immigrants. No health tradition is entirely static, and it is clear that infor-
mation was often consciously shared so that it is difficult to say whether or
not an aboriginal practice is ‘indigenous’. Modern compilations of tradi-
tional practices commonly straddle aboriginal and Euro-North American
self-care traditions.^8 This applies to, for example, ‘high blood pressure’ – a
condition that emerged in the aboriginal and European-derived traditional
medicine literature – after it became a widely used diagnosis in conventional
medicine in the early twentieth century. It is easy to speculate that, as an
increasingly common medical term, high blood pressure was seen to fit with
the long history of popular medicine (aboriginal and other) of blood purifi-
cation, and so was added to lists of uses for ‘blood purifiers’ (alder, consid-
ered below, is an example). Blood purification continues to be a popular
notion; it extends into the complementary/alternative medicine literature,
and merits the attention of conventional practitioners.^9
The greater the level of background knowledge when approaching a
patient, the more a practitioner will feel comfortable in making general-
izations if there is uncertainty over a treatment, as with alder for
headache; at the very least it falls within a veryweak tradition of usage.
As William Osler reminded physicians: ‘The greater the ignorance, the
greater the dogma.’
Step 2
Step 2 of the strategy comprises:
- ensuring that a culturally sensitive case history is taken^10
- when necessary, quickly accessing pertinent information in
computerised databases or reference books to help develop, along with
background knowledge, a dialogue with a patient about efficacy and
safety. Quick assessments are difficult and demand some evaluation of
the record of published and other information from practitioners and
of the popularity of usage over time.
If, for example, a weak tradition is indicated by a database (and
confirmed by a comprehensive literature search), there is no ‘scientific’ justi-
fication for encouraging, say, the use of a compress of alder leaves as a
generally effective treatment for a headache (see below). On the other hand,
given the safety and absence of known allergic reactions of alder leaves as a
traditional external application to relieve or ‘cool’ insect bites and inflam-
mation, a practitioner may well support a patient wanting to try the treatment.
Understanding the reason may be helpful. Maybe the query comes from an
aboriginal person who is comfortable following a traditional aboriginal
regimen that includes a spiritual component, e.g. acknowledging a connection
between the plant and the spirit world during the harvesting of glossy (or new)
Aboriginal/traditional medicine in North America | 47