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The King’s Touch and the Placebo Response

While King Charles II was traveling in his carriage along with an entourage of escorts and followers, the carriage broke down.  As the King was alighting from the carriage, the hem of his garment accidentally touched a man with a horrible skin condition.  Within two days, the skin condition was totally healed.  Word got around and eventually back to King Charles that the King possessed the healing touch.

Many sick people petitioned the King to “touch” them and be obliged, healing approximately four thousand people a year!  However, the King tired of this outlandish eccentricity and appointed, by decree, a royal stroker who had an official letter from the King bestowing the royal touch on to the stroker.

Several “strokers” were appointed over time and they would go down long lines of sick people with a variety of illnesses, touching them one by one and stretching the brain and beliefs into the epiphanies of divine healing.

One stroker, a man by the name of Valentine was particularly effective.  Because so many of the “patients” smelled, were covered with sores and other vulgar deformities, he chose to touch them with a feather.  The results were the same.  He would treat or “stroke” hundreds of people a day by simply and literally running down long lines of very ill, sickly, afflicted men and women and simply stroking them with a feather and spreading the contagious magic of healing.

England’s King Edward the Confessor also touched hundreds of subjects who also reported remissions and healing of a wide range of physical maladies and illnesses.

Touching is an essential part of human nurturing from birth onward and results in the brain releasing a cascade of neurotransmitters, as well as triggering the release of a number of genes.

As indicated in a previous blog on placebos, the placebo effect has been recognized for centuries.  Michael deMontaigne, a French philosopher, stated in 1572 that “there are men on whom the mere sight of a medicine is operative”.  And again, one of the remarkable things about many medications is that their effects are only slightly better than those obtained from a placebo.  Some drugs and surgical procedures have results that are no better than placebos.

With respect to the latter, orthopedic surgeon Bruce Mosely published a remarkable study in the New England Journal of Medicine in 2002.  His study has shaken surgical treatment to its core.  He selected world war II veterans, men in their 70’s who had major knee problems, pain and had great difficulty in walking without assistance.

He divided the men into three groups.  Group one, following the incision just had the knee rinsed with no further treatment.  Group two had the complete, normal surgical procedure – opening, rinsing, trimming and suturing.  Group three was about to make medical history.  They experienced a sham surgery where the procedure was started as if it were the real surgery and three small cuts were made in the knee.  Dr. Mosely then went through the same motions as if he were doing the real knee operation.  He had a video tape of an actual surgery running in the operating room so he could simulate each stage of the surgical procedure.  As he was going through the sham surgery, he could have for the appropriate instruments and make typical comments and sounds that he would usually make for the full forty minutes.  The three small surgical cuts were then sutured and nothing therapeutically had been done to the knee.  The results were astonishing!  All three groups improved and showed great mobility and freedom from pain.  None of the groups did better than the placebo group.

One of the subjects could barely walk, was limping in pain with every step and following the sham surgery had no stiffness, tiredness and he no longer dragged his leg.  As a matter of fact, he asked for the same operation on his other knee.  The patients were followed for six years and the sham surgery subjects sustained their “improvement” without further medical treatment.

Thus patients who received the “pretend” surgery did as well as those that received debridement or lavage.   Some who were barely able to walk before the surgery were now able to run.  In some cases, those who received the placebo surgery, at certain points in their recovery process, their reported results were better than those who had actually received arthroscopic surgery.

The question that must be running through your minds about the effectiveness of placebos, as it has through my mind many times is – why? – how do they work? – what are the underlying biochemical mechanisms?  No one knows.  Lots of theories – explanatory fictions – but no one knows for certain.

Psychologist Dr. Amir Raz suggests that perhaps some form of suggestive or implicit hypnosis may be involved.  Perhaps, but having practiced hypnosis for many years, there is no concensus or agreement amongst clinicians as to what hypnosis is or why it works.  So we have one explanatory fiction being utilized to help define and understand another explanatory fiction.

My favorite definition of hypnosis is that it is the “induction of conviction”.  However, that does not explain why some people who are highly hypnotizables (good hypnotic subjects) may not necessarily respond that well to hypnotic suggestions.  On the other hand, some low hypnotizables may turn out to be excellent and very responsive hypnotic subjects.

Perhaps bewilderment is the beginning of expanding into a wider perception and understanding.  Perhaps the older growth forests of the mind contain new watersheds of thought.  The challenge of course is aside from psychedelics, how can we develop and explore new, more enlightening corridors of consciousness that will create an energetic tango – stretching the brain well beyond its usual limits.  What do you think?

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