The importance of knowing about not knowing

Abstract

Within a pluralist medical culture, there is (from the doctors' point of view) a hierarchy of medical systems, differing in their wealth or power and in the degree of their systematisation. In the case studied, traditional medicine is at the bottom of the hierarchy and is so un-systematised as scarcely to constitute a system, though it nourishes nonetheless. The lack of system is seen in the disunity of traditional doctors, in their lack of a single consistent theory and in the wide variation in meaning in the medical terminology in daily use. Because traditional medicine is not itself a system, the claim of Islamic and European medicine to be systems of universal validity is popularly denied; they are simply tacked on (along with their ‘new’ diseases) to the existing kaleidoscope of medical ideas. Patients, then, unlike doctors, recognise only a single, wide-ranging corpus of illnesses for which all the different healers between them should possess the cures. The patient is not interested in knowing the cures or the ideas; nor are doctors necessarily interested in all the causes. Indeed what is striking is how little either patient or doctor needs (or wants) to know. Consequently, in analysing the popular culture, the notion of ‘alternative systems’ is largely irrelevant.