Placebo: Mind Over Matter in Modern Medicine (Paperback)

By exploring recent research in evolutionary biology and immunology, Evans proposes a new theory on how placebos work while investigating and evaluating current ideas of health and disease. He looks at the history of the placebo effect and investigates the efficacy of placebos by sifting the evidence and providing an opinion on which medical problems can be cured by its use.

In chapter 3, The Acute Phase Response, Evans sets out his theory of the function of a single biological mechanism in the placebo phenomenon; he also states that this is not a proven theory and needs much further research. The next chapter looks at the belief effect, the key mental event that triggers physiological processes that result in healing.

Investigating the physical and psychological aspects of health in evolutionary context, he also considers the potential of placebos to harm. In more metaphysical terms, one may say he looks at positive and negative mental energy, the curse and the blessing, but in scientific terms. Various alternative healing modalities are also discussed, as well as psychotherapy, which the author claims may be the purest placebo.

Ethical questions are considered next in the chapter The Witch Doctor’s Dilemma. The author concludes that the impressive findings of recent scientific research in mind-body medicine have revealed that the healing power of the mind may not be unlimited, but that it is certainly not insignificant. The mind fights disease in many ways and one of those is to prompt us to take action, whether by the use of allopathic or alternative medicine. The book concludes with copious notes, a bibliography and an index. I have found this an honest and open-minded look at the healing power of the mind, albeit from a strictly scientific respective.

The author draws on a wide variety of disciplines to argue his case for an evolutionary design for the placebo response in humans; an alteration in the distribution of different immune cells in order to balance energy expenditure with fighting off infection. Generally scientific journals are not keen on grand unifying theories for peer-reviewed articles so a book like this is a great outlet for the author's imagination. One of the major strengths of this book is that he avoids the temptation to uncritcally cite studies in his favour; he does point out their (often profound) limitations and tries to coax rather than preach his point of view. If nothing else, this is an excellent exercise in persuasion on scientific theory.

Would I recommend it for a patient wanting to find out more about the use of placebos in a clinical setting? Probably not, it's a little too technical in places. As another reviewer commented, great size for the bus or the train and indeed this has accompanied me to work on several occasions. A good read, but know what you're getting into!

The book introduces the Placebo effect to the reader who previously knew nothing about it - and should also be (re)viewed in this perspective. There might not exist enourmous amounts reliable evidence concerning the placebo effect, but I still missed 100 extra pages with more detailed descriptions of the experiments already done as well as a more thourogh presentation of the other placebo theories other than the authors own.

But, in the current size the books is extremely well fitted for a pocket and can be read in busses and trains. For a more thourough understandig of the placebo effect you'd have to consult medical and psychological litterature.