M e 18 CaIcross-Cultural Studiesin Health and IllnessAnt ropologyVOLUME 7 .NUMBER 1 .WINTER 1983": Breast-Feeding Determinants...in Low-incom~ C°';lntries. co -'. ~ " Popkin, Bllsborrow,Akin and Yamamoto¥.. Community Morbidity Patterns--'~ -and Mexican American Folk Illnesses..Trotter.. Migration, Modernization and Hypertension-I R. Hackenberg, B. Hackenberg,Magalit, Cabral and GuzmanDifferential Diagnosis in Paleopathologyand the Concept of Disease EvolutionKlepingerREDGRAVE PUBLISHING COMPANY,ICommunity Morbidity Patterns and Mexican AmericanFolk Illnesses: A Comparative MethodologyROBERT T. TROTTER IIThe general ethnographic parameters of Mexi- the researchers combined with the emphasis oncan American folk healing have been well ritual practices that is prevalent in anthropol-established, as evidenced by the seminal and ogy. This tendency produces descriptions ofthe recent works on the subject (e.g., Clark ethnomedical systems that suggest a general1959; Rubel 1960, 1964; Madsen 1961, 1964; pervasiveness of culturally-constructed folkRomano 1960, 1964, 1965; Kiev 1968; and illnesses treated by healing specialists with lit-Trotter and Chavira 1975, 1980, 1981). These tIe or no attention directed to the treatment ofworks, and the closely related ones presented symptoms or ailments within the home. Thisin their bibliographies, represent more than situation can be demonstrated by a brieftwenty years of nearly continuous ethnomedi- analysis of three works from the same geog-cal research in the Lower Rio Grande Valley of raphical area from which the data for this paperTexas. However, one critical factor has been are derived.neglected in these books and articles. To date, Madsen (1964) devotes one-third of hisno one has produced an ethnographically sensi- monograph (37 out of 112 pages) to a descrip-tive technique to establish the relative position tion of the existence and treatment of folkof the folk illnesses described in these works illnesses such as susto, and empacho, and thewithin the context of all of the health problems existence of folk healers, curanderos, in thefaced by Mexican American communities. community. While he describes some of theUnfortunately, this lack of balance may have negative attitudes of his informants towardscreated a false impression about Mexican physicians, he devotes virtually no space toAmerican ethnomedicine; a subtle form of cul- either positive attitudes towards physicians, ortural stereotyping brought about by the to the treatment of physical ailments in theinteractions of the theoretical orientations of home. Rubel (1966) devotes forty-seven pages34 MEDICAL ANTHROPOLOGY / Winter 1983 rI(18 percent of the total monograph) to culture sensitive method for determining: (1) the typesbound syndromes and folk healers, and, again of illnesses which are treated within the home,fails to take into account the possible home (2) the forms of treatment which are utilizedtreatment of physical ailments. Yet both when people attempt to cope with illness atauthors note an under-utilization of physi- home, and (3) the sociocultural characteristicscians, who, they point out, treat physical ail- of people using home treatments for illnesses.ments exclusively. This causes one to wonder This analysis of variation in treatment provideswhat their informants were doing to cope with a considerably different view of folk illnessesthe pervasive physical problems that occur in from the more homogeneous descriptionsall cultures. My feeling is that our inordinate found in earlier works.interest in rituals is at fault here. The ritualssurrounding the magico-religious part of Mex- METHODOLOGYican American ethnomedicine stand out to a The methodology used in collecting the datatrained observer, causing the more common, reported in this paper combines the strength ofbut less spectacular use of home treatments to an open-ended case study approach with thedisappear into the background of everyday liv- potential for quantification of results found ining in the community. a survey. The basic premises and data gather-Even in the author's own monograph (Troner ing techniques utilized are already described inandChaviro 1980), only approximately ten pages detail elsewhere (Trotter 1981a, 1981b), butout of 200 are devoted to descriptions of the will be briefly reviewed here for the sake ofhome treatment of physical ailments, less than 5 clarity.percent of the total monograph. On the other We are collecting case examples of the use ofhand, more than 50 percent of the work is home remedies (remedios caseros) in an on-devoted to descriptions of ritualized treatment going survey, then coding each case into a com-processes. These imbalances in the description of puter archive for analysis. Each case in the ar-the magical treatment of folk illnesses, compared chive is collected within a common format con-with the often ignored and more prosaic treat- sisting of the following items: the name orment of physical symptoms not conceptualized names of the remedy, the illness it treats, theas a folk illness, may well set up an assumed method of preparation and administration ofdichotomy in the mind of the reader, even the remedy, an example of an actual use of thethough the authors never intended such a dis- remedy, plus basic demographic data on thetinction. This dichotomy is the equation of ritu- informant who supplies the information (age,als and magical illnesses with ethnomedicine, sex, ethnicity, languages spoken, residence,and physical illnesses with biomedicine. Even place or country of birth, occupation, etc.).though there are multiple caveats in all three The data presented in this article representmonographs to the contrary, it is entirely possi- an analysis of all cases presented by Mexicanble that the reader could be left with a false American informants currently in the comput-impression of the pervasiveness of folk illnesses er archive. The number of case examples col-in the communities described. lected from individual informants ranged fromSince even unintentional cultural stereotyp- one to twenty-nine. However, this should noting, created by the conditions described above, be taken as the upper limit of knowledge ofcan have serious negative effects, this paper