1 - Healing and medical treatment

Summary

Ever since [ship physician] Stephen Maturin had grown rich with their first prize [about 1790] he had constantly laid in great quantities of asafetida, castoreum and other substances, to make his medicines more revolting in taste, smell and texture than any others in the fleet; and he found it answered - his hardy patients knew with their entire beings that they were being physicked.

Patrick O'Brian, Master and Commander, 1970

Even fictional doctors know that their patient's attitudes and understanding of medicine and treatment are a fundamental part of the healing process.

An ulcer trial

In the early 1990s, Dr. Frank Lanza, a gastroenterologist from Houston, Texas, led a large team of doctors in a test of a new drug for treating ulcers. Over 300 people participated in the trial which compared the effectiveness of a new drug known as lansoprazole (its trade name is “Prevacid”) with another, older, drug for ulcers called ranitidine (“Zantac”). The people who entered this study were diagnosed with ulcers by having a procedure called an endoscopy. In this procedure, a fiber optic tube - an endoscope - is put down the patient's esophagus, and a technician examines the wall of the gut on a little television screen. In each case, only after the technician saw an ulcer in the patient's stomach was the person admitted to the study.