Medieval doctors understood the placebo effect and used it

(ORDO NEWS) — Both historians and modern physicians often ridicule the treatments described in medieval texts. Perhaps what seems to us to be pure charlatanism was in fact a subtle understanding of the patient’s psychology.

Although the word “placebo” is of Latin origin, in its modern sense it began to be used not at all in the Middle Ages. It appeared from the text of one of the canonical memorial prayers – Placebo Domino in regione vivorum (“I will please the Lord in the land of the living”).

At the end of the Renaissance, this word pops up in medical use, but only in the sense of consolation: the French surgeon Ambroise Paré wrote that a doctor should treat from time to time, relieve suffering often, and console always.

In this context, the Latin placebo was used. By the 18th century, all these reflections of humanism ended, and the last greetings from the consoling doctor were “placebo” pills, which were prescribed “for general strengthening”.

They consisted mainly of powdered sugar and flour – as you can see, modern homeopaths have not come up with anything new.

Medieval doctors understood the placebo effect and used it 2
Early 19th century caricature. It depicts a charlatan, treating with the help of some “metal sticks”, which allegedly help with rheumatism and various inflammations. All hope of such a healer (as well as his patient) is only on the “placebo effect”

In the 19th century, the “placebo effect” became a topic for medical jokes, but in the middle of the 20th century, two works appeared at once on the positive effect of placebo: the author of the first was a physiologist from Yale, the second was a military doctor.

Both studies were heavily criticized because their authors were unable to reliably separate the alleged “placebo effect” from other factors (however, this is generally difficult outside of a controlled experiment, which in the case of living people is often unacceptable for ethical reasons).

Now philologists and medievalists have taken up such a dubious question in a scientific sense.

She studied the texts of three medical treatises written in England in the early Middle Ages: Bald’s Medicine Book, Medicine Book III, and The Old English Herbalist (9th century or later).

In these treatises, recipes are given, as well as methods for treating certain ailments. Historians suggest that the collections were commissioned by the crown or one of the major landowners under the influence of the educational reforms of Alfred the Great, the first king of a united England, whose actions ended the Dark Ages in the history of Britain.

Brackmann noted that these texts are written in such a way as to promote the patient’s response to drugs being taken or being produced.

She cited a typical example of a prescription description using an Old English herbal letter for medicine: “For stomach pain, take the same plant, weighing two coins, boil lightly in water, then let it drink warm. The pain in the stomach will decrease and calm down, so that soon there will be no pain.”

Medieval doctors understood the placebo effect and used it 3
Page from Bald’s Medical Book

The last formula – that everything will pass – is present in almost all recipes. It can range from “this will help him wonderfully” to “everything will be fine soon.”

The author of the work believes that such periodic reminders of the effectiveness of drugs and the obligatory good outcome of treatment have a certain purpose in the medical literature.

To the modern reader, these statements seem largely redundant. After all, medical texts of course assume that these remedies work, otherwise why write them? Nevertheless, Old English and Latin medical texts repeatedly state that the patient will soon get better, or that ointments or drinks are “good medicine.”

Brackmann believes that medieval physicians noticed that if the patient had the opportunity to talk regularly with the doctor, and he comforted him, telling him how everything would soon be in order, then the treatment was more successful.

That is, doctors simply persuaded patients: you will definitely get better, there is no other option. And so that negligent colleagues do not forget about the importance of consolation, they included such turns even in recipes for medicinal decoctions.

In fact, the question of the “placebo effect” in these texts is complex. It is possible to accept the variant of such naive psychotherapy under manipulation, which still remains an effective treatment, but Brackmann goes further.

She believes that some treatments, which are complete quackery, are also the application of the “placebo effect”. The patient will do what he was told, believing in success, and will definitely recover.

The researcher even gives an example of such an action: “For stomach pain and abdominal pain. When you see a dung beetle in the ground, scattering [dirt], grasp it with both hands along with its scattered [dirt], wave your arms vigorously and say three times: “Remedium facio ad ventris dolorum” [Latin: “Cure for pain in the stomach.” Then throw the beetle over your back onto the road.

Be careful not to look at him. When a person has a stomach or abdominal pain, grab your stomach with your hands; he’ll be fine soon.” Agree, given the “effectiveness” of such a “medicine”, the last statement sounds doubtful.

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