Physicians of Western medicine: An introduction (original) (raw)

1982, Culture, Medicine and Psychiatry

Anthropologists, including medical anthropologists, have directed their attention to the medical and other cultural systems beyond the frontiers of their own, principally Western societies. In their neglect, anthropologists may have followed an assumption of the neglected medicine itself, that it is scientific, and thus, they assume, beyond culture. The essays in this volume i explore a new frontier of medical anthropology: physicians of Western medicine. Such studies are of methodological and substantive significance in both medicine and anthropology. Medicine and its practitioners form a central institution of any society, reflecting and shaping its basic values of health and well-being, while employing and furthering its vital knowledge of human function. The essays here explore the theory and practice of Biomedicine, its cultural character, its cultural roots, and its cultural implications. They take Biomedicine as an ethnomedicine. While the medicine of our society is often regarded as monolithic,the essays here distinguish the very different disciplines which comprise our medicinethe many medicines. Not only is there a multiplicity of "specialties" within Biomedicine, but there are significant differences of ideology and practice which divide specialties and link them with others. Here we document the way in which these specialties and divisions defme their work, for example, 'physiological integrity', 'Christian psychiatry', and 'family medicine', thus shaping the beliefs and practices of the practitioner's world. Ethnography is inherently a comparative enterprise. Yet in our ethnographies of non-Western medicines, the standard of comparison has been a presumed ideal, a myth. We are concerned here to develop an ethnography of the clinical reality of Biomedicine, its divisions, its coherence, its incoherence. Biomedicine has been used also as a metric, a grid,-its nosological and sociological categories assumed universally applicable-'parasitic infection', 'depression', 'efficacy', 'the sick role', and even the distinction between 'patient' and 'healer'. Anthropological research has considered traditional 'psychiatrists' (Edgerton 1977) and even what might be called 'group therapy' (Crapanzano 1973), as well as ethno-obstetrics (McClain 1978), 'primitive surgery' (Ackerkneckt 1978), ethno-orthopedics (bone setters), and other indigenous healers. Some works have also given us accounts of the development and socialization of healers in traditional societies (e.g., Harvey 1979;.,Shchs 1947). Further exploration of our own medicine will elucidate its cultural,bases and provide firmer grounds for observation and comparison. If we are to understand disease and healing as universal rather than local phenomena, a fully