Health ideologies and medical cultures in the South Kanara areca-nut belt
Nichter, Mark A.
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The study is divided into four parts. The first provides a brief ethnography of the South Kanara areca-nut belt, the second a detailed account of the region's health ideologies, the third a portrayal of the region's pluralistic medical cultures, and the fourth an examination of the villagers' use of these medical cultures. The subjects of disease, etiology, the ontological role of illness, the language of disease, techniques of curing, and patient-practitioner relationships are investigated. Disease is considered to be a sign as well as a symptom of social and physiological imbalance.Three themes pervade the study: the nature of power, the ideal of balance, and the formal significance of acculturation. A conceptualization of power as unstable and transmutable underlies the Hindu ideal of balance; and it in turn has influenced the distinct but interrelated Brahman and non-Brahman cultures. This ideal underlies the structural principles of hot-cold, the tridosha, and the doctrine of multiple disease causality. The conjunction of the hot-cold principles and the doctrine of multiple causality facilitate the interaction of distinct strata of society and foster a complementary relationship between pluralistic medical cultures.The entrance of a new medical culture or paradigm into the villagers' universe is depicted as analogous to the entry of a new deity to the village pantheon. The appearance of a new deity or paradigm does not result in a loss of faith in existing practices or structural principles. It is rather incorporated into the established universe. It is either relegated to a particular domain or assimilated as a homologous expression of an already existing source of power or knowledge. The villagers' conceptual universe evolves as an aggregate of ideas organized by basic structural principles. Health planners are encouraged to recognize these principles and incorporate new ideas within the existing cognitive universe, emphasizing a unity of the traditional and modern.