Anthropology Final: Medical Systems: Social Constructions Of Curing & Illness

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Definitions of Medical Anthropology

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The application of anthropological theories and methods to questions of health, illness, and medicine.

The study of health, illness, and healing across the range of human societies and over the course of human experience, with an emphasis on how members of the community direct their behaviors, articulate their ideas, and organize their resources in these realms.

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Medicine

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Any and all practices that are intended to address or alleviate what a given group of people consider to be an affliction in need of attention

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Biomedicine

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The medicine of hospitals and mainstream doctors of the industrialized world.

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Health

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A dynamic condition combining individuals, society, and an adaptation to the environment.
Absence of disease?
Normal functioning?

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Disease

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Disease is a condition that is objectively identified with a medical label or diagnostic name, based on externally established signs.

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Illness

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Illness is the more subjective perception of the individual experience of suffering.

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Peruvian Shaman

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Use trance
Notion of Daño
Cleanse those who suffer
Non-scientific, non-objective

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Objectivity?

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Disease is a human label on a naturally occurring process.
ALL medical systems, including our own, are shaped by culture.

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How are diseases named and medical systems shaped?

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Some Examples of medicine in different cultures

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18th century view of onanism
Drapetomania in 1851
19th century and women’s ovaries
1960s and HRT
20th and 21st century combat and mechanical metaphors

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18th century view of onanism

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onanism-diseases of masturbation; there was a movement of social hysteria against masturbation

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Drapetomania in 1851

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a mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity.
in a paper delivered before the Medical Association of Louisiana[6] that was widely reprinted.

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19th century and women’s ovaries

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woman's energy centered around productive organs.
When a woman suffered a medical problem, doctors usually diagnosed the problem as a misdirection of energy.
The reproductive system was virtually the root of every physical and mental problem a woman may incur

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1960s and HRT

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hormone replacement therapy
HRT proponents argued that the menopause was unnatural and should be regarded – and treated - as an endocrine deficiency state. HRT was held not only to halt the aging process and keep women ‘feminine forever’, but also to prevent long-term diseases such as osteoporosis, heart disease and various cancers.

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Classic Projects in Medical Anthropology: The Case of the Cannibal’s Curse

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1950s New Guinea
Unknown disease called Kuru
Resulted in death
Related to cultural practices of grieving and burial
mortuary cannibalism,
wo major misconceptions concerning the nature of the disease:genetic disorder,slow virus

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Classical and Continuing Projects in Medical Anthropology: Birthing Cross-Culturally

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Natural process
Who helps and in what way
Other reproductive issues are of interest too

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Classical and Continuing Projects in Medical Anthropology: Asian Medical Systems

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Thousands of years old
Chinese medicine
Ayurvedic medicine of India and South Asia
Islamic medicine
Medical Pluralism

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Chinese medicine

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acupuncture, Traditional Chinese Herbal Medicine, traditional-yin yang,
etc....

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Ayurvedic medicine of India and South Asia

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"knowledge for prolonging life"
five-thousand-year-old holistic medical system that is widely practised in India.
sameness of self and nature
Ayurved looks at the whole patient: disease is regarded as a symptom of imbalance , so it's the imbalance that's treated, not the disease.
three forces, which reflect the forces within the self: pitta , the force of the sun, is hot, and rules the digestive processes and metabolism; kapha , likened to the moon, the creator of tides and rhythms, has a cooling effect, and governs the body's organs; and vata , wind, relates to movement and the nervous system.
herbal remedies

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Islamic medicine

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The belief that there is a cure for every disease
One of the features in medieval Muslim hospitals that distinguished them from their contemporaries was their higher standards of medical ethics. Hospitals in the Islamic world treated patients of all religions, ethnicities, and backgrounds, while the hospitals themselves often employed staff from Christian, Jewish and other minority backgrounds.
Muslim physicians and doctors developed the first scientific methods for the field of medicine.

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Medical Pluralism

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Medical pluralism is common among Asian Indians and the increasing popularity of complementary and alternative medicines in the USA has now provided Asian Indian immigrants with a wide variety of treatment options to choose from for their ailments. Many a times, these options are used simultaneously with each other.

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Diverse Theories:

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Understanding theory allows us to know why certain questions have been asked and methods used for answering them

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Organization of Theories:

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Biocultural approaches
Cultural approaches

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Cultural approaches

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emphasize the role of ideas, beliefs, and values in creating systems of illness classification and medical programs for curing

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Biocultural approaches

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an anthropological view of the ways in which people adapt to their environment and change that environment that make health conditions better or worse

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Examples of BioCultural Approaches

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Evolution, health, and medicine
Human biological variation
Bioarchaeology and the history of health
Cultural and political ecologies of disease

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Examples of Cultural Approaches

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Belief and ethnomedical systems
Social construction of illness and the social production of health
Healers in cross-cultural perspective
Culture, illness, and mental health
Critical Medical Anthropology (CMA)
Cultural and political ecologies of disease

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Uses evolutionary theory to understand disease in the past and now

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Cultural & bio evolution to understand our health today
Almost all our health requirements can be understood by our evolutionary environment
Little by little we became dependent on the vitamin range in our diet
Our cultural evo has outpaced our bio evo-same needs as paleolithic hunters & gatherers-but have gone from h/g to producers to cities, working at desks
Paleolithic ancestors walked a great deal-we are more sedentary
We drink coffee & tea, paleo drank water
We eat more fat, salt & sugar, paleo ate more purely
Was once good for us to crave-hunting & gathering, now it hurts us-fast food
More hear disease,obesity, etc….

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Human Biological Variation

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Concerns morphological, physiological, and genetic variation among human groups
Body structure, workings of internal organs
While a lot of bio traits are based on genetics, it is important to look at environment
Example: height & growth patterns-children in 3rd world countries are shorter
Skin folds for fat measurements
Plot child’s growth on a curve
What practices-when to wean babies, what feed
Puberty-how do different cultures go through puberty-girls in us tend to hit pub much earlier than 3rd world countries

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Bioarchaeology and the History of Health

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Seek to understand cases and consequences of culture change
How influences patterns of disease and mortality
How events in past influenced health
What happened when change from h/g to food production?
When changed to agriculture- health declined-nutrients narrowed-people crammed together in same place
Can tell from skeletal remains, when there were epidemics, death rates, different diseases effect the skeleton in different ways

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Cultural and Political Ecologies of Disease

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Overlaps biocultural and cultural approaches
Looks at medical issues ecologically
Humans share environment with other living things
Our culture shapes the relationship with these other elements
Flooding, etc… can effect people’s health
Prevalence of lyme disease increasing
Deer run out of places to live –carry deer ticks
New strains of antibiotic resistant bacteria because of misuse of antibiotics
Have to look at macrolevel-famine,

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Cultural Approaches in Medical Anthropology: Belief and Ethnomedical Systems

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Looks at variations in etiology, diagnosis, and treatment
Personalistic and naturalistic belief systems
A given cultural group’s medical system
3 general categories: etiology-why we get ill when we get ill, diagnosis-determine what makes person ill, treatment-what to do about condition
2 primay types-personalistic-sickness is seen to be due to supernatual forces directed at sick person, naturalisic-natural forces-germs, imbalance in yin & ang-not directed at you personally
New aspect-look at efficacy of various ethnomed systems-cultures that use herbal remedies use plants we did not know existed
Look at ability of mind to help heal the body-very strong relationships-placebo effect, nocebo effect-expects negative and it happens

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One study found that of group given sugar water and told it would induce vomitting

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80% did vomit. More sited nausea.

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The Social Construction of Illness

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Illnesses are culturally defined
Views change over time
Impacts the “sick role” and “hierarchy of resort”

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Examples of culturally defined illnesses that change over time

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Chronic depression would have once been laughed at
HIV/AIDS socially constructed in negative morals, now fight is more urgent, less fear of individual
Herpes used to be the #1 bad STD, replaced by AIDS

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Sick Role

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how do we define when we are sick-may call in sick, but expected not to go out and play soccer, stay in bed and rest, expected to be shortlived

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Culture, Illness, and Mental Health

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How we define “abnormal” is based on how we define “normal”
Culture bound syndromes

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abnormal v. normal

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Changes throughout time-Homosexuality was considered mental illness until recently

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Culture bound syndromes

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syndromes-soul loss of the Mong, anorexia,monks begging bowls-indiginous being replaced by western

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Why do we see certain mental illnesses in some places but not others?

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variation of same thing
how we see mentally ill

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2 theories

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Examples of how we see mentally ill theory

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Japan-man wanted to be an artist so family had him committed because no one should want to-treated horribly.Tend to treat mentally ill as bad

We tend to view schizophrenia at incurable and progressive, in egypt-viewed as acute

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Critical Medical Anthropology

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Looks at political and social processes linked to health
Global political-economic inequalities
Critical of biomedicine’s claim to be objective and superior
Address ways in which is it not unbiased
When picking samples for clinical studies, there is bias
Fail to look at global, political and economic inequalities