Does it work? This question lies at the very heart of the kinds of controversies that have surrounded complementary and alternative medicines (such as herbal medicine) in recent decades. In this article, I argue that medical anthropology has played a pivotal and largely overlooked role in taking the sham out of the placebo effect with important implications for what it means to say a therapy or drug `works'. If pharmacologists and clinicians have corporeally located the concept of efficacy in terms (...) of bio-availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the `savage mind') have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis. It was precisely as a mediating link between the somatic and the symbolic that I suggest a decriminalized placebo effect (as opposed to suggestion) could emerge in the middle of the 20th century. Taking the example of St John's Wort, I go on to show how notions of symbolic efficacy, spillover placebo efficacy and bio-efficacy co-circulate in recent attempts by herbalists, clinicians and pharmacologists to address the question of whether or not this herbal remedy `works' in the treatment of depression. (shrink)

The article aims at reconstructing how pain is used in contemporary societies in the process of engraving power. Firstly, a social phenomenological analysis of pain is conducted: Husserl’s and Merleau-Ponty’s ideas are used for clarifying the experience of pain itself; Elaine Scarry’s analyses are overviewed in order to reconstruct how pain contributes to the establishing of power. Secondly, this complex approach is applied in early modern context: the parallel processes of the decline of a transcendental and the emergence of a (...) medical interpretation of pain is introduced, along with the marginalization of violence. Thirdly, the era characterized by the triumph of medical pain management is analysed: it is argued that the constitutive role of pain in establishing power does not cease to exist with the emergence of technologies of discursive governance ; it is an open question, what sort of power is engraved through pain understood in strictly medical frames. (shrink)

Part personal documentary, part exercise in medical semantics, this essay brings the analytical tools of a linguist and the human perspective of a patient receiving treatment in the American health care system to bear on the language we use—for the most part unconsciously—to talk about illness and disease. Topics to be explored include linguistic ramifications of the illness/disease distinction; referring expressions for health disorders; the “linguistic construction” of disease (what's in a name?); the “translation” of biomedical information from the specialists' (...) dialect into everyday idiom; and the metaphoric/symbolic dimension of body-parts and their afflictions. (shrink)