Social science & medicine. Part B, Medical anthropology最新文献

In the first part of this interpretation of African therapy inspiration is drawn from Michel Foucault's description of the progress of the human sciences in Europe to understand in depth the meaning and practice of African therapeutics through the use of four universal categories of resemblance: harmony, emulation, analogy and sympathy. Harmony, in the African tradition, is a required major link between persons and things. Emulation as a principle in the medicine of the healers is the key to the coherence of a complicated play of forces that can provocate or annul sickness and disease. Analogy, the third type of resemblance, transcends harmony and emulation. It is at once source and code of all resemblances, establishing a cohesion and an interdependence between all kingdoms of the earth and the universe: mineral, vegetable, animal, human, ancestral, celestial. Finally, sympathy, the last resemblance, can only be defined in terms of its opposite, antipathy. It enhances analogy and gives it its meaning and value. It is characterization and calling of African healers.

In the second part this conception of life grounded in the antagonism between sympathy and antipathy. which embodies the relationship of healer to sorcerer, is shown to be dominant today, in urban as well as rural areas. Its distribution as well as its presence are far more than sociological facts, they engage the very life of man.

However the practice of African therapy opens up to another issue: the significance of the therapeutic act. Compared to scientific medicine, the medicine of the healers is very dependent on natural myths of origin concerning the fate of the species, whereas modern medicine tends to address the fate of the individual.

The traditional medical care system exists and functions in Kenya along with the modern medical system forming a plural health care system. Although the oldest and the most widespread, the former is the least understood and least accepted in any formal way, by Kenyan authorities. This is mainly due to the fact that the system is fluid and unsystematic, lacking in any form a working code of ethics and conceptualised often along the basis of ethnic cultural beliefs and practices on illness and disease. The approach is by no means static. Included in this approach are ethnic traditions and values, folk knowledge, medical taxonomy, patterns and regulations of health-seeking behaviour, supportive social institutions and structures as well as personnel used in the delivery of restorative and preventive therapy.

This paper which relies very much on linguistics, proposes a circular semantic network as an original framework for organizing nosological terms used by the Angbandi of Zaire. Such a framework is presented as an alternative to ethnosemantist and structuralist classifications. Building on this new interpretation of Angbandi nosology, the paper presents in the last section the notions of iconicity and circularity as key features of Angbandi medical science.

Four Yoruba traditional healers were interviewed on their professional associations and the objectives of such association. A semi-structured questionnaire was administered to 165 traditional healers on the ethics of traditional medicine and the discipline of erring members. Photographs were made of sign-posts related to the practice of traditional medicine found in strategic locations in and around Ibadan city. The results of the study showed a proliferation of Yoruba herbalist associations. These associations serve as meeting points for healers for social purposes, and to share their professional experiences. There are rules and regulations (mostly unwritten) that guide the practice of traditional healers. Disciplinary bodies also exist to deal with offending members. The misleading nature of one herbalist's sign post is highlighted. The disadvantage of not having a central professional body to control its activities, and the dangers of unsubstantiated claim of proficiency in the treatment of certain diseases by herbalists is emphasized.

The invited comments on this paper have stressed the growing interest in traditional medicine and have touched on some of the problems confronting researchers and health planners in matters relating to traditional healers. The author is in agreement with many of these comments and has attempted giving answers to some of the questions raised by the discussants.

Hot-cold food and medicinal categories from one Mexican community (Mitla, Oaxaca) are examined to describe general principles of classification, dimensions of use, and potentials for change. Intracultural variation in hot-cold knowledge and related dietary and medicinal practices are discussed to demonstrate how within one culture general structural principles of hot-cold balance can be shared, while content varies; also how knowledge is communicated so that use of hot-cold is retained in spite of differences in judgment and usage among population members.

Findings from this community are then compared with those from other Latin American communities and with data on hot-cold usage in the Near East, Far East and other Old World communities. While Mitla differs from many other Latin American communities in that hot-cold reasoning does not interfere with delivery of health care or acceptance of nutrition information, it is similar to them in that hot-cold is not an all pervasive cultural idiom, but is the major idiom in which the qualities of foods and their beneficial or harmful effects on the body are discussed. By contrast, in Asian medical systems, hot-cold is the major idiom for discussing moral, social, and ritual states, in addition to the qualities of foods and medicines; but it is only one of a number of concepts for discussing health, humors, and foods. Implications of between and within cultural variation for reporting illness beliefs and formulating health policy are discussed.

This paper examines the role of colonial rule and of international agencies in developing modern health care in Ghana. Our purpose is to discuss processes in Ghanaian society in a way that will be relevant for comparison to other non-Western countries. What factors in colonialism supported the evolution of modern health care? What health measures were implemented to make the Gold-Coast-now Ghana-hospitable to colonialism? What roles do international agencies play in the continuing evolution of modern health care?

This paper critically reviews certain trends in the medical anthropological literature on the Middle East. It identifies and analyzes the dominant theoretical orientations found in the study of medical beliefs, folk illness, healing and competing medical systems. Data from an Egyptian village are used to illustrate some of the theoretical limitations which characterize the study of these dimensions of the indigenous Middle Eastern health system. The paper advocates a political economy perspective which undermines the idealist, reductionist and dualist approaches to the study of health and illness in the Middle East. Alternatively, it suggests that analysis of health systems requires their placement in their broader political-economic environment. Health and illness are thus conceptualized as results of historically specific social orders rather than the consequences of ideologies of obscure origins.

This paper examines the significance of ethnicity in relation to folk healing within the context of a multiethnic urban setting. The principal findings that healers and clients are often not of the same ethnicity, that healers' practices are eclectic, and that healers and clients attempt to accommodate to one another's ethnicities are discussed. Implications of these findings for professional health care and general research are considered.