Chapter 40: The Placebo – Nocebo Continuum

 

This chapter looks at the body in relation to the ‘Placebo Effect’, the next chapter at the role of the cell, and the chapter after that will show how to optimise the choice of ‘medicine’ to be used. We all know the proverbs ‘a stitch in time saves nine’ and ‘prevention is better than a cure’, so, I will try to show that prevention of sickness might be a better option than what is happening now.

 

‘The fact that most doctors are not trained to consider the impact of the placebo effect is ironic because some historians make a strong case that the history of medicine is largely the history of the placebo effect. For most of medical history, doctors did not have effective means to fight disease. Some of the more notorious treatments once prescribed by mainstream medicine include bloodletting, treating wounds with arsenic, and the proverbial cure-all, rattlesnake oil. No doubt some patients, the conservatively estimated one third of the population who are particularly susceptible to the healing power of the placebo effect, got better with those treatments.’ (The Biology of Belief, Bruce H. Lipton, p 108)

 

This quotation contains several important points, but one ‘error’ that shows an interesting side to medicine that is not generally known and I don’t have a reference at hand. ‘The Black Death in England was a bubonic plague pandemic, which reached England in1348, and killed perhaps half the population. It was the first and most severe manifestation of the Second Pandemic, caused by the Yersinia pestis bacteria.’ (Wikipedia, Black Death). So many people died in Europe during, I believe, three pandemics, that the population ‘evolved’ a short-term defence to the plague by the body accumulating excess iron in the blood at the expense of the ‘disease’ of haemochromatosis (unknown at that time) in later years, and bloodletting prevented this affliction by removing iron from the body and excess accumulations of iron were used up in producing new haemoglobin. I believe that enough elderly patients made a remarkable recovery after bloodletting, because they had haemochromatosis that bloodletting became general medical practice. At least it was a treatment that worked for the ‘unknown disease’ and for the placebo effect.

 

I enjoy telling that story because it makes sense of the bizarre, in the same way that I like ‘solving’ the problems in this book, at least to my satisfaction, bearing in mind that I am seeking a ‘useable’ solution (until a better one comes along). No one seems to know why the placebo effect works, but it often works as well as ‘modern medicine’s sophisticated technology, including the most “concrete” of medical tools, surgery.’ (p 108) ‘Despite the fact that there are 650,000 surgeries yearly for arthritic knees, at a cost of about $5,000 each, the results were clear to Moseley: “My skill as a surgeon had no benefit on these patients. The entire benefit of surgery for osteoarthritis of the knee was the placebo effect.”’ (p 109)

 

I feel that a small digression at this point is warranted to ‘point’ the way into the problem of the placebo effect. Behind all this discussion is the Mathematics of the Mind and the attractors (which are the quotations) and the discussion is a means of ‘integration’ of the attractors. Mathematics uses the word ‘integration’ as a ‘summing’ and I am doing the same with the attractors, but in a different sense in that the wider the summation, the better is the result, whereas, in mathematics, we are summing to a ‘limit’. Another point that I want to stress is that a subject such as the placebo effect needs to be ‘put in its place’ in the ‘order of things’, and that is the power of the Mathematics of the Mind to enable us to (possibly) redesign the practice of medicine by bringing it into a ‘part of a whole’, or, in other words, reduce our reliance on it.

 

Whilst the use of placebos could have a beneficial effect on patients: ‘studies have shown the placebo effect to be powerful in treating other diseases, including asthma and Parkinson’s. In the treatment of depression, placebos are stars. So much so that psychiatrist Walter Brown of the Brown University School of Medicine has proposed placebo pills as the first treatment for patients with mild or moderate depression. (Brown 1998) Patients would be told that they’re getting a remedy with no active ingredient, but that shouldn’t dampen the pill’s effectiveness. Studies show that even when people know that they are not getting a drug, the placebo pills still work.’ (p 109)

 

This corresponds to the Hawthorne effect where worker that were being studied performed better because of the interest shown in their work. The medical profession have always used a ‘white coat’ approach to enhance their status and this seems to work, along with the attention, to produce a placebo effect even when patients are told that it is a sugar pill, as described above.

 

Just how good is the medical profession? ‘Last year a new study, based on the results of a ten-year survey of government statistics, came up with even more dismal figures. (Null, et al, 2003) That study concludes that iatrogenic (illness resulting from medical treatment) illness is actually the leading cause of death in the United States and that adverse reactions to prescription drugs are responsible for more than 300,000 deaths a year.’ (p 77)

 

This might sound like a lot of deaths, but the life expectancy in the developed world is longer than most of the world that use traditional remedies and this means that medical care in the developing world is probably inferior. However, going back to the quotation, above that: ‘some historians make a strong case that the history of medicine is largely the history of the placebo effect’, that does seem to be the case except for modern antibiotics which, unfortunately, seem to be reaching the end of their useful life because bacteria are so versatile.

 

The problem with medicines in general is that they appear to cause side-effects and that this problem is a result of the body using chemicals in different locations in the body for different purposes and a ‘medicinal dose’ is applied throughout the body which causes disruptions. ‘Complicating the drug side-effect issue is also the fact that biological systems are redundant. The same signals or protein molecules may be simultaneously used in different organs and tissues where they provide for completely different behavioural functions. For example, when a drug is prescribed to correct a dysfunction in a signalling pathway of the heart, that drug is delivered by the blood to the entire body. This “cardiac” medicine can unintentionally disturb the function of the nervous system if the brain also uses components of the targeted signalling pathway. While this redundancy complicates the effects of prescription drugs, it is another remarkably efficient result of evolution. Multicellular organisms can survive with far fewer genes than scientists one thought because the same gene products (protein) are used for a variety of functions.’ (p 75)

 

Apart from antibiotics, no form of medicine used throughout the world offers ‘real’ confidence in their use, and I would be content to agree that ‘some historians make a strong case that the history of medicine is largely the history of the placebo effect’. Herb based and animal parts ‘remedies’ are not spectacularly successful, nor the ‘energy’ based ‘needle sticking’ acupuncture and neither does homeopathic dilution convince that the results are anything more than the placebo effect.

 

It has to be mentioned somewhere that, whilst the placebo effect is for the good, the opposite effect, called the nocebo effect can be bad for us. ‘While many in the medical profession are aware of the placebo effect, few have considered its implications for self-healing. If positive thinking can pull you out of depression and heal a damaged knee, consider what negative thinking can do in your life…. Our positive and negative beliefs not only impact our health but also every aspect of our life. Henry Ford was right about the efficiency of assembly lines, and he was right about the power of the mind: “if you believe you can or if you believe you can’t … you’re right.”’ (p 111)

 

This statement sounds like ‘free-will’ and it is very powerful, given that the placebo effect can ‘fix’ knees, stop pain, promote happiness etc., whereas the nocebo effect can cause ‘bad’ thoughts, depression and even kill healthy individuals as in ‘pointing the bone’. The development of a head, and thus a ‘free-will’ or mind, enabled the organism to make the best decisions for the cells of the multi-celled organism. It is apparent that it is difficult to separate the mind from all of the cells that contributed to its making, and that is the point of the two chapters and the top down (this chapter) to the bottom up (next chapter), that there is no difference!

 

From the cells perspective, the cells are static unchanging differentiated into ‘organs’ reliant on the will of the mind/brain, but by pulling together they create nerves which allows creativity (the ninth sense) because action potentials in the nerves induce new action potentials due to quantum mechanical effects and these ‘spurious’ thoughts are creativity. The mind/brain is ‘different’ to the way cells function because it can create and give the organism more choice than the traditional five senses. That discussion is also part of the next chapter.

 

Keeping to the macroscopic, ‘free-will’ means freedom to make choices and that is the (evolved) purpose of the mind/brain, to confabulate the surroundings to recognise predators as soon as possible and choose to ignore, fight or flee. This decision-making can be as simple as two nostrils for smell as we saw in the simpler organisms prior to fish, and then fish and more advanced animals used a better method that we call logic. We evolved a reality from the possibility of existence and a probability space contains five dimensions, namely: three space, time passing and conservation/entanglement overall.

 

Conservation/entanglement is a logical dimension and has been fully discussed earlier, so moving on with the thought that those cells that banded together reaped the benefits of a new dimension and a new reality, and that is the world we live in today. Someone might discover how to use entanglement to instantaneously, at every point in the universe know/sense energy use or other factors and create a new reality.

 

I’m trying to say that the mind/brain evolved so that the cells could enter a new reality and they ‘own’ the mind/brain and keep track of it through their sensors that every cell must have (next chapter). Conversely, the mind/brain owes allegiance to the cells because the mind/brain only exist because the cells are prepared to die for the brain (apoptosis). In other words, especially when the next chapter is read, it is/will be obvious that every cell and the mind in the organism are ‘one’. On the scale placebo to nocebo, so the cells respond through their sensors, the hormone system, and sick cells will affect the mind/brain through the seventh and eighth senses.

 

Finally, putting it another way, the creativity/consciousness of the mind results from the cells banding together to form a mind (and a new reality) and the cells TRUST the mind and do what the mind tells them, through the cells’ senses, even to kill themselves (apoptosis), get better or get worse. That is the placebo/nocebo effect.

 

I would like to leave it there, but the ramifications are immense in that firstly we have not two effects in the placebo/nocebo, but a continuum, and the act of measurement that this continuum opens up links our mind to a wider plane as we seen in previous chapters. Secondly this continuum ranges from the mind repairing knees etc. to killing the whole individual. This is a huge power that the cells have turned over to the mind and is part of the second Law of Life, state of mind, exercise and nutrition, and this will be discussed later.