Caroline Currer - Concepts of Health, Illness and Disease: A Comparative Perspective

A Comparative Perspective

First published 1986 by Berg Publishers

Published 2020 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
605 Third Avenue, New York, NY 10017

Routledge is an imprint of the Taylor & Francis Group, an informa business

1986, 1991, 1993 Taylor & Francis

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing in Publication Data

Concepts of health, illness and disease: a comparative perspective.
1. Social medicine
I. Currer, Caroline II. Stacey, Meg
362.1 RA418

Library of Congress Cataloging-in-Publication Data

Main entry under title:

Concepts of health, illness, and disease.
Bibliography: p.
Includes index.
1. Health attitudesCross-cultural studies Addresses, essays, lec
tures. 2. DiseasesPublic opinionCross-cultural studiesAddresses,
essays, lectures. 3. Health attitudesAddresses, essays, lectures. 4. Dis
easesPublic opinionAddresses, essays, lectures. I. Currer, Caroline.
II. Stacey, Margaret. [DNLM: 1. Cross-Cultural Comparison. 2. Disease.
3. Health. 4. Sociology, Medical.
WA 30 C744]
RA427.C619 1986 614.4 8520759

ISBN 13: 978-0-9075-8218-2 (hbk)
ISBN 13: 978-0-9075-8219-9 (pbk)

Grateful acknowledgement is made to the following authors and publishers for permission to reproduce material used in this volume:

Arthur Kleinman (1978) 'Concepts and a Model for the Comparison of Medical Systems as Cultural Systems', Social Science and Medicine vol. 12, pp. 85-93, Pergamon Press Ltd; Paul U. Unschuld (1978) 'Die Konzeptuelle berformung der Individuellen und Kollectiven Erfahrung Von Kranksein', Sonderdruck aus Krankheit, Heilkunst, Heilung Verlag Karl Alber, Freiburg, Mnchen; Claudine Herzlich and Janine Pierret (1984) 'Malades d'hier, malades d'aujour d'hui, Paris, Payot; Hilary Graham and Ann Oakley (1981) 'Competing Ideologies of Reproduction: Medical and Maternal Perspectives on Pregnancy', in Helen Roberts (ed.) Women, Health and Reproduction, London: Routledge and Kegan Paul; Gilbert Lewis (1975) Knowledge of Illness in a Sepik Society, LSE Monograph on Social Anthropology no. 52, London: The Athlone Press; Gilbert Lewis (1976) 'A View of Sickness in New Guinea', in J. B. Loudon (ed.) Social Anthropology and Medicine, ASA Monograph no. 13, London: Academic Press; Gilbert Lewis (1980) Day of Shining Red, Cambridge: Cambridge University Press; Allan Young (1976) 'Internalising and Externalising Medical Belief Systems: An Ethiopian Example', Social Science and Medicine vol. 10, pp. 147-56, Pergamon Press Ltd; Joan Ablon (1973) 'Reactions of Samoan Burn Patients and Families to Severe Burns', Social Science and Medicine vol. 7, pp. 167-78, Pergamon Press Ltd; Jeremy Seabrook (1973) The Unprivileged, Harmondsworth: Penguin Books Ltd; Cecil G. Helman (1978) "'Feed a Cold, Starve a Fever": Folk Models of Infection in an English Suburban Community and Their Relation to Medical Treatment', Culture Medicine and Psychiatry vol. 2, pp. 107-37, D. Reidel Publishing Company Ltd; Roisin Pill and Nigel Stott (1982) 'Concepts of Illness Causation and Responsibility: Some Preliminary Data from a Sample of Working-Class Mothers', Social Science and Medicine vol. 16, pp. 43-52, Pergamon Press Ltd; Magdalena Sokolowska (1973) 'Two Basic Types of Medical Orientation' Social Science and Medicine vol. 7, pp. 807-15, Pergamon Press Ltd.

In addition, we should like to thank Jennifer Lorch for her help with translation, Alan Currer for help with the bibliography, and the Arts Librarians of the University of Warwick for help in tracing French sources. The manuscript was typed by Jeanne Summers and Fiona Stone, to whom we are most grateful.

In shortening extracts, the following conventions have been used:... in the text indicates that material has been omitted within an original paragraph.

.... between paragraphs indicates that material in excess of a paragraph has been omitted.

In reprinting the articles the conventions and spellings of the original have been brought into line with the publisher's house style.

CAROLINE CURRER MEG STACEY

Increasing interest has been shown over the last decade in concepts of health and illness and in what the systematic basis of the variations which are exhibited might be. This interest seems to derive from a number of sources. In health care delivery it is suggested that some at least of the manifold problems of communication between doctor and patient derive from their differing conceptualisation, or that professionals mistake alternative conceptualisation for ignorance or wilful misunderstanding, or that medical dominance eventuates in the only acceptable understandings of illness being those which are conceptualised in the mode of biomedical science.

Another source of interest has been the increasing understanding of the health problems of the 'third world' and a new awareness of the relevance and, indeed, utility of indigenous healers and healing. Any thorough-going critique of health care planning and administration requires the imaginative consideration of modes of healing based upon conceptualisations alternative to the contemporary dominant mode. Steven Feierman (1979) has described 'plural healing systems' where a variety of modes of health knowledge, practice and practitioners exist side by side in a society. Where there is such plurality, members have choices, both of which concepts to accept, to 'believe in', and of which healers to seek help from.

In much of the Western world, biomedicine is dominant and has a status in relation to the state analogous to that of the established Church of the medieval period. However, in Western societies not all sections of the population share the concepts associated with that body of knowledge and its modes of practice. Members also have access to, and possibly accept concepts derived from, other cosmologies or other modes of healing, and also from earlier formulations of biomedicine itself.

There are terminological difficulties in attempting to look at concepts of health and healing over time and space which, upon inspection, turn out to conceal conceptual or philosophical problems. These are made plain when one tries to translate terms from one language to another and yet convey the concepts correctly. Mark Field and Alphonse d'Houtaud have become aware of this in translating d'Houtaud's French work into English. Sometimes a concept does not have an English equivalent as, for example, to 'feel well in one's skin'. Such phrases can only be translated literally. Caroline Currer (Ch. 9) discusses the conceptual as well as the terminological difficulties of translating test questions from English into Pukhto. In Arthur Kleinman's and Paul Unschuld's papers the distinction between 'illness', a subjective state experienced by the sufferer and possibly recognised by others in consequence of her/his demeanour, and 'disease', a pathological condition recognised by biomedicine, is drawn out. This is an important distinction when relating medical and lay conceptualisations to each other; it is one that can be made in German as it can be in English. In Polish it is not possible (Sokolowska