Philippine Sociological Review: Cultural Context of Folk Medicine PDF

40 PHILIPPINE SOCIOLOGICAL REVIEW 3: The equal member joint economic 2. The common economic relationship...

40 PHILIPPINE SOCIOLOGICAL REVIEW 3: The equal member joint economic 2. The common economic relationships are the facilitator and facilitatee roles. relationship constitutes only 9% of all the Ninety-one per cent of the economic re- informants' economic relationships. lationships of the informants are of these 4. ThE' equal member joint economic ventures aggregate within the same class. types. Facilitator and facilitatee are un- Those in the upper class concentrate in equal not only in economic relationships, big scale enterprises, while those in the but also in other phases of community lower class are spread over several small inter-actions. scale economic projects..Cultural Context of Folk Medicine: Some Philippine Cases: F. LANDA JOCANO National Museum Introduction entific-and folk medical practices. In fact, The problem of etiology and treat- there is a dearth of materials on what ment of disease in its aboriginal setting makes possible the existence and opera- has sustained the critical interest of so- tion of 'these seemingly divergent me- cial scientists all over the world. Out- thods of healing side by side the, sam~ standing among the early works are W. locality without conflicts. Harold A. Gould,\ H. Rivers' Medicine, Magic, and Religion in.appraising this problem, pointed out (1924), and Forrest E. Clements'''Primi- We know even less about the reasons tive Concept of Disease" (1932). Over for the persistence of folk medical prac- tices in the. most sophisticated urb~n the last twenty-years, considerable num- I. cultures, or about the structural ac- ber of ethnographic materials on the con- commodations which must be made in cept of disease and therapeutic practices.the primitive environment with the' ad- have become available. The modern an-. vent of modern medical practices (1957- thropological views on folk medicine. are 507). best summarized in the scholarly works This paper is an attempt to show how of Erwin Akerknecht (1942-1947). The culture functions in the area of' h~altl\ pharmacology of native curers and sha- and illness..' To our knowledge there hav~ mans has also been studied by a num- been very Jew studies made in this area ber of fieldworkers (d. Hsu 1952; Steg- of research. Our primary aim in under- gerds and Korsch 1943; Fox 1963; Rubel taking this study is to indicate, fro~ I the 1960) and so has been the interrelation- academic standpoint, the social and ci.il~ ships between magic and science in man's tural elements of folk medicine and how understanding of sickness and disease (d. these elements structure the practice in Nurge 1958; Erasmus 1952; Hsu 1952; the community where it exists; and, from Lieban 1960; 1962; Simmons 1955; Gould the' extension-service standpoint, to sug- 1957; Frake 1961; Nydeggers 1963). gest the significance of cultural and so- However, we still know less about cial variables in introducing scientific med- the relationships obtaining between sci- ical practices in many rural areas.  JANUARY, 1966 41 The Concept of Disease The direct participation of the super- natural beings in the daily affairs of the Disease is one of the universal ex- living is normally brought into focus by periences and its occurrence is always the rural folks in their attempt to cope considered a terrifying abnormality to with the problem of health and disease. both civilized and "primitive" man. Be- Invisible agents are reported to have cause it is, a contingency for which so- taken active' part in the affairs of hu- ciety must provide, every known group mans without being seen. And when these of people has developed curative methods beings are displeased they cause their for coping with the demoralizing effects victims to suffer illness, death, or series of disease on normal life. Often these pre- of misfortunes. In Lian, Batangas, for ventive health measures are surrounded by a substantial body of beliefs, know- ledge, and practices (Scotch 1963: 30) example, the barrio folks believe that many of the illnesses which people suf- fer are due to the workings of the Nunu which is designed to make the medicine sa Punso (old man of the mound). This more effective. agent of disease, when angered, sends his Among the people of Barrio Tarong, mangolos to eat the "inside" of men, IIocos Norte, William and Corinne Ny- thereby causing them to experience pain deggers (1963: 779) report that illness is and discomfort.: Among the farmers of brought about by (a) loss of soul, (b) Capiz and Antique, illness is caused by spirits of the dead who visit their for- the spirits of fields and clearings.. mer abode, and (c) by supernatural tricks. Recognition of the causes of disease as Tremors, tics, dizziness, delirium or it is known and understood by modern coma are thought to be caused by soul medical practitioners is "a rare pheno- loss. Sudden shock or fright is thought menon" among the inhabitants of Guin- to detach part or all of an individual's hangdan, Leyte. As among the Tarong soul. Since a child's soul is weakly at- tached to his body, he is especially people, the Guinhangdans attribute the succeptible to this type of illness. To incidence of disease to spirit-gods, witches, avoid such loss, an adult returning home , and sorcerers (Nurge 1958: 1162). In con- from any trip with a child will call, trast with the former, however, the peo- "Come, Maria, do not stay." Or should ple in this eastern Bisayan community a child fall, water will be splashed on do not believe in soul loss. Illness is due the spot and some given to the child to drink, to keep his soul intact after to (1) the spirit-gods' injuring the sick the jolt (1963: 779). man's intestines causing him to suffer from pain; (1) the witches' (asuwang) Soul loss is the dominant diagnostic eating the, man's liver; and (3) the sor- theme on the etiology of illness and cerers casting charms over the sick man. death among the peoples of the Moun- Originally, these agents of disease. tain Province. The Ifugao, according to R.F. Barton (1930: 205), becomes ill and were fallen angels who were doomed suffers other misfortunes when this soul to follow Lucifer when he was ex- "has been carried by the betraying god pelled from Heaven. The encantos fall to his quarters in the Skyworld". Among into. the trees, the rivers, and onto the the Kulaman group in Mindanao, Fay earth. Earth beings are the tunanon, ,, ' Cooper Cole reports (1913: 157) that river and ocean spiris are the tubig- non, and tree spirits are the cahoynon Sickness may be caused by evil spirits,... the asuang or witches, were ori- or it may be due to a desire on the ginally humans who acquired and de- part of the kalaloa to leave its pre- veloped supernatural powers (Nurge sent abode. 1958:64). 42 PHILIPPINE SOCIOLOGICAL REVIEW In eastern Samar a special': class' of From the above selected cases it is environmental spirits known.r.as. the agta apparent that causes of disease in many are generally responsible' for.the occur- places in the Philippines are defined in rence of disease: The' agta are tiny, dark tenus of their social and culturai context. complexioned and hair-covered beings. In this setting, diagnostic decisions gen- They differ from the enkaritos.or the mala erally go beyond the patient's verbaliza- campania (Legapsi 1964 ms) in that they tion of his ailment. In fact, in many are malevolent and' cause illness' which cases,', even the patient's own categories cannot 'be cured. This pervasive influence of his illness is culture-bound. Disease in' of the supernatural 'beings 'over human many remote upland and rural areas is experience 'is recorded in detail by Ri- not only suffered and treated but it is chard Lieban (1000, 1002) among the people of Sibulan, Negros Oriental. In normally talked about. The constant ex- posure and participation of the rural folks this village; illness' is 'believed to be to village discussions about disease and brought about by 'contacts with the su- how these are caused enable them to pernatural beings known as inkantos. learn about the etiology of different di- seases and to be familiar with the me- Inkantos frequently, inhabit trees and thods of coping with them. This social- remote places, but they can be present ization process makes the people less in- anywhere. Some inkantos are conceived of as heads living in a mound of earth, trospective in their answers to diagnos- tic questions. others as dwarfs, giants, or a combina- tion of human and fish (Lieban 1962: Charles O.Frake (1961: 114) notes 307) among the Subanon of eastern Zamboanga Among the people of Lambunao in that a man, in answering the diagnostic Iloilo province, disease and death are questions; , said to be caused by the environmental solicits the readily preferred judgment spirits. These dwellers of the "invisible" and advice of kin,neighbors, friends, world are grouped into three categories: 'specialists, deities,' and 'ethnographers. Sickness comprise the third most fre- 1) the ibabaumon or spirits of the up- quent topic of casual conversation (af- perworld. Sometimes these spirits ter litigation and folk botany) among are known as udtohanon; they take Subanons of my acquaintance, and it care of such natural phenomenon 'furnishes the overwhelming predomi- as eclipses, lightning, thunder, nant subject to formal interviews with storms, and whirlwinds. When not the supernatural. propitiated with proper ritual every year, they cause epidemics like cho- , Folk theory of disease, from this stand- lera, boti (small-pox) and so forth; point, permits a dual explariation of the illness. As noted above, the Sibulan folks 2) the dutan-on 'or dwellers of the believe that illness is due to contact with middleworld or the earth. They are inkanto and the Tarong people attribute further grouped into (a) talunanon some to their affliction 'to the loss of or dwellers of deep forests who are responsible for the sogpa (vomiting soul. However, the symptoms of diseases of blood) ; malignu and (c ) ta- caused by these supernatural beings are mauni, those living in trees on clear- manifested 'in' the natural way-i.e., sto- ed hillsides or in the middle of the mach-ache, fever, enlargement of the fields; limbs, etc, While scientific treatment is '3)' idadalnionon or' dwellers of the' un- recognized as desirable this is generally derworld. They' 'are responsible for taken as the last recourse, and only af- death (Jocano 1963:56). ter all rituals for the propitiation of the  JANUARY, 1966 supernatural beings are exhausted and Treatment, found ineffective. In effect, many kinds Treatment of various illnesses vary from of treatments group to group. Among the Tarong peo- are tried in the experimental frame of ple, illness due to soul loss is treated mind. Most are harmless and some un- in the following manner. The sirkano nor- 'doubtedly help the sufferer mentally mally secures a used piece of the pa- or physically, but occasionally the at- tient's clothing. Stepping out into the tempted cure leads to dangerous com- porch or on the first rung of the ladder plications. One school-teacher applied gun powder and coconut oil to an open as the case may be, he waves thecloth~ blister on her heels (Nurge 1958:1160). ing as the name of the child is called. , Disease are diagnosed according to their specific symptoms or pathogenic Then the cloth is placed over the child like components or according to stages of a blanket. If a number of such at- tempts to bring back the soul does not their developments. Diagnosis of illness succeed, a sirkano specializing in the is often arrived at by asking questions, treatment of soul loss must be' sum- looking at the patient and by commu- moned. A similar type of cure is used nication with the spirits who caused the if a child becomes sick when his pa- ailment. In Guinhangdan the local curer rents are away and the illness is inter- has an exotic diagnostic techniques. She preted as yearning for the parents.: A ritually anoints the patient with co- soiled shirt or some such article' of conut oil and had him perspire for clothing will be sent to the child (Ny- about an hour. When he is uncovered, deggers 1963: 779). , the leaves were examined for the mis- Prayers to the Christian deities and sles which the annoyed inkantos have presumably shot into him or at him. Bits of hair, and or part of insects are chants to the environmental spirits are ex- plored for the cure of illnesses which are "proof" of.the disease causation. The caused by the angered supernatural be- tambalan examines his patient and then ings or diagnosed as due to the oversight waits for an inspirational diagnosis; the in their relationship with the humans. In knowledge "just comes to him" (Nurge Guinhangdan, Nurge (1958:67) notes that 1958:116). Incantation to spirits and prayers to Sometimes the determination of the Christian deities are used by all prac- causes of diseases is carried out through tioneers, and the tambalan also ob- serves a perpetual novena to an in- direct communication with the superna- kanto ancestor; failure to observe daily tural beings. The Nydeggers noted this devotion would cause him to become practice among the Tarong people in Ilo- ill. Occasionally, a lay person with a cos Norte. They relate the case of one persistent malady will vow to !a saint person. Damiana, who became suddenly to make an offering. or to perform a ill after having seen a man at her win- particular action if he is cured. dow one night. She was paralyzed from The common curing method employed the shock. When the sirkano was called, by folk specialists is the use of rituals he diagnosed soul loss resulting from the and sacrifices. So interwoven is ritual in shock for seeing a non-human as the cause the procedure that it is difficult to 'de- of the illness. To confirm this suspicion, lineate from the practice what is ritual- he "went into the darkest place of the istic and what is pragmatic. Sometimes sitio-hill, calling to and talking with non- the rituals are directed towards the su- humans" (Nydeggers 1963) in order to pernatural beings who are too remote determine who among the spirits caused to be involved in the affairs of man and the illness. not to the patient himself, or to the im- 44 PHILIPPINE SOCIOLOGICAL REVIEW mediate environmental spirits. At any rate, She placed the leaves and twigs of most offerings consists of: ,chicken or the various plants inside a kararaw (a eggs, rice" rice-wine or coconut beverages tray made of bamboo splints) and divided these into two parts. One-half ( tuba), betel or tobacco, coins, and cho- - she pounded in a small wooden mor- sen leaves and roots of known 'medicinal tar (lusung-lusung) and the other half plants. If the patient is in danger of dying , she boiled. The juice derived from the and if all minor paraphernalia have been pounded leaves and twigs was filtered tried to no avail, then a pig, a goat or any through an abaca cloth and placed in- sided a folded banana leaf. Pieces of big domestic animal may be slaughtered. flowing embers were placed inside a The diagnosis and treatment of disease coconut shell. in some areas may be illustrated by the following incident which took place among the Sulod, in Central Panay, when we When everything was ready, Dian- sa told her patient to lie down on the mat spread near the wall. She wound a piece of red cloth around his sto- were in the field. mach. Picking up the coconut shell. she blew the ashes off the embers, and One day a man from Masuruy, a dropped a pinch of kamangyan (na- sitio located at the foot of Mt. Kud- tive incense) into it. Then she fumi- kuran, came to Buri. He complained gated the wrapped juice before she of severe abdominal pain and came to placed it on the belly of the man. As be treated by Diansa, the 50-year old she did this, she called out in a loud female baylan in the area. Diansa, af- ter a brief interview with the man, voice: told him to sit on the floor with his I call upon you Dumalaphig, Pai- legs crossed. Then she took a piece burung, Pagsandan, Paharunan (all of ginger from the basket above the fire-place and cut it into seven slices. She put these on top of the man's head, identified spirits of the departed ancestors) to help me locate the charms. to remove the spell, of the in his armpits, on his buttocks and on evil ones. Let it look like a but- the soles of his feet. terfly if it is from -the spirits of the grassland; turtle-like if it is from Having done this, she seated her- the spirits of the trees: if it is from self in front of the man. Then she took the spirits of the streams or of the hold of his middle finger with her river, let it form a figure inside the right hand, and with her left she felt talug (wrapper) and show it in the his pulse, at the same time murmuring panabang ( twigs and limbahon.an unintelligible prayer. At length she (leaves) looked the man directly in the eye. Af- ter a while, she laid aside the man's After the invocation, Diansa open- hand and told him that he was "suf- ed her maram-an (chewing pouch) and fering from a' burugtang (a charm talked to the patient. The wrapped placed by the angered environmental juice remained in the folded banana spirits inside the stomach of the vic- leaf for thirty minutes before the leaf tim, causing him to suffer an indes- was opened. cribable abdominal pain). When unfolded the leaf revealed a Diansa told her patient that unless fat-like substance, Diansa said it was that burugtang was removed he would the burugtang or charm of the himyaw not be able to rest, and perhaps he (spirits of the fields) which. was re- would die. The man asked Diansa to moved from the patient's abdomen by remove the charm. She left the house the hirogom (power) of the plants. and when she came back she brought Pointing at the formed substance, which leaves and twigs of various plants. I looked like a butterfly, she said that inquired what the names of the plants the patient had displeased the spirits were but Diansa refused to tell me, of the fields' while he was working. saying that doing so would make her The man admitted having killed a medicine ineffective. strange looking insect two days be-  JANUARY, 1966 45 fore he went to be treated by Diansa if one is the proper sex,.has given in Buri. birth to a child, and has the inclina- tion. The man was then given the bowl of brew from the boiled leaves and The same is true with the hilot or "the twigs. He was advised not to consume sprain and broken-bone" specialists, al- all of the decoction but to leave a though in some cases their skill is thought portion of it, about a ginger-deep, in the vessel. Diansa dipped her finger to be inherited. Among the people from into the remaining brew and anointed Lian, Batangas, it is believed that no one the patient's forehead, palm,chest, and can be a hilot "unless he is born with back. She said later that the patient a skill to perform the job." Or in the was forunate to have consulted her; local dialect-"Ipinanganak na may hi- otherwise, he would have died. The patient, apparently relieved of his dis- lig" (trs. born with inclination). comfort, paid Diansa the sanag or ad- The skill of the tambalan, mananam- vance fee for the spirits. Diansa col- bal, sirkano or baylan is acquired in lected her fee two weeks later. adulthood. It is a learned profession. In most cases, their professional training in- The Local Specialists volve a rigorous, verbatim learning of all ' Every known group in the Philippines the rudiments of herb medicine and me- today has its own local "medical" spe- morizing of complicated rituals. More- cialist. This specialist is called by va- over, not everyone can become an her- rious names-sirkano, surhano, baylan, bolario. Becoming one largely depends on haplasan, tambalan, and the mananambal. the linahe or ( descent) and upon the. Normally, these practitioners act as the health custodian of the locality. They in- terpret the dreams, diagnose the illness, choice of the environmental spirits, which reveal themselves in dreams followed by trembling fits after waking. and attend to all ceremonies connected with the society's rite of passage. Often Among the Sulod of, Panay, the period these specialists are older men and wo- of training for babaylnaship ,lasts from men in the group and, as such they also seven months to a number of years, and function as religious and political leaders. it involves different tedious steps. The student-babaylan is taught during this At any rate the type of illness or period the different methods of curing di- the degree of development which ,an ail- ment has may be understood in terms seases, the ceremonial dances, and the of who among the specialists in the com- other features of the Sulod religious ri- munity-the family of the sick man ap- tuals. There are seven steps to undergo proaches for help. For prenatal care, de- livery assistance, and postnatal care the before anyone can become a baylan. (1 ) Baratakan-This is the period of partira or midwife is called. For ordi- apprenticeship during which spirit-pro- nary sprain or for broken limbs, the hilot tectors and spirits-friends are assigned. is called. For complicated illness the The student babaylan merely assists the tambalan, the sirkano, or the bay Ian is called. The latter is often an omnibus chief babaylan. practioneer. (2) Sanguban.-During this phase of Most partira and the hilot do not re- study, the student is taught to recognize ceive their knowledge from supernatural and memorize the names of all medicinal beings. They acquire their skills through plants and to learn all the symptoms of early trainings. In Guinhangdan, one may illness as caused by the' different spirits become a midwife.' of the forest streams and spring. 46 PHILIPPINE SOCIOLOGICAL REVIEW ,(3) Hangdugan.-The student makes Implications his first offering to his chief spirit-pro- Thus far we have described the va- tector, the sacrificial fowl being a black rious aspects of folk medicine as prac- chicken. It is also during this period that ticed in some areas of the Philippines. he learns the names of all his ancestral- We have likewise noted the cultural con- deities, especially those who were babay- text within which the different curative lan, good hunters, and fishermen, and procedures are defined and put to, use. successful farmers during their time on Let us now note some of the sociological earth. implications of our materials. (4) Tagbungan-or the period of ri- In our, description of the various folk tual study.c-The student is taught all of the magico-religious arts-ritual dances, songs, and, music-but he is not allowed practices relative to etiology, diagnosis and treatment of illness, we have noted that the rural folks attribute causes of to perform any of them in public. He diseases to the doings of the supernatural makes an offering which consists of two beings. Organic causes of sickness are black chickens, one of which is buried seldom accepted if at all known. An in- near the sources of a spring or river. digestion or a slight fever for example.(5) Hagbayan.- During this period, will be treated simply with leaves of the' student is allowed to attend to mi- plants or with a concoction derived from nor cases. He is calied merku. He assists powdered seeds. But as.the illness con- the chief baylan in public performances tinues to persist over a period of time, of important ceremonies. At the end of the curative measures we elaborated- this term, he departs for' a nearby cave i.e., from the application of leaves or the to communicate, with his spirit-friends drinking of the concoction to elaborate and to gather herbs for his himagan or rituals-are applied. Now the people begin ','medicinal oil." to generalize about the disease. The super- natural' beings enter into the picture. The (6) Turupadan.-By this. time the stu- treatment, changes in accordance, '\Vith dent is expected to know all the rudi- the diagnosed cause. Often the nature ~ents of curing ceremonies," to recognize and extent of treatment vary according all known medicinal plants, to memorize to the hierachical position of the causative all the names of 'departed ancestors, and agents in the pantheon of the superna- to dance the different ritual dances. He tural beings. performs these in the presence of the Soon from this standpoint, it is un- chief baylan. He is also. required to make derstandable why many rural folks pre- an offering to' his chief spirit-protector. The sacrifices consists of seven red chic- fer traditional practices over scientific ones. First, the local curer operates with- kens. in the cultural framework' of his group. Second, he develops his diagnostic tech- (7) Banawangon.-or period of. final niques within the area known to the peo- offering-The student kills a' black pig pIe and draws his curative materials from and offers its liver to his chief spirit- familiar objects. In this way, he sets up protector and the carcass to the less pow- three levels of mental attitudes among erful divinities. He invites the whole com-' his "patrons": (1) an assurance that the munity to witness his first public ritual system of folk-medicine is not at variance performed without the help. of the chief from what they already know; therefore, babaylan. He is now a full-fledged ba- it is the right practice; (2) a confidence baylan. that a particular curative measure is the  JANUARY, 1966 47 best way of coping with the present ill- bolario is a specialist not only III mde- ness because experience has illustrated icine but also in all things supernatural. in the past, that someone with similar The latter is not possessed by the medical ailment has been cured by this type of doctor, and, this makes his 'medical skill treatment; and (3) an acceptance that less effective. Taking all these into con- the practice is part of their way of life. sideration, one may predict that it will be the herbolario who will be" called for In contrast to this approach, modern medical assistance and not the, doctor, the medicine while effective is foreign to the nurse, or any public health worker. cultural orientation of many ruraf folks. They know that. the "parmasiyutica" (all Concluding Remarks medicine bought from' the poblacion is called by this' name) is effective but because there is no corresponding point On the basis of' the data and discus- sion presented above, the following ob- of reference from 'their own ~ulturalback­ servations emerge: ground or experience there. is.alw:iysa 1) there is a strong connection. be- general hesitation to accept it. To their tween (a) folk practices, (b) scientific eyes, the local practices are a body of medicine; and ( c). the culture of the traditionally sanctioned,. established for- group where such folk practice exists and mulae, approved by the supernatural be- where scientific medicine is to be in- ings, to be resorted to in time of need. troduced; Because of these divergent views re- 2) there IS a system of "common- garding. the effectiveness of scientific sense" attitude which acts as a 'cultural medicine, competition between folk and modern medical practices comes about very often. In order to test the healing sieve, a selective principle which guides the. people to determine which method of treatment is fitted for a particular illness; powers of the new medicine, the vil- lagers usually seek the help of medical 3) the limited use of scientific med- doctors, nurses, and' public health work- cine leaves the area of chronic, non-in- ers for such illness against which the lo- capacitating illness open for the develop- cal procedures have proved ineffectual. ment of folk practices which will con- Often' the patients are 'beyond help. And tinue to complement the structural posi- when this fails, the doctors and nurses tion of folk healers; are regarded with suspicion, their me- 4) the cultural matrix upon folk prac- thods are not good, their skills are doubt- tices are defined need be considered when ful, and their medicine "cannot cure." introducing scientific medicine in the area; Another point to consider in analysing why folk medical practices persist in 5) on a wider theoritical level, it is suggested that an' extensive study of folk- spite of the challenge offered by scien- medicine may help create an atmosphere tific medicine is the psychology of the of fuller and dynamic understanding of patients. To the sick man illness is a mys- social cooperation in various normal and tery caused by an unknown source which critical conditions. It is in this way that brings about pain and discomfort, and change can be introduced, for in. critical which also threatens his life. Before situations even quarrels, frictions and ). this impending crisis for which no one group differences are eliminated, or at has direct control, the patient and his least momentarily forgotten when the relatives are helpless. There is only one structural position of each participant solution to the problem-to call for the in the differing systems is understood herbolario! As we have noted the her- and defined. 48 PHILIPPINE SOCIOLOGICAL REVIEW Bibliography '. Ackernecht, KN.. "Problems of primitive' medicine." Bull.' Hist. Med. 1942 11 :503-21 1942 "Primitive medicine and culture pattern." Bull. Hist. Med. 12: 545-74 1943 "Psychopathology, primitive medicine and primitive culture." Bull. Hist. M ed. 14: 30-67 1945 "On the collecting of data concerning primitive medicine." American Anthropologist. 47: 227-32 1946 "Natural diseases and rational treatment in primitive. 1947 Clements, Forrests E. med. Bull. Hist. Med. 19: 467-97 "Primitive Surgery." 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