Caregiving is the Difference


Domestic medicine thrives on preparations made with locally available ingredients and people who have basic caregiving skills, and there’s a lot to unpack about it because those caregiving skills constitute the difference between domestic medicine and herbalism. I’ve been trying to think of a decent analogy to explain this more clearly, and it finally occurred to me the other day.

When I train street medics, their role is to provide someone with the best care that they are qualified to provide and to keep providing support to that person until they have transferred care of that person to the next tier of support. All our safety volunteers have as a baseline First Aid/CPR certification, Psychological First Aid certification and have taken a twenty-hour training class.

While they are not healthcare professionals, that doesn’t mean they aren’t knowledgeable. They have been taught how to be a good support person and to know the signs and symptoms that mean someone should see a professional. They are also trained to make sure the person has the emotional support they need and has their basic needs met for the day, which is perhaps unique to my group due to my experience. That is analogous to domestic medicine.

In days gone by people in every household were educated with some basic information about how to provide that kind of complete care for someone who is ill or injured. I could not disagree more with people who say otherwise just due to my lived experience, but I don’t just expect you to take my word for it.

James Mooney was an American ethnologist born to parents from Co. Meath who was sent to Ireland by the Bureau of Ethnology to observe Irish folk medicine practices. It might be one of the only times that the agency got a placement right. Mooney had this to say about domestic medicine in Ireland.

“It must not be supposed however that the people depend entirely on the skill of these doctors [bean feasa] on the contrary every housekeeper is well acquainted with all the virtues of the common herbs to which she never fails to resort in case of need- always accompanying the application with a prayer – and it is only when she exhausts her resources or is convinced that the illness is of supernatural origin that she applies to the cailleach luibh [herb hag].”[i]

Address to the American Philosophical Society on April 15, 1887, by James Mooney Bureau of Ethnology Washington DC.

Mooney lived in a time when most households practiced domestic medicine and most people still used many plant remedies and cared for their ill at home.

Less than one hundred years later this concept had all but disappeared. In 1967, Irish historian Seán Ó Súilleabháin was assuring us that “the traditional knowledge and practice of it [folk medicine] was, in any parish, in the hands of a comparatively small number of “wise” men and women.”[iii] This is nonsense. There’s an entry in the Schools Collection that supports Mooney’s conclusions saying “the people had many simple but effective remedies for their ills. Doctors would not be called on except in extreme case’s.”[iv]

I don’t know how he justified that statement given the vast number of entries in the Schools Collection that speak to herbal remedies, but mid-20th century was a time when data was ignored when it didn’t fit with people’s hypotheses. Even medical textbooks written in in the early twentieth century acknowledged that “every physician, nurse, and housewife has original pain-killers.”[ii]

It’s only since the recent push to transcribe and understand the early modern domestic medicine manuscripts that the educated elite are beginning to realize the extent to which wealthy households prepared and utilized medicinal preparations in the past.

One of my critiques of academia is that they frequently participate in that type of cultural erasure overlooking the fact that Indigenous people still use their traditional medicine as do people who live in poverty stricken rural areas or remote areas. They tend to overlook though that in some populations that continued for a long time due to cultural sedimentation.

I will admit that I don’t see those skills being passed down as often these days, but I live in a much wealthier and more educated area than the one in which I grew up.   I think it’s safe to say that most of the middle-to-upper class folks around me grew up with access to healthcare and have never had to chew clove gum because they couldn’t afford a dentist.

This false narrative of historical exclusivity occurs in modern herbal classes as well. In this case it’s an example of creating scarcity to sell you something. To be fair to a lot of my colleagues, it seems the idea was passed on to them. When people who own specialty health food stores or companies that sell herbal products are the ones “reviving your tradition” they tend not to mention the simplest things that don’t require a trip to their shop or website.

This has resulted in the unnecessary overharvesting of a lot of native medicinal plants which is one of the reasons I rarely use them. How many herbal shop owners tell you that arbutin which is the “active constituent” of Uva Ursi is also plentiful in pear skins and cranberry leaves?

Unfortunately, it is also is quite common to see people who have never used home remedies speak very disparagingly of them. Academic types will tell you that folk narratives were used to relay “operant knowledge” along with cultural norms, but it seems like they don’t really recognize that knowledge when they see it. Perhaps they are so removed from a culture in which people learn to take care of themselves that they just don’t see the common sense in folkways even when it is staring them in the face?

I shared this a while ago, but I want to pull it back up as an example of a story that contains a little fancy[v] and a little bit of operant information.

Mrs. Cleary got consumption they said “she was going with the fairies”. Tom Dunn the “man of nine herbs” told them to put her near the fire for that would keep the fairies away.[vi]

Mrs. Kelleher Co. Tipperary

Being “away with the fairies” is a term that originated in the 19th century. A.E.  Russell wrote of it saying, “Many go to the Tir-na-nog in sleep, and some are said to have remained there, and only a vacant form is left behind without the light in the eyes which marks the presence of the soul.”[vii] Despite the fanciful nature of the cause, the symptoms seem to correlate with a mental state of being dissociated perhaps due to shock or trauma.

When someone is in shock or has recently experienced severe trauma, it is quite useful to warm them up. It’s one of the things they advise you to do in first aid classes and in psychological first aid classes. That’s why you see everyone wrapped in blankets during a disaster response. You often see people in the stories advised to put changelings to the fire and I tend to believe this is all that phrase meant. I’ve also seen stories that advise splashing the afflicted’s face with cold water or chafing their hands.

Another example would be the numerous leighseanna (remedies) recommending applying butter to an injured area. People didn’t think butter was some magical cure. They were just massaging the area or chafing the skin. Chafing, which is the practice of rubbing the skin vigorously until it’s red to draw circulation to the area, is still done commonly by CNA’s and we still send people to licensed massage therapists. It’s not that odd once you think about what is being done in the simplest of terms. That’s the kind of critical thinking that it is useful to apply to what you read folklore. Look for common sense and set aside the fanciful, if you are so inclined.

Hopefully, these examples also hint at the idea that domestic medicine isn’t only about making homemade herbal remedies. It involves supporting someone through an illness by providing comfort and nourishment. That is intrinsically different from telling someone to take a tincture and some supplements three times a day while putting them on a restrictive diet. There are a lot of herbal practitioners out there who have clearly never provided primary care for a sick person at home and lack those skills as surely as a lot of medical physicians do.

Covid really made that apparent to me. We are going to talk about all of it because caregiving is a skill that we cannot afford to let disappear. At the end of the day modern medicine can’t do much other than to send people home to muddle through Covid as best they can. Nurses I had taught continuing education classes started calling me when they got sick and referring people to me for help. That’s what made me think it was time to do something with this website.

For those of you who haven’t grown up being exposed to these skills, I am attaching my introductory eBook on caring for the ill that I give to my students when they first start learning with me. I think you will find that it covers far more than just how to make herbal cough syrup.


[i] Mooney, James. The Medical Mythology of Ireland. Philadelphia, PA: MacCalla  & Company, 1887.138. Mooney uses a less familiar term cailleach luibh [herb hag] pronounced cawl-yakh liva. He does not equate the word cailleach with witch. He talks about witches later saying “Irish witches usually confine their operations to stealing butter and seldom harm the owners.”
[ii] Paul, George P. (George Phillip). Nursing in the Acute Infectious Fevers. Philadelphia, PA: Saunders, 1906. http://archive.org/details/nursinginacute00paul.
[iii] Súilleabháin, Seán Ó. Irish Folk Custom and Belief. Published for the Cultural Relations Committee of Ireland at the Three Candles, 1967.
[iv] The Schools’ Collection, Volume 0848, Page 163  © National Folklore Collection, UCD
[v] I use the phrase “a little fancy” a lot.  It’s from a quote by Melville in which he explains the value of embellishment. “It will be a strange sort of a book, tho’, I fear; blubber is blubber you know; tho’ you may get oil out of it, the poetry runs as hard as sap from a frozen maple tree; . . . to cook the thing up, one must needs throw in a little fancy. . .Yet I mean to give the truth of the thing, spite of this.”  
[vii] A.E. Russell The Irish Theosophist
[vi] The Schools’ Collection, Volume 0656, Page 085 Image and data © National Folklore Collection, UCD.

Published by Stephany Riley Hoffelt

If you want to read more about me, it's on the website www.domestic-medicine.com

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