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A Smartie idea

More power to the placebo, says Phil Hammond, who is in favour of the blue pill that heals by positive thinking

Are complementary therapies just clever placebos? And does it matter if they are? All therapies are evaluated by the same standard, the randomised controlled trial, and many both conventional and alternative have a job out performing dummy treatments such as sugar pills and sham needles. But that doesn't mean they don't work, because placebos work very well.

Some GPs used to prescribe obecalp (placebo backwards), along with pillula panis (bread pills), aq. menth. pip. (peppermint water) and the pink medicine (ingredients unknown). All were cheap, harmless and gave enormous benefit.

How can a pill with no active drug in it work? The human mind is very suggestible. The effects can be pleasing (hence placebo "I will please") or humiliating (a hypnotist turning you into a chicken on acid).

The first documented use of a placebo by a British doctor was in 1890 when a woman was given painkilling injections of water, believing them to be morphine. The jabs worked a treat, but when she discovered the deception she got rather shirty and called in the lawyers.

In one study, 56 students were given either a pink or blue sugar pill and told it could be a stimulant, sedative or placebo. Only three said the pills had no effect. Nearly three quarters of those taking the blue pill, a Smartie, felt drowsy, 32 per cent on pink Smarties felt less tired and 33 per cent of the group reported side effects such as dizziness, watering eyes and headaches.

Placebos don't just make you feel better, they cause tissue changes. In 1986, patients with swollen cheeks after wisdom tooth extraction received ultrasound therapy to reduce the swelling. The jaws shrank by 35 per cent compared with a control group not bad considering the probe wasn't even plugged in. They can also speed the healing of up to 70 per cent of duodenal ulcers. Impressive for a blob of chalk.

And placebos even work if you know you're taking one. If a therapist says: "I feel a so-called sugar pill will help you as it has helped many others. A sugar pill is a pill with no medicine in it at all. Are you willing to try this pill?", it can still work, but only if you believe in the therapist. Placebo effects are increased by magic (healing energies, third eyes, meridians) and if it works for you, why not? We should never pooh-pooh the power of the Smartie. Especially the blue ones

Phil Hammond is a GP, writer and broadcaster

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