Acoording to Hooper’s Medical Dictionary, Placebo is "an epithet given to any medicine adapted more to please than benefit the patient". It is an inert substance or drug or formulation that is administered to a patient who believes in its potential to cure.

Since the early 20^th century, the miraculous powers of the placebo,known as placebo effect, has been observed. This effect is brought about by the patient believing in the therapeutic potential of the administered substance, irrespective of its potency.

The belief of the patient goes hand in hand with suggestions from a person of authority or with information that the patient percieves as reliable. The placebo effect becomes evident when a patient’s symptoms are alleviated  after the administration of the placebo.

The nocebo effect (latin meaning ‘I will harm’)  is the other side of the same coin. Here the patient’s symptoms worsen when the placebo is administered.

The psychosocial aspect to medical treatment demands that  the patient has implicit faith in the given therapy.The placebo effect is a testimony to the positive response of the human mind to a therapeutic approach.

The common practice of prescribing antibiotics to treat influenza and cold  is a pointer to the use of placebos in modern medicine.

Most of the drug trials that are undertaken for a condtion compare the efficacy of a new drug with either an already available  proven drug or a placebo where no such drug is available.  If the drug trial  beats the placebo effect by a stastical margin, it is accepted for treatment. In case of benign conditons there are not much  ethical dilemmnas if a patient’s gives a proper informed consent, however in case of life threatening condtions or cancers the use of placebo is ethically questionable.      

Doctor –Patient relationship

The word ‘placebo’ has several meanings. But when used in the patient –doctor context it means,in Latin, ‘I will please’. Placebos are an integral part of doctor -patient relationship. Restoring the patient to normal health and boosting their morale is considered as the prime task at hand by many doctors.

Thus, when a well-intending doctor prescribes a placebo he actually means “I shall gratify the patient’s request for a medicine or a drug which I cannot/will not supply, by giving him an ineffective drug, in the pretext that it is effective”.

The most common placebos prescribed are vitamins, for complaints of fatigue, and antibiotics, for viral infections.Sugar pills and syrups are not uncommon.

An Australian doctor coined the word ‘Obecalp’ (‘placebo’ spelled backwards) in 1998, in order to mask the word ‘placebo’ and make  it less decipherable  to the patient.

Placebos can be very effective in treating specific cases .For instance, burns patients with respiratory distress cannot be administered opoids, like morphine, or opioid derivatives such as pethidine because these medicines will aggravate the respiratory distress.This is when a normal saline injection will  help tremendously  by relieving pain in these burns patients who are convinced that they are being given a pain killer.