If you have suffered this assault you will know that three things happen after the extraction: it hurts,- your face swells up like that of a chipmunk,- and you can’t open your mouth. These are three signs of the now familiar inflammation response to damaged tissue: pain, swelling and stabilization of the part by reflex action to prevent movement.At the Eastman Dental Hospital in London, a team had been working on ways to help this troublesome condition. Ultrasound has been used for many years as a physiotherapy treatment for inflammation with the rationale that the deep heat produced by the absorption of sound would hasten the end of the inflammatory process. Despite the fact that five of six trials of ultrasound on limbs had shown it to be no better than a placebo, they decided to try its effect after tooth extraction. They found it to be highly effective. Then, in a double-blind fashion, they massaged the face with the ultrasound machine in some patients when the machine was working and in others when the machine was turned off, unknown to the doctor or patient. There was no difference in the two groups. Next, they tested whether the massage was having the effect and trained the patients to massage themselves in the way the doctor moved the machine. This self-administered massage had no effect. Up to this point, they had shown a typical placebo effect in which a doctor in a white coat massaging the face with an impressive machine had a marked effect irrespective of whether the machine was turned on or not. Furthermore, there was no effect if the patient applied the machine. The pain was reduced by doctor-applied treatment. They went further. The swelling of the face was markedly reduced and the ability to open the mouth was improved. This placebo effect was the same as that of a substantial dose of an anti-inflammatory steroid.The reason for choosing this example from many is that the effect was not only on the pain, which unthinking dualists would say is ‘only mental’, but also on the swelling and on the muscle spasm. Evidently, this placebo response required a doctor in a white coat with an impressive machine, and this combination improved not only the patients’ subjective report, but two objective signs of inflammation that are usually assigned to mechanical body processes. The rational explanation is that the brain affects hormones, which in turn affect inflammation.*62\219\2*