I feel like this is important, if a little dry. Some of the terms I use are also used by people outside the discipline and they don’t always mean the same thing. That doesn’t mean anyone is necessarily wrong. It just speaks to the lack of cohesion between disciplines, which is one of my strongest critiques of academic.
Anthropologist, Arthur Kleinman first defined a society’s health care system as being comprised of the popular, folk, and professional sectors. This is the model which I learned in college and has been useful to me in studying the history of healing.
The professional healthcare sector is comprised of academically trained providers such as MD’s, naturopathic physicians and yes, clinical herbalists. In the past these healers were often trained through an apprenticeship to a professional healer who agreed to see to their education. Prescriptive formulas or professional patent medicines employed by professionals. frequently replaced native medicinal preparations.
Cultural healing systems such as Āyurveda and Traditional Chinese Medicine (TCM) were constructs of the literati of their respective cultures. Study was most frequently limited to males of the elite class and required education of a level that few received in these highly stratified societies. Education in these modalities is still expensive to obtain.
Western practitioners mentioned by those discussing the history of herbal medicine, such as Hippocrates, Dioscorides and Gerarde, were academic elites and as such members of a professional healthcare sector. Even Culpeper, who was frequently at odds with the English College of Physicians, began his career having been apprenticed to an apothecary.
This leads me to tangent for a moment on the term “herbalist” which I find more and more problematic to use. Historically, the term herbalist came about as a descriptor for someone who had authored an herbal. Take John Gerarde as an example. Gerarde is often spoken about as an herbalist. Technically he did author (or at least plagiarized) one of the most influential herbals of the Middle Ages, but he was not a naturalist. He was a junior warden of the Barber-Surgeon’s Company and consequently a professional physician, in his era. He was also a sexist, asshat-but I digress.
My point is that herbalist is at best a modern construct and you would be hard pressed to find a historical figure that corresponds with the modern idea of an herbalist.
The folk health care sector is comprised of the traditional healing specialists of a community. Historically, these healers included lay midwives, fairy doctors, bean feasa, and “cunning folk” with far more in their repertoire than the therapeutic delivery of plant medicine. Folk healers often work from a framework influenced by indigenous cultural ideas about the spirit world influencing health and the communal aspects of wellness.
Folk healing is not limited to a particular spiritual practice. In many Gaelic communities, priests were called on as folk healers when it was thought an illness was caused by the supernatural-what anthropologists sometimes term a “naturalistic” cause. Modernly it is at least theorized that a lot of these types of conditions were due to mental health problems and mental health professionals now fill this roll. To my way of thinking that is just wrong. But more on that later.
Popular Health Care or Domestic Medicine
Popular health care refers to self-care, or familial care, practices informed by popular knowledge. Often knowledge of this nature is passed along by word-of-mouth – frequently as home remedies that are passed down through the generations or through community skill-sharing networks. In its strictest sense, the term does not apply to any particular type of remedy. It also is not limited to addressing illness. Self-care in the form of diet, hygiene and simple protective measures are aspects of the popular healthcare culture.
Self-medication still accounts for more than 80% of medical care in our society. It is not a thing of the past; it was simply co-opted by the pharmaceutical companies. People stopped self-medicating with the old home remedies and started buying over-the-counter replacements. We take aspirin or Tylenol instead of decoctions. We stopped making ointments and turned to Vick’s Vaporub, Ben Gay, and more recently –essential oils. Grandma’s marshmallow syrups were outperformed-first by patent medicines and then by Robitussin.
The work I have done in trying to educate people about the early practice of domestic medicine is in part, trying to illustrate the widespread nature of early popular health care practices. I am also restore our respect for women as the “keepers and carriers of knowledge”.
Where Modern Herbal Healers Fit?
Traditional Western Herbalism employs botanical therapeutics in a way that is grounded in Greek Medicine and the professional methods of physicians the late 19th and early 20th century.
This is what some anthropologists call cultural sedimentation. Basically what this means is that professional medical practices of the past are picked up by the folk healers and common folk, who keep using these methods even after the professionals have moved on to new approaches. Tinctures are an example of a type of patent medicine used primarily by the professional healthcare sector, until modern times.
That in no way invalidates their usefulness. Botanical preparations were the only type of medicine animals and humans had at their disposal until the beginning of the 20th century and we certainly learned much about their effective delivery through centuries of trial-and-error experimentation.
All of that being said, I really hesitate to label Traditional Western Herbalism as folk healing. It is taught and disseminated in a way similar to other professional healing practices. In fact, that may be one of our greatest challenges. As members of the professional sector, we have had to pay for our education and clinical training, but we are not duly recognized as professionals in many places.
I also think the training a modern herbalist receives omits many of the responsibilities that I consider inherent to the role of the folk healer.
What is Ethnomedicine?
My anthropological focus is actually ethnomedicine, rather than ethnobotany. I investigate far more than how plants were used by a culture because I was taught that to understand a native healing practice, you have to know a place. You have to understand that culture’s history, social structures, agricultural practices, and spiritual beliefs in a way that gives you a complete picture as to how healing occurs in a society-both physical and emotional. You have to learn to view illness and treatment according to a native explanatory model and put aside the biomedical model.
Illness vs Disease
Disease is a biomedical condition or a pathological state that exists whether or not they are culturally recognized. Illness is more of a social construct -based on whether or not, a condition has been stigmatized or devalued in a society. Anthropologists tend to understand that is not always easy to distinguish between the biological aspects of illness and the social aspects. This distinction is what makes it entirely possible for me to view ASD as an illness but not think of it as a disease that needs to be cured.
So that covers some of the terminology that I might use as I eventually move on in this series and some ideas that I have explored in my research.