a trend toward maturation of vaginal epithelium, persist in raising the
question of whether black cohosh acts somehow like estrogen.^30Science has not been able to deal convincingly with the possibility,
certainly not proven, of oestrogenic effects and theoretical adverse effects,
especially for those with a history of hormone-sensitive cancers or a family
history. In the current climate of practice, a practitioner has a responsibility
to provide the pros and cons for the use of a treatment giving a critical
evaluation of non-scientific as well as scientific data.
Magico-religious/spiritual practices
Introductory comments
As problematic as the critical appraisal of information on herbs can be,
some practitioners may find greater difficulty in responding to queries
about what have long been called magico-religious, magical and spiritual
practices. Nowadays, the distinction between these categories is commonly
blurred, because they depend on how supernatural forces are viewed by
individuals.
Although this chapter is not concerned with Mexican traditional prac-
tices, they have become part of other North American countries to which
Mexicans migrated.
Magico-religious practices commonly embrace beliefs in supernatural
influences; these include shamanism, in which a shaman, in the context of
healing, can act as a medium for an entering spirit (maybe the spirit of a
renowned ancestral healer) to ‘orchestrate’ the care through the healer. On
the other hand, some will describe, say, the charming away of warts as
merely ‘magical’, meaning a magical circumstance – a view perhaps influ-
enced by a popular idea of a healer as someone who is able to help a person
develop their own inherent healing powers, or, as some might say, enhancing
‘the power of the mind over the body’. The ‘power’ (or skill) of some such
healers may be viewed as a result of a deep knowledge of traditions, perhaps
including the ability to make spiritual connections – in other words,
divorced from being able to control supernatural forces. Thus ceremonies
and their healing powers for individuals and communities, e.g. the sweat
lodge, sweetgrass and smudging, and talking circles, are cast in different
ways (magico-religious, spiritual or relatively secular, perhaps invoking
psychosocial explanations), according to the observer.
It is incumbent on a practitioner responding to the question from a patient
about a ceremony (perhaps an aboriginal person looking to reconnect with
traditional ways) to appreciate the spectrum of ceremonies and how they may
help with specific physical, mental or psychological problems. To do so
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