I think the ethnomedical approach is most useful in studying health, since it addresses health and illness within indigenous constructs and local disease taxonomies. Hence, anthropologists can explore cultural explanatory models of etiology, pathophysiology, treatments, and prognosis of an illness entity. The ethnomedical approach is also valuable in its incorporation of linguistic categories used in the relaying of an illness narrative, and can be a lens to interpret an individual’s “language of distress” (a term used by Cecil Helman) and whether they will be compliant with physician instructions. It evaluates the effectiveness of traditional remedies of popular, folk, and professional sectors of a society, and can provide insight into an individual’s “strategy of resort to healing”, a phenomenon described by John Janzen.
Disease represents the visible, clinical, and physiological manifestations of abnormalities in bodily function or structure, or infection with a pathogen. In contrast, illness is an individual’s experience of distress or disorder with regard to health within a particular sociocultural context. The distinction is apparent because the former invokes biomedicine, while the latter is of subjective nature, in that illnesses are not uniformly identified by Western physicians and are based on patient perception.
Miner is referring to American culture, which I inferred from his description of cultural hero “Notgnishaw” chopping down a cherry tree, who I recognized as George Washington.
One cultural value of the Nacerima is purification and cleanliness as an indicator of health, as revealed through “shrine” or bathroom rituals and “mouth-rites” or teeth-brushing.
Another Naceriman cultural value is esteem for medical practitioners, as exemplified by their fee-for-service paradigm (they are “rewarded with substantial gifts”). Additionally, prestige for practitioners appears through their portrayal as the guardians of a privileged and sacred knowledge; for example, they write ingredients for medicines in “an ancient and secret language,” which represents the medical terminology with which laymen are not familiar. Furthermore, the Nacerima value specialization and compartmentalization of medical practice typical of the reductionism of Western biomedicine. This trait is highlighted by the use of medicine men, herbalists, dentists (“holy mouth men”) and psychoanalysts (“listeners”) and their hierarchy in terms of reputation and power. A final cultural health value of the Nacerima is privacy and modesty with respect to bodily matters such as excretion and parturition, due to a “pervasive aversion to the natural body and its functions” which alludes to shame surrounding bodily taboos.