Multiple Medical Realities

My original motivation for this site was to create a link I could send to people who messaged me after taking one of my history classes at herbal conferences. Those of you who have been to one of my classes will recognize this as the content I cover on my first slide.

Like most anthropology students interested in medical anthropology, I was assigned Arthur Kleinman’s Patients and Healers in the Context of Culture.  Classifying things helps my brain, so I was drawn to the way he breaks down the various components of healthcare in societies.

To teach this at conferences, I had to tweak a couple of things to line up with the language modern herbal practitioners use. In most people’s minds the practice of domestic medicine is lumped together with ritual healing practices, and they call that “folk medicine” or “traditional medicine” which causes a lot of confusion. It often results in the use of herbal remedies becoming exclusively associated with magic workers in a society and that’s not how it works. Consequently, I have moved even further away from the use of the term “folk ” in recent years.

Popular Sector – Domestic Medicine
The term domestic medicine refers to self-care, or familial care, practices informed by popular knowledge. Historically, domestic medicine was grounded in autonomous self-care and common production of locally available remedies. It is an empiric practice grounded in experiential knowledge and not bogged down with a lot of theory.

Knowledge of this nature is passed down through the generations or via community skill- sharing networks. In some populations most of this transmission is through word-of-mouth, but medicinal formulas have also been recorded in the form of manuscript recipe books, commonplace books, and journals. We have a rich paper trail of the kinds of household remedies used by people throughout written history and there is archeological evidence that gives us a glimpse at prehistorical use, as well.

Gradually people of means began to buy over-the-counter herbal preparations from apothecaries.  These days pharmaceutical and nutraceutical companies have co-opted self-medication, but it is still the primary form of healthcare in the US.  Every time someone takes ibuprofen for a headache, or sprays Biofreeze on a pulled muscle, they are practicing domestic medicine.

The best summarization I have seen of the way domestic medicine worked historically was something James Mooney said in 1887. Mooney was American ethnologist born to parents from Co. Meath who was sent to Ireland by the US Bureau of Ethnology to observe Irish folk practices. 

“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].^[1]

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

Ritual Healing Specialist
This brings us to the next sector. In most cultures we find specialists, such as the cailleach luibh working from a framework influenced by Indigenous beliefs. One belief across many cultures is that illnesses are thought to be attributable to supernatural causes such as demons or ghosts. Anthropologists sometimes call these personalistic illnesses. 

To cure these illnesses, ritual healing specialists use supernatural means to discover the cause and cure the illness. I call them ritual healing specialists. Julian Goodare who put the database of the Scottish witch trials online calls them “traditional magical healers.” Ronald Hutton calls them “service magicians” which I also enjoy a great deal. The terms are simply to distinguish them from those magic users in the community who are thought to do harm by uncanny means or maleficence.

The ritual healing specialists in a community use benevolent magic. They channel magical healing power and are sometimes responsible for undoing the harm done by another. They might speak pisreóga, charms, incantations, or prayers while leading their patients through elaborate healing rituals.  They might work these rituals with sacred herbs, but they also work with other natural items like magical water, stones, or amulets. They might be a priest who performs an exorcism. The point of distinction here is that these healers have far more in their repertoire than the therapeutic delivery of plant medicine.

There has been a lot written by anthropologists about the ritual practices of Indigenous cultures all over the world. The problem with reading those works is that we cannot always trust that the observations made by those researchers were accurate. Prejudices often distorted their observations, and they frequently took practices out context because they did not understand the Indigenous framework they were observing. Sometimes they were being purposefully misleading in order to justify land grabs and ethnocide.

US government ethnographers sent to gather information about various Indigenous groups were the worst. Many of them were missionaries who used terminology about witchcraft to describe Indigenous practices without bothering to distinguish between service magicians and those considered threat to their community. For example, a “witch doctor” was a service magician who used benevolent magic to heal someone who had been harmed by maleficence, but the term was thrown around indiscriminately to refer to anyone who used magic and even some people who were just using plant medicine to heal an illness.

It’s worth pointing out that I use the term “witch” when referring to those who would cause harm. Witch is derived from the old English words “wicca” and “wicce” which are tied to the Old English word “wǽcan” meaning to weaken, oppress, or trouble “wác.” There is not really a word that is an accurate translation for that in the Goidelic languages.

I won’t be spending a lot of time talking about ritual healing specialists on this site, although there is definitely some overlap at times. There are enough blogs out there trying to cash in on the “witchy” trend and I prefer to spend my time lifting the voices of people whose contributions have been less sensationalized.

Professional Practitioners
The professional healthcare sector is comprised of trained providers such as medical physicians, nurse practitioners, naturopathic physicians, herbal clinicians, chiropractors, and so on. They engage in their practice as a means of supporting themselves financially — either by charging clients or through patronage.

Achieving professional status typically involves academic training, apprenticing oneself to an established practitioner, or both. This is still how the AMA works modernly. You first go to medical school and your residency is your apprenticeship.

Professional practitioners tend to believe that illnesses have mechanistic causes that are to be diagnosed and treated by the application of whatever theory of medicine they practice.  In the early modern era, humoral medicine was just as mechanistic in nature as germ theory is today.

Midwifery
To me midwives hold in a confusing place in all of this, so I am giving them their own space. Technically, the term translates simply to “with the woman” and was used to refer to the professional in the community who helped deliver babies and provide care for women. There were midwives who were part of the professional sector. Professional midwives were sometimes even called in to examine women and help identify witch marks.

But many midwives were not professionals in the modern sense. My great-grandmother attended births in her community for decades. She was also known for sharing her knowledge of home remedies with younger women in the community.  We are fairly certain no one ever paid her, except maybe with some eggs or a chicken?  So, I consider her to be a part of the popular healthcare culture of her community, but other researchers might argue that classification.

Final Words
You will note my research is focused mostly on Britain and Ireland. I choose to focus on the knowledge that informed my cultural practices and traditions.  As a leftist who is actively working against such things, I would be the worst sort of hypocrite if I capitalized on anything else. That is cultural appropriation and I want no part of it.

I hope that this website inspires people from divergent backgrounds to research their culture and find their stories.  I would love to hear them and promote your work, but as I have mentioned elsewhere those are not my stories to tell.