There’s a medical myth with which a friend of mine and I have become obsessed: this idea that scientific research into the “placebo effect” began in earnest during World War II. As I’ve written before, the classic story is that Dr. Henry Beecher, a Harvard graduate transported to a military base hospital during the darkest days of the 20th century, ran out of morphine while treating soldiers in pain.
What did he do? He injected them with saline (a solution of salt and water to match the body’s own fluids, with no medication inside) and noticed that the soldiers’ pain went away just the same. After the war, he dedicated his research time to studying this apparently powerful placebo effect—although showed no evidence of a healing, “mind over body” placebo effect.
As with any myth, this World War II story changes in the telling. Sometimes, the saline injection is deliberate, whereas other times it’s an accident. Some say Beecher did it; others, that it was a crafty nurse. The whole discovery takes place in Italy… unless it really was Northern Africa, or perhaps a Pacific Island. In one book, I saw that it was cigarettes that had been handed out in lieu of morphine!
At the time of writing, I have not seen any primary source confirming that this ever happened. Author Shannon Harvey spent days going through Beecher’s own archive at Harvard to no avail. Whenever a scientific paper mentions this story, it cites a reference that is itself citing another indirect quote, creating a tangled mess of storytellers pointing at each other when asked where they heard this bit in the first place. The earliest mention of this story I was able to find is published in 1969: “Beecher (1959), for example, has shown that in battlefield situations saline solution by injection has 90 per cent of the effectiveness of morphine in alleviating the pain associated with acute injury,” wrote the author, Martin Orne. That 1959 reference? Yeah, there is no such demonstration in it, but publication of the myth in 1969 established that, contrary to one hypothesis, this entire affair was not simply misremembered from , where a contaminated box of morphine vials is temporarily replaced by pills stuffed with sugar scraped off of doughnuts. That being said, we can’t dismiss the impact that this episode of the famous TV show may have had on shaping the myth as we know it today. More on that later.
This was the state of affairs when, in December of last year, my friend hosted a livestream meetup from Liverpool that I attended virtually and during which we learned that this whole “saline replacing morphine” business might be traced back not to the Second World War… but to the first one.
And given that Beecher was barely a teenager at the time, he would not have played a role in this version of the story.
A Jesuit’s deceit
Mike Hall has been, it’s fair to say, obsessed with placebo effects——for many years, dissecting the near-magical claims made in their service on the podcast he co-hosts, . Placebo effects are many: they are the reasons why a medical intervention may look like it has a benefit when it fact it doesn’t. It’s why clinical trials typically have a placebo arm, so that any benefit seen in those people can be subtracted from what is seen in the intervention arm, to see if the intervention has any actual benefit.
After Mike’s livestream last December, a listener who had followed both Mike’s and my commentary on placebo effects over the years and who had chatted with us during the virtual event let us know that he had found an early mention of this “saline replacing morphine” story that we might have missed. David McConnell, who is a retired IT worker with an interest in skepticism, shared a link to  which featured an article called “The History of the Placebo,” written by Robert Jütte. Funnily enough, that article popped up when he repeatedly asked the artificial intelligence platform built into the Brave web browser to look for references on the topic—and unlike some citations spewed by AI, this one was not hallucinated.
In it, Jütte cites a Jesuit employed as a watchman during World War I who saw others administer saline injections as placebos. Jütte’s source? Archives of the German Jesuit Province in Munich.
Given the aforementioned history of poor scholarship on the issue of placebo research, we had to track down this original source to confirm its validity. JĂĽtte replied that he had a copy of this century-old text possibly from his former Ph.D. student, and that McConnell could find it by writing to the Jesuit archives in Munich, which he did.
And sure enough, we received a scanned copy of this historic, typewritten text—in German. Mike Hall enlisted the help of a native German speaker to translate it, and it revealed a fascinating piece to this whole Henry Beecher/placebo research puzzle.
The tale was written by Fr. Josef Wegener—a title denoting either a priest or a Roman Catholic monk—who relates his experience as night watchman every fifth night from March 1916 to March 1917. The ward he was assigned to was meant mainly for men who had been shot in the head. One of his tasks was to help bring the latest car-load of injured men to the ward and pull them out of their blood-soaked uniforms.
Wegener would give an evening prayer in the ward and turn off the lights. The soldiers who were better off could sleep, but those in significant pain would beg for morphine. A patient might threaten to give up on Catholicism if he did not receive this drug. This happened every night, soldiers begging for a pain reliever.
“We used extensive persuasion to avoid giving it to them,” Wegener writes, presumably because morphine supplies were limited. “When the uproar wouldn’t stop,” he continues, and here is the line we’ve all been waiting for, “there was no other way than to trick them with an injection of saline solution.” (In the original German, “Wenn das Geschrei nicht aufhören wollte, gab es oft kein anders Mittel, als sie durch eine Kochsalzeinspritzung zu täuschen”.)
To be clear, this bit of arcane Jesuit documentation does not prove that the Beecher story is false. It simply demonstrates that the idea of deceptively giving pain-riddled patients a shot of saline instead of morphine can be dated back at least to the Great War. Given that the drug was first marketed to the general public in 1817 (and that the use of the opium poppy from which it is extracted has been documented as far back as the 3rdcentury BCE), we might yet find earlier instances of doctors playing this trick on their patients and hoping for the best.
But did it work?
What’s interesting in that Jesuit’s diary is that nowhere does he say that the saline helped in any way! Beecher is said to have noticed that the saline had acted as if it had contained morphine, hence his interest in placebos; but Wegener makes no such notes, which is strange given both situations involve deceitfully using saline in lieu of morphine to treat soldiers who had been brought back from the battlefield in pain. Was the placebo response not noticeable in World War I? Was it simply not documented?
Or is this whole Beecher myth concocted from collated bits and pieces into a single “ah-HA!” moment primed for remembrance? The deceptive use of saline during the First World War mixed with Beecher’s later research into placebo effects mixed with that episode of M*A*S*H in which the characters run out of morphine. It’s possible we are looking at a Frankenstein’s creature of a placebo myth, which is still regularly cited in the medical literature as fact.
All I can say for now is that the investigation continues.
