It is interesting to read about the possible activation of endogenous opiate release in the brain as a result patient-physician interaction as a special "placebo effect."1 This reminds me of earlier confidence placed by patients in their family doctor's bedside manner. Frequently, doctors became very popular because of their marvelous bedside manner. Was the placebo intensity proportional to the art of the doctor? Also, how about the osteopathic principle of the laying on of hands in order to relax a patient and create confidence. Even more fanciful, might not at least some so-called miracle cures reflect a particularly strong placebo effect, either generated by compulsive faith or by a religious environment. If the foregoing are all reflections of the placebo effect, this system should be characterized quantitatively and studied for adaptation and training. Conceivably this could lead to site-specific self-anesthesia. Intriguing!
Robert J. Rutman, PhD, Professor Emeritus University of Pennsylvania ...
