Diagnosing Lead Poisoning

To the Editor: In their Clinical Problem-Solving article, Beigel et al. (Sept. 17 issue) 1 describe a patient with abdominal pain of unclear cause whose symptoms responded well to the administration of a placebo. The discussant mentions that “the patient's response to a placebo injec-tion . . . raises the possibility of a psychological cause.” A change in the patient's condition due to the injection of a placebo should not necessarily be interpreted as evidence of a psychogenic cause. Placebo medications and procedures have been shown to be efficacious in treating angina 2 (one of the diagnoses considered by the discussant) as . . .