Medical Rituals Research Articles

Why Pimping Works: The Neurophysiology of Emotional Memories.

A time-honored medical ritual that combines emotion and cognition into a seamless consolidation of lucid memories is a feared teaching method in medical education. The resulting neurophysiology is explained from a neurosurgeon's perspective - equal parts guilt and dread as a prescription for an improved and sustained trainee fund of knowledge. Much of the available literature published with regard to pimping explores its pedagogy and use in medical practice. This review aims to explore the neurobehavioral and biological aspects of pimping in why it remains a popular teaching model. We describe the neuromodulatory process of integrating emotions and memory as observed during pimping. Additionally, we explore the neuronal pathways and circuits involved in memory encoding, consolidation, and retrieval. Finally, we explored theeffects of this methodology as it is currently used in the United States medical education system.

The Folk Medicine Concept in Vernacular English of the XIX Century

The research is devoted to studying the Folk Medicine concept in English based on British ethnographic and folklore materials, as well as dictionaries of dialects published in the XIX and early XX centuries. The work aims to analyse the Folk Medicine concept and its representation as a component of the folk world picture, verbalised in that time’s medical language, the core of which is a set of folk nominations used to denote folk names of diseases associated with ancient medical practices. On the periphery, folk texts represent superstitions as necessary constituents of folk medical practices connected with the mentioned nominal units. A comprehensive methodology of conceptual analysis allowed identifying the basic ideas about Folk Medicine. Based on the statement that the meaningful component of the Folk Medicine concept is realised in the folk consciousness, the key verbalised nominations’ definitions denoting the disease names, and their compatibility with adjectives and verbs, were analysed. The influence of medical rites and rituals on the semantics of lexical units was proved. The analysis identified the basic semantic features of the Folk Medicine concept, including ethnonymic, colourative, anthroponymic, mythological, spatial and temporal components.

Leverage the power of ritual to improve community health worker efficacy and public health outcomes: Lessons from Bihar, India

Biomedical health interventions now have global reach and interact in complex and often poorly understood ways with traditional medical rituals that precede biomedicine. People often experience biomedical practices and treatments as rituals because they are very similar from an experiential perspective. 1 Yet the global public health community often views ritual practices of communities as obstacles to adopting new health-promoting behaviors. The lack of engagement with the biomedical and traditional medical rituals of local populations has obscured understanding the critical functions of these behaviors, limited the potential to leverage ritualization to increase behavioral uptake, and stymied social and behavioral change efforts. Our large-scale, mixed methods research with Community Health Workers (CHW) in Bihar, India, has shown that understanding the rituals of a community provides critical insight into their identities, norms, values, and goals. We propose that health interventions should be informed by, and build upon, knowledge of health rituals. A deep understanding of existing beliefs and behaviors will allow local health "influencers" such as CHW to encourage new and modified rituals that integrate the best of biomedical and traditional health practices in ways that preserve their meaning and shared purpose. Grants INV-008582 and INV-016014 to C.L. from The Bill & Melinda Gates Foundation funded this manuscript.

Sumaranun dance: Movement changes from medical ritual to dance movement

This article aims to discover the history of Sumaranun dance creation and conduct research on the implicit meaning of each Sumaranun dance movement in the community of Iranun. This minority ethnic group lives on the beach coast, particularly in the Kota Belud district. The Sumaranun dance began as a medical ritual involving both the supernatural and reality. When this medical ritual was rarely practised, it was modified to become a dance, the Sumaranun dance. This research focuses on the changes in the Sumaranun dance, from a medical ritual to a dance. This research is field research that uses the method of direct observation and interviews to gain detailed information that has been done in the community of Iranun that lives at Rampayan Laut village, Nanamun village, and Kota Bongan village. This research finds that medical ritual and Sumaranun dance are closely related until they become entertainment performance. Keywords: Iranun, change, movement, medical ritual, Sumaranun dance. Tarian Sumaranun: Perubahan gerakan dari ritual pengobatan menjadi gerakan tari AbstrakArtikel ini bertujuan untuk mengungkap sejarah penciptaan tari Sumaranun dan mengkaji makna tersirat yang terkandung dalam setiap gerakan tari Sumaranun pada masyarakat Iran yang merupakan etnis minoritas yang tinggal di pesisir, khususnya di wilayah Kabupaten Kota Belud. Tarian Sumaranun yang awalnya merupakan ritual pengobatan yang melibatkan alam gaib dan dunia nyata. Akibat ritual pengobatan ini tidak lagi dilakukan, maka ritual pengobatan ini diubah menjadi sebuah tarian yaitu tari Sumaranun. Penelitian ini melihat perubahan yang terjadi pada tari Sumaranun dari ritual medis menjadi sebuah tarian. Penelitian ini merupakan studi lapangan yang menggunakan metode observasi langsung dan wawancara untuk memperoleh informasi rinci yang telah dilakukan antara masyarakat Iran yang tinggal di desa Rampayan Laut, desa Nanamun dan desa Kota Bongan. Hasil penelitian menemukan bahwa ritual pengobatan dan tari Sumaranun memiliki hubungan yang erat sehingga menjadi sebuah pertunjukan hiburan. Kata kunci: Iranun, perubahan, gerak tari, ritual pengobatan, tarian Sumaranun

Diseases of the Indigenous Peoples of Yakutia in Photo Projects of the Late XIX ‒ First Third of the XX Centuries

Disease theme of indigenous population of the Northern national outskirts of Russia, as well as the study of special knowledge in the field of traditional medicine and healing practices, for a long time belonged to the taboo part of knowledge. However, at the beginning of the twentieth century, there was a turning point in the visual culture of region, when the picture of diseases was expressed through the camera and became public. There are works of photographers documenting the course of the most dangerous diseases, such as leprosy and external manifestations of mental disorders. The aim of this study is to study external factors that influenced the genesis of the “medical” series of visual images of the population of Northeast Asia. The research methodology is based on a cultural and historical analysis of the events that preceded its appearance and subsequent application in medical practice in order to document the course of diseases in the Soviet period. This article presents the results of a brief review of the prehistory of the “medical” direction in ethnographic photography of the Yakut region. The circle of photographers of the Yakut region is defined, where stories illustrating the diseases that the local population suffered from are reflected. At the beginning of the twentieth century, footage of medical practices and shamanistic rituals for healing were presented in the photo projects by I. V. Popov and A. P. Kurochkin. In the 1920s-1930s. the genre of “medical photography” is represented by the works of the doctor-epidemiologist T. A. Kolpakova, military surgeon E. A. Dubrovin, unknown with the initial “D”, who worked in the medical detachment of the Commission for the Study the Productive Forces of the Yakut Republic (CYR) The Academy of Sciences of the Soviet Union and the People’s Committee the Health of the Russian Soviet Federative Socialist Republic. The experience of studying this topic serves as a clear illustration of the specifics of the region and in some way confirms the conclusions made by the participants of numerous expeditions that studied the foreign population of the Yakut region and predicted the inevitable extinction in the future. Keywords: medical anthropology, anthropology of disease, visual research, indigenous people, visual text, visual sources

Challenges in visceral medicine during COVID-19

HintergrundDie sich weltweit ausbreitende COVID-19(„coronavirus disease 2019“)-Pandemie hat sich innerhalb weniger Wochen auch in Deutschland zu einem zunehmenden Problem im Gesundheitssystem und in der gesamten Gesellschaft entwickelt. Da auch die Viszeralmedizin im Fokus steht, sind deutliche Veränderungen im Vorgehen notwendig.Material und MethodeErforderliche Strukturen und Herausforderungen der Viszeralmedizin werden für notwendige Eingriffe nach Screening und bei SARS(„severe acute respiratory syndrome“)-CoV(„coronavirus“)-2-infizierten Patienten beschrieben und die Anforderungen an die Viszeralchirurgie dargestellt. Hierfür erfolgten eine Analyse der aktuellen und themenbezogenen Literatur und die Erläuterung des Vorgehens im Krankenhaus der Grund- und Regelversorgung am Niederrhein.ErgebnisseBei der Anpassung an die Krisensituation kann die Etablierung eines Systems für ein Krankenhaus in Deutschland dargestellt werden. Hierfür erfolgten unter anderem die Schaffung eines Corona-Screening-Centers am Haupteingang der Klinik und die Etablierung eines Krisenstabs für COVID-19. Spezifische interne Leitlinien wurden für das Vorgehen erstellt, erläutert, durch internationale Studien belegt und mehrfach den jeweiligen Anforderungen der Situation angepasst.DiskussionDie Krise ist mit deutlicher Verzögerung im Vergleich zu anderen Ländern in Deutschland milde verlaufen. Entsprechende Vorbereitungen konnten in vielen Krankenhäusern getroffen werden, um möglichst gut vorbereitet zu sein auf schwerkranke SARS-CoV-2-infizierte Patienten auf den Intensivstationen, auf der Isolierstation, im Operationsbereich und in der Endoskopie. Der Schutz der Mitarbeiter und der Patienten ist dabei oberstes Ziel. Letztlich werden wir durch Aufarbeitung der Pandemie auch medizinische Rituale und Angewohnheiten überdenken müssen.

Understanding the ethical implications of the rituals of medicine.

Rituals may be understood broadly as stereotyped behaviours carrying symbolic meanings, which play a crucial role in defining relationships, legitimating authority, giving meaning to certain life events and stabilising social structures. Despite intense interest in the subject, and an extensive literature, relatively little attention has been given to the nature, role and function of ritual in contemporary medicine. Medicine is replete with ritualistic behaviours and imperatives, which play a crucial role in all aspects of clinical practice. Rituals play multiple, complex functions in clinical interactions and have an important role in shaping interactions, experiences and outcomes. Longstanding medical rituals have been disrupted in the wake of coronavirus disease 2019 (COVID-19). Medical rituals may be evident or invisible, often overlap with or operate alongside instrumentalised practices, and play crucial roles in establishing, maintaining and guaranteeing the efficacy of clinical practices. Rituals can also inhibit progress and change, by enforcing arbitrary authority. Physicians should consider when they are undertaking a ritual practice and recognise when the exigencies of contemporary practice are affecting that ritual with or without meaning or intention. Physicians should reflect on whether aspects of their ritual interactions are undertaken on the basis of sentiment, custom or evidence-based outcomes, and whether rituals should be defended, continued in a modified fashion or even abandoned in favour of new behaviours suitable for and salient with contemporary practice in the interests of patient care.

The role of patient beliefs in open-label placebo effects.

Recent research on open-label placebos, or placebos administered without deception or concealment, suggests that they can be effective in a variety of conditions. The current research sought to unpack the mechanisms underlying the treatment efficacy of open-label placebos. A health care provider induced an allergic reaction in 148 participants via a histamine skin prick test. Participants were then exposed to 1 of 4 conditions additively leveraging various mechanisms of open-label placebo treatments: a supportive patient-provider relationship, a medical ritual, positive expectations, and a rationale about the power of placebos. There were no main effects of condition on allergic responses. However, participant beliefs about placebos moderated the effect of open-label placebo treatment condition on physiological allergic reactions: the condition including all 4 components of open-label placebos (a supportive patient-provider relationship, a medical ritual, positive expectations, and a rationale about the power of placebos) significantly reduced physiological allergic reaction among participants with a strong belief in placebos compared with participants in the control group. Participants' beliefs about placebos interact with information from the provider to reduce physiological allergic reactions in response to an open-label placebo treatment. This study underscores the importance of measuring and understanding how participants' beliefs influence outcomes of treatment, and furthers our understanding of when and how open-label placebo treatments work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A politics of the senses: the political role of theKing’s-Evil in Richard Wiseman’s Severall Chirurgicall Treatises

Written by Richard Wiseman, sergeant-surgeon to King Charles II of England, ‘A Treatise on the King’s-Evil’ within his magnum opus Severall Chirurgicall Treatises (1676), acts as a proto-case series which...

Myth, Manners, and Medical Ritual: Defensive Medicine and the Fetish of Antibiotics.

Given the global crisis of antimicrobial resistance, the continued misuse of antibiotics is perplexing, particularly despite persistent attempts to curb usage. This issue extends beyond traditional "wastage" areas, of livestock and community medicine, to hospitals, raising questions regarding the current principles of hospital practice. Drawing on five focus group discussions, we explore why doctors act in the ways they do regarding antibiotics, revealing how practices are done, justified, and perpetuated. We posit that antibiotic misuse is better understood in terms of social relations of fear, survival and a desire for autonomy; everyday rituals, performances, and forms of professional etiquette; and the mixed obligations evident in the health sector. Moreover, that antibiotic misuse presents as a case study of the broader problematic of defensive medicine. We argue that the impending global antibiotic crisis will involve understanding how medicine is built around certain logics of practice, many that are highly resistant to change.

Psilocybin-induced spiritual experiences and insightfulness are associated with synchronization of neuronal oscillations.

During the last years, considerable progress has been made toward understanding the neuronal basis of consciousness by using sophisticated behavioral tasks, brain-imaging techniques, and various psychoactive drugs. Nevertheless, the neuronal mechanisms underlying some of the most intriguing states of consciousness, including spiritual experiences, remain unknown. To elucidate state of consciousness-related neuronal mechanisms, human subjects were given psilocybin, a naturally occurring serotonergic agonist and hallucinogen that has been used for centuries to induce spiritual experiences in religious and medical rituals. In this double-blind, placebo-controlled study, 50 healthy human volunteers received a moderate dose of psilocybin, while high-density electroencephalogram (EEG) recordings were taken during eyes-open and eyes-closed resting states. The current source density and the lagged phase synchronization of neuronal oscillations across distributed brain regions were computed and correlated with psilocybin-induced altered states of consciousness. Psilocybin decreased the current source density of neuronal oscillations at 1.5-20Hz within a neural network comprising the anterior and posterior cingulate cortices and the parahippocampal regions. Most intriguingly, the intensity levels of psilocybin-induced spiritual experience and insightfulness correlated with the lagged phase synchronization of delta oscillations (1.5-4Hz) between the retrosplenial cortex, the parahippocampus, and the lateral orbitofrontal area. These results provide systematic evidence for the direct association of a specific spatiotemporal neuronal mechanism with spiritual experiences and enhanced insight into life and existence. The identified mechanism may constitute a pathway for modulating mental health, as spiritual experiences can promote sustained well-being and psychological resilience.

New Views: Handheld Ultrasound at the Bedside.

New Views: Handheld Ultrasound at the Bedside.

Medical Rituals and Media Rituals

In the present article the author examines the ritual elements of the professionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (with medical expertise frequently) identify themselves with these roles? Is their way of reception critical or naive? How media rituals are organizing, modulating the students' medical perception and expectations. Is there a mediated shadow initiation via media or it is excluded and denied? Does it perfuse the common social experience of becoming a doctor via peer communication and peer shaping of model behavior? We search the answers in the context of a theory of media rituals.

Medical circumcision and manhood initiation rituals in the Eastern Cape, South Africa: a post intervention evaluation

The objectives of this study were first, to report the adverse events reported following male circumcision performed by medical professionals after a one‐day training workshop; second, to report on the attitudes towards, beliefs surrounding and experiences regarding circumcision and initiation; and third, to assess the HIV‐risk behaviour of young men attending initiation schools post medical circumcision. Initiates who had been medically circumcised by trained healthcare providers were examined and interviewed on the seventh day after circumcision and, in addition, focus‐group discussions were conducted with initiates. Results indicate that of the 78 initiates physically examined on the seventh day after circumcision by a trained clinical nurse, seven (9%) adverse events (complications) were found. Initiates reported mixed attitudes towards combining medical circumcision with traditional initiation. The majority of the initiates (70%) felt that they could be stigmatized as a result of choosing medical rather than traditional circumcision and 20% thought that the relationship between medical and traditionally circumcised men was hostile. Prior to circumcision, most initiates (92%) had been sexually active and had engaged in HIV‐risk behaviour. Focus‐group discussions revealed that sexually active initiates, when asked about sex after circumcision, indicated they wished to abstain for a short period before resuming sexual activities with intended condom use being high. Findings are promising for efforts to up‐scale integrated medical circumcision alongside traditional initiation into manhood.

Sports medicine pearls and pitfalls: Pearls on the power of placebo

Placebo Wars: Sham Acupuncture Beats Sugar Pills A recent study suggests that different placebo treatments can produce different results. A total of 270 adults with persistent arm pain from repetitive use were studied. The study was a duel between two placebos: sham acupuncture versus inert pills. The main outcome measure was pain self-reported on a 10-point scale. During the first 2 weeks, little difference was seen, but over the next 4 weeks, pain scores decreased significantly more in the sham acupuncture group than in the pill group. The sham acupuncture group also improved more on the Levine symptom severity scale. Sham acupuncture also was the more credible placebo: three quarters of participants on it thought they were getting active treatment, compared with less than half of participants on the placebo pill. Another point: reported side effects were different in each group and mirrored what they were told to expect. This study, like all studies, has limitations and confounders, but it suggests that placebo effects are malleable and depend on behaviors embedded in medical rituals [1]. Sham Arthroscopy Surgery itself can be a placebo. In a controlled trial of arthroscopic surgery for the pain and stiffness of osteoarthritis of the knee, 180 men were randomized (about 60 in each group) to lavage, debridement, or sham surgery. Most men reported some improvement over the next 1 to 2 years, but at no point did either of the intervention groups report less pain or better function than the placebo group [2]. In fact, if anything, the sham surgery group did slightly better in terms of the major outcomes. This study sparked criticism and controversy, but it is not the first study to suggest that surgery can have a strong placebo effect.

Sham device v inert pill: randomised controlled trial of two placebo treatments

Objective To investigate whether a sham device (a validated sham acupuncture needle) has a greater placebo effect than an inert pill in patients with persistent arm pain.Design A single blind...

Personal view: cost and benefit of medical rituals in gastroenterology

Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention with little chances of achieving a medically relevant goal. The aim of the article is to analyse the cost-benefit relationship of rituals in gastroenterology and the reasons why gastroenterologists utilize them. Ritualistic disease management is described in terms of medical decision and threshold analysis. If the perceived benefit of a ritual exceeds its cost, the ineffectual path becomes more attractive than expectant management or doing nothing. To engage in an ineffectual intervention, the threshold probability for success needs to exceed its cost-benefit difference divided by the benefit associated with success. In choosing an ineffectual intervention, doctors tend to underestimate the true costs of a ritual and overestimate its probability of success. The availability of an effectual path leads to more stringent conditions for the benefit associated with an ineffectual path. A better understanding of their economical underpinnings should lead to more restricted utilization of rituals in gastroenterology, especially, in situations where they drain scarce resources disproportionately to their perceived benefit.

Ritual in Western Medicine and Its Role in Placebo Healing

Ritual has long been thought to play an important role in the healing processes used by ancient and non-Western healers. In this paper, I suggest that practitioners of Western medicine also interact with patients in a highly ritualized manner. Medical rituals, like religious rituals, serve to alter the meaning of an experience by naming and circumscribing unknown elements of that experience and by enabling patients' belief in a treatment and their expectancy of healing from that treatment. These are all critical elements necessary to mobilize the potent placebo effects reported elsewhere to result from doctor-patient interactions.

The Word and Wax: A Medical Folk Ritual among Ukrainians in Alberta

The Word and Wax: A Medical Folk Ritual among Ukrainians in Alberta

Too Many Throat Cultures?

Abstract This study of sore throats in a college population revealed predominately mild physical abnormalities and a low incidence of group A beta hemolytic streptococci. A concern is raised about the criterion for the interpretation of the bacitracin disc test. In the endemic or usual circumstance, the generally healthy adult complaining of sore throat while living in a good environment and having no major physical findings has an acute rheumatic fever risk approaching zero. The risk of an adverse reaction to penicillin would appear to be greater. The physician must consider the host, the environment, and the epidemiologic factors that may affect the rheumatogenicity of the organism. In light of these ambiguities, the practicing physician should reevaluate the medical ritual of throat culturing.