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)

This article seeks to provide a set of pointers for methodological reflections on Foucauldian-inspired analyses of the exercise of power. Michel Foucault deliberately eschewed methodological schemata, which may be why so little has been written on the methodological implications of his analyses. While this article shares the premise that we should refrain from a standardized methodology, it argues that providing broad pointers for analyses informed by the critical ambition and conceptual framework offered by Foucault is both desirable and possible. The (...) article then offers some reflections and general guidelines on how to strengthen the methodological quality of Foucauldian analyses. We argue that the quality of Foucauldian-inspired analysis of modern power may gain from methodological reflections around four pointers: curiosity, nominalism, conceptual grounding and exemplarity. (shrink)