8.3: Medical Systems

Naturalistic System

Naturalistic Systems can be an approach to the explanation, diagnosis, and treatment of illness which focuses on the underlying bio-mechanical processes behind human disorder. Naturalistic medicine is largely the foundation of the Western model of bio-medicine and practitioners rely heavily on the use of imaging technologies and the scientific method to develop treatment plans. Philosophically, naturalists approach human disorder from the perspective that illness is impersonal and that there is always an identifiable source of pathology in the diagnostic process.

Personalistic System

Largely uncommon in the developed world, the personalistic approach to medicine explains human disorder in terms of preternatural sources of pathology (such as spiritual possession or religious transgression). Illness is considered unique to the patient and medical practitioners often call upon supernatural forces to facilitate the diagnosis and treatment of disorders because the illness is caused by supernatural forces as well. An example of this is the “evil eye.” A person who is envious of another’s good fortune may transfer malignant influence through the “evil eye”, which will result in harm to the recipient.[4]

Modernly, personalistic systems of medicine are most commonly found in small-scale societies. Globally, the personalist approach in decline and has disappeared completely in some cultures. For example, therapeutic shamanism was commonly practiced amongst Inuit peoples and a complex tradition of spiritual healthcare was reported by early ethnographers (see Merkur 85). These traditions are now very rarely practiced and many of the traditional practices have been lost entirely (see Shamanism amongst Eskimo peoples).

Medical Models

Medical models are the explanations of health and illness that are accepted by different cultures. The biomedical model is the most widely accepted medical model by many cultures, including the vast majority of Western culture, but there are multiple other explanations that are accepted by some cultures.

The medical model of disability is a model by which illness or disability is the result of a physical condition, is intrinsic to the individual (it is part of that individual’s own body), may reduce the individual's quality of life, and causes clear disadvantages to the individual.

Some anthropologists believe that the biomedical model is quite provincial. They do not believe that there is enough room for the interpretation of the psychological, behavioral, and social aspects of all of the illnesses. Something called a biopsychosocial [2] model has been proposed. In this there would be more room different aspects of health care.

Humoral

The term Humoral refers to elements in the blood or other fluids that reside within the body. In medicine,the term humor refers to a fluid substance. The aqueous humor is the fluid that normally resides within the front and rear chambers of the eye. The humors were part of an ancient theory that believed that health came from balance between the bodily liquids. These liquids were termed humors. If these fluids were not balanced, a person was more likely to become infected with diseases.

Paired qualities were associated with each humour and its season and element,the humors were:

1. Phlegm: winter, water, characteristics: rational, calm, unemotional
2. Blood: spring, air, characteristics: courageous, hopeful, amorous
3. Gall: (black bile thought to be secreted by the kidneys and spleen) autumn, earth, characteristics: analytical, wise, despondent
4. Choler: (yellow bile secreted by the liver) summer, fire, characteristics: short-tempered, fast, irritable

This theory which was also known as the humoral theory, humoralism, and humorism was devised before the time of Hippocrates (c.460-c.375 BC). Today pathology rests on a cellular and molecular foundation. All of the humors have been dispelled, except for the aqueous humor and vitreous humor of the eye. The theory of humors was commonly used until the nineteenth century when modern medical techniques were developed.

The health and healing system of Haiti incorporates humoral-influenced concepts from West Africa. Their system relies on monitoring and regulating their four humors (hot and cold, dry and wet). Eventually their system was simplified, with the dry and wet humors being omitted. They believe a balance is necessary to maintain good health. The balance is affected by the season, how they live and especially how they eat.[5]

Kallawaya Traditional Medicine

The shamans of the Kallawaya people, located in the Andes in Bolivia are an example of humoral medicine. They believe that health and illness are affected by the balance of spirit and soul caused by the earth, or the goddess Pachamama. Their healing art is based in their ability to look into the lives of the ill to see patterns in the day to day aspects such as work, health, routines and relationships and to recognize where there are imbalances. Shamans make use of music, dance, and animal sacrifice to help appease the divine, thus curing illness. The shamans use many herbs, for instance most of the Kallawaya healers have knowledge of at least 300 herbs. They also incorporate alcohol and ayahuasca, which, with the guidance of the shaman, can produce a drug-induced state of healing[6]

Ayurveda

Figure \(\PageIndex{1}\): Dwanandhari Deva is believed to be the Lord of Ayurveda

Ayurveda is a 5000-year old traditional system of medicine in India that originated during the Vedic period of Indian history.[3] It is also practiced as an alternative system of medicine in other parts of the world, where yoga, meditation, massage, or healing herbs or foods are used as a supplement to the biomedical model.

Ayurveda is a humoral system, in which blood, chyle, flesh, fat, bone, marrow, and semen are the primary elements. These are divided into air (or spirit), phlegm, and bile, each of which represent a divine force, or dosha. The three doshas are vata (air), pitta (bile) and kapha (phlegm). According to Ayurveda, humans are dominated by one or two of these doshas. Having a balance between the three means that one is in complete health. This balance is achieved through moderation of sleep, sexual intercourse, medicine, and food. Different types of foods are beneficial to people of different doshas. When the doshas are too far out of balance, it can lead to both physical and mental sickness.

Ayurvedic practices include hygienic rituals, ingestion of certain foods and herbs as treatments, and yoga or meditation. The balance between the physical and mental is an important aspect of Ayurvedic healing.

Spiritual Healing

Figure \(\PageIndex{2}\): A man practices yoga meditation outside.

Spiritual healing practices transmit energy to a person in need through means of meditation, prayer, or the presence of a healer, and provide an alternative to standard medical procedures. It is part of the holistic approach to healing which involves the unification and harmony of the mind, body, and spirit in order to achieve wellness. Sickness often originates in the mind so spiritual healing can be beneficial in alleviating stress, coping with emotional issues, and increasing overall happiness. The absence of such mental problems can eliminate physical troubles. For example, meditation aids in lowering heart rate, decreasing high blood pressure, and lessening cholesterol levels because it clears and calms the mind to the extent that stress does not affect the physical state of the body.

A popular and recommended act of spiritual healing, is found in Yoga. It has been said by many that it allows and gives a sense of self-awareness, benefits to positive mental presentation, and overall encourages personal strength and confidence through living a spiritual and healthy lifestyle.

Another act of spiritualism comes through shamanism and shamanistic rituals. The shaman is a person in the community who has been given the power of healing sometimes through divine annunciation, Where god or some form of a deity gives the person the ability to heal. This healing can come in several forms, that of rituals that give the shaman the power to heal, such as the trance dance or boiling energy that the !Kung perform. Another for comes as herbs and medicine that the healer gets knowledge about from the divine connection that they have.

Religion often plays a role in spiritual healing in that people form a relationship with a higher source and are able to channel energy from such a source. This being could be God, nature, or something else meaningful to the individual. It is important to note that if the individual who chooses to form this connection holds full commitment and trust in the higher source, feelings of security, peace of mind, and guidance and are likely to follow, all of which are essential in maintaining a healthy lifestyle.

Kundalini Tantric Yoga

A popular form of spiritual healing is found in Kundalini Tantric Yoga, practiced in various parts of India and the United States. Kundalini energy refers to dormant or spiritual energy within the body that we are usually unaware of. Once Kundalini energy is activated through deep meditation and yoga, the Nadi system, referring to channels of Kundalini energy, is activated as well. This creates a connection between the seven levels of chakras; the centers of consciousness potential that reside along the spine. Each chakra corresponds to a set of desires connected to a certain element.

Figure \(\PageIndex{3}\): The seven different chakras pictured in their locations, with the exact number of petals each chakra is said to have.

The first of the seven chakras is called the Muladhara. Its color is red and it is said to lie between the genitals and the scrotom. It governs sexuality and instinct. The second chakra is orange and it is called the Svadhisthana. It lies on the belly and is said to govern, among other things, creativity. Manipura is the third chakra. It is yellow, lies just under the solar plex and controls one's will power. The fourth chakra is the Anhata. Anhata is located near and governs the heart. It is the color green. Vishuddha is the fifth. Its color is turquoise and it governs the voice. It is located in the throat. Ajna, the sixth chakra, is indigo blue. It lies in the brain and governs wisdom. The final chakra can only be tapped upon once all the other chakras have energy flowing through them. It is called Sahasrara. It is purple and it brings enlightenment. It sits on top of the head and is said to inspire universal consciousness and unity.

The goal of Kundalini Tantric yoga is to free oneself from such desires as energy moves higher and higher along the chakras, opening them until it reaches the seventh chakra, called the Sahasra Chakra, located at the top of the cranium. A person can move energy through his or her chakras through tantric yoga, a form of yoga in which one seeks to free the mind of desires through various breathing exercises, contemplation, and meditation. When the seventh chakra is finally opened, a person is said to achieve full consciousness and liberation from the slavery of desires. Through the spiritual experiences one has encountered with the opening of each chakra, the result is inner harmony and overall happiness, which are significant aspects of living a positive, healthy lifestyle.

On a religious note, Hindu mythology offers an explanation for the movement of Kundalini energy throughout the body as one practices Tantric yoga. It is said that the serpent goddess Kundalini Shakti resides at the base of the spine, coiled up around the first chakra. As energy is activated and released through Tantric Yoga, she awakens and rises up the spine, opening the chakras along the way and energizing these conscious potentials. When she reaches the seventh chakra, she is united with her spouse, the God Shiva. Shiva is a symbol of change and the destruction of old habits. Their union leads to the liberation of the individual practicing the yoga, turning them into an “individual of the universe.”

Western Biomedical Model

Figure \(\PageIndex{4}\): Cell culture vials.

This is the most popular medical model in medicine today and can be found all across Western societies, as well as others. It looks at humans as biological organisms in order to discover methods for curing diseases and treating illness. This model focuses mainly on physical processes such as physiology and biochemistry and disregards social or spiritual factors. Under the biomedical model, health is defined as the absence of pain or disease, and the body is treated with scientifically-based methods.

It should be noted that the Western approach to biomedical theory and practice is constantly adapting in response to new scientific and philosophical revelations regarding illness. The model focuses on the treatment and cure of disease through medical science, and does not promote disease prevention. In recent years, naturopathic medicine (once largely considered at odds with orthodox bio-medicine)has gained recognition as a viable facet of treatment for a wide variety of disorders. Biomedicine is seen as a model that allows for the repair of the body and to fix problems that happen to the body from the surrounding environment. Biomedicine arose during the industrial revolution as a way to help people recover from diseases that affected them. (http://www.open.edu/openlearn/body-mind/health/health-studies/what-biomedicine)

One of the criticisms of the Western Biomedical Model is that it discounts the personal knowledge and beliefs of its participants. The system is said to consider ‘professional knowledge’ as the correct, rational, scientific approach while lay beliefs are considered non-rational, unscientific, suppression and are thus ignored. This leads to potential tension between health care providers and patients.[7]

Ethnographic example: The biomedical model has been critical in the development of our country. One of the many influences it has had was treating tuberculosis, a life threatening infectious disease. In 1880, after studying the disease, scientists confirmed that it was contagious. Even before antibiotics this helped to dramatically decrease the number of people that died by using quarantining and sanitizing methods. The first successful immunization was developed in 1906 by Albert Calmette and Camille Guérin. The bovine-strain tuberculosis vaccine (also known known as bacille Calmette–Guérin or BCG), became mainstream after World War II in the U.S., Great Britain and Germany. In the mid 20th century, the antibiotic streptomycin was discovered and offered an effective alternative cure for tuberculosis. Many strains have become resistant to certain antibiotics, however, forcing immunologists to develop new vaccines and treatments to cure more virulent species.

Immunization

Figure \(\PageIndex{5}\): Infant being administered a measles vaccine in Kibati, Congo

The term immunization refers to rendering an organism immune to a specific communicable disease. Immunizations work by triggering the human body to produce antibodies that will help fight a particular disease. The antibody response is created by injecting a small amount of either a dead or live virus, (depending on the virus) into the person receiving the immunization in order to initialize a immune system response to the virus. Therefore in the future if the person who was immunized was exposed to the virus, he or she would already have the antibodies to fend off the virus. Along with the introduction and transmission of many new complex diseases, population growth and the globalization of medicine has brought about the eradication of many previously devastating disorders, including smallpox and polio, through wider availability of immunizations. Many parents in Western countries routinely schedule immunizations for their children to prevent them from contracting a specific communicable disease. While many vaccinations are routine and readily available only in developed nations, the continued globalization of medicine will eventually have a dramatic effect on the improvement of health care in developing countries.[8] [9]

There is a great deal of controversy over vaccination in some cultures regarding the morality, ethics, necessity, safety, and practicality of vaccination have led some parents to keep their children from being vaccinated. Opponents of vaccines claim that they are dangerous, ineffective, and infringe on personal rights.

And example of this is the current debate over whether or not certain vaccines cause autism in children. There is a small but dedicated group of doctors who claim that vaccines may be linked to the onset of autism in children. As a result many parents are insisting their children be exempt from the mandatory vaccines although there are no medical findings which prove the link between the two.[10]