Wall P D
Department of Anatomy & Developmental Biology, University College London, UK.
Ciba Found Symp. 1993;174:187-211; discussion 212-6.
The placebo response is a powerful widespread phenomenon which relieves many conditions including pain. It depends on the patient's belief or expectation that the therapy is effective. It is an unpopular topic because it is confused with quackery or seen as an expensive artifact or taken to challenge the rationale of a therapy or to mock the reality of the senses. In order to avoid taking the subject seriously, myths are invented claiming that placebos work only on hysterics or hallucinators or that they are the equivalent of doing nothing or that they act only on the mental results of pain and not on the pain itself. These myths are dismissed. A model of the brain is presented in which preconscious decisions are made as to appropriate behaviour. Pain is perceived only after a decision has been made that it is appropriate to the biological needs of the individual.
安慰剂效应是一种强大且普遍存在的现象，它能缓解包括疼痛在内的多种病症。这取决于患者相信或期望该疗法有效。它是一个不受欢迎的话题，因为它与江湖医术相混淆，或被视为一种昂贵的假象，或被认为是对某种疗法基本原理的挑战，或是对感官现实的嘲弄。为了避免认真对待这个问题，人们编造出一些荒诞说法，声称安慰剂只对癔症患者或幻觉症患者有效，或者说它们等同于什么都不做，或者说它们只作用于疼痛的心理结果而非疼痛本身。这些荒诞说法不攻自破。本文提出了一种大脑模型，其中关于适当行为的潜意识决策会预先做出。只有在做出符合个体生物学需求的疼痛决策后，疼痛才会被感知到。
