March 3, 2001 (Ira Pilgrim)


For hysterical maidens I prescribe marriage, for they are cured by pregnancy.

Hippocrates, c.400 BC

When you hear that someone is hysterical, you probably picture someone screaming uncontrollably. That person is usually a female and, if you have ever seen the adolescents at a Sinatra, Beatles, or Elvis concert, that is the image that comes to mind. The word comes from the Latin word for uterus and it used to be considered to be a strictly female condition. The word has been broadened by psychologists to encompass a variety of physical symptoms that are caused by the mind. For example, there is hysterical paralysis, in which a part of the body is paralyzed. Under hypnosis, the paralysis can be made to disappear.

One December evening, many years ago, we had a laboratory Christmas party at a local tavern. One man was a strict Mormon who didn't drink, so we ordered him a Shirley Temple, which looks like a regular drink but contains no alcohol. After he had consumed it, one of the men told him that it contained vodka which he couldn't taste. The man's speech became slurred and when he stood up, he staggered. He had become a stereotype of a drunk. When he was told that it was a joke, his symptoms disappeared.

The mind can do funny things. Whenever a new drug is tested, half of the subjects get a placebo(Latin for "I shall please"). It is usual for members of the placebo group to show the same kind of improvement as do people in the test group. Viagra, is supposed to make men get an erection more easily (As Bob Dole says, before he took Viagra he had erectile dysfunction; meaning that he couldn't get it up). When it was tested , 20% of the men in the placebo group reported improved sexual function. This principle holds for just about every drug tested, including cancer treatments and pain remedies. A sugar pill is a hellofalot cheaper than Viagra and it can do the same thing for one out of five men. Everything that is touted as an aphrodisiac works on enough people to keep it selling, even though it has no physiological effect whatever. I shouldn't say "no effect," because it does work in one out of five people. If done skillfully, a person can make lots of money with substances and treatments that actually don't do a damn thing. You don't have to travel far to find these bogus treatments; every small town has several miracle peddlers.

If the doctor doing the test knows which of his patients got the drug and which ones got the placebo, he will unconsciously communicate this to his patients, who will react accordingly. Therefore, to do a test properly it must be done in what is called a "double blind" study and neither the physician nor the patient knows who is getting the drug and who is getting the sugar pill. In psychological experiments, this can sometimes be impossible.

Another principle that seems to hold in medical practice is that injections work better than pills, so many doctors use injections of thing that don't do much of anything, such as vitamin B12 injections. The beneficial effect on the patients can sometimes be miraculous.

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