Cultural Anthropology/Health and Healing

Theoretical Approaches in Medical Anthropology

Three theoretical approaches exist in understanding human health. First, is the epidemiological or the ecological approach. This approach examines the way culture and the natural environment interact to create the patterns of which result in health and disease. The second is the interpretivist approach, which looks at the way cultures use symbolic meaning to describe and understand health and disease. The third is critical medical anthropology, which focuses on how socioeconomic and political factors affect human health.

Epidemiological Approach

Epidemiology is the study of factors that affect health and disease among populations and is considered a fundamental aspect of public health research. Epidemiology focuses on identifying disease risk factors based on how, when, and where they occur. By collecting this data, epidemiologists provide data for measuring the occurrence of health phenomena. Anthropologists may use this approach to examine cultural patterns such as food, work location, sexual activity, water, and medical practices that may affect or show a correlation with the prevalence of a particular disease. Epidemiology involves the usage of mapping out diseases and showing where in an environment that disease arose. This can be done using geographic information systems to identify where in a population a disease has spread and how far. (http://www.spatialepidemiology.net/)

In addition, epidemiological studies are divided into two types: Retrospective and Prospective. Retrospective describes whether the events have already occurred and Prospective describes whether the events may occur in the future. Retrospective studies are the most common of epidemiological studies and are also known as case-control studies. Case-control studies take place when there is an outbreak of disease in the population and the cause of the disease is unknown or when the population is not familiar with the disease. (http://pmep.cce.cornell.edu/profiles/extoxnet/TIB/epidemiology.html)

Interpretivist Approach

Cultures throughout the world use different systems of meaning to describe and respond to illness. Anthropologists who study these differences with symbolic meaning employ the interpretivist approach to medical anthropology. This approach looks at illness from an emic perspective attempting to understand health and disease relative to a particular culture. Using the emic approach allows the anthropologist to understand the illness from the internal perspective of the subject rather than from an outsiders viewpoint. By gaining an emic perspective on a culture, medical anthropologists can further understand that notion of "embodied person-hood." Embodied person-hood is defined as the relationship of cultural beliefs and practices in connection with health and illness to the sentient human body, this is the core focus for anthropologists using the interpretivist approach.

Critical Medical Anthropology

Critical medical anthropology focuses on how economics and politics shape the overall status of human health. Critical medical anthropology addresses the disparities in the quality of health and care in the presence of social inequalities. Social divisions based on race, ethnicity, gender and class can influence access to health care and susceptibility to disease. Critical medical anthropologists acknowledge these social factors when looking at the prevalence of a particular disease and ways to prevent it. In a 1998 study of inner-city Hispanic children, critical medical anthropologist Merrill Singer found that food insecurity and hunger were prevalent conditions. By identifying variables associated with these conditions, Singer was able to determine risk factors for food insecurity and hunger that could be used by policy makers to improve food programs and public health policy. Critical medical anthropologists have worked hard to critique bio-medical practices to decrease health problems such as hunger, malnutrition, and disease in order to promote wellness.

Ethnomedicine

Ethnomedicine refers to the medical systems based on the cultural beliefs of varying ethnic groups (e.g. Traditional Chinese Medicine).

1. Ethno-nosology: Refers to the cross-cultural systems of classification of health issues.. In a wide sense, nosology deals not only with diseases, but with any kind of medical condition, like injuries, lesions or disorders. Medical conditions, like diseases, can be defined by cause, pathogenesis (mechanism by which the disease is caused), or by a collection of symptoms, medical signs and biomarkers, particularly when the other two definitions are not available (idiopathic diseases). From a nosological point of view, medical conditions could be divided in disorders, diseases, syndromes, lesions and injuries, each one with some specific meaning

2.Culture-bound syndromes: Also known as culture-specific syndrome, or folk illness, is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease, whether it be psychological or physical, only within a specific society or culture.

3. Disease/Illness Dichotomy: Dichotomy is the division of one thing into two parts or a subdivision into halves or pairs. In medical anthropology, the two aspects of sickness are divided to better care and heal those in need. Disease and Illness are two very different things in the medical field that are responded in different ways. Diseases are the biological and psychological malfunctioning of the body physically. Illnesses deal with the psychology of the human where the psychosocial experiences bring on the sense of illness or disease.

4. Diagnosis/Divination: A diagnosis is the act of identifying or determining the nature and cause of a disease or injury through the evaluation of a patient. Divination is the seeing of future events or somehow gaining unknown knowledge through the supernatural.

Traditional Healing and Western Medicine

Cultures around the world offer various perspectives on the relationships between healing, spirituality, and illness. The coexistence of traditional and biomedical healing systems common in many places, and finding somewhere where only one method is relied upon is difficult. Medically pluralistic societies and cultures provide a variety of treatment options in both traditional and modern practices.

Traditional healing is largely regarded as the oldest form of structured medicine, and from it came the later forms of medicine commonly practiced. Traditional healing was originally an integral part of semi-nomadic and agricultural tribal societies, and involved the use of ceremonies that included plant, animal or mineral- based medicines, energetic therapies, or physical techniques. Common medical practices and persons that lie in the realm of traditional healing include acupuncture, herbalists, shamans, and faith healing.

Western medicine, compared to traditional healing, bases its theories and practice of medicine on the scientific method and on knowledge supported by scientific research. The practice is more based in empiricism rather than culture, but its effects and use can be seen in a wide variety of societies. Many civilizations, both current and early, utilized forms of Western medicine including Ancient Egypt, Greece, and the Medieval Arab Empire. Modern day Western medicine was considered to have been developed around 300 BCE by Hippocrates. Common medical practices and persons employed by Western medicine include surgeons, physical therapists, psychiatrists, and dentists.

The "sick role" is a term used in traditional medicine that is prevalent in western societies. It is culturally defined as an agreement between the patient and family members of the patient to acknowledge that the person is sick. Examples of this can be seen when a person has cancer and is encouraged by his or her family to seek treatment, thus acknowledging the sick role in the process.

Often in Western culture, traditional healing concepts still exist in the form of various superstitions and traditions. The concept of the Aphrodisiac though it has little scientific backing is still common in western culture. An Aphrodisiac is a food or substance that is believed to increase sexual energy or prowess. Examples of aphrodisiacs differ between cultures examples include oysters in English speaking countries, Balut in the Philippines, and Durian throughout Southeast Asia.

Healing Substances

Cultures use a variety of different substances for healing. Some cultures rely on drugs to induce a state of healing, while others put their lives in the hands of healers such as shamans to regain health. In many cases, people rely on both medical pluralism and medical syncretism. Medical pluralism refers to the integration of biomedicine and other forms of healthcare, while medical syncretism is the fusing of more than one medical practice, such as fusing spiritual practices with biomedical practice. It is important to note that in many cases the state of healing that is accomplished in one culture may not be able to be accomplished in another due to differing perspectives on how the substance is meant to affect a person. For example, there is a vast difference between the use of drugs for recreation and their use for healing. In some cultures it is believed that during drug use a person reaches a heightened state in which they are able to begin healing, whereas in other cultures this heightened state is used for pure enjoyment.

A flowering peyote, in cultivation.

Examples of healing substances include Peyote, a rare cactus found in Mexico containing the chemical mescaline which induces hallucinogenic experiences if ingested properly. This cactus has historically been used ritualistically in many indigenous cultures. It causes an enhanced feeling of introspection and visual or audio hallucinations. Another example is the magic mushrooms of Oaxaca, similar to the Peyote in which the consumer enters a psychedelic state and is able to allow the mushrooms to heal themselves spiritually and physically. Ayahuasca is an Amazonian plant mixture that is capable of inducing altered states of consciousness, usually lasting between 4 and 8 hours after ingestion. Shamans or medicine men take ayahuasca to communicate with nature or to see what is causing a patient’s illness on a spiritual level. The drink is taken in the form of tea, typically in a ceremonial session under the guidance of an experienced drinker. The main ingredient of this jungle tea is a vine, Banisteriopsis caapi, which like the tea itself is also called ayahuasca (which means ‘vine of the soul’ or ‘vine with a soul’). This vine is combined with a variety of plants that contain the psychedelic drug DMT. The Banisteriopsis caapi contains an MAOI, which allows the DMT to be active orally. Coca, tobacco and alcohol can also be considered healing substances and are more prevalent across cultures than the aforementioned drugs.

Ethnobotany

Ethnobotany The study of native plants that is used by a particular culture. The study of these plants is used to garner accurate understanding of their medical potential and cultural usage. An ethnobotanist's job is to travel to different locations in the world for the purpose of studying the relationships between plants and culture. Their knowledge is gleaned from the perspective and information provided by the culture with which the plant is used. Ethnobotanists look for plants which effectively treat disease or relieve symptoms. These plants can then be synthesized into medication to provide treatment for other populations.

Mayan priest performing healing

The roots of ethnobotany can be traced back to an ancient Greek surgeon named Dioscorides. He was the first person to organize plants into specific classifications. Around AD 77, Dioscorides produced the publication, “De Materia Medica”, which consisted of information on all the plants he researched. This botanical reference book compartmentalized approximately 600 plants. It also included facts about the plants such as; what season it was in bloom, how to use it medicinally, its toxicity level and whether or not it was edible. In 1542 Leonhart Fuchs achieved a similar feat when he published, “De Historia Stirpium”, another botanical reference book that catalogued plants indigenous Germany and Austria (the book contained information on about 400 plants). Another important figure in the development of ethnobotany was John Ray. He was the first person to understand and explain the concept of species; he also produced important publications such as, Catalogue of Cambridge Plants, Synopsis Methodica Avium et Piscium and Methodus Plantarum (works were published between 1660–1713). The methods for categorizing plants continued to develop and it reached its apex with a Swedish medical student named Carl Linnaeus. Linnaeus invented the classification system known as taxonomy. This system of classifying organisms is still utilized in contemporary times. His book, Species Plantarum, had listings for approximately 5,900 plants. The term ethnobotany was developed by John Harshberger around 1895. Harshberger was the professor of botany at the University of Pennsylvania. He spent many years traveling the globe researching and cataloguing different regions native plant life.

Ibogaine

Iboga, a principal component of ibogaine

As stated previously, ethnobotany is the study of how a culture uses its indigenous plants for medicinal purposes. An example of an idiosyncratic way of healing (pertinent to ethnobotany) can be seen in the religious rituals of the Bwiti. Bwiti is a religion that is practiced by the people of Gabon (a country in west central Africa). This particular creed relies heavily on the use of ibogaine (a powerful psychoactive which is derived from the root of the Tabernanthe ibona shrub). Tabernanthe iboga is indigenous to Gabon and is easily accessible to people of the Bwiti religion. Iboga is most commonly ingested through chewing on the root of the shrub or brewing the plant into a tea. The plant is revered by the Bwiti because of its hallucinogenic properties which cause practitioners to receive revealing visions and deep introspective self-contemplation. Iboga is consumed for religious ceremonies, initiations, coming of age rituals and healing processes. When a person within the Bwiti community becomes ill he or she is fed iboga to get in touch with their imbwiri. The imbwiri is a spirit represented in a human configuration which will either cure the individual or provide valuable information on the antidote. Iboga was brought to Europe by French and Belgian researchers in the late 1800’s. By the 1960’s ibogaine (although still rare) had been introduced to many different parts of the world. (mainly as a psychoactive drug). The medical potential of this drug was discovered by a man named Howard Lotsof in 1963. He realized that this substance could combat heroin and opiate addiction. It also could alleviate the painful and mentally exhausting withdrawal symptoms. Howard cured his own heroin addiction through this method and introduced ibogaine to his friends who were also habitual heroin users with positive results. As time progressed ibogaine was found to be useful in treating many addictions including unhealthy reliance on cocaine, crack, alcohol, methamphetamine, and nicotine. Even though this drug showed potential towards battling addiction it was outlawed in many countries (including the U.S.) because of its hallucinogenic properties. Although ibogaine has been marked illegal there are still underground clinics that provide full treatments serving the drugs medical ideology. Research on ibogaine is still being conducted today and it could eventually become a fully marketable, synthesized anti-addiction medication.

Ayahuasca For thousands of years Amazonian shamans have been concocting and administering one of the most powerful psychoactive substances on earth. The main psychoactive ingredient in Ayahuasca is DMT, and users report life-changing trips, often involving out of body experiences and extraterrestrial contact. Ayahuasca remains a schedule 1 drug in the U.S. and many other countries. The brew is made by mixing Banisteriopsis caapi, which contains the DMT, with Psychotria Viridis, which contains MAO inhibiting alkaloids and allows for oral ingestion. Ayahuasca is gaining popularity in the western world as people attempt to create centers in the U.S. where one can safely consume the drug.

The Candlenut Tree The Kukui or Candlenut tree, is an example of an indigenous plant used by a culture for food, medicine, and other purposes. Native Hawaiians used the nut, sap, and leaves for various everyday uses. The nut, which produces copious amounts of oil, was strung onto palm fronds and used a torch or candle (thus the name Candlenut). The nut was also roasted and sprinkled on food for added flavor, but it was also known to have laxative properties. The sap of the green nut was spread on cuts and cold sores to speed up healing. The leaves and flowers were used for making lei. As a child growing up in Hawaii, my friends and I made spinning tops out of the shell of the nut. Many visitors to Hawaii would recognize the Kukui nut as the black, shiny nut strung on ribbon to make a lei that lasts indefinitely. The unique part about this tree is that all of the components of the tree are toxic, but the seed, leaves, flowers and bark can be all be used in medicine systems if used in the correct way. The candlenut tree provides a multitude of uses including health benefits, decoration, jewelry making, and more.

The Cure-All Herb

The "Cure All Herb" is a herb called Combretum micranthum, but is most commonly known as Kinkiliba. It is found in West Africa, specifically Senegal. This drinking herb has a positive impact on the population drinking it. Kinkiliba is the most common herbal tea found throughout West Africa. Many West-Africans begin their morning with a cup of this powerful tea that is great for maintaining general health and well-being. Kinkiliba is known to aid in the treatment of fevers, colds, aches, pains, and the flu; but is also used to aid weight loss, sleep loss, and even cancer. This herb is a natural diuretic and helps to speed up the healing process when one is ill. One may also apply solutions of the leaves or the roots to speed up the healing of old wounds. This miracle tea is also known to prevent malaria and lower blood pressure. The herb serves as an antibacterial and antispasmodic as well.

The Detoxifying Herb

Kelle (khaya senegalensis) is a common herb used throughout West Africa for a body cleanser and energy booster. West Africans soak the bark in water and drink the mixture for a general detoxification and intestinal cleanser. Kelle is also used to bring down fevers and to combat general fatigue. Khaya senegalensis is very effective when it is used as a body cleanser or an energy booster, but it also has other uses. For example, the seeds and leaves can be used to treat fevers and headaches, and the roots can help with the treatment of mental illness or as an aphrodisiac.

Acacia Senegal

Uses - Gum arabic’s main effect is to form a soothing, protective coating over the respiratory, alimentary, and urinary tracts. In conjunction with various astringents, it is helpful for coughs, sore throat, and catarrh (excessive discharge or buildup of mucus in the nose or throat, associated with inflammation of the mucous membrane.), as well as in cases of diarrhoea and dysentery. The mucilage makes a good vehicle for other medicines, in addition to having nutritional value in its own right. However, most of the gum arabic imported to USA goes to the food industry to give body and texture to products for bakers and a hard sheen coating on candies.

Marijuana

Some cannabis bud, which is well-cured (i.e. dried slowly following a specific procedure). The strain is Sweet Tooth #3

Marijuana has an extensive medical and shamanic history throughout a multitude of cultures. Researchers often site the Chinese to be one of the first cultures to recognize it's medical potential. Author Robert Deitch states, "The Chinese Emperor Fu Hsi (ca. 2900 BC), whom the Chinese credit with bringing civilization to China, seems to have made reference to Ma, the Chinese word for Cannabis, noting that Cannabis was very popular medicine that possessed both yin and yang." Marijuana has long been used in Chinese medical practices. Other cultures such as the Egyptians, going as far back as 1213 BC, have made use of cannabis. It was found in the tomb of Ramesses II. Ancient Egypt would often use marijuana for a myriad of issues such as inflammation, psychological problems, treat glaucoma, cataracts, hemorrhoids, vaginal bleeding, in addition to many other issues. In modern America, the homeopathic potential of cannabis only just began to be recognized in 1973 when Oregon decriminalized the use of marijuana. It wasn't until 1996 that California became the first state in the United States to legalize medical marijuana. Recently the use of medical marijuana has become much more widespread across the country. The most common use for medicinal cannabis is pain management, specifically for patients with long term illnesses, such as cancer. Muscle spams can be much improved with the use of medicinal marijuana, especially in the case of treating multiple sclerosis. Cannabidiol, also known as CBD in marijuana is the non-psychoactive, medicinal part of the cannabis plant. CBD unlike THC, the active ingredient in the plant that creates the euphoric “high”, is almost exclusively used for medicinal purposes. If one where to intake only the CBD parts of the herb, one would only feel pain relief, in addition to relief of any specific ailments they may have – such as an epileptic’s reduction in seizures. In conclusion, marijuana has numerous medicinal properties that have been respected and cultivated by cultures throughout our long human history.

Echinacea

Native to North America and has long been used by the Plains Indians for its medicinal properties. It is believed to shorten the duration of a cold and treat many of the symptoms such as coughing, sore throats, and headaches. Recent studies have suggested that Echinacea has little or no effect on the duration or severity of a cold, and it is merely taken to provide some sort of comfort to the sick person, in many ways a placebo. The effectiveness of Echinacea is still a subject of debate, but it remains a culturally important remedy in North American ethnobotany.

Goldenseal

Also known as Orange-root, Orangeroot, or Hydrastis Canadensis, is a perennial herb in the buttercup family Ranunculaceae, native to southeastern Canada and the northeastern United States and is another prominent herb used in North America. Goldenseal was in extensive use among certain Native American tribes of North America, both as a medicine and as a coloring material. Goldenseal was extensively used for cancers and swellings of the breasts by the Eclectics, although it was not considered sufficient for cancer alone

Pacific Yew

Also known as taxus brevifoila or the Western Yew, is a small fir like a tree that can be identified by its flaky bark, as well as its flat needles that protrude horizontally from either side of the twig. It is usually found in shaded environments alongside trees such as Douglas firs and hemlock. The bark is a traditional medicine used for “internal problems like ulcers and liver ailments”(Turner & Hebda). In recent years Yew bark has become famous for containing a cancer-fighting compound called Taxol that slows or stops cell replication in cancer cells. It is most commonly used in the treatment of breast, lung, and ovarian cancer. "Pacific Yew, Taxus Brevifolia." Native Plants PNW. N.p., n.d. Web. 01 Dec. 2016. "Paclitaxel (Taxol®, Abraxane®): Cancer Drug Information | CTCA." CancerCenter.com. N.p., 01 Jan. 0001. Web. 01 Dec. 2016. "Taxus Baccata (common Yew)." Taxus Baccata (common Yew) | Plants & Fungi At Kew. N.p., n.d. Web. 01 Dec. 2016. Turner, Nancy J., and Richard J. Hebda. Saanich Ethnobotany: Culturally Important Plants of the WSANEC People. Victoria, BC: Royal BC Museum, 2012. Print.

Essential Oils

Another form of ethnobotany that has been on the rise in popularity in the United States is the use of 'essential oils'. Essential oils are potent oils that are “extracted from flowers, barks, stem, leaves, roots, fruits and other parts of the plant by various methods” (Ali, et al., 2015). Those who use them believe that they are nature's medicine, and if used properly can treat many infections and ailments, replacing or assisting modern medicine. Through laboratory studies, scientists have found that these oils contain antiseptic and skin permeability properties. Certain essential oils can be even more effective than pharmaceutical antibiotics due to their complex chemical makeup.

One popular way that essential oils are used is through aromatherapy. “Inhalation, local application, and baths are the major methods used in aromatherapy that utilize these oils to penetrate the human skin surface with marked aura” (Ali, et al., 2015). Through use of single oils, as well as combinations or mixtures of oils, people have used essential oil aromatherapy to get relief from “numerous ailments like depression, indigestion, headache, insomnia, muscular pain, respiratory problems, skin ailments, swollen joints, urine associated complications, etc.” (Ali, et al., 2015).

Many are still skeptical of its use, the FDA has not approved of the oils act as medicine. However, use of plants has been the way that many cultures have historically gone about creating medicine, and the effectiveness of essential oils has been proven to many who choose to fight their ailments a more natural way. Some examples of essential oils are Lemongrass, peppermint, orange, and countless others all of which can be used in different ways. Essential oils are starting to become more well known and potentially used on an everyday basis for some, and they are easy to find at pretty much any local grocery store or market.

Critics of Ethnomedicine

Although most individual ethnomedical practices have been criticized for various traits they possess (e.g. claims of spiritual healing being a hoax, psychiatry not being able to cure alcoholism), one argument stands out as criticizing almost all forms of ethnomedicine. This argument criticized the mental orientation of most forms of ethnomedicine. Biologist Horacio Fabrega Jr. Writes:

The implicit assumption adopted by the researcher is that he is dealing with a disorder that is either typically psychiatric or at least psychiatric-like. Excessive preoccupation with this dimension on the part of culturally oriented anthropologists has tended to obscure the influences that biological components have on [culturally defines] illnesses. Consequently, the potential of examining the reciprocal influences that psych culture and biological factors have on instances of illness occurrence [as defined and categorized by subjects] has been missed.

Doctors and anthropologist who practice ethnomedicine experience criticism for making the assumption that an ailment can be cured using ethnomedicine without weighing the possibility of biological medicine.

Biopiracy

Biopiracy is the exploitation of plant and animal species by foreign entities to restrict their general use. There are two parts to biopiracy, being bioprospecting that exploits plant and animal species by claiming patents to restrict their general use. The second piece is the 'piracy', this takes place when individuals or corporations patent these plants and the methods of processing plant based substances, aromas or the genetic information for their exclusive use and sale. The patent often prohibits the communities that identified or actively use the bio active properties, developed processing and extractive technologies and bred the plants, for personal use or sale.

A related concept is bioprospecting. This term is sometimes used to refer to biopiracy with a less negative connotation, where the assumption is the patented item had a known use already. Alternately, the bioprospecting company is searching for novel compounds or genes in items that were not used traditionally. Companies can harvest plants or organisms with little to no opposition in some parts of the world, and then patent any part of them that ends up being useful.

An example of biopiracy was the basmati rice patenting! Basmati is a variety of long, slender-grained aromatic rice which is traditionally from the Indian subcontinent. In 1997 the US Patent and Trademark Office (USPTO) granted a patent (No. 5663484) to a company called 'Rice Tec Inc' based in Texas. There have been many efforts by the Indian government to reclaim the use to their traditional rice grain and to some avail. In one attempt the Indian government filed fifty-thousand pages of evidence to prove that high quality basmati rice varieties already contain the qualities that Rice Tec Inc had patented. Due to a large movement against rice Tec in March 2001 the USPTO rejected seventeen of the twenty claims the patent was based on!

Medical Systems

Naturalistic System

Naturalistic Systems can be an approach to the explanation, diagnosis, and treatment of illness which focuses on the underlying bio-mechanical processes behind human disorder. Naturalistic medicine is largely the foundation of the Western model of bio-medicine and practitioners rely heavily on the use of imaging technologies and the scientific method to develop treatment plans. Philosophically, naturalists approach human disorder from the perspective that illness is impersonal and that there is always an identifiable source of pathology in the diagnostic process.

Personalistic System

Largely uncommon in the developed world, the personalistic approach to medicine explains human disorder in terms of preternatural sources of pathology (such as spiritual possession or religious transgression). Illness is considered unique to the patient and medical practitioners often call upon supernatural forces to facilitate the diagnosis and treatment of disorders because the illness is caused by supernatural forces as well. An example of this is the “evil eye.” A person who is envious of another’s good fortune may transfer malignant influence through the “evil eye”, which will result in harm to the recipient.

Modernly, personalistic systems of medicine are most commonly found in small-scale societies. Globally, the personalist approach in decline and has disappeared completely in some cultures. For example, therapeutic shamanism was commonly practiced amongst Inuit peoples and a complex tradition of spiritual healthcare was reported by early ethnographers (see Merkur 85). These traditions are now very rarely practiced and many of the traditional practices have been lost entirely (see Shamanism amongst Eskimo peoples).

Medical Models

Medical models are the explanations of health and illness that are accepted by different cultures. The biomedical model is the most widely accepted medical model by many cultures, including the vast majority of Western culture, but there are multiple other explanations that are accepted by some cultures.

The medical model of disability is a model by which illness or disability is the result of a physical condition, is intrinsic to the individual (it is part of that individual’s own body), may reduce the individual's quality of life, and causes clear disadvantages to the individual.

Some anthropologists believe that the biomedical model is quite provincial. They do not believe that there is enough room for the interpretation of the psychological, behavioral, and social aspects of all of the illnesses. Something called a biopsychosocial [2] model has been proposed. In this there would be more room different aspects of health care.

Humoral

The term Humoral refers to elements in the blood or other fluids that reside within the body. In medicine,the term humor refers to a fluid substance. The aqueous humor is the fluid that normally resides within the front and rear chambers of the eye. The humors were part of an ancient theory that believed that health came from balance between the bodily liquids. These liquids were termed humors. If these fluids were not balanced, a person was more likely to become infected with diseases.

Paired qualities were associated with each humour and its season and element,the humors were:

1. Phlegm: winter, water, characteristics: rational, calm, unemotional
2. Blood: spring, air, characteristics: courageous, hopeful, amorous
3. Gall: (black bile thought to be secreted by the kidneys and spleen) autumn, earth, characteristics: analytical, wise, despondent
4. Choler: (yellow bile secreted by the liver) summer, fire, characteristics: short-tempered, fast, irritable

This theory which was also known as the humoral theory, humoralism, and humorism was devised before the time of Hippocrates (c.460-c.375 BC). Today pathology rests on a cellular and molecular foundation. All of the humors have been dispelled, except for the aqueous humor and vitreous humor of the eye. The theory of humors was commonly used until the nineteenth century when modern medical techniques were developed.

The health and healing system of Haiti incorporates humoral-influenced concepts from West Africa. Their system relies on monitoring and regulating their four humors (hot and cold, dry and wet). Eventually their system was simplified, with the dry and wet humors being omitted. They believe a balance is necessary to maintain good health. The balance is affected by the season, how they live and especially how they eat.

Kallawaya Traditional Medicine

The shamans of the Kallawaya people, located in the Andes in Bolivia are an example of humoral medicine. They believe that health and illness are affected by the balance of spirit and soul caused by the earth, or the goddess Pachamama. Their healing art is based in their ability to look into the lives of the ill to see patterns in the day to day aspects such as work, health, routines and relationships and to recognize where there are imbalances. Shamans make use of music, dance, and animal sacrifice to help appease the divine, thus curing illness. The shamans use many herbs, for instance most of the Kallawaya healers have knowledge of at least 300 herbs. They also incorporate alcohol and ayahuasca, which, with the guidance of the shaman, can produce a drug-induced state of healing

Ayurveda

Dwanandhari Deva is believed to be the Lord of Ayurveda

Ayurveda is a 5000-year old traditional system of medicine in India that originated during the Vedic period of Indian history. [3] It is also practiced as an alternative system of medicine in other parts of the world, where yoga, meditation, massage, or healing herbs or foods are used as a supplement to the biomedical model.

Ayurveda is a humoral system, in which blood, chyle, flesh, fat, bone, marrow, and semen are the primary elements. These are divided into air (or spirit), phlegm, and bile, each of which represent a divine force, or dosha. The three doshas are vata (air), pitta (bile) and kapha (phlegm). According to Ayurveda, humans are dominated by one or two of these doshas. Having a balance between the three means that one is in complete health. This balance is achieved through moderation of sleep, sexual intercourse, medicine, and food. Different types of foods are beneficial to people of different doshas. When the doshas are too far out of balance, it can lead to both physical and mental sickness.

Ayurvedic practices include hygienic rituals, ingestion of certain foods and herbs as treatments, and yoga or meditation. The balance between the physical and mental is an important aspect of Ayurvedic healing.

Spiritual Healing

A man practices yoga meditation outside.

Spiritual healing practices transmit energy to a person in need through means of meditation, prayer, or the presence of a healer, and provide an alternative to standard medical procedures. It is part of the holistic approach to healing which involves the unification and harmony of the mind, body, and spirit in order to achieve wellness. Sickness often originates in the mind so spiritual healing can be beneficial in alleviating stress, coping with emotional issues, and increasing overall happiness. The absence of such mental problems can eliminate physical troubles. For example, meditation aids in lowering heart rate, decreasing high blood pressure, and lessening cholesterol levels because it clears and calms the mind to the extent that stress does not affect the physical state of the body.

A popular and recommended act of spiritual healing, is found in Yoga. It has been said by many that it allows and gives a sense of self-awareness, benefits to positive mental presentation, and overall encourages personal strength and confidence through living a spiritual and healthy lifestyle.

Another act of spiritualism comes through shamanism and shamanistic rituals. The shaman is a person in the community who has been given the power of healing sometimes through divine annunciation, Where god or some form of a deity gives the person the ability to heal. This healing can come in several forms, that of rituals that give the shaman the power to heal, such as the trance dance or boiling energy that the !Kung perform. Another for comes as herbs and medicine that the healer gets knowledge about from the divine connection that they have.

Religion often plays a role in spiritual healing in that people form a relationship with a higher source and are able to channel energy from such a source. This being could be God, nature, or something else meaningful to the individual. It is important to note that if the individual who chooses to form this connection holds full commitment and trust in the higher source, feelings of security, peace of mind, and guidance and are likely to follow, all of which are essential in maintaining a healthy lifestyle.

Kundalini Tantric Yoga

A popular form of spiritual healing is found in Kundalini Tantric Yoga, practiced in various parts of India and the United States. Kundalini energy refers to dormant or spiritual energy within the body that we are usually unaware of. Once Kundalini energy is activated through deep meditation and yoga, the Nadi system, referring to channels of Kundalini energy, is activated as well. This creates a connection between the seven levels of chakras; the centers of consciousness potential that reside along the spine. Each chakra corresponds to a set of desires connected to a certain element.

The seven different chakras pictured in their locations, with the exact number of petals each chakra is said to have.

The first of the seven chakras is called the Muladhara. Its color is red and it is said to lie between the genitals and the scrotum. It governs sexuality and instinct. The second chakra is orange and it is called the Svadhisthana. It lies on the belly and is said to govern, among other things, creativity. Manipura is the third chakra. It is yellow, lies just under the solar plex and controls one's will power. The fourth chakra is the Anhata. Anhata is located near and governs the heart. It is the color green. Vishuddha is the fifth. Its color is turquoise and it governs the voice. It is located in the throat. Ajna, the sixth chakra, is indigo blue. It lies in the brain and governs wisdom. The final chakra can only be tapped upon once all the other chakras have energy flowing through them. It is called Sahasrara. It is purple and it brings enlightenment. It sits on top of the head and is said to inspire universal consciousness and unity.

The goal of Kundalini Tantric yoga is to free oneself from such desires as energy moves higher and higher along the chakras, opening them until it reaches the seventh chakra, called the Sahasra Chakra, located at the top of the cranium. A person can move energy through his or her chakras through tantric yoga, a form of yoga in which one seeks to free the mind of desires through various breathing exercises, contemplation, and meditation. When the seventh chakra is finally opened, a person is said to achieve full consciousness and liberation from the slavery of desires. Through the spiritual experiences one has encountered with the opening of each chakra, the result is inner harmony and overall happiness, which are significant aspects of living a positive, healthy lifestyle.

On a religious note, Hindu mythology offers an explanation for the movement of Kundalini energy throughout the body as one practices Tantric yoga. It is said that the serpent goddess Kundalini Shakti resides at the base of the spine, coiled up around the first chakra. As energy is activated and released through Tantric Yoga, she awakens and rises up the spine, opening the chakras along the way and energizing these conscious potentials. When she reaches the seventh chakra, she is united with her spouse, the God Shiva. Shiva is a symbol of change and the destruction of old habits. Their union leads to the liberation of the individual practicing the yoga, turning them into an “individual of the universe.”

Western Biomedical Model

Cell culture vials.

This is the most popular medical model in medicine today and can be found all across Western societies, as well as others. It looks at humans as biological organisms in order to discover methods for curing diseases and treating illness. This model focuses mainly on physical processes such as physiology and biochemistry and disregards social or spiritual factors. Under the biomedical model, health is defined as the absence of pain or disease, and the body is treated with scientifically-based methods.

It should be noted that the Western approach to biomedical theory and practice is constantly adapting in response to new scientific and philosophical revelations regarding illness. The model focuses on the treatment and cure of disease through medical science, and does not promote disease prevention. In recent years, naturopathic medicine (once largely considered at odds with orthodox bio-medicine)has gained recognition as a viable facet of treatment for a wide variety of disorders. Biomedicine is seen as a model that allows for the repair of the body and to fix problems that happen to the body from the surrounding environment. Biomedicine arose during the industrial revolution as a way to help people recover from diseases that affected them. (http://www.open.edu/openlearn/body-mind/health/health-studies/what-biomedicine)

One of the criticisms of the Western Biomedical Model is that it discounts the personal knowledge and beliefs of its participants. The system is said to consider ‘professional knowledge’ as the correct, rational, scientific approach while lay beliefs are considered non-rational, unscientific, suppression and are thus ignored. This leads to potential tension between health care providers and patients.

Ethnographic example: The biomedical model has been critical in the development of our country. One of the many influences it has had was treating tuberculosis, a life threatening infectious disease. In 1880, after studying the disease, scientists confirmed that it was contagious. Even before antibiotics this helped to dramatically decrease the number of people that died by using quarantining and sanitizing methods. The first successful immunization was developed in 1906 by Albert Calmette and Camille Guérin. The bovine-strain tuberculosis vaccine (also known known as bacille Calmette–Guérin or BCG), became mainstream after World War II in the U.S., Great Britain and Germany. In the mid 20th century, the antibiotic streptomycin was discovered and offered an effective alternative cure for tuberculosis. Many strains have become resistant to certain antibiotics, however, forcing immunologists to develop new vaccines and treatments to cure more virulent species.

Immunization

Infant being administered a measles vaccine in Kibati, Congo

The term immunization refers to rendering an organism immune to a specific communicable disease. Immunizations work by triggering the human body to produce antibodies that will help fight a particular disease. The antibody response is created by injecting a small amount of either a dead or live virus, (depending on the virus) into the person receiving the immunization in order to initialize a immune system response to the virus. Therefore in the future if the person who was immunized was exposed to the virus, he or she would already have the antibodies to fend off the virus. Along with the introduction and transmission of many new complex diseases, population growth and the globalization of medicine has brought about the eradication of many previously devastating disorders, including smallpox and polio, through wider availability of immunizations. Many parents in Western countries routinely schedule immunizations for their children to prevent them from contracting a specific communicable disease. While many vaccinations are routine and readily available only in developed nations, the continued globalization of medicine will eventually have a dramatic effect on the improvement of health care in developing countries.

There is a great deal of controversy over vaccination in some cultures regarding the morality, ethics, necessity, safety, and practicality of vaccination have led some parents to keep their children from being vaccinated. Opponents of vaccines claim that they are dangerous, ineffective, and infringe on personal rights.

And example of this is the current debate over whether or not certain vaccines cause autism in children. There is a small but dedicated group of doctors who claim that vaccines may be linked to the onset of autism in children. As a result many parents are insisting their children be exempt from the mandatory vaccines although there are no medical findings which prove the link between the two.

Globalization and Health

Epidemiologic Transitions

New Infectious Diseases

A disease that emerges within a population that is new or the number of infectious cases within a population or geographic area rapidly increases. Since 1940 over 300 new infectious diseases have been discovered, some of the most well known being severe acute respiratory syndrome (SARS), methicillin-resistant staph (MRSA), and Human Immunodeficiency Virus (HIV). Many drug-resistant strains of diseases are becoming more common and 71% of these new infectious diseases start in the wildlife. As globalization increases, infectious diseases will continue to affect a larger and wider population. Classification of disease is as follows; an epidemic is a local outbreak of a rare disease. When this disease spreads through many human populations across a large region, it is then classified as a pandemic.

Medical Pluralism

The integration of biomedicine and other forms of health care. Examples of medical pluralism include taking antibiotics and vaccines upon acute trauma or infection, as well as relaxation rituals to decrease stress and improve mental health. Medical pluralism includes involving different wellness techniques to improve, maintain, and prevent overall well-being. In earlier times, medical pluralism was considered a war zone and was seen as "other" or alternative medicines therapies that were trying to take over. Today, medical pluralism is seen as a positive thing as it can provide multiple solutions/treatments to something [5]

Diseases of Development

The main causes of illness and death in developed countries are cancer and diseases of the respiratory, cardiovascular and nervous systems. In the developing world, communicable diseases are the main problem, with deaths occurring primarily due to respiratory infections, HIV/AIDS, infections at birth, diarrhoeal disease and tropical diseases such as malaria. Failure to use existing treatments effectively, inadequate or non-existent interventions, and insufficient knowledge of disease all contribute to damaged health.

Globalization

Malaria

Malaria.

Malaria is a disease that is spread by mosquitoes. Mosquitoes pick up malarial parasites from the blood of infected. While only one species of mosquito can carry the parasite, there exist four types of the malarial parasite leading to four types of malaria. Symptoms include fever, shivering, pain in the joints, headache, vomiting, convulsions, and coma. If an infected person is not treated, he or she can die.

In recent years, globalization has increases the spread of malaria through travel, war, and urbanization. Persons traveling to countries which have a larger rate of malaria cases can become infected and carry the disease back to their country, and malaria-carrying mosquitos can stow away on international flights to bring the disease far from infected areas. War time refugees who spend long periods exposed to the elements and cross borders fleeing violence are more likely to come in contact with malaria-carrying mosquitoes as well.

HIV and AIDS

AIDS (Acquired Immune Deficiency Syndrome) is an incurable disease that attacks the patient’s immune system. AIDS is caused by infection with HIV (Human Immunodeficiency Virus), which is transmitted through the exchange of bodily fluids by sexual contact, sharing needles, and coming into contact with infected blood. HIV/AIDS is a global disease where its highest rates are in poor countries that lack a developed health service. While the lifespan of an infected person can be extended via anti-retroviral drugs, the disease is ultimately fatal.

Despite efforts in numerous countries, awareness and prevention programs have been unsuccessful in reducing the numbers of new HIV cases in many parts of the world where poverty and social mores increase peoples’ risk of infection. Even in countries where the epidemic has a high impact, such as South Africa and Swaziland, a large portion of the population do not believe they are at risk of infection. While initially, HIV prevention focused on preventing sexual transmission of HIV through behavior change, in more recent years it has become evident that HIV prevention requires interventions that take into account underlying socio-cultural, economic, political, and legal factors.

Smallpox

Smallpox is a highly contagious disease caused by the Variola virus. Symptoms of the disease include hemorrhaging, blindness, back ache, and vomiting. The virus attacks the skin cells after an incubation period, causing pimples and pustules to form that can further spread the disease. Smallpox is easily transmitted through airborne pathways such as coughing or sneezing, as well as through contaminated bedding and clothing.

Smallpox was a common disease in the 15th century in Eurasia, being spread by explorers and invaders such as Columbus. During the 16th century, Spanish soldiers introduced smallpox by contact with the Aztec natives in Tenochtitlan, causing a devastating epidemic that killed thousands. In 1617, smallpox reached Massachusetts and spread to Boston by 1638. Persons who fled after an outbreak in 1721 spread the disease to the other thirteen colonies. A vaccine was developed in the 18th century, and by 1979 the disease has since been completely eradicated globally.

Mental Health and Culture-Bound Syndromes

Culture Bound Syndromes are those in which changes in behavior and experiences have substantial effects on peoples lives. These are identified as syndromes not sicknesses. A syndrome is a group of symptoms when present together are characteristics of a specific disorder, disease, etc. The patterns of the symptoms that characterize or indicate can be of a particular social condition like heavy pollution. Syndromes can be a culture bound syndrome like Anorexia Nervosa or they can be a biological syndromes like Down’s Syndrome. The word syndrome comes from the Greek meaning “run together”. Medical anthropology describes culture-bound syndrome as a combination of psychiatric and somatic symptoms that are considered to be an identifiable disease that is only discovered within a specific society or culture. There are no changes in the biochemical or structural of body organs or functions, and the disease is not recognized in other cultures. A substantial portion of mental disorders are at least partially if not completely conditioned by the culture in which they are found. Some disorders however are more culture-specific than others. The concept of culture-bound syndromes is a controversial subject to which many psychologists, medical doctors and anthropologists reject the concept.

Addiction

Addiction is a serious mental health issue that is present in cultures worldwide. Addiction is the condition of being mentally or physically reliant to a chemical substance, action, or item. Addiction is often sprouted from an early age. Factors that can effect an individual's likelihood of becoming a substance abuser can range from their upbringing and environment in their youth, to the people they chose to surround themselves with later on in life. Many substances are highly addictive upon first use such as heroin. Heroin has become one of the largest health concerns in many countries with alarming rates of growth. According to www.drugabuse.gov 90,000 people in the United States reported trying heroin for the first time in 2006, compared to the alarming 156,000 people who tried it just 6 years later in 2012. Addiction often originates as a mental disorder through the cravings and desires of addicts, but can soon develop into a physical dependence which can lead to many negative health effects. Addiction to many different drugs including heroin almost always quickly deteriorates the addict's body and is very often fatal.

Addiction can also occur due to cultural factors such as being addicted to a certain activity or a certain hobby a great deal to the point that it interferes with other activities that are necessary in everyday life for wellbeing.

Obesity

High-fructose corn syrup, found in most soda beverages, is public enemy number one in the war against obesity.

Obesity is a condition affecting more than 300 million people.() Obesity is most common in first world countries and it affects millions of people. Obesity the term used to describe a person who is overweight to the point that it becomes the cause of many other afflictions that could potentially threaten their life. A person is obese when their body mass index (BMI) exceeds 30 kg/m2()The World Health Organization (WHO) considers obesity to be one of the top 10 causes of preventable death worldwide. Overweight individuals in developing countries are considered attractive and desirable due to connotations such as excess wealth, the ability to live lavishly and abundantly, etc. Interestingly, this is the opposite to the view of body weight in developed countries, where thinness implies beauty, wealth, and good health. One who is wealthy can eat a balanced and healthy (and often more expensive) diet and has the luxury, time and money to exercise in either a gym or with the help of a personal trainer.

Ataque de Nervios

Term used among Caribbean Latinos used to describe a culture-bound syndrome, or state of mind, characterized by uncontrollable shouting, crying, aggressiveness, shaking or trembling, fainting, and suicidal gestures. Ataque de nervios typically follows a stressful event - death of a loved one, divorce or other domestic conflicts. This affliction is shares features of a panic attack defined by the DSM-IV, an ataque, usually following a precipitating event, occurs in the absence of acute fear or apprehension, and is accompanied by amnesia for the ataque.

Mal de Ojo

Medical problems, such as vomiting, fever, diarrhea, and mental problems (e.g., anxiety, depression) could result from the mal de Ojo (evil eye) that an individual has experienced from another person. Mal de Ojo is initiated when a person of higher strength gazes upon the weaker counterpart out of envy or admiration. The condition is common among infants and children; adults might also experience similar symptoms resulting from this mal de Ojo. There are many different ways in curing mal de Ojo. In Latin America the most common way is to have the parent rub an egg on the child while saying a prayer over the child then put the egg in a bowl and put it under the child's pillow. In the morning if the bowl has this white fog then you can tell the child was affected by the mal de Ojo. This process also cures it.

Eating Disorders

Pop icons suffering from Anorexia have raised popular awareness to this disease.

Eating disorders are defined as any of a range of psychological disorders characterized by abnormal or disturbed eating habits. The most common eating disorder is anorexia nervosa.

• Anorexia Nervosa

Anorexia Nervosa is a eating disorder and is commonly shortened to anorexia. Anorexia Nervosa is a psychiatric illness which is specifically defined as the "obsessive fear of gaining weight". This fear causes the individual to avoid food consumption. This disorder most commonly affects young teenage girls. In total, males account for only 10% of the reported cases. Bulimia Nervosa is a similar culture-bound syndrome to Anorexia Nervosa in which purging is the method of losing weight. Many times people who have these eating disorders though do not have one strict eating disorder. It tends to be a combination of anorexia, bulimia and binge eating. For example, a person may restrict themselves to not eating, but if they do they may go and work out excessively and then binge eat after In some cases however, these eating disorders are developed as a coping mechanism for problems other than the common fear of weight gain. Providing its victims with a sense of control, anorexia and bulimia can help ease the mind even if the goal is to find stability in areas other than weight loss.

The process used to initially lose and prevent weight gain is voluntary starvation, but other methods such as purging, excessive exercise and the use of dietary pills are used also to control body image. One of the proposed reasons for the cause of this disease is the effect of images portrayed by the media on young women and men, demanding a necessity to be slim, because that is the only socially acceptable way to look

Symptoms include:

-Refusing, avoiding, or not wanting to eat in public

-Anxiety

-Weakness

-Brittle skin

-Shortness of breath

-Obsessiveness about calorie intake

-muscle loss/degeneration

-Additionally, anorexic people have a tendency to create a distorted, negative view of themselves "Anorexia". Mama's Health. Retrieved 2009-03-10.</ref>

http://images.mylot.com/userImages/images/postphotos/1897668.jpg

• Body Image and Fitness

Eating disorders such as anorexia nervosa are often caused by body image issues. Every culture around the world has varying ideas of what the “ideal body” should look like. These standards are especially high in the in United States. With an increasingly high exposure to social media, fashion magazines and beauty advertisements, adolescents in the US (especially young women) are feeling an increased pressure to obtain these “perfect bodies.” In recent years there have been cases of some people going to the extremes to be “perfect,” which are more often than not unhealthy and potentially life-threatening. For example eating disorders such as Anorexia nervosa or Bulimia nervosa.

Avoidant/Restrictive Food Intake Disorder

Avoidant/Restrictive Food Intake Disorder, or ARFID, is an eating disorder that was recently made independent from EDNOS (Eating Disorder Not Otherwise Specified) when the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was released in 2013. Originally, there was a disorder labeled as "Feeding Disorder of Infancy or Early Childhood" which listed similar diagnoses, but this was removed in the DSM-V, as it was decided that ARFID was a disorder that also occurred in adults.

The disorder itself can be described similarly to a phobic fear, and usually stems from anxiety around new and unfamiliar foods, rather than with body image and self-esteem issues that are associated with eating disorders such as anorexia or bulimia.

To be diagnosed with ARFID, the DSM-V gives these criteria:

• Disturbance in eating or feeding, as evidenced by one or more of:
• Substantial weight loss (or, in children, absence of expected weight gain)
• Nutritional deficiency
• Dependence on a feeding tube or dietary supplements
• Significant psychosocial interference
• Disturbance not due to unavailability of food, or to observation of cultural norms
• Disturbance not due to anorexia nervosa or bulimia nervosa, and no evidence of disturbance in experience of body shape or weight
• Disturbance not better explained by another medical condition or mental disorder, or when occurring concurrently with another condition, the disturbance exceeds what is normally caused by that condition

A person with ARFID acts similarly to a child who is a "picky eater." They typically have a small number of "safe foods" that they eat normally and do not have any trouble with for the most part, but most new or unfamiliar foods outside of their safe ones cause seemingly irrational and extreme (sometimes phobic-level) fear and anxiety, often leading to a full-on anxiety/panic attack or breakdown. This may be caused by a food's appearance, smell, texture, or any other number of reasons.

Many teenagers and adults with ARFID have gone and continue to go undiagnosed and untreated for most of their lives, due to the disorder only being classified in recent years. It can also be assumed that the majority of people who have ARFID are completely unaware that their strange eating problems are likely a legitimate disorder, and not just "picky eating" that they never grew out of in childhood. ARFID can get in the way of not only a person's health, but also their social life: people with ARFID may tend to avoid social gatherings involving food, holidays that involve eating may become more anxiety-inducing than enjoyable, etc.

While there has not been much research done on the treatment of ARFID, many people choose Cognitive Behavioral Therapy or hypnotism as ways to work towards a normal food palette and healthy diet.

Amok

Malaysian sudden mood change/aggression.

Amok is the psychological disorder where males who typically have never acted out before experience a sudden mood change and become violent and angry. Deep shame experienced by the male often seems to be the cause of the sudden mood changes, these changes can be caused by situations and feelings such as jealousy or gambling losses. People suffering from a mood change will often attempt to hurt or kill anyone they run into. Often people who have these mood shifts will end up being killed by a bystander out of self-defense or other reasons, or the person suffering from Amok will commit suicide. The word was derived from the Malay, Indonesian and Filipino word "amuk" which means "mad with rage." The term has been changed into slang in the United States and the phrase Running Amok is used to describe someone who is acting crazy or can't control themselves.

Dhat Syndrome

The patient is preoccupied with the excessive loss of semen by nocturnal emissions. There is a fear that semen is being lost and mixed in urine. In the Hindu culture and religion, it is believed that "40 meals create one drop of blood, 40 drops of blood create one drop of bone marrow and 40 drops of marrow create one drop of semen." It is thought in the Hindu culture in India, although not isolated there, that the loss of semen can deteriorate your health and create health problems. Symptoms of Dhat Symdrome are depression, preoccupation, trouble sleeping, inability to perform sexually, exhaustion and headaches, and others. In order to treat these symptoms of depression and anxiety, counseling or anti-anxiety or anti-depression medications have been found to be of use. [7]

Genital Retraction Syndrome (Koro)

Retraction into body. (Malay Koro, Sudan melting penis/cell phone phenomenon)

•Genital Retraction syndrome is a culture-bound syndrome occurring mostly in African and Asian men. This syndrome causes the men to think that their penis is going to shrivel into their stomach and that they will die. In South East Asia this syndrome has become known as “Koro”, which means “head of the turtle”. It can also be referred to as penis panic. In this case a large group of men can become panicked about their genitalia disappearing. Often these fears come about in cultures where witchcraft is used, or where biological education isn’t available. In 1997 lynch mobs in Ghana attacked foreigners they accused of being sorcerers capable of shrinking men’s penises.

Latah

Latah is a culture-bound syndrome that exist in Malaysian and Indonesian cultures. People showing signs of this syndrome respond to minimal stimuli with exaggerated startles. Sometimes, after becoming started, people suffering from this syndrome will obey the commands or imitate the actions of the people around them. Most occurrences of Latah are intentionally provoked to act as entertainment for those surrounding. Latah is very closely tied to specific factors in the cultural systems of the Southeast Asian societies in which it is found. The Latah syndrome exemplifies the very dynamic and complex ways in which neurophysiological, experiential, and cultural variables coincide with each other to produce a strongly marked phenomenon in these cultures. It is most widely known as a hyperstartling condition which mainly occurs in Malayan cultures. Latah is also the name for those who have the condition, which consists mainly of adult women. During episodes of this behavior, Latah's are usually not held responsible for their actions. It is also closely related to another condition called Hyperexplexia. (SE Asia women, obey, not responsible for acts)

Piblokto

[[Image:Inuit-Kleidung 1.jpg|thumb|right|Two Inuit women and child. Origin: Taken by Angsar Walk [8] Piblokto, pronounced (pee-block-toh) and loosely translated from Inuit to English means "running crazy" is a hysterical/dissociative state. It occurs mostly in the winter season and typically shown in Inuit or Eskimo women and is characterized by short attacks of disturbed behavior that are not remembered by the individual afterward.

The symptoms can include running naked through the snow, an insensitivity to extreme cold, coprophagia (the consumption of feces), echolalia (the repetition of words), depression, screaming, crying, and violence towards other people and animals. Piblokto is most often seen in women of the Inuit tribe. These people inhabit the areas of northern Canada,Greenland, the coastal regions of Alaska and north eastern Asia/Russia. They are able to inhabit very harsh conditions and tolerate the snow and ice of the Arctic tundra for most of the year. There has never been a recorded case of Piblotko in children, although women in tribal groups have been recorded as having as many as 5 attacks of hysteria a day. The Inuit people's diet mainly consists wild game, whale and seal meat. A diet high in protein, selenium, and fats may help these people escape the risks of cancer but not the biological/psychological malady of Piblokto. Although commonly thought of as a psychological ailment, Piblotko may be linked to vitamin A toxicity, or hypervitaminosis A. Vitamin A toxicity is caused by an overconsumption of pre-formed Vitamin A, which is the result of high amounts of vitamin A in the diet at one time. This can lead to altered mental state, confusion, headache,and irritability, as well as many symptoms that are common to Piblotko. Piblotko has also been recorded in Inuit dogs and while these dogs are not considered infectious, they are shot when symptoms first occur and then eaten by the tribe. SAD- seasonal affective disease; loosely linked to this syndrome, as the weather and light are factors that play straight into symptoms like depression.

Susto

Susto is a Folk Illness that is most commonly found in Latin America. The term "susto" comes from the Portuguese and Spanish word for fright. In this way, the illness is called “fright sickness”. It is also referred to as "spirit attacks," most common among Native Americans. The disease is usually generated from a traumatic experience like the death of a loved one, an accident, or anything else that might cause physiological pain. It is most common in women but can also be found in men and children. The illness in not recognized by Western Traditional Medicine, but is commonly compared to anxiety disorders.

Symptoms of susto can be nervousness, anorexia, insomnia, listlessness, despondency, involuntary muscle tics, and diarrhea. Treatments for this illness are mostly natural and herbal, such as consuming marijuana teas, Brazil wood, and orange blossom. The most effective treatments are done by what is called a healer and can include different sort of rituals. The closer these rituals are practiced to when the traumatic experience occurred, the better. It is also very important to recognize the event and not suppress it.

Susto is often compared to other biomedical illnesses. In 2002 studies about susto were conducted in; Latin communities, the United States, Mexico and Guatemala. First they defined susto in the different communities. Although the definition differed from region to region, the main idea was that susto was an illness caused by fright, and not necessarily loss of soul. It was seen as a serious illness that could even lead to death. But to better understand this folk illness, in biomedical culture and culture I am familiar with in United States, susto is best related to depressive disorders, post traumatic stress disorder, and somatoform disorders.

Opsophagos

Opsophagos was an ancient Greek label given to anyone who had an extreme and irrepressible desire for eating fish.

The term is a definition one’s character, not literally their general palate for fish. Charging someone with the term is directed in a very negative manner- it parallels being indicted with having over-indulgent behavior, a taboo in Greek society. Opsophagos is synonymous with words like unsophisticated and barbaric- words opposite of rationality. The fish is simply a symbol for overindulgence.

Greek tall tales describe an opsophagos as a gluttonous and greedy man who would consume all prepared fish, sharing none with anyone. The painted image of an opsophagos was the opposite of an ideal human- a man with a heat-resistant throat to handle fish too hot for anyone else to eat, thus keeping the fish for only themselves.

Opposite of America’s Judeo-Christian tradition, Greek thought and morality is more flexible than the orthodox, black and white view of simple rights or wrongs. For example, instead of ruling out women or wine, Greeks believe in “nothing in excess”-enjoy life’s pleasure but under control. This is contrary to the American idea of suppressing vices and how negative habits should be cut out completely “cold turkey”.

http://www.nytimes.com/books/98/09/06/reviews/980906.06jenkynt.html

http://www.washingtonpost.com/wp-srv/style/books/reviews/courtesansandfishcakes0830.htm

Ghost Sickness

A Dust Devil is an example of a manifestation of Ghost Sickness

Ghost Sickness originates from the Navajo Nation and is believed to be a psychotic disorder associated with death. Common symptoms include fatigue, recurring nightmares, hallucinations, and a constant feeling of terror. The people of the Navajo Nation believe that a Chindi causes Ghost Sickness. A Chindi is the ghost of the Navajo Tribe and many believe that this ghost is released during a person’s dying breath, and it is also believed to nearly always be an evil force. A common manifestation of a Chindi is believed to be a Dust Devil, and the direction they spin signifies whether it is a ‘good’ Chindi or a ‘bad’ one; a clockwise spin is considered good – a counter-clockwise is considered bad. Other Native American tribes have modified beliefs of Ghost Sickness and have attempted to prevent or avoid passing it on. For example, the Lakota Tribe attempted a ban on mourning rituals in order to avoid the illness in the 1800's, but many still practice modified rituals.

Windingo

Windigo (or Witiko) A culturally bound syndrome found among the Algonkian Indians, NE United States and Eastern Canada. Windigo is the famous syndrome of obsessive cannibalism or the consumption of another’s flesh. Windigo has fallen under skeptical eyes and to many is now somewhat discredited. A modern medical diagnosis of this condition would probably label it as paranoia, due to the irrational perceptions of being persecuted for suffering from Windingo. Fear of prosecution is prevalent among victims of Windingo because of the cultural universal that eating humans is wrong. Windigo was supposed to have been brought about by consuming human flesh in desperate circumstances such as famines. Afterwards, the individual who consumed flesh was supposed to be haunted by cravings for human flesh and thoughts of killing and eating humans. In other words, Windigo is the unwanted transformation into a cannibal.

In the Great Lakes of Canada and the United States where climate was harsh, Windingo would develop among families who, isolated in their homes due to heavy snow storms, had inadequate food and supplies. Symptoms of Windigo include vomiting and lack of appetite. The individual would then begin to develop delusions of him or herself believing they are becoming a Windigo Monster. People suffering from Windigo psychosis claim to see others as edible, which only increases with time. As the individual becomes aware of the transformation they begin to deeply fear becoming a cannibal. Victims of Windigo psychosis often experience severe panic and anxiety. Suicide is common in order to prevent themselves from becoming Windigo monsters.

Zar

Zar[10] is experienced in Ethiopia, Somalia, Egypt, Sudan, Iran, and other places in the Middle East and North Africa. The feeling you get when you have zar is spirit possession. Some symptoms that could occur are dissociation episodes including shouting, laughing, singing, weeping, or hitting the head against some sort of surface. Individuals may refuse to do simple tasks such as eat or go about their daily tasks in life; they may also show withdrawal and apathy. In some cases the person might develop a long-term relationship with the possessing spirit, but this is the rarest symptom. Zar can also be used as part of the training and practice of shamanistic healers. [11] This is usually practiced in Africa and is unfamiliar in Europe. Since this is a trance that is induced voluntarily as part of a shamanistic ritual, it is not considered a disorder.

Zar was experienced in many cases when immigrants would move from Ethiopia to Israel. This is when zar was known to happen the most. Zar as a voluntarily induced spirit would occur the most in Northern African countries. One of the most common possession phenomena in Africa and in other continents is the belief in possession by spirits, known as zar.

Chapter Glossary of Key Terms

Medical syncretism - Fusing of more than one medical practice, such as fusing spiritual and biomedical practices.

Personalistic Systems - Where an illness is considered unique to the patient and medical practitioners often call upon supernatural forces to facilitate the diagnosis and treatment of disorders because the illness is caused by supernatural forces as well

Ecological Footprint -The ecological footprint is a quantitative tool that is used to measure human demand on nature, an example would be how much people consume and how much waste they produce.

Biomarkers A measurable substance in an organism whose presence is indicative of some phenomenon such as disease, infection, or environmental exposure.

Peyote:- A healing substance that is native to Mexico and southern US, it is a hallucinogen, containing mescaline.

Aphrodisiac- A food or substance that is believed to increase sexual energy or prowess

Essential oils: A collection of natural oils that can be used in many different ways to help soothe or fix different types of sicknesses and pain.

Humor: In the medical field, a humor is a type of fluid substance. It was once believed that one's health was connected to the balance of four particular humors in the body: phlegm, blood, black bile, and yellow bile.

Medical Pluralism: Integration of biomedicine and other forms of healthcare.

The Cure-All Herb: A common drinking herb know as kinkeliba, which is used by the west African population to help with colds, flues, and many other health ailments.

Biopiracy: the exploitation of plant and animal species by foreign entities to restrict their general use

Placebo effect an effect that is due to the patient’s belief in the treatment

Biocultural analyses the relationship between human biology and culture. How evolution influences disease and how people interpret and explain these based upon their culture.

Medicalization the process of making a human condition and creating criteria to define it and then treat it as medical conditions to create prevention strategies, treatment, and study.

The explanatory model of illness How patients describe and evaluate their illness. Their view on their condition and their abilities to cope and the affiliation with the disease outcome.

Cultural bound syndrome A disease that is only recognized within a certain culture that has a combination of psychiatric and somatic symptoms

References

Ali, Al-Wabel, Shams, Ahamad, Khan, & Anwar. (2015). Essential oils used in aromatherapy: A systemic review. Asian Pacific Journal of Tropical Biomedicine, 5(8), 601-611.

http://en.wikipedia.org/wiki/Running_amok

^ http://home.earthlink.net/~youngturck/Chapter13.htm

^ http://www.who.int/tdr/publications/tdr-research-publications/globalization-infectious-diseases/pdf/seb_topic3.pdf

^ http://www.medanthro.net/definition.html

http://www.4woman.gov/faq/anorexia-nervosa.cfm

^ Fock, Niels (1963). Waiwai. Religion and society of an Amazonian tribe. Nationalmuseets skrifter, Etnografisk Række (Ethnographical series), VIII. Copenhagen: The National Museum of Denmark.

^ Altshul, Sara. "Incontinence: Finally, Relief That Works." Prevention December 2005: 33. Academic Search Premier. EBSCO. 30 January 2006

^ http://dictionary.reference.com/browse/syndrome?qsrc=2888

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^ World Health Organization. 8 Mar. 2009 <www.who.int/bulletin/bulletin_board/83/ustun11051/en/>.

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"Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V.." Am J Psychiatry February 2008 9 Mar 2009 <http://search.medscape.com/medline-search;jsessionid=02EF3791A6C560EFD57A1211CF77FB0D?newSearch=1&queryTextanorexia>.

1.http://www.annfammed.org/cgi/content/abstract/3/3/255 2.note|Hahn, Robert. Sickness and Healing. Yale University Press, 1996.

"Female Genital Mutilation: A Call to Action",Troubia N: New York, New York, Women, Ink, 1993. 48 p.

1. ^ True, William R. 1984. Prospective on Postdoctoral Public Health Training for Medical Anthropology. Medical Anthropology Quarterly 15(4): 95 – 96.
2. ^ Scheper-Hughes, Nancy, and Margaret Lock. 1986. Speaking “Truth” to Illness: Metaphors, Reification, and a Pedagogy for Patients. Medical Anthropology Quarterly 17(5):147-40.
3. ^ Rubel, Arthur. 1964. The Epidemiology of Folk Illness. Ethnology 3:268 – 83.
4. ^ Sargent, Carolyn, and Thomas Johnson. Handbook of Medical Anthropology: Contemporary Theory and Method Revised Edition. Westport, CT: Greenwood Press, 1996.