Medical beliefs and practices derived primarily through oral-traditional processes rather
than from printed texts or formal academic or clinical training. Because folk medicine—
also known as traditional, vernacular, or community medicine—exists outside the
“official” medical establishment and the regulatory system that governs nurses,
pharmacists, physicians, and other licensed health-care professionals, it has often been
marginalized, equated with quackery, or simply dismissed as a curious anachronism—a
vestige of an earlier and simpler time. Yet, as folklorists, anthropologists, ethnobotanists,
medical specialists, and researchers in other fields have documented, folk medicine is
both widespread and active in contemporary America, representing one of many options
in a complex and highly diversified health-care system.
One distinctive characteristic of folk medicine is its multiplicity of forms, almost all of
which can be subsumed into three main categories: household medicine (home remedies),
herbalism and other forms of naturopathic healing, and magical medicine.
Of the three, home remedies are the most recent in origin and the simplest to prepare
and use, requiring little specialized knowledge or expertise. Made from ingredients
commonly found in the kitchen cabinet, the refrigerator, or the garage, they are for many
people the option of first choice for minor ailments and injuries. Some household
prescriptions take the form of generalized wisdom, as in the familiar proverb “Feed a
cold, starve a fever,” while others offer specific practical advice, such as gargling with
salt water to ease the irritation of a sore throat, drinking whiskey mixed with sugar or
honey as a cough suppressant, putting moistened tobacco on a bee sting or insect bite to
reduce pain and inflammation, or pouring kerosene on a cut to prevent infection.
Older and more complex than home remedies are naturopathic cures derived from
animals, minerals, and plants. Plant-based preventatives and cures, known collectively as
herbalism, have played an especially prominent role in American folk medicine.
Herbalism was an integral part of Native American healing systems long before the first
European settlers arrived with their own rich naturopathic traditions, and it continues to
flourish in many parts of the country, both independendy and as a constituent of larger
magico-religious systems.
The botanical pharmacopoeia is extensive and varied, furnishing the ingredients for
salves, poultices, teas, and other decoctions used to treat a host of illnesses and injuries,
ranging from colds and coughs to heart disease, diabetes, and cancer. A particular plant,
such as aloe (Aloe vera), may serve a single function, in this instance as a burn ointment,
or a plant may have multiple functions, as in the case of sassafras (Sassafras albidum),
which is made into a tea and taken internally as a blood purifier or a spring tonic; as a
cure for colds, flu, and fevers; as a means of breaking out measles or chicken pox; and as
a heart remedy.
While sassafras tea can be made with relative ease simply by boiling the roots in
water, the preparation of a number of other medicinal plants such as poke (Phytolacca
americana) requires specialized knowledge and skill. Indigenous to the Eastern United
States, poke has long been used for medicinal purposes, its specific functions dictated by
the season at which it is harvested and the part of the plant from which the medication is
extracted. The berries, for example, furnish a juice that is reputed to be effective in treating boils and sores. The leaves, when harvested early in the seasonal cycle, provide
the chief ingredient in what is commonly referred to as “poke salad,” a popular spring
tonic and blood purifier. The root itself has traditionally been used to treat stomach
cramps and other intestinal problems.
Just as a particular plant may serve a variety of medicinal functions, so, too, might a
particular illness be amenable to a multiplicity of treatments. In a recent study of
rheumatism cures used by a prominent Appalachian herbalist, for example, two Duke
University botanists, John Crellin and Jane Philpott, identified twenty-three different
plant ingredients, including the bark of Bowman’s root, the cucumber tree, and the
yellow poplar; the bark or leaves of the apple, bay, and beech tree; the bark or berries of
the prickley ash; the roots of black cohosh, button snakeroot, devil’s shoestring, gentian,
Indian hemp, joe-pye-weed, Sampson snakeroot, and sassafras; poke root or berries; tops
and roots of Queen Anne’s lace; angelico root or leaves; ratsvein leaves; skullcap leaves
and stem; and hydrangea bark, leaves, and root. Similar findings have been reported for
various other illnesses, both in contemporary field studies and in older regional
collections such as Wayland D.Hand’s PopularBeliefs and Superstitions volumes of the
Frank C.Brown Collection of North Carolina Folklore (1961–1964), Ray Browne’s
Popular Beliefs and Practices from Alabama (1958), Harry Hyatt’s Folklore from Adams
County, Illinois (1935), and Vance Randolph’s Ozark Superstitions (1947).
While the herbalists still actively practicing such cures may treat hundreds or even
thousands of people a year, the tradition has been gradually declining as the once
plentiful stocks of indigenous plants needed to sustain it have diminished and reliance on
over-the-counter drugs, health foods, and the like has increased. But another ancient form
of folk medicine, based on principles of homeopathic and contagious magic, remains
strong. Magical medicine—though sometimes aided by home remedies or herbal
treatments—depends for its efficacy not on materia medica (substances believed to have
medicinal properties) but on verbal charms, ritualized actions, and other practices
involving the diagnosis, removal, transference, deflection, or infliction of disease by
supernatural means.
According to folk-medical belief, certain ailments can be cured by verbal magic alone,
as evidenced by the well-known remedy for styes that advises the sufferer to recite the
words “Sty, sty, in my eye, go to someone passing by.” More typical, however, are cures
in which the verbal charms are accompanied by ritual procedures. In the magico-religious
tradition known as “talking out fire,” for example, the healer recites, in words that appear
garbled and incomprehensible to the patient and anyone else who might be present, a
charm that summons divine powers to the aid of the sufferer, as in this recently collected
example:
There came three angels from the West,
Three angels of the best, Three angels of God.
Go away fire and come frost.
In the name of the Father, Son, and Holy Ghost.
While reciting the charm, the healer blows on the burned area, passes a hand above the
surface, or makes direct contact with the wound—gestures that are all based on homeopathic or contagious principles and intended to alleviate pain as well as to reduce
scarring.
Similar combinations of charms and rituals are also used to stop the flow of blood
from a wound (“bloodstopping”), to cure “thrush” or “thrash” mouth in children, and to
“talk off” warts—a malady for which there are numerous other magical cures as well.
One simple expedient, based on homeo-pathic magic, is to tie knots in a piece of string with the number of knots corresponding to
the number of warts to be disposed of, and then to throw the string into running water or
bury it in a damp place so that the string (and, by symbolic extension, the warts) will
decompose quickly. An alternative strategy, based on contagious magic, is to
symbolically transfer the warts to another person through an intermediary object such as
a coin, which is rubbed on the affected areas and thrown into the road on the assumption
that whoever picks up the coin will get the warts as well. Sometimes the receptor is a tree
rather than a person. In a practice called “nailing,” for example, the wart is pricked with a
nail, which is then driven into a tree. An alternative is to rub a piece of cloth or some
other material on the wart, then bore a hole in the tree, and insert a wooden plug.
“Plugging,” the term commonly used for this practice, may also be combined with a
procedure called “measuring” to effect cures for other kinds or problems, such as asthma
in children. First, the child stands against a tree or doorjamb while someone draws a line
to mark his or her height. Then a hole is bored at exactly that point, and a lock of the child’s hair is stuffed into the hole and plugged, the expectation being that when the child
grows taller than the mark the asthma will disappear.
When the illness to be treated is believed to have an unnatural origin, a more complex
system of countermagic must be employed to combat it. Those who believe, for example,
that certain individuals possess an evil eye—the power to inflict serious physical and
psychological harm on another through an intense stare—typically arm themselves with
eye-shaped amulets and horn-like charms to symbolically deflect or pierce the invasive
eye of the so-called “overlooker” or “fascinator.” If, despite these precautions, someone
falls victim to the influence of the evil eye, other magical procedures may be used,
including blessings and benedictions intended to cancel out the eye’s pernicious effects
plus various diagnostic and curative rituals performed by someone in the family or
community whose powers are commensurate with those of the overlooker.
In cultures in which the evil eye is only one of many supernaturally induced
afflictions, the folk-medical response system is especially complex. Participants in such
traditions must be careful, for example, about how they dispose of nail parings, hair
clippings, items of clothing, or anything else that has been in contact with them lest these
materials come into the possession of someone who wishes to do them harm or gain
power over them. Even these cautionary measures provide no defense against illnesses
inflicted through homeopathic rituals in which a doll or a piece of knotted string is used
as a symbolic surrogate for the intended victim. Further complicating the process of
diagnosis and treatment is the fact that the symptoms of unnatural illness—lassitude,
depression, numbness, skin rash, and the like—are also indicators of many natural
illnesses. If these symptoms persist even after treatment with home remedies, herbal
cures, over-the-counter medications, or drugs prescribed by a physician, the usual
recourse is to enlist the aid of an occult practitioner.
As the foregoing discussion suggests, folk-medical prac-titioners do not conform to a
single prototype. Rather, they are an extremely heterogeneous group that includes men
and women of all ages, occupations, classes, and cultures. Some of them dispense
medical advice or treatment so infrequently, to such a small number of people, that they
have no distinct identity as healers; others are so well known for their medical expertise
that people within and outside the community consult them on a regular basis. Some see
themselves as agents of a divine power conferred at birth or passed to them at a later
stage of life by a tradition bearer who sees in them the spiritual strength and humanistic
concern needed to receive the gift; others are believed to have been born evil or to have
obtained their powers through sorcery or witchcraft. Some are specialists, practicing a
single cure, such as stopping blood, or a single tradition, such as herbalism; others
participate actively in all three major branches of folk medicine.
Essential to any meaningful study of folk-medical practitioners is an awareness of
their varying roles in the communities to which they belong. In the Cajun culture of
southwestern Louisiana, for example, the principal folk practitioners are called
“traiteurs,” a term that is commonly applied to three very different types of people:
magico-religious healers; individuals who dispense home remedies, patent medicines,
and herbal cures; and specialists in the occult tradition known in that part of the country
as “hoodoo.”
Among the Pennsylvania Germans, folk healers are differentiated into two major
groups: “powwows,” who practice an occult tradition known in German dialect as brauche, and herbalists. In practice, however, the boundaries between the two are often
blurred because the herbalist’s natural cures are often accompanied by verbal charms, and
the powwow’s magical formulas are frequently complemented by the use of herbs or
other naturopathic remedies.
Divisions are more sharply drawn in the ethnomedical system known as
curanderismo, widely practiced by Mexican Americans in the Southwestern United
States. As the name suggests, the central figure in this cultural tradition is the curandero
(a healer reputed to draw his powers from both the natural world and the spiritual world),
but other types of practitioners may also be consulted. These include herbalists,
midwives, folk chiropractors, and other benevolent healers as well as sorcerers or witches
known as brujos.
The same kind of diversity can be seen as well in other ethnomedical systems such as
root working or root medicine, a predominantly African American tradition concentrated
in the rural South and in many inner city neighborhoods of the Northeast. Participants in
this tradition may consult different types of practitioners depending on whether a
particular illness is diagnosed as physical or spiritual, natural or unnatural. If symptoms
indicate a physical problem resulting from natural causes, the patient’s initial response
will usually be self-treatment with home remedies or a consultation with an herbalist. If
the problem is perceived to stem from some spiritual failing in the patient, he or she may
consult with a minister or some other respected religious figure who acts in the capacity
of spiritual adviser or family counselor. If, on the other hand, there is some reason to
suspect unnatural causation, a root doctor will in all likelihood be called upon to verify
that diagnosis, cast counterspells against the rival conjurer, and administer whatever
potions might be needed to restore the victim’s health.
It is important to keep in mind that in these and other culturally based systems, folk
beliefs and practices have by no means displaced official medicine. Rather, they coexist
with it, as well as with other forms of alternative medicine such as chiropractic,
osteopathy, and acupuncture. The reasons for this phenomenon are numerous and
complex.
One factor, certainly, is the scarcity of medical doctors in many parts of the country—
particularly in rural areas where the population is too small or too scattered to support a
private practice and where the closest hospital or clinic may be located in the next county.
It is not surprising, then, that under these circumstances, people would rely on traditional
remedies or turn to folk practitioners, many of whom are both accessible and willing to
offer advice or treatment on short notice, often in their own homes.
Even when professional medical care is available, many people cannot afford it—a
problem that becomes more pronounced with each new increase in the cost of health
insurance, hospital treatment, prescription drugs, and everything else connected with the
official health-care system. By contrast, a community herbalist will typically charge only
enough to cover expenses, and most magico-religious healers adhere to a rigorous taboo
system that prohibits any kind of payment or even any expression of thanks on the
grounds that their gift comes not from themselves but from God.
Because such practitioners are often members of the patient’s own family or
community and usually perform their treatments in the familiar environs of the home or
workplace, their interactions with patients are also likely to be more informal and less
stressful than those that occur in a clinical setting, where the patient may have to wait several hours in a crowded office for a brief consultation with a physician whose caseload
often precludes the kind of personal attention offered by his or her folk counterparts.
Moreover, there are certain illnesses for which the sufferer will consult only a folk
practitioner because they do not exist in the disease taxonomies of the official medical
system. Participants in the curanderismo tradition, for example, routinely consult
physicians for broken bones, pneumonia, and other natural illnesses, but not for problems
such as mal de ojo (evil eye) or mal puesto (sorcery), which only a cultural insider can
fully understand and treat.
While the prominence of folk medicine in individual and community health-care
systems can be easily documented, questions about the efficacy of particular treatments
and procedures are more difficult to answer because the proof required by participants in
folk-medical tradition is very different from that demanded by medical researchers. For
members of the former group, the efficacy of a home remedy, an herbal cure, or a
magical procedure can be verified through anecdotal or experiential evidence alone. For
those in the scientific medical community, on the other hand, no valid conclusions can be
drawn without exhaustive laboratory experimentation and rigorously controlled clinical
trials.
Sometimes, scientific research corroborates folk belief, as in the case of foxglove
(Digitalis purpurea), which was prescribed as a heart tonic by community herbalists long
before pharmacological studies confirmed its cardiotonic properties. Conversely, some
long-standing folk remedies, such as ingesting turpentine for kidney problems, have been
shown to pose serious health risks even when taken infrequently and in moderate
dosages. For still other remedies, the medical evidence is inconclusive. Sassafras, for
example, has been popular as a spring tonic and blood purifier since colonial times, but
laboratory experiments have suggested that the plant’s main active ingredient, safrole, is
a potential carcinogen.
Even more problematic are magico-religious beliefs and practices, which participants
in the tradition accept on faith but which are rarely amenable to laboratory or clinical
testing. People who have had the fire talked out of a burn, for example, typically attest to
the efficacy of the cure by saying that it immediately alleviated the pain they were
experiencing and prevented scarring, but testing these claims scientifically is a difficult
task because there is no way to quantify pain, to determine whether the burn was severe
enough to produce scars if left untreated, or to control for other variables by establishing
experimental and control groups.
Whether medical science confirms or condemns a particular folk-medical practice is
ultimately less important than whether the patient has faith in the practitioner and the
treatment. As long as the latter two conditions prevail, folk medicine will continue to
flourish—not as a substitute for mainstream medicine but as one important constituent in
a complex, multidimensional health-care system.
James W.Kirkland
References
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