Medical anthropology in Mexico

Medical anthropology in Mexico

Sock. Sci. Med. Vol. 28. No. 12. pp. 1343-1349.1989 PergamonPresspk. Printedin Great Britain MEDICAL ANTHROPOLOGY INTRODUCTION Medical anthropolog...

918KB Sizes 0 Downloads 178 Views

Sock. Sci. Med. Vol. 28. No. 12. pp. 1343-1349.1989 PergamonPresspk. Printedin Great Britain

MEDICAL

ANTHROPOLOGY

INTRODUCTION

Medical anthropology has a long history in Mexico. At the time of the Conquest of Mexico, the Spaniards found a thriving medical system. Hernan Cortes had his wounds healed by native practitioners and several friars described the way of life of Mexican Indians, including a record of their medical skills. Since then scientists in Mexico have been interested in nonWestern medical systems. We present here the role that medical anthropology has played in understanding these systems and in trying to improve the health conditions of Mexico. The purpose of this article is to give Englishspeaking readers an overview of the activities that medical anthropologists have carried out, and the publications that have appeared in Mexico in recent years. We acknowledge the influence that many foreign medical anthropologists have on their Mexican colleagues. But for our present purpose, this account is limited to work published in Mexico, or by scholars affiliated to Mexican institutions. BACKGROUND

The groups that lived in Mexico before the conquest had developed medical knowledge and practices based on their cosmovision and the resources available to them. This corpus was altered with the European conquest and later developed into what we call now the traditional Mexican medical systems. These are very dynamic and incorporate new trends with ease. Some of them still have a strong pre-Hispanic influence. while others do not have it at all. At the same time, official medicine has become deeply rooted. There are many schools of medicine, the vast majority belonging to the mainstream of scientific medicine. Homeopathy is a system that has wide acceptance. The Escuela National de Homeopatia was founded in 1895 and followed soon by the Hospital National Homeopatico. In 1912 a group of homeopaths founded the Escuela Libre de Homeopatia. The Escuela National de Homeopatia in 1937 became an institution of the Instituto Politicnico National. and the homeopathic hospital is now part of the Secretaria de Salud. Homeopaths are licenced by the government to practice medicine. Biomedicine or official medicine reaches most of the inhabitants in the cities and large villages through public and private physicians and institutions. It is highly regarded by the people. who are amazed at is effectiveness. attained through the use of complicated technology. surgery. powerful drugs. and by surrounding itself with an aura of power and selfAddress correspondence to: Dr L. A. Vargas. Ingenieros 55. Miguel Hidalgo. D.F.. 11800 Mexico.

IN MEXICO

assurance. Nevertheless, traditional medicine is still widely used, both where official medical institutions are absent, and in those rural and urban settings where they are more available. Patients in many modern hospitals comply with the prescriptions of their doctors, whilst also following those of their family or their curanderos. Medical students working in hospitals during the first stages of their clinical practice often experience cultural shock. They have learned a terminology and a way of understanding health and disease not always shared with their patients. Some of the ideas and practices of their patients seem irrational and sometimes life-threatening (for example, applying cow dung to the umbilical stump of the new-born). This situation becomes more stressful during the months in which some of the last year medical students or ‘pasantes’ have to spend a year working as community doctors in isolated communities. There they face what they consider bizarre medical practices, unusual terminology, and in many cases get to know the practices of the local healers and midwives. These ‘pasantes’ treat a varied pathology of common diseases against which little can be done, since they are linked to poverty and poor hygiene. Most of their patients cannot afford the diagnostic procedures and medical treatments that modern medicine considers essential. The range of medicines that can be prescribed is also limited by their cost and availability. At the same time ‘pasantes’ observe that the very healers and midwives they despise are respected by the community because they are effective. Most physicians deal with this incongruency by denying the situation and considering folk medical beliefs and practices as something pertaining to ignorant and superstitious people, or at least a phenomenon which they cannot understand. Very few explore the matter further and become interested in studying the success of these seemingly unscientific practices. A third group has tried to explore them with more objective criteria. These common responses towards traditional medicine have a certain parallel in the way these have been analyzed by scientists in Mexico. DESCRIPTIVE STUDIES

What we call the studies of admiration and description of traditional medical practices started with the works of early sixteenth century writers that have been considered models of modern ethnographic studies. The foremost author was Fray Bernardino de Sahagun [l] whose wealth of information and methodology to register the way of living of the Mexica still amazes. He was followed by Fray Diego Duran [2] and many others. Later more scholarly works were written, such as Francisco Xavier Clavijero’s history (31. With more practical ideas

1343

1344

Beyond the Anglophone World

in mind, some Spanish physicians coming to the New World studied Indian medicine and incorporated it in the European practice of their times. The most interesting figure of this group is Francisco Hernbndez, who spent many years in Mexico, collecting information, classifying and trying to understand the mode of action of native plants, animals and minerals used in medicine. In recent years the Universidad National Autonoma de Mexico has finished the publication of all of Hernandez’ works, a task that took more than 20 years to finish [4]. Botanical expeditions such as the one by Martin Sessi and Jo& Mariano Mociiio, sent by the King of Spain, have left us with accurate descriptions of many herbal remedies [S]. These sources require still more study. Over the years Mexican physicians continued to assess the results of traditional medicine. They reported them in isolated publications and some products became part of the Western pharmacopea. One of the first serious efforts to study scientifically the medicinal products of Mexican traditional medicine was undertaken by the Instituto Medico National which published papers on the pharmacology of several plants, based on experimental research. This has also been one of the major purposes of Instituto Mexican0 para el Estudio de las Plantas Medicinales (IMEPLAN), which evolved into the Unidad de Investigacibn Biomedica en Medicina Traditional y Herbolaria of the Instituto Mexican0 de1 Seguro Social and has reexamined several popular remedies. This institution is incorporating the leaves of Zapote blanco, a hypotensor, and of guava, an antidiarrheal, into Mexico’s official pharmacopea. IMEPLAM published two journals: Medicina Traditional [6] and Estudios de Etnobothica y Antropologia Mkdica [7j, that served as a forum for those interested in these subjects. UNAM has continued the publication of the latter as Estudios de Antropologia MPdica. IMEPLAM has continued the efforts of the old Instituto Medico National in analyzing products that have a low cost, are easily available and are effective and safe and can be incorporated into the medical arsenal. The main difference is that it has used an interdisciplinary approach and set realistic goals by selecting areas of priority to conduct their research in relation to Mexico’s major health problems [8]. Descriptive analysis of the modern native Mexican medical systems continue to understand their variability and complexity. Fortunately they are included in most ethnographical studies and many of the ‘modern’ trends such as ‘naturismo’ are being explored. For instance, a group at Universidad Aut6noma de Querktaro has started a project studying the parallel medical care systems that are available in the city of Querttaro [9]. ‘Espiritismo’ and ‘espiritualismo’ are medical systems that have aroused considerable interest, since they have local features and are widely used [lo]. The Escuela National de Antropologia e Historia and other institutions that teach anthropology have sponsored several dissertations on medical anthropology. Unfortunately most of them remain unpublished [ 1I].

THE ROLE OF .MEDICAL HISTORIANS

Medical history has been another approach to understanding Mexican medical systems. Medical historians such as Francisco Fernindez de1 Castillo, Jose Joaquin Izquierdo and Germin Somolinos wrote about several aspects of Mexican medical history, including traditional and pre-Hispanic medicine. A new point of view of the approaches used in studying those historical sources was presented by Ganzalo Aguirre Belt&, a physician and anthropologist, in his reception speech at the National Academy of Medicine [12]. This is a crucial paper, since it broke with the etic approach and made a plea for viewing native medical systems within context of their own time and culture. His approach has been followed by several Mexican medical historians. Two of the most important are Fernando Martinez Cartes and Alfred0 Lopez Austin. Martinez Cortls published a book analyzing Nghuatl medicine [13] and has coordinated the Historia General de la Medicina en Mexico, the first volume of which was published in 1984 [14]. Alfred0 Lbpez Austin has produced several important articles with his translations of the NahuPtl texts obtained by Sahagim, and has analyzed Fray Bernardino’s research techniques [ 151. L6pez Austin also wrote a general overview of Mexican medicine, commenting on several texts [16]. His most recent work in this field is ‘Cuerpo human0 e ideologia’, a reconstruction of the Ndhuatl views of the structure and function of the human body [17]. This book is about to be published in English. Carlos Viesca, Juan Somolinos, and Iganacio de la Pefia have also made important advances in our understanding of pre-Hispanic medicine [18]. With the contribution of anthropologists and historians from the U.S.A. such as George M. Foster and Bernard0 Ortiz de Montellano, medical history with an anthropological perspective is flourishing in Mexico. At UNAM and other universities, courses on Mexican medical history are offered to undergraduate medical students each year. At the Facultad de Medicina of UNAM, medical anthropology has recently been incorporated into this required course. Monographic courses on Nahuatl medicine for physicians, historians and anthropologists have been offered in recent years. THE APPLIED APPROACH

The first modern contributions to medical anthropology came from Gonzalo Aguirre Beltrbn, Isabel Kelly, and Hictor Garcia Manzanedo. Aguirre Belt& wrote ‘Programas de salud en la situacibn intercultural’ [19] and ‘Medicina y magia’ [20] recently reprinted. The first book contains a fairly complete program of what we now call primary health care, from the anthropological perspective. It inspired several activities in public health and was the base of medical services offered by Instituto National Indigenista in Indian communities. Aguirre Belt& continues to be a very influential figure in Mexican medical anthropology and is one of its few authors with a theoretical approach. Also in the early 196Os, Isabel Kelly was working on several aspects of traditional medicine in Mexico. She published an excellent

Beyond the Anglophone World guide on how to obtain information to adequately deliver primary health care (211, and made one of the pioneer appraisals of the potential role of midwives in medical services [22]. Hector Garcia Manzanedo, a student of Kelly, produced a field guide on how to obtain information on issues relevant for health and social services, containing a detailed list of issues to be identified in the community [23]. One of Garcia Manzanedo’s most important contributions was as a teacher at Escuela de Salud Publica, where he made students conscious of the role that the social sciences play in public health. This trend was continued by Jorge Miranda, Ricardo Loewe, Miguel Angel Gonzalez Block and other anthropologists, who continue to influence the new generations of public health personnel. In the early 1970s several anthropologists, historians and physicians formed the informal ‘Grupo de Antropologia Mtdica’ to share ideas and develop their points of view. This group has influenced younger generations through the teaching of its members in two different ways. They stimulated interest in the study of Mexican medical systems. Most of them gathered once a week at Hospital General de Mexico as the Seminario la Medicina del Hombre en su Totalidad, which started as a Balint group, stimulating practicing physicians to have a more humanistic approach in the care of their patients. It evolved to encompass more activities such as informal courses on medical philosophy, psychiatry, and history, which enabled them to develop a theory of the doctor-patient relationship. Although most of these results are yet to be published, some appear in Fernando Martinez Cortes’ book [24]. This group has tried to synthesize the British and Spanish approaches to humanistic medicine, but in the setting of a developing country, where frequently physicians and patients have different views about health, di ease, diagnosis and treatment. Members of the group continue to teach classes on Medicina Humanistica and Historia y Filosofia de la Medicina at the undergraduate level at UNAM’s medical school. They also were the first to present a session on traditional medicine at Mexico’s very conservative Academia National de Medicina. Other research groups are active in medical anthropology. One is at the Departamento de Etnologia y Antropologia Social of the Instituto National de Antropologia e Historia (DEAS), Selene Alvarez, Carmen Anzures, Silvia Ortiz, Isabel Lagarriga, and others have done ethnological studies in urban areas, focussing on spiritualism [25]. The Direction de Culturas Populares has sponsored research on folk medicine. Lilian Schetler has written a broad overview of medicine and witchcraft [26], while several monographs on traditional medicine have been prepared by native bilingual teachers [27]. Eduardo L. Menendez at Centro de Investigaciones y Estudios Superiores en Antropologia Social has done interesting studies on alcoholism and on the social setting of Yucatec medicine [28]. Gonzalo Aguirre Beltran in the Veracruz branch of the same institution has started research in the Sierra de Zongolica. His most recent contribution is a general text on medical anthropology [29]. Marian Teresa Sepulveda at Instituto National de Antropologia has

1345

made important contributions on the analysis of traditional medicine in the state of Michoacan [30]. Centro de Estudios Mayas at Universidad National Autonoma de Mexico, has published some very interesting texts on the medical systems of some Maya groups [31]. Some physicians have also written articles or books dealing with folk medical practices [32]. Finally some institutions that deal with problems of mental health have opened positions for anthropologists to study problems such as drug consumption, adjustment to poor living conditions, and alcoholism. In Mexico, Raquel Bialik was a pioneer in this type of research [33]. At Universidad National Autonoma de Mexico, Leticia E. Casillas founded and has been in charge of the only Mexican Department of Medical Anthropology within a medical service: the Oftcina de Antropologia Medica of the Direction General de Servicios Medicos. She conducted several epidemiological studies on the health problems of university students, including nutrition and alcohol consumption, studying their perceptions of the medical services they use [34]. At the Facultad de Medicina, Roland0 Collado teaches and researches medical demography, folk illness and utilization of medical services [35]. The Departamento de Historia y Filosofia de la Medicina has an active group of medical historians headed by Carlos Viesca [36]. The Instituto de Investigaciones Antropologicas is the institution of Alfred0 Lopez Austin, Alfonso Villa Rojas, Noemi Quezada, Luis Albert0 Vargas and several other biological and cultural anthropologists interested in health, disease and medicine [37]. Luis Berruecos at Universidad Autonoma Metropolitana has specialized in the anthropological aspects of alcohol consumption [38]. Some groups focussed on medical anthropology have started to work in other cities including Cuemavaca, Queretaro [39] and Tuxtla Gutierrez. They are engaged primarily in teaching. One of the Cuemavaca groups has organized two congresses of folk medicine which combined scientific and commercial ventures. TEACHING MEDICAL ANTHROPOLOGY MEDICAL SCHOOLS

IN

Recently a small group of medical historians and anthropologists has started teaching a mandatory one-week course in medical anthropology to undergraduate medical interns at UNAM. This has proved a fruitful experience. These students are in the stage where they are experiencing their contact with patients in public hospitals and are about to leave to become ‘pasantes’ in a small village. Some of them have become interested in pursuing medical anthropology as a speciality. At the same time, anthropologists want to know more about the subject. This has led to UNAM considering the possibility of offering a master’s degree in medical anthropology. The contents of this course have already been prepared and it is in the final stage of official academic approval. The Seminario La Medicina de1 Hombre en su Totalidad continues to be offered at Hospital General de Mexico. It teaches a course on the doctor-patient relationship, using the medico-anthropological

Beyond the Anglophone

1346

approach, to residents and physicians in charge of outpatient clinics. This group is also promoting research on how hospital patients perceive and solve their medical problems. This Seminario has now become part of the Unidad de Antropologia Medica de1 Hospital General de Mexico, is sponsored by the Hospital general de Mexico de la Secretaria de salud, Facultad de Medicina and Instituto de Investigaciones Antropologicas, both of Universidad National Autonoma de Mexico. This Unidad will be responsible for clinical aspects of the “maestria de antropologia midica” to be taught at UNAM, for continuing the Seminario La Medicina de1 Hombre en su Totalidad, and for research. It is expected that this new unit will make important contributions to the application of medical anthropology in clinical settings. The interest of Mexican medical anthropologists today is focussed on developing techniques that will close the cultural gap between patients and physicians trained in scientific medicine. They are conscious that the doctor-patient relationship that has developed until now is not satisfactory for patients. The health problems that burden the Mexican people have persuaded the government to make medical services more available to a larger number of the population, but medical schools are not producing the kind of physicians that are needed. The formation of family doctors has been encouraged but they feel frustrated since the ideal Mexican medical students is still to specialize in a third-level hospital. One important objective of medical education is to help doctors become interested and feel professional accomplishment in attending to people’s real needs. At the same time medical anthropology plays a role in planning adequate services and activities in health communication and education. Basic studies are still needed to have a better understanding of both physicians and patients. The number of theoretical studies is still small. CONCLUSION

Despite its long and complicated history, medical anthropology in Mexico is still in its adolescence. The regular appearance of a journal of medical anthropology in Spanish, the beginning of formal courses at universities, the creation of a unit specializing in clinical anthropology, and the growing number of professionals in the field, heralds the beginning of a more mature period. Mexican medical anthropology still lacks a solid theoretical background and critical reviews of what has so far been done. The progress of Mexican medical anthropology is supported by the great wealth of its medical tradition. Pre-Hispanic sources need further studies. Indian medicine of some areas such as Chiapas and the Tarahumara are quite well known, but other regions or groups have not been studied at all. Medical practice in urban centers is complex, and only the group at Queretaro has attempted to analyze it. Few of the medicinal products used by traditional practitioners have been studied scientifically, and only two have been incorporated into the official pharma-

World

copea. For many years to come, Mexico will continue to be an interesting living laboratory for medical anthropologists.

REFERENCES

1. SahagGn B. de. Florentine Code*: General History of the Things of New Spain (Translated from Nahuatl by Anderson A. J. 0. and Dibble C. E.). School of American Research and University of Utah, Santa Fe. N.M. 1950-1963. A detailed account of Sahagun’s research methodology can be found in: Lopez Austin A. The research method of Fray Bernardino de Sahagun: the questionnaires. In Munro S. Edmonson: SixteenthCentury Mexico: the Work of Sahagun (Edited by Edmonson M. S.). DD. 111-149. Universitv of New Mexico Press, Alburquerque, N. Mex., 1974. 2. Duran D. The A:tecs: The history of the Indies of New Spain (Translated by Heyden 0. and Horcasitas F.). Orion Press, New York, 1964. Duran D. Book o/the Go& and Rites and the Ancient Calendar (Translated by Horcasitas F. and Heyden D.). University of Oklahoma Press, Norman, Okla., 1971. 3. Clavijero F. J. Historia Antigua de Mexico (Edited by Cuevas M.). Coleccion Sepan cuantos. No. 29, Editorial Porrita, S.A.. 1964. 4. The complete works of Francisco Hernandez, with a biography, comments, index, etc., has been published as: Hernandez F. Obras Completas. Universidad National Autbnoma de Mexico, Mexico, 196&1984. 5. A recent review of their work is in: Lozoya J. Plantas y Lutes en Mexico. La Real Expedicidn Nueva Esparia (1787-1803). Ediciones

Cientifica a

de Serbal, Barcelona, 1984. 6. A total of IO issues of medicina rradicional, directed to the lay public, were published by Instituto Mexican0 para el Estudio de las Plantas Medicinales (IMEPLAM) from 1977 to 1980. A total of three issues of Estudios de Etnobotanica y Antropologia Medica, containing scholarly articles, were nublished bv IMEPLAM from 1976 to 1978. It is beine continued as Estudios de Antropologia Medica, and Vol. 4 was issued by Instituto de Investigaciones Antropologicas de la Universidad National Autbnoma de Mexico in 1986. Among the publications of IMEPLAM, are: Aguilar Contreras A.- and Zolla C. Plantas Tdxicas de M&co. Instituto Mexican0 de1 Seeuro Social, Mexico, 1982. Diaz J. L. Indice y Sinonimi% de las Plantas Medicinales de Mexico. Institute Mexican0 para el estudio de las Plantas Medicinales. Mexico. 1976. Diaz J. L. Uses de las Plantas Medicinales en Mexico. Instituto Mexican0 para el Estudio de las Plantas Medicinales, Mexico, 1977. Lozoya X. (ed.) Estado Actual del Conocimiento en Plantas Medicinales Mexicanas. Instituto Mexican0 para el Estudio de las Plantas Medicinales, Mexico, 1976. Lozoya X. and Enriquez R. El Zapote Blanco, lnvestigacidn

Sobre

una Planta Medicinal

Mexicana.

Consejo National de Ciencia y Technologia, Mexico, 198I. Lozoya X. and Lozoya M. Flora Medicinal de Mexico. Instituto Mexican0 de1 Seguro Social, Mexico, 1982. Lozoya X. and Zolla C. (Eds). La Medicina Invisible. Introduccidn al Estudio de la Medicina Tradicional en Mexico. Folios Ediciones, Mexico,’ 1983.

Zolla C. Traditional medicine in Latin America, with particular reference to Mexico. J. Ethnopharmac. 2, 3741,

1980.

9 Recent publications of the group working in Queretaro are: Palacios de Westendarp P. El sistema medico. Investigation. Revta Inform. Cent. Invest. Univ. Autdnoma dez Queretaro, II, 4-25, 1983. Pitia Perrusquia A.

Beyond the Anglophone

10.

Antropologia Medica y Sistema Medico Naturista. Investigacion. Revta Inform. Cent. Invest. Univ. Autdnoma de Queretaro V, 15-29, 1986. Palacios de Westendarp P. La Medicina Homeopatica: Una Alternativa Terapeutica. Investigation. Revta inform. Cent. Invest. Univ. Autdnoma Queretaro, V, 5&56, 1986. Lagarriga I. Magia y Religion Entre 10s Espiritualistas Trinitarios Marianos. Estudios 4 Departamento de Etnologia y Antropologia Social. INAH, Mexico, 1914. Lagarriga I. Medicina Traditional y Espiritismo.

16. 17.

Los Espiritualistas Trinitarios Marianos de Jalapa, Veracruz. Secretaria de Education Publica, Coleccion

II.

12. 13. 14.

15.

SepSetentas No. 191, Mexico, 1975. Ortiz Echaniz S. Espiritualismo en Mexico. Cuadernos de Trabajo de1 DEAS, INAH/SEP, No. 20, Mexico, 1977. Among these dissertations are: Alvarez Heydenreich L. La enfermedad y la cosmovision en Hueyapan, Morelos, Tesis para obtener la maestria en Etnologia, Escuela National de Antropologia e Historia, 1981. Anzures y Bolaiios C. La medicina traditional en Mexico: proceso historico, sincretismos y conflictos, Tesis para obtener la maestria en Etnologia, Escuela National de Antropologia e Historia, 1976. Fragoso R. Etnomedicina de 10s actuales matlazinca, Tesis para obtener la maestria en Etnologia, Escuela National de Antropologia e Historia, 1978. Gottdiener Estrada E. La medicina traditional y la medicina institutional entre 10s henequeneros de Yucatan. Tesis para obtener la licenciatura en Antropologia Social, Escuela de Ciencias Antropologicas, Universidad de Yucatan, 1976. Leiter Ferrari W. La atencion traditional de1 parto en Mexico y su subsistencia en un pueblo suburban0 de origen nahua, Tesis para obtener la maestria en Antropologia Social, Escuela National de Antropologia e Historia, 1982. Palacios Sierra P. Saber medico y cambios socioculturales en una comunidad campensina, el case de Santa Ana Tlacotenco en el Distrito Federal, Tesis para obtener la maestria en Antropologia Social, Escuela National de Antropologia e Historia, 1984. Rojo M. and Isabel A. M. La mujer diabetica y su context0 sociocultural. Un estudio con pacientes del Hospital General de Mexico. Tesis para obtener la Licenciatura en Antropologia Social, Escuela National de Antropologia e Historia, 1985. Aguirre Beltran G. Funcion social de la medicina precortesiana, Gaceta Med. Mexico %. 1143-1148, 1966. Martinez Cartes F. Las Ideas an la Medicina Ntihuatl. La Prensa MCdica Mexicana, Mexico, 1965. This General History of Medicine in Mexico is under the general editorship of Fernando Martinez Cortis, it is expected to be in at least 4 volumes, the one published so far is: Martinez Cartes F. Lopez Austin A. and Viesca C. (Eds) Historia General de la Medicina en Mexico, tomo I, Mexico Antiguo, Universidad National Autonoma de Mexico and Academia National de Medicina, Mexico, 1984. Alfred0 Lopez Austin’s texts with his translations of medical texts of Sahagtin are: Lopez Austin. Salutaciones a 10s enfermos en idioma nlhuatl. In Doctor Francisco Femandez de1 Castillo, 50 Afros de Vida Profesional, pp. 91-104. Facuhad de Medicina de la Universidad National Autonoma de Mexico, Mexico, 1973. Lopez Austin A. Cuarenta clases de magos del mundo nahuatl. Esrud. Cult. Nahuatl VII, 87-117, 1967. Lopez Austin A. De las enfermedades del cuerpo human0 y de las medicinas contra ellas. Estud. Cult. Nahuatl VIII, 51-121, 1969. Lopez Austin A. De las plantas medicinales y de otras cosas medicinales. Estud. Cult. Nahautl IX, 125-230, 1971. Lopez Austin A. Textos acerca de las partes del cuerpo human0 y de las enfermedades y medicinas en 10s Primeros Memoriales de Sahagim. Estud. Cult. Nahuatl X, 129-153, 1972.

18.

19.

20. 21. 22. 23. 24.

25.

1347

World

Lopez Austin A. Description de medicinas en textos dispersos del libro XI de 10s Codices Matritense y Florentino. Estud. Cult. Ntihuatl Xl, 45-135, 1974. Lopez Austin A. Textos de Medicina Ntihuatl. Instituto de Investigaciones Historicas de la Universidad National Autbnoma de Mexico, Mexico, 1975. This very important text has been reprinted in Mexico, and will be published soon in English by the University of New Mexico Press, the original edition is: Lopez Austin A. Cuerpo Human0 e Ideologia. Las Concepciones de 10s Antiguos Nahuas. lnstituto de Investigaciones Antropologicas de la Universidad National Autonoma de Mexico, Mexico, 1980. An important periodical containing articles on Mexican medical history is: Boletin Mexican0 de Historia y Filosofia de la Medicina, published by Sociedad Mexicana de Historia y Filosofia de la Medicina, currently in its tenth year. This book was reprinted a few years ago as: Aguirre Beltdn G. Programas de Salud en la Situation Intercultural, 2nd edn. Instituto Mexican0 de1 Seguro Social. Coleccion Salud y Seguridad Social, Mexico, 1980. Aguirre Beltran G. Medicina y Magia. Instituto National Indigenista, Coleccion de Antropologia Social No. 1, Mexico, 1963. Kelly I. Lo Antropologia, la Cultura y la Salud Publica. Universidad de 10s Andes, M&da, Venezuela, 1960. Kelly I. An anthropological approach to midwifery training in Mexico. J. Trop. Pediat. 1, 200-205, 1956. Garcia Manzanedo H. Manual de Investigacidn Aplicada en Servicios Sociales y de Salud. La Rensa MCdica Mexicana, Mexico, 1983. The main contributions by Fernando Martinez Co& on the uses of a clinical approach based on medical anthropology are: Martinez Co& F. Medicina Humanistica. Impresiones Modemas, Mexico, 1966. Martinez Cartes F. Consulta Medico Entrevista Clinica. Ediciones de1 Seminario Medicina de1 Hombre en su Totalidad, Mexico, 1979. Martinez Cortis F. Enfermedad y Padecer. Ediciones de1 Seminario Medicina del Hombre en su Totalidad, Mexico, 1983. Some of their publications are: Alvarez Larrauri. L4 Salud Robada. Editorial Guinto Sol. Mexico. 1986. Alvarez Larrauri S. Hacia una Participation Democrtitica en la Gestion de la Salud, Cuadernos de Trabajo de1 DEAS. No. 35. INAHISEP. Mexico. 1987. Anzures y Bolafios C. Medic& traditional y cultura. Acta Medica de la Escuela Superior de Medicina de1 Instituto Politenico National. XVII, 47-53, 1981. Anzitres y Bolafios C. La Medicina Traditional en Mexico: Proceso Historico, Sincretismos y Conflictos, Instituto

de Investigaciones Antropologicas de la Universidad National Autonoma de Mexico, Mexico, 1983. Anziues y Bolaiios C. Las culturas populares y el Florilegio Medicinal de Juan de Esteyneffer. Es& de An&p. Med. 4. 381-394. 1986. Laaarrina I. Espiritismo, Contacto Constante Con el ML Ak Cuademos de1 Muse0 National de Antropologia, INAH/SEP, Mexico, 1981. Lagarriga, I. Conceptos brisicos de la medicina traditional en Mexico. Acta Medico a? la Escuela Superior de Medicina

de1 Institute

Politecnico

National

XIX, 1983. Lagarriga 1. La medicina traditional en 10s otomies de1 sur de la Huasteca. Acta Medica de la Escuela Superior de Medicina &I Institute Politecnico National XXI, 61-69. 1985. Laaarriaa I. and Alcaraz

V. M. Enfermedad y religion entre-los espiritualistas trinitarios marianos. Estud. Antrop. Med. 4, 77-90, 1986. Ortiz Echaniz S. Origen, desarrollo y caracteristicas de1 espiritualismo en Mexico. Am. indig. XXXIX, 147-170, 1979. Ortiz Echaniz S. La communicacidn con lo sagrado y sus representaciones simbolicas en el espiritualismo trinitario mariano. Revta Mexicana Estud. Antrop. XXIX, 21-33, 1983. Ortiz Echaniz S.

1348

Beyond the Anglophone

Medicina traditional y medicana cientifica: el case de la curacion espiritualista. Acra Medica de la Escuela Superior de Medicina de1 Institute Politecnico National XX, 49-52, 1984. Ortiz Echaniz S. La curacion espirituahsta. Cuicuilco (Escuela National de Antropologia). IV,

32-39, 1984. Ortiz Echaniz S. La curacion coma base de1 proselitismo de una doctrina religiosa. Estud. Antrop. Med. 4, 91-96, 1986. Ortiz Echaniz S. La busqueda de identidad en el espiritualismo trinitario mariano. In Historia de la Religion en Mesoamerica y Areas Afines (Edited by Dahlgren B.), pp. 251-261. Instituto de Investigaciones Antropologicas de la UNAM, Mexico. 26. Schemer L. Magia y Erujeria en Mexico. Panorama Editorial, S.A., Mexico, 1983. 27. Some of the monographs by bilingual teachers are: Araueta A.. Prado X.. Macias E.. Sanchez M.. Rico L. M.: Sanchez M., Rojas G. and Velazquez J. Fuentes y Datos

Para

el Estudio

de la Medicina

P’urhepecha,

Direction General de Culturas Populares, Cuademo de Trabajo 2, Mexico, 1982. Beltran Morales F. Medicina Traditional en la Comunidad Zapoteca de Zoogocho, Oaxaca. Dire&on General de Education Indigena,

SEP e Instituto National Indigenista, Mexico, 1982. Cohn Juarez C. La Medicina Traditional en el Area Mazahua. Unidad Rezional de Michoacan de la Direccion General de C&uras Populares, Cuadernos de Trabajo 6, Moreha, Michoacan, 1982. Range1 R. La Medicina Traditional en Caltzontzin. Unidad Regional de Michoacln de la Direccibn General de Culturas Populares, Cuademos de Trabajo 18, Morelia, Michoac;in, 1982. Rendon S. Notas Sobre el Curanderismo en la Meseta Tarasca. Dire&on General de Culturas Populares, Cuademos de Trabajo/CID/3, Mexico, 1982. Reyes Antonio A. Plantas y Medicina Naua en Matalpa Indigena. Direction general de Educacibn Indigena, SEP e Instituto National Indigenista, Mexico, 1982. See also: The special issue on Medicina tradicional, Mexico Indigena (published by Instituto National Indigen&a) 9, marzo-abril, 1986. This special issue has 23 articles dealing with several aspects of Mexican Indian medicine. Sassoon Lombard0 Y. Mito, magia, religion y medicina traditional. Mexico Indigena IV, 22-27,

1988.

28. Menendez Eduardo L. Cura y Control, la Apropiacidn de lo Socialpor la Practica Psiquiatrica. Editorial Nueva Imagen, S.A., Mexico, 1979. Mentndez Eduardo L. Poder, Estrattjicacidn y Salud. Analisis de las Condiciones Sociales y Economicas de la Enfermedad en Yucatan. Ediciones de la Casa Chata, No. 13, Mexico, 198I. Menendez Eduardo L. Hacia una Practica Medica Alternativa, Hegemonia y Autoatencion (Gestidn) en Salud. Cuadernos de la Casa Chata 86, Centro de

Investigaciones y Estudios Superiores en Antropologia Social, Mexico, 1984. Menendez, Eduardo L. Alcoholism0 II. La Alcoholizacion, un Proceso Olvidado Patologia, lntegracidn Funcional o Representation Cultural. Cuadernos de la Casa Chata 150, Centro de

Investigaciones y Estudios Superiores en Antropologia Social, Mexico, 1987. 29. Aguirre Beltran G. Antropologia Medica. Centro de Investigaciones y Estudios Superiores en Antropologia Social, Mexico, 1986. 30. Sepulveda M. T. Magia, Brujeria y Supersticiones en Mexico. Editorial Everest Mexicana, S.A., Mexico. 1983. Sepulveda M. T. La herbolaria entre 10s purepecha prehispanicos. Estud. Antrop. Med. 4, 269-314, 1986. 31. Ruz M. H. (Ed.) Medicos y loktores. Enfermedad y cultura en dos comunidades tojolabales. In Les Legitimos Hombres. Aproximacidn Antropological al Grupo Tojolabal, Vol. III, pp. 1.43-194. Centro de Estudios

Mayas, Universidad

National

Autonoma

de Mexico,

World

Mexico, 1983. Campos T. El sistema medico de 10s tojolabaies. In Los Legitimos Hombros. Aproximacion Antropologica al Grupo Tojolabal (Edited by Ruz M. H.), Vol. III. pp. 195-234. Centro de Estudios Mayas, Universidad National Autbnoma de Mexico, Mexico, 1983. 32. Some examples are: Irigoyen Rascon F. Cerocahui. Una Comunidad en la Tarahumara. Facultad de Medicina de la Universidad National Autonoma de Mexico. Mexico, 1974. Vega Franc0 L., Toca T., Rojas C. E., Hernandez Z., Alanis M. Iiiarritu M. and Juarez Rosas M. Las enfermedades de 10s niiios en la medicina traditional. Bol. Med. Hosp. Infant. XXXVI, 68-87, 1978. Several interesting articles on ‘Medicina tradicional, alternative para la salud’, can be found in Estud. Tercer Mundo 2, December 1979. 33. Bialik R. Un enfoque antropologico para el estudio biopsicosocial de 10s habitantes de una vecindad en el barrio de Tepito. Cuad Cient. CEMESAM 11, 173-192. 1983. Biahk R. El consumo de alcohol en Tepito. In El Alcoholismo en Mexico, II Aspectos Sociales, Culturales y Econdmicos (Edited by Molina Piiieiro V., Berruecos

L. A. and Sanchez Medal L.), pp. 259-276. Fundacibn de Investigaciones Sociales A.C., Mexico, 1983. 34. Some of her contributions are; Casillas L. E. El uso recursos medicos en el hogar: estudio de familias urbanas y suburbanas en la ciudad de Mexico. Estud. Etnobotan. Antrop. Med. III, 95-l 14, 1979. Casillas L. E. La salud y la cultura en las zonas urbanas marginadas. La Medicina Moderna y la Antropologia Medica en la Poblacion Fronteriza MexicanoEstadounidense (Edited by Vehmirovic V.), pp. 88-91.

Organization Panamericana de la Salud, Washington, D.C., 1979. Casillas L. E. La distancia personal y la enfermedad en el Mexico prehispPnico.- Actes XLN Cow. des Amer. VI. 335-339. 1979. Casillas L. E. La colaboracion entre la salud escolar y la antropologia medica: el case de la escuela Arqueles Vela. Memorias aks las VIII Jornadas Internas de Trabajo de la Direccidn General de Servicios Medicos de la Universidad National Autdnoma de Mexico, Mexico D. F., pp. 373-390,

1983. 35. Collado Ardon R. and Jose Garcia T. La actitud de 10s medicos en Mexico respect0 a 10s curanderos. Salud Pub!. Mix. XVII, 459470, 1975. Collado Ardon R. Medicos y Estructura Social. Universidad National Autonoma de Mexico y Fondo de Cultura Economica, Archive del Fondo 70, Mexico, 1976. Collado A.. Castro1 R. G. and Caceres E. Salud mental y enfermedad mental en America Latina. Universidades (Union de Universidades de America Latina) XXII, 44345, 1983. Collado A., Castro R. G. and Cdceres E. Epide-

miologia de una enfermedad paralela: “La perdida de1 alma”. Higiene 38, 2627, 1988. 36. Most of the articles written by the medical historians appear in: Estudios de Cultura Nahuatl, Estudios de Antropologia Medica, and Boletin de la Sociedad Mexicana de Historia y Filosofia de la Medicina. Some examples are: Viesca T. C. and Ruge T. Aspectos pisquiatricos y psicologicos del susto. An. Antrop. XXII, 475490, 1985. Viesca T. C. La enfermedad en la medicina nahuatl. Estud. Antrop. Med. 4, 315-334, 1985. Viesca T. C. Medicina Prehisoanica de Mexico. El Conocimiento Medico de 10s Nahubs. Panorama Editorial, 1986. Mexico D. F., 1986. Viesca T. C. Posibihdades para abordar el estudio de la medicina nahuatl. Estud. Cult. Nahuatl 18, 295-314. 1986. made by the staff of 37. Some of the contributions Instituto de Investigaciones Antropologicas are: Matos Moctezuma E. and Vargas L. A. Anomalias de1 pie en murales y codices prehispanicos. An. Antrop. IX, 95-103, 1972. Montoliu M. Los dioses de 10s cuatro sectores cosmicos y su vinculo con la salud y enfer-

Beyond the Anglophone medad en Yucatan. An. Antrop. XVII, 47-65, 1980. Montoliu M. Concept0 y use de las piedras y otros minerales en la medicina traditional. Estud. Anrrop. Med. 4, 65-75. 1986. Quezada N. Amor y Magia Amorosa Entre 10s Artecas. Supervioencias en el Mexico Colonial. lnstituto de Investigaciones Antropologicas

de la Universidad National Autonoma de Mexico, Mexico. 1984. Simoni J.. Vargas L. A. and Casillas E. Merohcos and health education. Bull. Pan Am. Hlrh Organ. 17, 4-13, 1983. Vargas L. A. and Matos E. El embarazo el parto en el Mexico prehispinico. An. Antrop. X, 297-310, 1973. Vargas L. A. Las relaciones interpersonales y la enfermedad en la epoca prehispanica. Actes XLH Cong. lnr. Amer. Paris VI, 341-347, 1978. Vargas L. A. (Ed.): QuP Debo Saber Sobre Medicina cial? Ediciones

Traditional

Durante

mi Servicio

1349

Universidad National Autonoma de Mexico, Mexico, 1985. 38. A book containing articles on anthropological aspects of alcohol consumption in Mexico, by Luis A. Berruecos, Luis Albert0 Vargas, Jorge Miranda Pelayo, Larissa Lomnitz, Leticia E. Casillas and Raquel Biahk is: Molina Pitieiro V., Berruecos L. A. and Medal L. S. El Alcoholismo en Mexico, II Aspectos Sociales, Culturales y Econdmicos. Fundacion de lnvestigaciones Sociales AC., Mexico, 1983. 39. See for example: Palacios de Westendarp P. Conocimienros y Practicas Medicas en una Comunidad Campesina. Centro de Estudios Antropologicos de la

Universidad Autonoma de Queretaro, Queretaro, 1986. Prado X. Embarazo y parto en la medicina traditional de1 area p’urhepecha. Relaciones. Estud. Hiss. Sot. El Colegio de Michoacan 20, 113-120, 1984.

So-

La Medicina del Hombre en su Totalidad, Mexico. 1981. Villa R. La imagen de1 cuerpo human0 segim 10s mayas de Yucatan. An. Antrop. XVII, 3146. 1980. Villa Rojas A. Terapeutica traditional y medicina moderna entre 10s mayas de Yucatan. An. Antrop. XVIII, 13-28, 1981. Villa Rojas A. Breves consideraciones sobre la creen cia de1 “ma1 de ojo” An. Anrrop. XIX, 147-161, 1982. Villa Rojas A. Enfermedad, pecado y confesion entre 10s grupos mayences. An. Anfrop. XX, 89-110, 1983. Villa Rojas A. Estudios Etnoldgicos. Los Mayas. Instituto de lnvestigaciones Antropologicas de la

World

Institute de Investigaciones Antropologicas

LUIS

VARG.G

and Direction

General

de Servicios

Medicos National University Villa Obreg6n D.F., 20 Mexico

of Mexico

LETICIA E. CASILLAS