Cultural Meaning, Explanations of Illness, and the Development of Comparative Frameworks

Abstract

Starting with the cultural domain of illness and considering the issue of cross-cultural comparisons at the level of meaning, this article discusses the cognitive anthropological approach taken in my research, specifically examining the use of structured interview methods and the collection of illness case histories for cross-cultural comparative endeavors. I situate my own work in relation to several past attempts to construct conceptual schemes for comparing theories of illness causation across cultures. Based on my analysis, I suggest that the tension between existing comparative schemes and efforts to understand how illness is culturally constituted in specific locations can be productively used to construct a comparative framework that remains open to ethnographic possibilities (cf. Hallowell 1960:359). (Cross-cultural comparisons, theories of illness, Ojibway, Tarascan) Illness and suffering are universal human experiences which come to be endowed with cultural meaning. As such, the domain of explanatory frameworks for illness is an appropriate one for cross-cultural comparative research. How illness is understood and dealt with in diverse cultural settings is addressed by a large number of medical anthropology studies. In addition, several general schemes for categorizing theories of illness causation across cultures exist. Three of the better-known proposals (Murdock 1980; Young 1976; Foster 1976) are reviewed here. Although these schemes have been around for some time, their continued relevance is attested to by recent medical anthropology textbooks that organize discussions of cross-cultural variability in etiological understandings with reference to one or more of these schemes (e.g., Anderson 1996:82-86; Loustanau and Sobo 1997:91-103; Brown 1998:15, 110). The ethnographic material considered here is drawn from two field studies.(1) One site is Pichataro, a town in the highlands of the west-central Mexican state of Michoacan, where both Pur6pecha (Tarascan) and Spanish are spoken. (Most of this work was carried out in conjunction with James C. Young.) The other site is an Ojibwa community in Manitoba, Canada. This choice was influenced by A. Irving Hallowell's insightful writings (e.g., Hallowell 1942, 1955, 1976), which led to an appreciation that the Ojibwa might be an illuminating contrast with Pichataro. (Rather than Ojibwa, the terms Anishinaabe, or its plural Anishinaabeg, will be used, as this is how people refer to themselves.) Research in the Anishinaabe community was explicitly designed to be comparative with my earlier work in Pichataro. Adopting a cognitive anthropological approach, the intent was to make comparisons at the level of cultural meaning. In both sites, the focus was on discovering the nature of cultural knowledge brought to the occurrence of illness, how this knowledge is applied in evaluating illness, and what considerations are brought to bear in making treatment decisions; i.e., how illness forms part of these meaningful worlds. Cultural understandings are resources which may be variably drawn upon to help make sense of one's own or another's experiences (Garro 2000). Thus, cultural understandings do not function in a top-down deterministic manner but rather are better seen as tools (which both enable and constrain interpretive possibilities) available to navigate the ambiguity surrounding illness and other troubling experiences. COMPARATIVE FRAMEWORKS FOR THEORIES ABOUT ILLNESS Murdock (1980) coded the ethnographic literature from 139 societies to examine the cross-cultural distribution of twelve illness theories. These theories are of two main types; natural causation and supernatural causation. Theories of natural causation he defined as any theory, scientific or popular, which accounts for the impairment of health as a physiological consequence of some experience of the victim in a manner that would appear reasonable to modern medical science (Murdock 1980:9). …