title: The placebo response: its putative role as a functional salutogenic mechanism of the central nervous system.
abstract: The concept of placebo has evolved over time. Generally believed to be the basis of the premodern pharmacopoeia, the placebo has been adopted in practice as a harmless but unscientific approach towards alleviating symptoms. Currently, many medical scientists view placebos pejoratively as confounding elements in the analysis of randomized control trials.This article examines the changing attitudes towards placebos and the persistent controversies that surround their administration. The possible role of the placebo response as a functional salutogenic brain mechanism is considered, and elements of Edelman's neurobiological model of self and attractor theory are combined to explain how a unitary response by the central nervous system might yield diverse placebo effects. It is concluded that placebo responses are rooted in the complexity of mind/body interactions and that their underlying physiological mechanisms may be elucidated via methods that directly examine brain activity as the basis of subjective experience.
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston 02114, USA. rkradin@partners.org
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kradin
mesh_terms: D002490:Central Nervous System / Q000502:physiology*; D006801:Humans; D019222:Mind-Body Relations, Metaphysical; D015990:Placebo Effect; D010919:Placebos / Q000627:therapeutic use; D013812:Therapeutics
chemical_list: D010919:Placebos