Does Chinese medicine have the secret to better health or is it the ritual surrounding the practice that heals?

Practiced for thousands of years in China, acupuncture has edged into mainstream medicine in the United States. After studying acupuncture and herbal medicine in China, Ted Kaptchuk returned to the United States where American patients seemed to get better more quickly than his Chinese patients. Kaptchuk, who is also trained in Western medicine, began wondering if the exoticness and ritual of acupuncture elicited a greater response than the actual practice itself.

In "Healing Rituals," Kaptchuk attempts to untangle the complex relationship between ritual and healing. To do so, he must compare placebo effect to placebo effect - that of popping a pill to that of being stuck with needles. So Kaptchuk took a group of people suffering from carpal tunnel syndrome - the painful result of spending too many hours at a keyboard - and treated them in one of four ways. One group got an active analgesic pill, while another group got a sugar pill. A third group received real acupuncture, while the final group got "sham" acupuncture that looked and felt like the real thing to the unknowing patient, but that used retractable needles that never actually pierced the patients' skin. The study is still underway, but no matter what the verdict, Kaptchuck thinks his study is an important first step in quantifying "the magical capacity for self-healing" we call the placebo effect.

Italian research shows just thinking you've taken a pain killers tricks the brain into releasing natural relief.

At the University of Turin in Italy, Fabrizio Benedetti and his colleagues are documenting the physical changes that ritual can induce in people who think they are receiving pain killers. Benedetti and his colleagues subject volunteers to pain by inflating a blood pressure cuff and cutting off the blood supply to the arm and hand. The volunteers rate their pain on a scale of zero to ten, but researchers also measure the volunteers' physical responses to the pain - blood pressure, heart rate, breathing rate and sweating. Then the researchers inject the volunteers with what they know might be an active pain killer or a placebo. The Turin team has shown that a placebo injection can lower a subject's experience of pain. When this happens, the scientists have also demonstrated that there is an increase of natural pain killers called "endogenous opioids" in the brain. Moreover, giving volunteers a drug that blocks these opioids cancels out the pain relief caused by placebos. It's more evidence that the placebo effect can lead to physical changes in the body, the result of that still mysterious chemistry between a hopeful patient and a caring doctor.

For more on this topic, see the web feature:
Medicine Men and the Puzzling Placebo
Coincidental Cures