folk medicine

FOLK MEDICINE

Folk medicine refers generally to healing practices traditionally used for alleviating illness and injury, or to aid in childbirth. It is a category of informal knowledge distinct from "scientific medicine", as well as more formal and systematic, but unscientific, medical practices such as Ayurveda. However, it may coexist with these in the same culture or society. Folk medicine as a system includes: home remedies; folk aetiologies of disease; preventative medicine; reproductive techniques; medicinal properties of plants; anatomical knowledge, and healers. Folk medicine may also include elements from the history of medicine. For example the hot-cold concept of health and illness is absent in Spanish folk medicine and did not exist at the folk level in the past (Tan, 1989). However these beliefs are now widespread in Latin America and the Caribbean, and according to Foster (1953) were derived from the élite and scholarly Hippocratic-galenic traditions that were brought to the Spanish colonies by Spanish physicians and clergy. Spanish medical practice at the time of Cristopher Columbus was based on classical Greek and Roman medicine with diffusions from Arab medicine. Other Hippocratic principles are the oppositions of raw / cooked, hot /cold, wet / dry, sweet / sour. In addition, wellbeing is determined by a balance between different elements, bile, phlegm, and blood (Strobel, 1985).

Classical History

Early recognised compilers of existing and current herbal knowledge were the Greeks Hippocrates, Aristotle, Theophrastus (b. 370 BC), Dioscorides and Galen. Roman writers were Pliny and Celsus (Kay, 1996). Dioscorides (Pedianos Dioskurides) included the writings of the herbalist Krateuas, physician to Mithridates VI King of Pontus from 120 to 63 BC in his De Materia Medica (Codex Vindobonensis) (Blunt and Raphael, 1994). De Materia Medica was translated into several languages and Turkish, Arabic and Hebrew names were added to it throughout the centuries (Blunt and Raphael, 1994). Latin manuscripts of De Materia Medica were combined with a Latin herbal by Apuleius Platonicus and were incorporated into the Anglo-Saxon codex Cotton Vitellius C.III. These early Greek and Roman compilations became the backbone of European medical theory and were translated by the Arabs Avicenna (Ibn Sīnā, 980 - 1037), the Persian Rhazes (Rāzi, 865 - 925) and the Jewish Maimonides (Kay, 1996). Translations of Greek medical handbooks and manuscripts into Arabic took place in the eighth and ninth centuries. Arabic folk medicine developed from the conflict between the magic-based medicine of the Bedouins, the Arabic translations of the Hellenic medicine and Ayurvedic medicine (Slikkerveer, 1990). Spanish folk medicine was influenced by the Arabs from 711 to 1492 (Hernández-Bermejo and García Sánchez, 1998). Translations of the early Roman-Greek compilations were made into German by Hieronymus Bock whose herbal published in 1546 was called Kreuter Buch. A Dutch translation Pemptades by Rembert Dodoens (1517-1585) was translated by Charles de L'Écluse (Carolus Clusius, 1526-1609), and was published in English by Henry Lyte in 1578 as A Nievve Herball. This became John Gerard's (1545 - 1612) Herball or General Hiftorie of Plantes (Blunt and Raphael, 1994; Kay, 1996). Each new work was a compilation of existing texts with new additions.

Women's folk knowledge existed in undocumented parallel with these texts (Kay, 1996). Forty-four drugs, diluents, flavouring agents and emollients mentioned by Discorides are still listed in the official pharmacopoeias of Europe (Blunt and Raphael, 1994). The Puritans took Gerard's work to the America where it influenced American folk medicine (Kay, 1996). Francisco Hernandez, physician to King Phillip II of Spain spent the years 1571 - 1577 gathering information in Mexico and then wrote Rerum Medicarum Novae Hispaniae Thesaurus, many versions of which have been published including one by Francisco Ximenez. Both Hernandez and Ximenez fitted Aztec ethnomedicinal information into the European concepts of disease such as "warm", "cold", and "moist", but it is not clear that the Aztecs used these categories (Ortiz de Montellano, 1975). Juan de Esteyneffer's (Johann Steinhöfer) Florilegio medicinal de todas las enfermedas compiled European texts and added 35 Mexican plants. This Florilegio is still used by Mexican healers. Martin de la Cruz wrote an herbal in Nahauatl which was translated into Latin by Juan Badiano as Libellus de medicinalibus indorum herbis or Codex Barberini, Latin 241 and given to King Carlos V of Spain in 1552 (Heinrich et al., 2005). It was apparently written in haste and influenced by the European occupation of the previous 30 years. Fray Bernadino de Sahagún’s used ethnographic methods to compile his codices that then became the Historia General de las Cosas de Nueva Espana, published in 1793 (Heinrich et al., 2005). Castore Durante published his Herbario Nuovo in 1585 describing medicinal plants from Europe and the East and West Indies. It was translated into German in 1609 and Italian editions were published for the next century.

Maria Mies linked the burning of female herbalists as witches in Europe to the rise of capitalism and the development of male-dominated medicine and law in the Middle Ages. This argument has been followed more recently by Silvia Federici who writes that the witch burning was designed to crush the economic independence of women. "The persecution and burning of the midwives as witches was directly connected with the emergence of modern society: the professionalization of medicine, the rise of medicine as a ‘natural science’, the rise of science and of modern economy. The torture chambers of the witch-hunters were the laboratories where the texture, the anatomy, the resistance of the human body — mainly the female body — was studied. One may say that modern medicine and the male hegemony over this vital field were established on the base of millions of crushed, maimed, torn, disfigured and finally burnt, female bodies.

There was a calculated division of labour between Church and State in organizing the massacres and terror against the witches. Whereas the church representatives identified witches, gave theological justification and led the interrogations, the ’secular arm’ of the state was used to carry out the tortures and finally execute the witches on the pyre. Mies, 1986".

Folk medicine is sometimes associated with quackery when practiced as theatrics or otherwise practiced fraudulently, and sometimes with witchcraft and often with shamanism, yet it may also preserve important knowledge and cultural tradition from the past. Practicing scientists sometimes go out of their way to suppress alternative medicine (see Angell and Kassirer, 1998 and BMJ 2007 September 29; 335(7621)). In a fertility survey (Anderson and Cleland, 1984) women who said they used herbs as contraceptives (93.5 % of women in Bangladesh) were placed in the category 'not using'. However unbiased scientific analysis requires that all knowledge claims be subjected to a minimalist standard of rationality that requires that belief be apportioned to evidence and that no assertion about folk medicine or 'theory' be immune from or rejected without critical assessment (see Hawkesworth, 1989). The International Council for Science (ICSU) was asked to carry out a study on the concept of 'traditional knowledge' (Dickson, 1999) in the context of the signing of the Declaration on Science and the Framework for Action at the 1999 World Conference on Science in Budapest, and the 26th General Assembly of the ICSU in Cairo, Egypt (Nakashima and Guchteneire, 1999). Prior to the signing debate took place on whether indigenous knowledge (IK) was scientific or not and scientists expressed surprise at seeing the issue on the agenda. Scientists suggested that including indigenous and traditional knowledge on the agenda might lend ill-deserved credibility to IK or open the door to anti- and pseudoscientific approaches like creationism and astrology. Nakashima and Guchteneire (1999) wondered whether the discomfort of the scientists might be related to their unwillingness to view science as one knowledge system among many. The debate led to a discussion on the nature of scientific knowledge itself; for example what makes the theory of natural evolution 'scientific' and thus distinguishable from astrology when neither can be replicated or reproduced? (Anon, 1999).