Schönbächler G
Forsch Komplementarmed. 1998;5 Suppl S1:18-22. doi: 10.1159/000021070.
Placebo from a Biosemiotic Point of View The rise and success of modern science, first in physics, later in medicine, was based on a mechanic linear model of causality. Its only category of explanation of natural processes is the mechanical machine. As human beings using and processing signs we cannot recognize ourselves in this reductionistic model. As all living creatures we perceive, interpret and answer the stimuli of the environment. To explain the behaviour of organisms we need a semiotic-circular causality. Semiotics, the study of signs, can be subdivided in semantics, the theory of meaning of signs, in syntax, the theory of the forms and the arrangement of signs, and in pragmatics, the theory of the contextual rules of communication. Semiotics is not exclusively concerned with language, but helps as so-called biosemiotics also to explain the network of communication of a living organism. The 'Denkstil' of established pharmacology is likewise restricted to mechanistic causality. One of the consequences is the fact that theplacebo effect is defined as 'non-specific' or 'non-characteristic'. Such negative definitions exclude concrete questions of investigation. We have to accept a biosemiotic view in pharmacology, to see drugs as signs consisting of a physical vehicle equipped with meaning. The therapy with drugs must be seen in a broader treatment context investigated by pharmacopragmatics. The semiotic expansion of pharmacology does not invalidate the achievements of classic pharmacology, but elucidates in addition a view of the pragmatic components and makes the scientific integration of the placebophenomenon into drug therapy possible. The placebo effect loses its inconsistency.
从生物符号学角度看安慰剂 现代科学的兴起与成功,首先在物理学领域,随后在医学领域,是基于因果关系的机械线性模型。它对自然过程的唯一解释范畴就是机械装置。作为使用和处理符号的人类,我们无法在这种还原论模型中认识自己。作为所有生物,我们感知、解释并回应环境的刺激。为了解释生物体的行为,我们需要一种符号学循环因果关系。符号学,即对符号的研究,可以细分为语义学,即符号意义的理论;句法学,即符号形式与排列的理论;以及语用学,即交流语境规则的理论。符号学并非只涉及语言,而是作为所谓的生物符号学,也有助于解释生物体的交流网络。既定药理学的“思维方式”同样局限于机械因果关系。其后果之一就是安慰剂效应被定义为“非特异性的”或“无特征的”。这种否定性定义排除了具体的研究问题。我们必须在药理学中接受生物符号学观点,将药物视为由带有意义的物理载体构成的符号。药物治疗必须在由药物语用学所研究的更广泛治疗背景中看待。药理学的符号学拓展并没有使经典药理学的成就无效,反而进一步阐明了语用成分的观点,并使将安慰剂现象科学地整合到药物治疗中成为可能。安慰剂效应不再显得矛盾。