“Mesmerising Science: The Franklin Commission and the Modern Clinical Trial”, 2018-11-20 (; similar):
Benjamin Franklin, magnetic trees, and erotically-charged séances—Urte Laukaityte on how a craze for sessions of “animal magnetism” in late 18th-century Paris led to the randomized placebo-controlled and double-blind clinical trials we know and love today. By a lucky coincidence, Benjamin Franklin was in France as the first US ambassador with a mission to ensure an official alliance against its arch nemesis, the British. On account of his fame as a great man of science in general and his experiments on one such invisible force—electricity—in particular, Franklin was appointed as head of the royal commission. The investigating team also included the chemist Antoine-Laurent Lavoisier, the astronomer Jean-Sylvain Bailly, and the doctor Joseph-Ignace Guillotin. It is a curious fact of history that both Lavoisier and Bailly were later executed by the guillotine—the device attributed to their fellow commissioner. The revolution also, of course, brought the same fate to King Louis XVI and his Mesmer-supporting wife Marie Antoinette.
In a stroke of insight, the commissioners figured that the cures might be affected by one of two possible mechanisms: psychological suggestion (what they refer to as “imagination”) or some actual physical magnetic action. Mesmer and his followers claimed it was the magnetic fluid, so that served as the experimental condition if you like. Continuing with the modern analogies, suggestion would then represent a rudimentary placebo control condition. So to test animal magnetism, they came up with two kinds of trials to try and separate the two possibilities: either the research subject is being magnetized but does not know it (magnetism without imagination) or the subject is not being magnetized but thinks that they are (imagination without magnetism). The fact that the trials were blind, or in other words, the patients did not know when the magnetic operation was being performed, marks the commission’s most innovative contribution to science.
Whatever the moral case may be, the report paved the way for the modern empirical approach in more ways than one. Stephen Jay Gould called the work “a masterpiece of the genre, an enduring testimony to the power and beauty of reason” that “should be rescued from its current obscurity, translated into all languages”. Just to mention a few further insights, the commissioners were patently aware of psychological phenomena like the experimenter effect, concerned as they were that some patients might report certain sensations because they thought that is what the eminent men of science wanted to hear. That seems to be what propelled them to make the study placebo-controlled and single-blind. Other phenomena reminiscent of the modern-day notion of priming, and the role of expectations more generally, are pointed out throughout the document. The report also contains a detailed account of how self-directed attention can generate what are known today as psychosomatic symptoms. Relatedly, there is an incredibly lucid discussion of mass psychogenic illness, and mass hysteria more generally, including in cases of war and political upheaval. Just 5 years later, France would descend into the chaos of a violent revolution.