The Greatest Benefit to Mankind: A Medical History of Humanity. Roy Porter

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СКАЧАТЬ dirt and awaiting his fate. More active therapies embrace two main techniques – herbs and rituals. Medicines are either tonics to strengthen the patient or ‘poisons’ to drive off the aggressor. Choice of the right herbal remedy depends on the symbolic properties of the plant and on its empirical effects. Some are chosen for their material properties, others for their colour, shape or resonances within broader webs of symbolic meaning. But if herbs may be symbolic, they may also be effective; after much pooh-poohing of ‘primitive medicine’, pharmacologists studying ethnobotany now acknowledge that such lore provided healers with effective analgesics, anaesthetics, emetics, purgatives, diuretics, narcotics, cathartics, febrifuges, contraceptives and abortifacients. From the herbs traditionally in use, modern medicine has derived such substances as salicylic acid, ipecac, quinine, cocaine, colchicine, ephedrine, digitalis, ergot, and other drugs besides.

      Medicines are not necessarily taken only by the patient, for therapy is communal and in traditional healing it is the community that is being put to rights, the patient being simply the stand-in. Certain healing rituals are rites de passage, with phases of casting out and reincorporation; others are dramas; and often the patient is being freed from unseen forces (exorcism). Some rituals wash a person clean; others use smoke to drive harm out. A related approach, Dreckapotheke, involves dosing the patient with disgusting decoctions or fumigations featuring excrement, noxious insects, and so forth, which drive the demons away.

      A great variety of healing methods employ roots and leaves in elaborate magical rituals, and all communities practise surgery of some sort. Many tribes have used skin scarifications as a form of protection. Other kinds of body decoration, clitoridectomies and circumcision are common (circumcision was performed in Egypt from around 2000 BC). To combat bleeding, traditional surgeons used tourniquets or cauterization, or packed the wound with absorbent materials and bandaged it. The Masai in East Africa amputate fractured limbs, but medical amputation has been rare. There is archaeological evidence, however, from as far apart as France, South America and the Pacific that as early as 5000 BC trephining was performed, which involved cutting a small hole in the skull. Flint cutting tools were used to scrape away portions of the cranium, presumably to deliver sufferers from some devil tormenting the soul. Much skill was required and callous formations on the edges of the bony hole show that many of the patients survived.

      BODY LORE

      Illness is thus not just biological but social, and concepts of the body and its sicknesses draw upon powerful dichotomies: nature and culture, the sacred and the profane, the raw and the cooked. Body concepts incorporate beliefs about the body politic at large; communities with rigid caste and rank systems thus tend to prescribe rigid rules about bodily comportment. What is considered normal health and what constitutes sickness or impairment are negotiable, and the conventions vary from community to community and within subdivisions of societies, dependent upon class, gender and other factors. Maladies carry different moral charges. ‘Sick roles’ may range from utter stigmatization (common with leprosy, because it is so disfiguring) to the notion that the sick person is special or semi-sacred (the holy fool or the divine epileptic). An ailment can be a rite de passage, a childhood illness an essential preliminary to entry into adulthood.

      Death affords a good instance of the scope for different interpretations in the light of different criteria. The nature of ‘physical’ death is highly negotiable; in recent times western tests have shifted from cessation of spontaneous breathing to ‘brain death’. This involves more than the matter of a truer definition: it corresponds with western values (which prize the brain) and squares with the capacities of hospital technology. Some cultures think of death as a sudden happening, others regard dying as a process advancing from the moment of birth and continuing beyond the grave. Bodies are thus languages as well as envelopes of flesh; and sick bodies have eloquent messages for society.

      It became common wisdom in the West from around 1800 that the medicine of Orientals and ‘savages’ was mere mumbo-jumbo, and had to be superseded. Medical missions moved into the colonies alongside their religious brethren, followed in due course by the massive health programmes of the modern international aid organizations. By all such means Europeans and Americans sought to stamp out indigenous practices and beliefs, from the African witchdoctors and spirit mediums to the vaidyas and hakims of Hindu and Islamic medicine in Asia. Native practices were grounded in superstition and were perilous to boot; colonial authorities moved in to prohibit practices and cults which they saw as medically, religiously or politically objectionable, thereby becoming arbiters of ‘good’ and ‘bad’ medicine. Western medicine grew aggressive, convinced of its unique scientific basis and superior therapeutic powers.

      This paralleled prejudices developing towards folk or religious medicine within Europe itself. The sixteenth-century French physician Laurent Joubert (1529–83) wrote a huge tome exposing ‘common fallacies’. Erreurs populaires [1578] systematically denounced the ‘vulgar errors’ and erroneous sayings of popular medicine regarding pregnancy, childbirth, lying-in, infant care, children’s diseases and so forth, insisting that ‘such errors can be most harmful to man’s health and even his life’. ‘Sometimes babies, boys as well as girls, are born with red marks on their faces, necks, shoulders or other parts of the body,’ Joubert noted. ‘It is said that this is because they were conceived while their mother had her period … But I believe that it is impossible that a woman should conceive during her menstrual flow.’ Another superstition was that whatever was imprinted upon the imagination of the mother at the time of conception would leave a mark on the body of her baby.

      Elite medicine sought to discredit health folklore, but popular medicine has by no means always been misguided or erroneous. Recent pharmacological investigations have demonstrated the efficacy of many traditional cures. It is now known, for instance, that numerous herbal decoctions – involving rue, savin, wormwood, pennyroyal and juniper – traditionally used by women to regulate fertility have some efficacy. Today’s ‘green pharmacy’ aims at the recovery of ancient popular medical lore, putting it to the scientific test.

      Once popular medicine had effectively been defeated and no longer posed a threat, scholarly interest in it grew, and great collections of ‘medical folklore’ and ‘medical magic’, stressing their quaintness, were published in the nineteenth century. But it is a gross mistake to view folk medicine as a sack of bizarre beliefs and weird and wonderful remedies. Popular medicine is based upon coherent conceptions of the body and of nature, rooted in rural society. Different body parts are generally represented as linked to the cosmos; health is conceived as a state of precarious equilibrium among components in a fluid system of relations; and healing mainly consists of re-establishing this balance when lost. Such medical beliefs depend on notions of opposites and similars. For example, to stop a headache judged to emanate from excessive heat, cold baths to the feet might be recommended; or to cure sciatica, an incision to the ear might be made on the side opposite to the pain.

      Traditional medicine views the body as the centre or the epitome of the universe, with manifold sympathies linking mankind and the natural environment. Analogy and signatures are recurrent organizing principles in popular medicine. By their properties (colour, form, smell, heat, humidity, and so on) the elements of nature signal their meaningful associations with the human body, well and sick. For instance, in most traditional medicine systems, red is used to cure disorders connected with blood; geranium or oil of St John’s wort are used against cuts. Yellow plants such as saffron crocus (Crocus sativus) were chosen for jaundice, or the white spots on the leaves of lungwort (Pulmonaria officinalis) showed that the plant was good for lung disease, and so on. Sometimes it was argued that remedies had been put in places convenient for people to use. So, in England, the bark of the white willow (Salix alba) was valued for agues, because the tree grows in moist or wet soil, where agues chiefly abound, as the Revd Edmund Stone, of Chipping Norton in Oxfordshire, observed in his report to the Royal Society of London in 1763:

      the general maxim, that many natural maladies carry their cures along with them, or that their remedies СКАЧАТЬ