conventional and domestic medicine. Recently compiled lists of uses by, for
example, North Carolina Cherokees continue to reflect this with all the
appearance of information taken from non-aboriginal sources: ‘roots in
alcoholic spirits for rheumatism; tonic; diuretic; anodyne; emmenagogue;
slightly astringent; tea for colds; coughs; consumptions; constipation; tea for
rheumatism; fatigue; hives; to make baby sleep; backache’ (Hamel and
Chiltosky,^18 page 30).
As already indicated, practitioners generally find such lists problematic
and difficult to interpret. Moreover, they offer no sense of the differences of
opinion that have existed among practitioners over time. In the nineteenth
century, some physicians who questioned or expressed caution over efficacy
for ‘female conditions’ were widely recognised medical ‘authorities’ at a
time of widespread usage of herbs, e.g. Robley Dunglison in the USA made
no mention of black cohosh’s emmenagogue action in his New Remediesof
1843, while noting that it was employed ‘chiefly in domestic practice, as a
remedy in rheumatism, dropsy, hysteria and in various affections of the
lungs’.^25 On the other hand, in his popular General Therapeutics and
Materia Medicaof 1850, Dunglison did raise cautions in stating that the
testimony of ‘pharmacological writers in regard to its action is sufficiently
imprecise’.^26 He noted another authority when indicating that, although
some practitioners consider it to have a ‘practical affinity for the uterus’,
that was not the case because ‘it probably exerts some influence over the
nervous system of the nature not exactly understood’. Questioning
comments about its effects on the uterus were in line with doubts about the
general value of the herb for female complaints, although it was felt that a
tonic action – as with many other medications – might be helpful. Further
instances of questioning comments cannot be given here, although they do
support an ongoing uncertainty about effectiveness for women’s complaints.
Lay (sometimes called social) validation of a treatment: concepts of disease
An important aspect of step 1’s preparation is an understanding of why the
persistent reputation of many non-conventional therapies over time rests on
lay validation. This aspect is multifactorial and complex, and certainly
demands effective communication skills for a practitioner to uncover relevant
issues for individual patients. They may include:
- popular interpretation of medical advances
- testimonials from relatives and others about successful outcomes
- treatments rationalised on the basis of beliefs about a disease (often
popular beliefs current at the time such as blood purifiers) - treatment by a practitioner (perhaps an aboriginal healer) who
supports beliefs that are compatible with those that the person holds,
e.g. the connections between plants and the spirit world.
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