Donizetti in Berlin: playful operatic approach to placebo and quacks

Donizetti's 1832 opera 'L'Elisir d'Amore' is a multi-level satire on reverence for quacks and their

placebos, gullibility of rural communities [set in France, to spare hostility from Donizetti's native Italian audience] and the transformative effect of wealth on desire. In an engaging production [Der Liebestrank],

Berlin's Deutsche Oper makes the most of humour and farce in the opera, cheerful choruses belying the critical content of the libretto.

Berlin-based American soprano Heidi Stober is a fine Adina - the heroine of the story.

Italian tenor Enea Scala as Nemorino is almost undone in his wooing of Adina by the intoxicating effects of an Elixir bought from travelling quack Dolcamara. Nemorino expects the potion to make him irrestible to women - it is in fact wine, rather than the magical potion ascribed by Dolcamara [a showman's performance by Seth Carico] to a recipe from Tristan's Isolde - queen of the Irish. Dolcamara's non-singing assistant at times steals the show with his magician stage-effects.

The quack (from the medieval quacksalver - hawker of salves) came to prominence from the 17th century, with surprisingly not until 1881 the first organisation formed (in the Netherlands) aimed at protecting the public from quacks.    

Donizetti was inspired by the plot of Tristan and Isolde. This idea in fiction of the effective magic potion dates from ancient mythology e.g. Circe bewitching Odysseus' men and through to Oberon's 'love-in-idleness' in Shakespeare's Midsummer Night's Dream - a different kind of magic, with origins in the Roman Cupid and the viola.

To her credit, Adina rescues Nemorino from his rival, recruiting officer Becorino [Simon Pauly], and she is not deterred by erratic alcohol/placebo induced dalliances of her man [excellent Elbenita Kajtazi as Giannetta leading the inheritance-inspired female interest in newly wealthy Nemorino].

Adina eventually rescues and accepts Nemorino, not realising and therefore not influenced the fact that he has progressed from no prospects to wealthy heir during the action of the opera. The chorus is large and at best excellent, though esp. in the first act often struggling to keep up with the orchestra and to fine unposed ways to occupy the stage. 

The word placebo appears not to have been used in a health context until the late 18th Century, not long before the 1832 premiere of Donizetti's opera. However the concept of the triad of properties of a potion – medicine, poison and magic charm – dates to Ancient Greek meanings of the word φάρμακον ‎(phármakon), as used for example in Homer's Odyssey. Nemorino suffers both the perceived magical effects and actual toxic effects of his alcoholic treatment. 

As an aside, Chaucer in his Canterbury Tales, uses Placebo as name and code for the behaviour of a character in The Merchant's Tale: pleasing by flattery to obtain advantage, an interesting parallel to the behaviour of the Dolcamara in the opera. 

In medical use, although provision of a placebo may be  well-intentioned within 'do no harm' as a precept, double-blind trials in the modern era show that a placebo may have powerful unintended adverse effects.