title: Placebos in 19th century medicine: a quantitative analysis of the BMJ.
abstract: OBJECTIVE
  To provide the first quantitative data on the use of the term "placebo" in the 19th century.
  
  
  METHODS
  Computer search of BMJ's archival database from January 1840 (the first issue) through December 1899 for uses of the words "placebo(s)." Grounded theory was used to categorise the implications of uses of the term.
  
  
  RESULTS
  71 citations contained the term "placebo(s)." Of these, 22 (31%) used the term to mean "no effect" or as a general pejorative term, 18 (25%) portrayed placebo treatment as permitting the unfolding of the natural history (the normal waxing and waning of illness), 14 (20%) described placebo as important to satisfy patients, 7 (10%) described it as fulfilling a physician's performance role, 3 (4%) described its use to buy time, 3 (4%) described its use for financial gain, 2 (3%) used it in a manner similar to a placebo control, and only one implied that placebo could have a clinical effect. Only one citation mentioned telling the patient about his placebo treatment.
  
  
  CONCLUSIONS
  Nineteenth century physicians had diverse a priori assumptions about placebos. These findings remind us that contemporary medicine needs to use rigorous science to separate fact from its own beliefs concerning the "provision of care." As in previous generations, ethical issues concerning placebos continue to challenge medicine.
authors.affiliation: Program in Placebo Studies and Therapeutic Encounter, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Raicek
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Stone
authors.forename: Ted J
authors.initials: TJ
authors.lastname: Kaptchuk
mesh_terms: D049672:History, 19th Century; D006801:Humans; D010506:Periodicals as Topic / Q000266:history*; D010919:Placebos / Q000266:history*; D009626:Terminology as Topic
chemical_list: D010919:Placebos