Much Ado About Nothing: Cosmetics Testing with a Placebo

By: Johann W. Wiechers, PhD, JW Solutions

Posted: February 23, 2009

It was my wife’s idea to write about nothing, but when the topic is nothing, there is nothing to argue about. At least that's what I thought, until I looked more closely at the topic of this column, the placebo.

Officially, the word placebo comes from Psalm 116, verse 9, where it is written in Latin, Placebo domino in regione vivorum, meaning “I will please the Lord in the land of the living,” or “I will walk before the Lord in the land of the living.” These words were the beginning of the congregation's response to the clergy during the prayer for the dead that was sung at funerals in the Middle Ages.

In France, food was provided for relatives after a funeral and it soon became customary for distant relatives and other, unrelated individuals to attend the ceremony; these individuals would simulate great anguish and grief in hopes of obtaining their share of food and drink. The latter practice was so widespread that these unrelated people were soon recognized as the personification of all things useless, and were considered to be archetypical simulators. Since the first collective act of these grief simulators was to chant "Placebo domino in regione vivorum," they were collectively labeled in French as either placebo singers or singers of placebo. They were so labeled because they sang the word "placebo," and not because they were "choral placaters," using their song to please.

The modern meaning of the word placebo has also been surrounded by lamentations. In 1939, the Italian physician Fieschi introduced a technique for patients with Angina pectoris where he blocked two internal mammary arteries so that more oxygen would become available to the heart. Dramatic improvements were seen: three quarters of the patients showed an improvement and one quarter of the patients were cured. Due to this success, this technique became the standard surgery practice for the next 20 years.

In 1956, American surgeon Leonard Cobb expressed doubts about this technique and thus studied its validity by performing two types of surgery. In a group of nine patients, he made the incisions but did not do anything more than that, whereas in a second group of eight patients, he performed the full Fieschi technique. The results were dramatic because similar improvements were seen in both groups.That was the end of the Fieschi technique and the beginning of the documented surgical placebo effect.