\ De. 504 SICKNESS— and HEALING An Anthropological Perspective | ROBERT A. HAHN‘incaoton of Haba 1984; chapter 4 an cxpnton of Hs 1985. Chap- teri eyed fom anal plished eS Sct ond ate 21 {19851 163-1; ches and re revsed om erties St plished in ‘atic brs Qtarey aniespredeesr and chaper i cevison fachuperrin Haha and Gxinee 1985. unk pbs ofthe ce {ex permision ose previsypblsed mei. aio thank Ape Ceacar-Crofts for pemision ro reproduce te owe of xyes Willa Obra the Arrienn Calle of Obseccansand Gye gis the potgeph ad fo scene 0 exellent lib. Take or ‘de alo eo many nimble Liban i Sele and Alen fr nameroot techs in cure places Pot hs eet doe ew hogs, Span Shea hs shared with mes ave or which pst so mess, INTRODUCTION cin artaplog tole en mre By desing oe ‘Suen, ca ad prctoope ranger Keyes a ‘oy sped fr og, ab eceg te ~Geoan 190145 Io all epochs and ereywber, sickness and eaing are pial Inuman concerns. Were uadestnding of sickest andthe response fo sickneschtough healing vary grey fm ime ime and place ope, fdamenely shaped by hivorl and exunl crcumaanc, Cone lary Westerns are sceuored 0 taking tel om views of sicker beating for graned—ehe way things te, rely. Suivand-ach deat ‘x, and there ay be pete ehniqus for eel uetmene. Alcon ‘Westinesrengeze that their medicine, Biomedicine i imperfect in oil, sil, ts undying penile of pathology and chespeutcs ae ‘resumed co be corer Aleaative,noe-Wtern views ae generally [ire primi, pce, and enenily mingled od het oso feneieforexmple, maliial pass empl seen. ‘THE ANTHROPOLOGICAL PERSPECTIVE inthis bok, Late to step ase from the Wesern perspective ‘enamine he worl ofsckes nd healing om ananchrpelogea espe iii Remain widen Semester attive ha dil foe the pewling Weser view in zegudieg systems of Sckass and baling expres cleat! yee , opie fates of einking, jung, ad behing sae by the members of 2 {ci Ince fe ifthe Book, Lepore ways of concelvigg sik and ling i whic he ey of Were medi ot ake fe goed In ‘heed al having willy suspended the perspective of Wertenmei> ‘oe, Lveture ovefec pon Taek miliary i he noi, heen ‘teil, “Tne ancoplogcal perspective bas an earn theme: bough b= i abou snes and pares of eaing ety flr fom soy city allan egal clearly By enalacingacrosscutl bound ‘Sis, soto evk wder audience che Woes of thes They {tet the “nrmane in dizee cer sings a teachers, They att pty tolerant abeoad ad unusly hepa hone—bot oe "Anthologies be “new” forms of sickness discovered in foi stings, snes hat ap appa Stange and implausible on est pcounce Tyas tke eiuly “ew wap ling mitosed beyond {iow clon toundere. Whar nc” depends on where one has een ‘hd wha one bar sen, Anttopoogis empe sndeneand the concep Sh theca yale the unde ome of sickness ad bling ea te par of dic own cain. By reprcening a broader ange of human ‘aration, tay may expuod Westea ides abo sma. The goa ef his ‘owculaleoountr is aoc 0 syns larson ao abe gga, Dunham Hodgepedge bu © promore mana espe, communication ‘oe bounds, sad exchange where maybe Bee 1 deiberaey say he "emp te de fom the Wester ppc ‘ge do aoe peed vo undestand sks and eling enti fom he [paspuive ef totes clare oral az, colle of my owa cua ‘Seumpton. Ty do so would be o deny ee fndunentlsnceepelagial tener thr the conrps td pemibs dnt guide the way people undead {Se meld—thel"wodview”-~are prfundly shaped bythe ula > fing they inka. Like pases, pins, aod ote ees anthopolo- (gets ota oftheir 1 Go deny ny altar 8. "Nor do [dey she woptecdoned knowledge of wentietcrcary Bio swan. Ln ronished diy by seme discoveries aod iverson. ‘Wher sic 00, rae 20 Blsmeicine for medial care—noe ingiy rene eielyconnenen but bere lier eae for any condi ‘ion ofthe best cement rable anywhere. ln ny epidemiological (encha ell, bud og fdings of Binredsne. Tama Westerner snd fave rove up a socey where Biomesicive real, "Média sntvopologiscommoay conte sn esa dilemma aod 3 rn ma Rei rg ei scene rt ponte chatie tietiatngerte ee ‘eo cee cea aera io cmeeetereaeee aaa Sper apt tata quviruterecmmonbicidgeaeroe Sere wecteeenegae tat iarocemienieet ere ee emreeneindanace inte occ den pe Seeger ee Sprit comer ce pear asraramesemntaeectate, Sacre rete el eer a eee shcecraiee semana naa eetnor eens pocamats aii eae ecto canig ty wie bn nga cigaendm amet Soccer n conten aati ieeit Sees ey ieee ae Sees armrest ‘amet et Sedalia mie pcre Spee eens Hioaiiaesamerome ieee ee ts Soraeemmmntemmreese SSronitea mtg ian Se Eves pear pd gp Sipe ee goles een tae Poorest erected cs ir ieraerenetimrehe an cee na Sete wastage sacs creche et aun ieee eres cmnstes inline geen eae See eeetation, Orso Newt meee: "Weate ike slr who muse rcostacrour thipon de opens, withnat everdamaatling ws dock and rebuing with ‘he ber of pace (quoted ia Quine 1960 my easton). “Toe challenge of ethropolgy-—and o other icpines tha ark ab uaetsandiog of human poomens nbc ano he phenome fed only inthe bvrvers home stings to develop anche ae rk thee as xpi, rao, nd cosistet as pssibleand tae isa the ‘Sine tne etptve tothe erative rho che cut aewee. If ‘te beg om the clturein which Bemcicine preva, we mus st ake fur Biomesia femewoce ur cla and systemic a posible. But, at che ‘en, we should aorszume at he premio his yste tal ot (clase senhe, Ours oct oly plc snd. “A Cey se he tem abeboaey (om ehe Ged aay, “eation of scope") co cefer to aoe borane thoughe ad ebay is ess ‘Sour fan so anhsopolgite Ive clasd che tvkward but tefl em ‘eben e othe pt sien cael pte concen with {ices healing The ol ula oases cots several ‘pstar—or empl, scence, raigion, economics, and medicine ech of ‘which maybe dough oss heving thes ase ares 2 ditntive dancin GF kaowiedge snd pace; + mess of scliation—ibeesching OF this ‘Soman o special and ocean an ome ia which the nevis of hit ‘oman rconduce ‘Tae dma dees wha clr srem it sboa. The domain of mali ioe distinguishing hae "neal om tos nares lncloed in the drain are the ons, vle,kxowedge, ad ecnigoes ofboth [rscttines and laypersons. Th darn aso iho iden about proper ‘havior bot pases nd bales) ad bout sanctions for mioehavoe, soca che going f skort by pent ore neglect of sas of [pce by lee In many "ritand on Westen Sits, the do- Fn of medicine pelea rented or that of rligin, plies, he ese of cia ile sik ay ivolve the world of anes spi, {healing may gue the slain otc coi. “Sealine way in wich scleral dal is inclested ia noe icee~foremmple, in the von guess of shamanism and the peemedi- (Gl educcon, redial schoo, intnbip and eetdency of Bioline. “Thaoug tlio, a nie prodoe nd maine he person sch (Sis ler and specials, ho ccy ie cl, In Biomed wells in many adiconal medial yes he wcilation 6 bel iva © prolonged and atdiou apprenticeship in wich epee practitioner ply = Teng sole, Socilincon ix ao te may in which a soley educates is ppslstion abe sickest and healing i informs pti ow eo behave ‘he sick both ina ori of mete segs "ily acl syn bat «deed wre in which cites ae ‘cen ut The ate tay fc netatons and sengs, Soc 5 Msp (sand doctor fe, a wel at designed sler—for empleo” “edie,” “wrgec,” “psc,” “ure” “lb wecbican. "poe len” In iin sce, hea sve my noha fed pice boty bermarked by ime and ra SICKNESS te mesic asi widely eo oe cual slag tesocher, whan, hens do cares haven commen tan ag Be led ‘het’ Hwan ine be dtd nha oon wt oo rin Nompante say ‘Broly pakng, he ace sche ian uawnied codon in ges pom toe mind, a i, oon ce wd ume kesh determine by te psp sd ee ce of ene the patie om the Ltn ot ain pon sono, {brea Sess repset snd eps te pares of Indu pers wich sory, What counts aad bas nay Alterra urine mic eri amperes an oper singe a ser oe Wh sa he ema ome Geodon oeptgen the pace pyle, oe hil eno ‘aca eet whic sn cre, eve ny Bente ‘ens bd Shai, o prelim xcure es [ponte rebut ise abject pen sd es. is ot commnly reopen the Wetter sow wat “pends sl rand steal bedi gly femome cto ating {Stoo fed centred pe, earnest a selene cn Wasr rn De 93 ae 0 in may son Wrens, pons a repel eattaly sd in. ‘tony nk wich te: big, hn sgh: Aun ed Independence sho gay Wenn ves aarti omnes wehother Conqen in the sates, about “tmeng wrong Tod wade son enon or belgie pty fo Wee ide Fcoxmpl, whereas dahon hc cpa ftp ay behoghe of puto in the We dscns so she py ‘mrad ry be eae apatite Sicko en Sats or czech egy acres oe lie pln of pono. Ofe, thug noe aay, sc poss cheaces low ber enya ik. Ofen, bar ott, aed eso it in th knee cer dct, om ee pine ck eld ‘ay fm aed ott pater Howeer mach «ys wiv pes i ee perros of thir ikncen, pinay hows pro wok wel inch woe oie Ine ohinec ins owe von dc been fen towers oo‘ nernopuction threat his died cap and fenton, The abe of eon esc” tr dave fom he sonar ote, ar ee opr fr ample, in Soviteppchiy inthe mie ander trent ener, i piel ‘ast dagoors rn ohich he ppd welling of cy voposed po is merber wid pete fcr lathe so-alled pcs. By ‘er un abe ociing schon och oc cs moet oct ffi ac sckaese. Te ciel ating of odin ain 0 what ES been called the "erry gin of et (Dark 1973) in which + eon cocn spot ix het utnlagal condiin fr soe be Ercfcb own thio, the lesa etn Incaded ihc se brken nbs, incest “oewoce” ais charge non wy, Where hai i nah cnn ne'scacnetion trite minal word sinsome Amazonian beso with acest iis (isin some tara Alan sce), iicales i hunting ay be ‘pneu sides and cence by ales. Abo focal we eum ‘Ens mch esuromob enti alvugh he tim may not hve hed {le tocrperence hese ara vent 8 wrong nd undesirable, we expe ‘Say, ils sla Reo she would hae ade such fdgmens of he bucome, Childbirth commonly a ely event, WHEN, howe Po- (hee lvl of pin (and psue a weld exceeding moe ober vee i Serco nln ean ban unwanted condion of he moter slr oy. ry my bring nach ue, omy be x healthy eat o es ica sl be patolgial wea pes no pychodyaamic pocss ordi laced thea oe ties bs "Unemployed pores a ike tobe uawaneed condos, but hey rot cevtly endo fone selfor onc cancion wth che ‘Nod Yee thy may become at ofthe elf inezeported nd icae ould emonhly be repudedssichnene, Whar of peony chance Sec pdr, eo ei os Inger che sicko Aqsn, | Boe chy ae teem regeded ‘sec when hy espe oh fd aoe. Tee ht fey meng, sing, mek, clumsy, unable 0 arse. ‘Str efter oss fk, They nay thei Beste then thy ply conscious ein ont ieee when thy become objet On the oie nd, we may ence sicknemi si tn which pacogeic mater sdetberey jc or inged 0 Ince the bods deere, We may al exude eters "sik conditions Suches pew, the aman end," amsng the elder} o ches who, Falowing oral reco, wis ode Though with side es, ime thao sd ce ld nan End produ deed outs, “Te cncpion sae elie bee dfs soe Gm the conceson ound wie} i Biomed. The smicopalogil con Lf tus denes sca cacao the peeve Oe patent, ho ecrmines the woe of the hale. a Bamikine skein a ‘stutance in tly 0 Bevel fein in ways derived by the Blysician, who defies the problem ofthe pat, indpenden ofan Sometimes Coney fhe patents jademen. HEALING Given this oneprainin of tickoes, «denicon of “haling” is relaivelyseghornard. Broly speaking, htling tthe rds of Sle. The worl fa and Bastiat erie frm he German et ot ole, aainaredy of good omen.” If one dope this once, is of wil vary with moins of whe” which, ike naion eel? a "peso vey geal om secingoaeing snd cpoch euch icles ‘ling not al the eed ov cafes tai he esoaion prior healthy stne—bur ao rhailiaton-—the companion fe ae of elth—d palcion abe mitigcon of meting in he ack Healing iss sequence of evens, some of which maybe delibertly cite, cxbers unintended Dunn 1976) Atbough we general desigare sealers eons who specie ia ietetiorlheaing, thi eignacon cna be mit eng. Healer may ile healing, ba hey may alo ide wad Deling may ocr withoa on sie fi itrwentas, Patents hem selves thei bodies tnd misds—ofen cose the pasive expen of ‘alin may nd comely do pli prominent sin theron healing, (Other pecans nr repeied aa ny hel wel teal oo ‘And nenpeoaal fre, 00-fr erp, he sel environ may aya eng ele. PLAN OF THE BOOK In thes ao this ook, develop an snherologica fame wok fe ering sickest and being nal cll seings, without ‘Sruning the che pespectve ofan oe clues tac or Beer thane {Choe 1, "The Univer of Sickness" eplcsitsesin declan ficknes and eabores + definition of sce nhich she undeyng ‘ely ios, asasumed ia Biomedicine, the patents bcogy asso by ‘Splyiin bar ther the paren perepon of lecing snd dsubanc i Ii" orheset Paucar anaomy aod pysilogy may pay xprominen le in the elogy and emedy asics Ii the pi, however, wih it char encepe, theese, who dernier place at he cate ric {Chott also propos cee basic Kind of scours sickness et may be bl in dierene cueralsecings: dnc acm, sah ste ey ofBiomedicine, in which the paien?s boy is rgudel asthe sat of che ‘tuntinsd enedy ofcckaea linac, sucha ies above ses ‘See pola thought inthe Wes, which the pon, ied is ore ‘hind, Lod, dail erioomene, scenes the oes feces enstion {nd retmea and ar aut, aha ofwadiionat Chinese medic ine in which atalace In coum fer sre seen the source of caess nd the means rede. ‘Caster “Caltur-oud Syndromes abound,” argues ha the nosion of ult and syodome, wed by pein aswell as by aaccopolo- iss, i elf alu cally based. Soppsely,clt-boued syndromes [citation of skeet: thought © Be oandonyindelimied cultura Secsng:Runaing inky abeburn olga decribed in Mays, the trot afro of eucuchound ayame. Caleare Bota soto a ‘Sonmoaly destbed a congraea snd largely explaieable in texms of thet ‘Sern {ncn that he of clece bound yadrmer sums ba sme ‘Sootiena are Bound by thee clear! serngs sp that oes a nt. Sgt cer, tnt al onions of ene are afc by tee clear Secing swells by han biology, paycbnogy, ad he physi aod ia ‘vtoanens.[conlode that tbe cuegary“clere-beund symone” it Iilading sod should beabandaned ‘Chapa 3 Then Tacos of Scknes and Healing” seviews the wide range of htc that nthropologi hee popoedzscoun fr ions ine medical syste fein diferen seins Soe have argued hae Ime seme, ad indeed cule ar whole, ae lee dined by ‘Saprion oti physealemioemeae. Ae the tier extreme, sme a8- theoplogss pesto ble thc media seems, like ee re of hua ‘Store, ae scary lisse ment tons, minimally on ‘tenes by ee py emionaeae the wd becomes he may ie iSbeticedeobe. Leger both extees a focorsctand pepo ew beeween he we. “Chapter 4 "he Roof oie and Cale ia Sichss and Healing preset «vide age of erence te che tind cl etnshipe, abd ‘cel organiza ofaudly fc proces ofsicenes ad ling ink fost mone Te placebo fic ina pod exemple ofthe ele of ei Intgey shape by the pacers clara seing—im events oealing ane of fico twel. Threw oscens ad bags causally asociaed with {hes nd cle evireaere in thse way that hey are aso ‘wth patbopens and ediinrruns counrer to» fendamenal premio Bicmedicine. The sociocultural model r proposed to complement rather ‘han ele he Biomedical ede ‘Chapeer,“Asthmpaogy snd Epdemiology: One Logic Two 00 siden th rinthip eemeenewobase approaches othe ndetanding of eke and healing. Seoeanhrpologiss we many epidemilgi be- Tice tae the Ss etd of there cipline ae eal distin, foe nstaopucrion ° consi { crib we pracsoerof hee dpe bev then ‘veto dn hit wor. "hen show how eadamenelasumpcons made Dy pectin of exh Siping ae bse on principles ofthe oe ct pliseand how praceivonesefech tus practic the oe dixipline without [Keowig i {eemmendexlotion of sic commonalies canst prec of bath acpince: 1 ilae the potential of ellabortion sible solaons to the pabn of ondemanding te pene gap be {ree white and back infer moeality rae a he Utes Sas "Faved bale the bok enmins several ices of Biomedicine an snthoplogic perspective. Caper 6 poneys"Bhomedcioe a2 Catal ‘Syc” concntaing ome preeminet pceonrs, physicians. The ‘hope dios the way i which physician define the domain of edi- ‘e--focating co the body-vand the way ee body i divided by medial ‘Specie, The chprer then desrites the process of medal ection, ont ‘of ehe mon gieling tals of icin koowe, Pal, desibe che fhe hee elatonbip betwen pics and he poi ‘Chore anesthe culture of Biomedicine “A Worl of ler Moti: Poi of lacie" nepal medicine the tol ea of Biomediie, beevedon teri "Bary Siegler” for seve mechs ‘ouniestand how he taght fis wok and how heeearedcoleagurs nod so By seviewag che development ofthe principal extbook of beri, Wilts Oboe, fom the frst edcon, published in 1903, the igh teenth, publited in 1985, chaper 8, "Diviins of Labor Obsecican, “mans sd Soy in Wilms Ori, aoalyes he swenitcea (olurs fBmedal Mo shout women paint ond cel sein and “South datibutton ofthe inte mec seg, Thiscectas ely [Buide he ening mone beige and he once fest lies {ihe Unied Sats since the tor of the centr. Paiculry in eler fio, wowen te depced ws cildbeingtachne; ty we ceed ‘etal, widows aensin co thi xpenene. Edison of Wil i ‘he 150s inadaced a efi to aon ro the women thamsles, Receot ‘ios have ven mie choice to women pants bur ave ao given frmincce a str eos "se obser pee he ts “Chpeer 9, “Beeween Two Words Physicians as aie," expo he aul bez plyicns al h paiene by examining be expences of pponinaclyeweaypiyiane who Beeame sik and wrote abu te x ‘enc, eveling the encounter of evo works~~puient ad hele {neue poco, forthe mon put, thie ae ommonaies among theo nce thas pica ptente—thel stl lineal wenment of hie ‘racket sbuequene copncon ha eey ate serine dope ‘on of che patie role, ei awarens of itance nad coldness in ther ‘hyscane ad inthe media sem, ei ackno eden: ofthe ae or ‘coal socal supose and thir ambitalene sears fom patent? ©