Victorian Diseases - Why are they back?

Tuberculosis, Typhoid, Whooping cough, Gout and Rickets. They are diseases many of you might have believed were locked away in the dim and distant past, well...in Great Britain at least. However, last month the NHS Health and Social Care Information Centre revealed that these diseases are re-emerging, and at alarming speed. In this post, I will be looking at why they are back, and how treatments have improved over the past 100 years...


Tuberculosis (TB)
Tuberculosis is an infection that mainly affects the lungs, however; it can also impact on the bones and the nervous system. Symptoms include: night sweats, tiredness, fever, persistent coughing and weight loss. TB (historically called consumption) killed one in four people in Victorian England.

What caused its disappearance?
There are a number of factors which contributed to its disappearance. For example, less crowded living conditions in the 20th century helped cut down rates of infection. Furthermore, the introduction of the BCG (Bacillus Calmette–Guerin) vaccine in the 1920s, the discovery of antibiotics in 1928 and the introduction of the antibiotic streptomycin also contributed to its disappearance.

Why is it back?
A rise in immigration from Eastern European countries (where TB is more common) is the main reason. Another reason is our increasingly crowded cities.

Treatment
Then: Treatments included being quarantined in country-side sanatoriums, and being put in steam rooms with herbs.
Now: We give extra BCG vaccines for babies in high-risk areas. Suffers can now also be prescribed antibiotics.


Typhoid/Cholera
They are bacterial infections caught by drinking contaminated water. Symptoms include: sickness, fever and diarrhoea. Both diseases were epidemic in Victorian England because of poor sewage systems with one in five dyeing.

What caused there disappearance?
New vaccines in the late 19th Century and the introduction of antibiotics in the 1940s contributed to there disappearance.

Why are they back?
The main reason is because of increased international travel. There are an estimated 500 cases of typhoid each year in Great Britain. For cholera, no cases have originated in Great Britain for over 100 years, however; there were 12 reported cases of British people infected abroad during 2012.

Treatment
Then: As well as bed rest, salt water and sugar were used to combat dehydration caused by diarrhoea.
Now: Antibiotics are used. Vaccines are also recommended for anyone travelling to countries where typhoid and cholera are widespread.


Whooping Cough
Whooping cough is a bacterial infection of the lungs and airways. It begins with a persistent dry cough and progresses to a fever and bouts of coughing that have a 'whooping' noise. It killed more than 1000 people a year in Victorian England.

What caused its disappearance?
A vaccine introduced in the 1950s mainly contributed to its disappearance.

Why is it back?
The bacteria that cause whooping cough have gained resistance towards the antibiotics used to treat it. The introduction of new vaccines have also proved less powerful. Furthermore, a small minority of people in rural areas haven't been immunised.

Treatment
Then: In Victorian England, patients were rehydrated with a mixture of sugar and salt water.
Now: Antibiotics are widely used. All pregnant women are also offered a vaccine. Furthermore, children are vaccinated at two, three and four months, and then given a pre-school booster.


Gout
Gout is a form of arthritis. It is caused by the crystals of a compound called uric acid forming in joints which results in inflammation. In Victorian England, gout was associated with the port-swelling rick. This is because alcohol and rich food increased the risk of gout.

What caused its disappearance?
It did not completely disappear, however; improvements in medicine in the 20th century meant that it was more easily treated.

Why is it back?
The main reason cases have increased is because obesity and alcohol consumption are no longer confined to the rich. In 2009, 48,717 patients with gout were admitted to hospital. This increased to 86,866 cases in 2013.

Treatment
Then: Opium was taken with whisky and cocaine was used as an anaesthetic.
Now: There are a few different treatments. Ice packs and painkillers can be used to ease discomfort and a drug called allopurinol can be used to lower uric acid levels. Furthermore, eliminating alcohol and red meat from the persons diet can reduce the risk of future attacks.


Rickets
Rickets is a childhood disease that leads to 'soft' bones. It is caused by a lack of vitamin D. Rickets was epidemic in 20th Century England because the smog produced in cities blocked the natural sunlight.

What caused its disappearance?
Foods started being fortified with vitamin D in the early 20th Century.

Why is it back?
One in four children are now not getting enough sunlight. Furthermore, efforts to combat skin cancer have also meant that people spend less time in the sun. Dietary deficiency is also to blame.

Treatment
Then: Cod liver oil has been used to combat rickets from the 1700s. In the 20th century, all children were prescribed cod liver oil until the 1950s.
Now: The government recommends that all children under five take daily vitamin D supplements. It is also advised that families should spend up to 20 minutes in the sun a day without sun cream.

World First Aid Day

As you may know, I write a weekly First Aid post called "First Aid Fridays" - this series is inspired by my volunteer role as an Event First Aider for the British Red Cross, this is a popular series which provides an insight into everyday first aid which can be provided by anybody. I strongly believe that first aid knowledge should be available to everybody as it can save lives - in line with this, I have decided to write this post celebrating World First Aid Day and giving some information on how to get involved.


World First Aid Day was started by The International Federation of Red Cross and Red Crescent Societies (IFRC) in 2000 where they stated that every 2nd Saturday in September will be a day ceremonies will take place in order to 'raise awareness of how first aid can save lives in everyday and crisis situations.'  Since this initial setup, more first aiding groups have joined in to help promote the importance of first aid knowledge.

In order to do my part for raising awareness, I have decided to list below various ways in which you can get involved and begin to expand your first aid knowledge.

First Aid Apps

Multiple first aid providers have released free mobile apps which give instructions on how to deal with everyday first aid scenarios. Listed below are the two apps which I believe are the most informative and user friendly.

1. British Red Cross First Aid App

Available on multiple platforms, the British Red Cross have created a simple to use app which not only gives step-by-step instructions on how to deal with first aid scenarios, but it also includes videos and animations to aid explanations. Further to this, the app also includes a Q&A section for each scenario - despite having first aid training, I still find this app very informative and it can act as a way to refresh knowledge.



2. St John Ambulance First Aid App

Similar to the BRC app, the St John app includes an extensive range of information for first aid scenarios varying from choking to resuscitation. The app contains a similar amount to the Red Cross app - St John Ambulance also provide a First Aid for Cyclists App which includes specific advice to cyclists.


One day having these apps on your phone may aid you in saving someones life. As they are free, I can't see a reason why you wouldn't want to download them!

First Aid Training

There are multiple companies and charities which provide first aid training to members of the public. This training ranges from workplace first aid to the use of an AED; these courses vary in cost but the information and qualifications you gain from them are invaluable. An alternative route to gaining this first aid training is to join an organisation who provide Event First Aid - for example, the British Red Cross are willing to allow volunteers to join their Event First Aid team; in return for the charity providing you with free training, it is asked that the staff give their time to volunteer as First Aiders at local and national events. By providing First Aid staff to these events, the charity are given money which is invested into further training for their volunteers. 

Subscribe to Weekly First Aid Posts

Not only do we provide weekly first aid posts, but so does many other first aid groups. Most of this information can be accessed using Facebook and Twitter - I have included some links to weekly first aid posts which are free to access.

1. Website:
The Med School Project - First Aid Fridays

2. Twitter: 
The British Red Cross - Twitter
Sierra Rescue (Water First Aid) - Twitter 
St John Ambulance - Twitter

3. Facebook:
The British Red Cross - Facebook
St John Ambulance - Facebook


I hope that reading this post has not only raised awareness of first aid but it has inspired you to increase your first aid knowledge through one of the methods above.

First aid can be the difference between life and death so learn it today!


For more information:
https://www.ifrc.org/global/rw/20140901-FAD-en/

Isn't It As Easy as X and Y?

How do you tell whether a chromosome is male or female? You pull down its genes!

Typical human chromosomes.
Following an A2 biology lesson about sex-linkage within our genetics, I became intrigued whether the combination of gametes during fertilisation always produce an XX or XY combination within pair 23, or whether it is possible for other combinations to occur. In the following article, I will show my findings.

Pair 23 of the chromosomes in human DNA is also known as the sex chromosomes as these are what determine your gender. A homologous pairing of two X chromosomes are generally found in a female whereas males normally have a pairing of an X and a Y chromosome - however this is not always the case. There are multiple disorders where the pairing has not occurred correctly and just a few of these are listed below.

The first fascinating disorder is called Quadruple X syndrome; this is a case where a female has two extra X chromosomes. This is a rare condition which is believed to have only affected around 100 women since 1961. A defect within meiosis is the cause of this condition which can lead to a reduced quality of life for the sufferer - some symptoms which are present include flat nasal bridges, enamel defects, joint abnormalities and abnormal curvatures of the spine. The only known treatment for this condition is to address each symptom for the individual, for the few cases which have occurred, this treatment has worked well.

A few sex chromosome
disorders.
The next genetic disorder which I chose to investigate is Klinefelter syndrome which is where a person has the genetic combination of XXY. As the genetic combination includes a Y chromosome, it may be believed that the person is genetically a male however the phenotype may be male, female or even intersex. This is the most common sex chromosome  aneuploidy which often does not present any symptoms; for some of the sufferers, they only encounter issues during puberty. Some of these issues include infertility in males and possible lack of muscle control. Not only this, but males who suffer from this condition are also more likely to develop health problems which are typically present in females - these include breast cancer and osteoporosis. There is no cure for this genetic condition however some of the symptoms can be tackled individually; for example to overcome the infertility, IVF treatments can occur.

The final genetic disorder which I chose to read into was XX male syndrome, this is an extremely rare condition which occurs due to unequal crossing of chromosomes during meiosis in the father - during this unequal crossing over, the male SRY gene (Sex-determining Region Y protein) is placed within the X chromosome. When this faulty X chromosome then joins with the mothers X chromosome, a child with a genotype of XX is formed. Genetically this child is a female however they have the genitalia of a male. This condition is estimated to affect 4.5 individuals per 100,000 births. As a result of this condition, sufferers are often infertile and can lack facial hair. There is no current cure for this genetic disorder.

Overall, following this specific research I have been amazed by the variety of sex chromosome disorders which actually occur - there is a range of conditions which my post does not fully demonstrate as I have only focused only three particular conditions. Could there be a treatment for these disorders and would they be feasible to operate?

What do you think about this scheme? Feel free to discuss ideas and opinions in the comments section.

For further reading please see:
http://anthro.palomar.edu/abnormal/abnormal_5.htm
http://biology.about.com/od/basicgenetics/a/aa110504a.htm


First Aid Fridays - Allergy

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

This week the post is about an extremely common condition which all of you are likely to have experienced. The remedy is often simple but more severe allergic attacks can be life threatening - learn how to recognise and treat an allergic reaction. An allergy is a response by the immune system to a normally harmless allergen; the allergy can be presented through various symptoms including a red rash, mild itching, swelling, wheezing or even severe anaphylaxis. Common allergens include animal fur, dust, pollen, stings and certain medications.

Recognition Signs:

- A red, itchy rash appears.
- Red and itchy eyes.
- Wheezing/difficulty breathing.
- Swelling of hands, feet and face.
- Abdominal pains, diarrhoea and vomiting.

Procedure: 
  1. Assess the casualty's vital observations - this is to determine the severity of the allergic reaction. Question the casualty whether they have any known allergies.
  2. Remove the allergen if it is possible to do so; do this by moving the allergen or by moving the casualty.
  3. If the casualty is struggling to breathing, make them comfortable and encourage them to focus on regaining control of their breathing - reassure them and monitor their progress.
  4. Treat any of the symptoms and encourage the casualty from scratching any itchy areas - this could lead to further injuries. Allow the casualty to take any of their allergy medication.
  5. If you are concerned about the condition of the casualty or any of their vital signs, seek medical advice. If the breathing gets worse or remains out of control, emergency medical assistance may be required (by calling 999).

For more information, see page 220 of the DK First Aid manual.


Scared To Death

Is it possible to be truly scared to death, if so how does this happen?

A person can most certainly be scared to death. In a case where organ failure causes sudden death, the organ that failed is almost always the heart as no other organ can cause a persons death so quickly as to be considered 'sudden. In the case of being scared to death, heart failure is also the culprit.

Heart failure can be caused by many things: high blood pressure, a myocardial infarction, anemia and others, but in the case of being scared to death, the failure of the heart is caused by a large rush of adrenalin to the heart, induced by the bodies 'fight of flight' instincts. When a person is threatened, the hormone Adrenaline is released into the blood system from the Adrenal Glands. The purpose of this adrenaline release is to increase the heart rate and blood pressure as to prepare someone to either run away from a threat or fight it.

But how does adrenaline cause the failure of the heart? The huge rush of adrenaline causes calcium ions to flood into the heart causing the heart to contract. If the number of calcium ions is big enough then the heart's nervous system (composed of the sinoatrial node, atrioventricular node and purkinje fibres) which keeps the beating of the heart regular can be overwhelmed, which would cause an irregular beating pattern that was inefficient at pumping blood around the heart. Because of this not enough blood would be pumped around the body and the sufferer would die, swiftly.


Technology Update: Sniffing Out Bacteria

This is a series featuring short posts about the latest advances in medical technology.
 
The research team and the e-nose.
A research team based at Leicester University have announced that they have created an electronic nose which has been able to sniff out different strains of Clostridium difficile bacteria. The is analysed by the e-nose smelling organic compounds from a person; being able to distinguish between the different strains of Clostridium difficile has allowed the researchers to determine whether the person providing the sample is carrying 'good' or 'bad' bacteria. Could this technology smell out an infection? Or could it even sniff out even more?


The team in Leciester have now begun to investigate whether the e-nose could smell out cancer. Lung and breast tumours release a chemical with a unique smell when forming; if the e-nose could detect these odours early on, these cancers could be targetted before developing into a severe state. The team are also investigating whether this new technology could be used to screen patients. Using technology like this as a screen process will not only be time-efficient to operate, but it would also allow for an earlier diagnosis to be made (if bacteria can be detected before they spread into a larger infection then the bacteria growth can be prevented). Over 1600 deaths in 2012 included the prescence of C.difficile so using this technology to find the bacteria earlier on may save lives and hopefully lower this death toll.
Clostridium difficile.

The team are particularly happy with this technology as it is a huge advance on the current equipment available to staff currently on the wards - current equipment only allows for the bacteria to be detected however it does not give information on the strain of the bacteria. Knowing the strain of bacteria which has caused the illness allows for doctors to prescribe more suitable and appopriate treatments for the patient.

 

Watch this space, Leicester teams are sniffing out the future in medicine!


For further reading, see:
http://www2.le.ac.uk/offices/press/press-releases/2014/september/scientists-develop-2018electronic-nose2019-for-rapid-detection-of-c-diff-infection

Music to my ears...

Music - we listen to it everyday, but what good does it actually do for us?

Being a musician myself, I have often wondered what benefits we gain both from playing and listening to music. While there is the frequently quoted urban myth that listening to classical music of the likes of Mozart or Bach as a child increases intelligence, listening to music does have a large impact on both our mental and physical well-being.

Music therapy is becoming increasingly popular in the treatment of many mental health disorders. It involves performing, and occasionally, writing music so that the patient's emotions can be reflected and expressed. This is often within an intervention-like group and, according to a recent survey by the mental health charity Mind, has been found to be the most helpful form of therapy after counseling. Indeed, according to the British Association for Music Therapy it is shown to be especially beneficial to those with autism, as it improves communication skills and is used as an outlet for creativity.

However, listening to music has more everyday health benefits. Listening to relaxing or slower music has been proven to help and even prevent chronic back pain. This is because the autonomic nervous system – the part of the body responsible for controlling blood pressure and heartbeat - is sensitive to the effects of music. A study in Austria found that listening to music slows down the heart rate and lowers blood pressure, which in turn reduces the tension in muscles in the back. Indeed, one study found that the effect of listening to music is similar to having a massage!

Not only that, but music has been shown to strengthen the heart. Listening to music releases endorphins from the brain which help to improve vascular health. In addition, patients who listened to music immediately after cardiac surgery found that they were less anxious and even felt less pain. It is also capable of reducing the levels of the stress hormone cortisol in the blood and boosting the immune system.

Finally, music is an obvious go-to for those suffering from depression. Everyone has that one song that instantly brightens their mood, but research now suggests that it's the kind of music you listen to that influences this. Classical music such as Beethoven have been found to be particularly uplifting, while heavy metal and techno could potentially make depressive symptoms worse.

Music will forever influence cultures all over the world and, with more and more being discovered every day, our health as well. Maybe, as musician Billy Joel once said, “music in itself is healing”. With so many health benefits waiting to be discovered, perhaps one day this could be true.


First Aid Fridays: Croup

Welcome to a new series called “First Aid Fridays”. This is a series inspired by my voluntary work as an Event First Aider with the British Red Cross and all articles published are written in accordance with the ‘DK First Aid Manual Revised 9th Edition’ (which is authorised by the UK’s largest first aid providers). In this series I have decided to write a short article each week explaining the authorised procedures to follow in order to administer first aid to various injuries – the sole purpose of this series is to educate the readers with knowledge to apply in order to care for a casualty and possibly even save lives.

The written articles of this series only contain a summary of each condition and First Aid procedure; therefore it is advised that further training or reading of the full manual is completed to understand the full procedure. Reading these articles alone does not classify as First Aid training.

Croup is when a child has breathing difficulties due to the inflammation of the windpipe or larynx; Croup can appear to be severe however it generally passes without lasting effects and harm. The main area to be aware of is that severe, persistent Croup has similar symptoms to a much more serious condition known as Epiglottitis, a condition where the Epiglottis has become infected and may block the airways completely - if this is the case, the child requires urgent medical assistance. 


Recognition Signs:

- Distressed, unnatural breathing in a young child.
- A short, barking cough.
- A rasping noise when breathing.
- A croaky voice.
- Cyanosis.


Procedure:

  1. Sit the child down in a comfortable position (such as on your knee) and support their back. Reassure the child and do not panic as parental anxiety can worsen the condition.
  2. If it is safe to, create a steamy atmosphere as this can relax the muscles and relieve some of the pain. You can create this atmosphere by taking the child into a bath room and running a hot shower.
  3. If the Croup is severe or if suspect that the condition is Epiglottitis, call for urgent emergency assistance using 999. Record and monitor the vital signs of the child until help arrives.
A diagram highlighting where Croup affects.

For more information, see page 101 of the DK First Aid manual. 

One Child, Three Sets of DNA

After listening to a Radio Four programme called Mum and Dad and Mum, I was intrigued about the potential for a human being to have 3 different people's DNA within their genetics and what advantages or disadvantages this modification may have.

Alana Saarinen with her parents.
The story within the programme describes how a 13 year old girl called Alana Saarinen was born; unlike most of the population, Alana is different as she has DNA from three different people. Due to medical conditions, Alana's birth mother was infertile and therefore conceiving a child would have been near impossible so a form of In Vitro Fertilisation (IVF) called cytoplasmic transfer was conducted to form a fertilised egg. Through this method, a sperm cell from the father along with cytoplasm from a donor's egg cell is fused with the mother's egg; this combination, if successful, forms a fertilised egg which can then be placed back into the mother for development. This form of IVF was a US scheme which aided the birth of a small selection of children, however in 2002 the FDA (an American regulator) requested for the treatment to be stopped due to the fear of the health of the child being compromised (due to possible genetic disorders).


Since this stop in 2002, no treatment like this has taken place in humans however scientists in the UK have recently requested for the government to consider a new, similar treatment. The proposed treatment is called mitochondrial replacement and produces a similar result as the US scheme, but through a different method. Mitochondrial replacement includes the maternal nuclear genome being placed into a donor's egg (which has had the donor genome removed) along with the father's sperm. This treatment is targeted for those who cannot conceive naturally due to medical conditions or those who wish to have a child but do not want to pass down their own mitochondrial diseases. This new treatment has raised a variety of ethical debates and worries which I hope to analyse and justify below.

The first worry has been proposed by some government officials who state that this process may lead to designer babies as scientists are able to modify the genetics of the baby; this is a worry also held by many others and is debatable. I believe that it is obvious that this treatment is specifically designed to overcome issues with conceiving naturally rather than just modifying genetics - this is because the process does not focus on selecting certain mitochondria for transfer, instead the selection of mitochondria is matched for suitability using anonymous donations. As long as the donations remain anonymous, I see that this designer baby argument is less likely to occur.

Other arguments against this treatment feature the worry that the genetic modifications could lead to miscarriages, difficult births or children with genetic defects. This is a point which is difficult to argue as both sides of the debate have little information to defend their argument; looking at the information from the US scheme, it can be seen that there was one miscarriage (suspected to be due to the fetus missing an X chromosome) and there was also 2 out of the 17 children who were also missing an X chromosome. To see that three out of eighteen successful fertilised eggs led to children with missing X chromosomes is alarming, however there is no evidence to prove that this is due to the treatment - it could just be coincidence or due to another stage of the treatment. Other than this, there is very little information regarding the US treatment as most of the patients were never followed up. Thirteen years on, looking at Alana, it can be argued that the treatment did not lead to defected children as she appears to have perfect health - whether she is like the rest of the experimental group or not is unclear.

Opposing these views are the arguments from those who support this treatment and argue that everybody should have a right to have a child and therefore this treatment should be available to all that need it. It is believed that between 1000 and 3000 people in the UK have a mitochondrial disease and therefore they may not be able to naturally conceive a child - this can be 'heart-breaking' news for those who want a child and putting people through this may not be considered fair as their condition isn't self inflicted. Why should people be restricted from living their lives how they want to, just because of a genetic disorder?

Furthermore it has been argued that if this treatment is readily available, the number of children born with mitochondrial diseases may be reduced. The argument explains that if people are aware of the condition and get tested to find that they are a sufferer, they may be inclined to have a child through the IVF treatment rather than naturally - this can prevent the child inheriting the disease and therefore could reduce the cost to the NHS for the treatment for these diseases. Surely this supports the principle that prevention is better than treatment?

Overall, it would appear that this is a controversial topic and a decision cannot be made hastily. Both sides of the argument features supportive points which all must be taken into consideration before a decision can be made. In my personal opinion, I believe that further testing must be continued on animals and primates and then it should be allowed for small sample of humans. During this testing, only a small number of humans should be allowed and the progress should be monitored for many years - this will allow for any side effects or disorders to be highlighted; if this is all clear, a larger sample size should be used and if this also is successful, the treatment should become readily available for those who need it. If during any human testing a worry is risen, the treatment should be stopped and severely reviewed.

If the UK government allow for this researched treatment to take place, the UK will be the first country in the world to conduct this treatment - this could be beneficial as it could increase the reputation of the NHS as well as boosting the income however it could also be negative as we may see a surge of international patients wanting this treatment, this could place a strain upon the NHS infrastructure and compromise patient satisfaction.

IVF treatment.

For further information on the subject, listen to the Radio 4 podcast:

http://www.bbc.co.uk/programmes/b04fz6lg

Sources:
- Images: Off Google images, contact me for further information.



Magic or Medicine?

Placebo (comes from Latin for ‘I will please’) is a simulated medical treatment with no therapeutic value, its purpose is to deceive the recipient and can merely affect the patients psychologically, however Placebo can often produce an actual improvement in their conditions. Is this magic or medicine?
  • In a recent study 50 percent of Parkinson's patients showed improved motor function after receiving a Placebo.
  • Psychiatric illness has among the highest rates of Placebo response - anywhere from 30 to 50 percent of the people in a depression medication study will respond to Placebo.
  • Placebo can keep heart failure patients alive. In a worldwide study with thousands of patients, those taking a Placebo regularly experienced similar reduced mortality as those taking a heart failure pill.
  • Placebo won't shrink a tumour or reduce a fever but they do affect pain, insomnia, anxiety, asthma, depression, irritable bowels and stomach ulcers (subjective symptoms).
  • You can even Placebo yourself into inebriation.   
     
     Sugar pills are one of the most common types of Placebo which are made completely identical to the real drug but contains basic ingredients such as sugar which will not physically help the patient in any ways. Other types of Placebo may contain some active ingredients however aren’t proven to work on the patient's particular condition. They would produce the same side effect as the real drug to the patient. Placebo treatments do not only come in the form of pills, they can be injections, creams, surgeries, drinks and other types of medical therapies. 97% of doctors in the UK has prescribed Placebo at least once in their career.

     New drugs are always tested against Placebo preparations as the control group in clinical trials in order to assess the efficiency of drug before it is marketed. When neither the patient nor the doctor is aware of which preparation an individual has been given this is called a ‘double blind trial’. A more realistic and accurate set of results can be obtained in this way.

The Placebo effect itself remains mysterious. Doctors still don’t fully understand how it operates and why its effect can be varied from large, small or non-existent for a given treatment or patient. It seems the power of Placebo increases when the size of the pill is bigger or there’s larger number of them. If someone believes the Placebo would have a negative effect, they can experience that negative effect. This is called a Nocebo.

Our minds tell us to believe a brand named drug works better than a generic drug; an expensive drug with good packing is better than a discount drug- even though the active ingredients are exactly the same and manufacturer is the only difference. A placebo injection has bigger effect than a placebo tablet- the appearance of drugs had almost as big an impact on health as whether the pills had any drug in them.


The scientists are faced with a paradox when it comes to the use of a Placebo. It is beneficial when it eases your pain from a migraine and helps you recover from depression or anxiety. It also has the advantage of producing fewer side effects.  However the biggest concern for the doctors is the act of having to deceive their patients. Patients should have the right to be honestly and fully informed about the treatments or medicines that they are taking. It is genuinely unethical for doctor to prescribe placebo to patients who are in a life or death situation as it cannot cure the illness, which effectively means the patients are sacrificing their safety for the investigation of new treatments.

Your brain has the power to generate effects in response to whatever it believes to be true. So the next time when you feel under weather, be positive and make the magic happen.