© 2019 Allan YOUNG
2019 – № 1(17)
Citation link:
Young, A. Nekotorye vyvody dlja social’noj antropologii iz medicinskih predstavlenij i praktik [Some Implications of Medical Beliefs and Practices for Social Anthropology]. Medicinskaja antropologija i biojetika [Medical anthropology and bioethics], 1 (17).
Keywords: medical beliefs, medical practices, medical anthropology, meanings studies, interpretative turn, professional etiologies, folk etiologies, anthological consequences of illness, ritual, dramaturgical event
Abstract. In the article, a classic of American Anthropology, Allan Young, elaborated on two topics. Acknowledging that our notions of the phenomenon of illness are fully mediated by biomedical categories, the author tries to depart from understanding the phenomena in the frameworks of what is called “Western”, or “scientific” paradigm, and to find a way to describe it in a more neutral manner. The author’s other goal is to fit studies in medical anthropology into studies of the social in their entirety, including into studies of collective beliefs (Durkheim 1915), symbols and rituals (Turner 1967, Geertz 1966). He describes how certain episodes of illness play the same ontological role as religious beliefs and rituals: they convey and confirm important ideas of the real world. Apart from ontological problems, medical beliefs and rituals solve practical and social ones: they are an attempt, on the one hand, to relieve the symptoms of illness and, on the other hand, to justify the sick person for his deviant behavior (to which the author, in line with Talcott Parsons, ascribes illness). In the final section, Allan Young elaborates on the dramaturgical shape in which episodes of severe acute illnesses develop. As a dramaturgical event, illness is opposed to day-to-day life and is marked by extraordinary emotions; its participants fit into a small number of pre-defined roles. Illness also imparts connectedness to the world of events and experiences; this connectedness is absent or unmanifested in routine settings.
Author info:
Allan Young is Professor Emeritus at the Department of Social Studies of Medicine, Anthropology and Psychiatry of McGill University (Canada).
* Translation of: Young, A. (1976). Some Implications of Medical Beliefs and Practices for Social Anthropology. American Anthropologist, Vol. 78, No. 1, p. 5–24
Summary
Anthropologists have explored medical interests from two general points of view. The first focuses on how the epidemiology of disease is affected by traditional medical practices and by particular social and ecological settings (see Fabrega 1972:196-206). In this article I limit myself to the second approach, which aims to understand what medical beliefs and behavior mean for the people who hold and perform them. Put briefly, my argument will be this: (1) People maintain their medical traditions because they affect undesirable biological states in expected ways, and because they are effective ways for dealing with disruptive events that cannot be allowed to persist. (2) A consequence of these meanings is that some kinds of sickness episodes also perform an ontological role-communicating and confirming important ideas about the real worldanalogous to the one which Durkheim (1915:387), Geertz (1966:29-34), Turner (1967:27-29), and others have attributed to religious belief and ritual.
The majority of works which have described what medical beliefs and practices mean for the people who hold and perform them have focused on phenomena (such as witchcraft, sorcery, and possession) that are closely tied to sickness episodes. With notable exceptions (e.g., Turner 1964, 1968; Spiro 1967; Harwood 1970; Crapanzano 1973), these studies deal with medical traditions anecdotally and as dependent variables in order to understand some other conceptual category. Little attempt is made to fit the chosen ailments into a more comprehensive matrix of diagnostic and therapeutic classifications and techniques, and so the reader remains ignorant of what alternative diagnoses and therapies the medical system permits for labeling this combination of signs, what other sorts of socially important outcomes are latent in it, and what are the rules by which rival diagnoses are contested and how they can he manipulated during the course of a sickness episode. Disease episodes are either described in ways that render their courses inevitable and their meanings unambiguous, or they are so cursorily given that it is difficult to get an idea of what, from an emically medical point of view, is going on (e.g., Lewis 1969:198, 208, 211-213).
A second obstacle is the misapplication of the Western medical paradigm. The interests of sick people, curers, and people who worry that they may become sick are dominated by a medical paradigm.‘ This means that they frame their questions and organize their behavior in order to identify, remove, arrest, alleviate, or prevent the disease symptoms that have intruded or threaten to intrude into everyday life. In brief, their interests focus on the efficacy of medical beliefs and practices.
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