their recovery [172][173][174][175][176][177][178][179][180][181][182] e.g. by light/colour, sound/noise, nutrition, smell, etc.…”

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