In lieu of an abstract, here is a brief excerpt of the content:

55 Review WALKIN' OVER MEDICINE: TRADITIONAL HEALTH PRACTICES IN AFRICAN-AMERICAN LIFE By Loudell F. Snow, PhD, 311 pp. Boulder, CO: Westview Press, 1993. $58.00 (hardcover); $19.95 (paper). Research ON African-American ethnomedicine (commonly referred to as "folk medicine") frequently contains an insidious but powerful bias: that African-American ethnomedicine represents an interesting, but inherently erroneous, ragtag collection of superstitions instead of a well-developed, integrated system of beliefs and practices that provides people with a meaningful account of health, illness, and disease as well as practical relief. Walkin' Over Medicine confronts this bias head-on by presenting a richly detailed ethnographic account of African-American ethnomedicine based on 25 years of primary research conducted by Michigan State University anthropology professor Snow and her students, and an extensive examination of research conducted by others. The result is a dense portrayal that not only traces the traditional foundations of African-American ethnomedicine, but also demonstrates its uses and functions in the everyday lives of its adherents. In doing so, the book makes several ineluctable points. First, as Snow makes abundantly clear, health is considered a seamless web of body, mind, and spirit that must be maintained in harmonious balance. A disorder in one realm therefore necessarily affects the other two. This means that Cartesian duality (the dichotomous split between physiological properties on the one hand, and emotional and mental ones on the other hand), which constitutes an essential epistemological underpinning of biomedicine, carries little meaning in this system. Moreover, the accent on spirituality and the degree to which African-Americans rely on spiritual guidance as a vital means of maintaining health and overcoming illness find no counterpart in biomedical practice. Second, Snow effectively dispels popular and prevalent myths concerning which segments of the African-American population rely on the traditional wisdom of ethnomedicine, and under which circumstances they use it. Although it is commonly assumed that only the elderly, rural, or those with limited Journal of Health Care for the Poor and Underserved »Vol. 5, No. 1 · 1994 56___________________________________________________________ formal education place their faith in ethnomedical traditions, Snow demonstrates that young, middle-aged, old, rural, urban, formally and informally educated African-Americans alike draw upon the system. Facile theories about the availability of biomedical care also cannot be evoked to explain why patients are motivated to self-treat and to consult an array of alternative healers; a substantial number of patients whom Snow interviewed regularly attended biomedical clinics while concurrently utilizing ethnomedicine. Third, Snow does not romanticize the system. This is a refreshing departure from many accounts which posit folk and lay medical practices as either monolithically beneficial or denounce them as all harmful or silly. Instead, Snow discusses advantages as well as drawbacks. One case (pp. 273-4) involves a woman who believes that God guards her against the onslaught of illness. As Snow points out, such strength of faith likely confers emotional fortitude, and hence, placebo effects, but ultimately it can prove disadvantageous because the woman believes that she is categorically protected from all serious diseases, including AIDS. Similarly, alternative healers are analyzed realistically in their variations, with some distinguished as experts who empathetically and effectively treat patients, and others as charlatans who exploit or ignore people in need. Fourth, the importance of attentive listening to patients is underscored. Snow repeatedly documents that biomedical practitioners misunderstand many African-American patients and their problems either by failing to acquaint themselves with the ethnomedical system, or by failing to ask the right questions during clinical interviews and history-taking. On their part, patients fail to volunteer information that they fear will be used to label them ignorant, gullible, or superstitious. In no small measure does this result from the legacy of biomedicine as a sociocultural system which teaches its practitioners to select and label only certain problems as salient, and thereby reinforces for patients the necessity of edi ting their histories, beliefs, and presentations of complaints. The tragically ironic outcome is the reproduction of a situation in which biomedical providers remain unaware of the existence and importance of the ethnomedical system, and patients remain too intimidated to voice their knowledge and concerns. It is evident throughout the book that...

pdf

Share