Nature, culture and Well Being

Nature, Culture and Wellbeing
The other day I met Prof. Susan Viswanathan and during the course of our discussion she suggested to give a talk on this occasion in the coming up seminar for 34th — in Sociology.

The suggestion was exciting and I accepted it, feeling that it will give me an opportunity to interact with this August gathering of intellectuals from colleges and universities all over the country.

I did think that how I could fit in this refresher course which aimed to improve the academic abilities of the participants, but the suggestion and kindness was such that I could not resist.

The Prof. may have thought that the way I practice is something difference that the rest of the medical practitioner. Something likes looking up the man as a whole. The illness is the manifestation of the condition of disorder as a whole, an non-functioning of the man in total being effected by his habits, surrounding and relationship with people and nature. To be healthy is to undo the hardship and realization of the cause of his unwell.

Regarding the topic very kindly worked out on the suggestion she made, “Nature, culture and Well Being”. For a medical person this seem to perfect topic as we deal with human being along with other living. This is a challenge for the professional to justify the relationship with human being.  As a matter of fact we do have culture which is originated since ancient time of medical practice in India and in the rest of the world. Medical history do establishes the connection interwoven among these with human illnesses and health. The healthy living do attract a healthy environment. A healthy culture do gives a healthy mind and a good environment gives a strong physics. So the healthy mind and body is the gift of nature and culture.
(As a medical man, how do I fit into it, but at the same time I do fit into this discussion, as we deal with the nature, culture and well being of human beings?) So logically, I appreciated the idea and the next task was how to make a considerable contribution , so that this August gathering can improve or benefit, maybe in a very small manner.

Philosophically also, there is a connection between nature, culture and well being. Infect, experiment shows that they are interlinked in their own way, environmentally, worldly, and in connection with the human existence. A detailed analogy will be explainable.

Scientifically thinking also there is a relationship as one cannot exist without the other and one does contribute in the management of each other, that means nature, culture, well being and an as a whole.

Nature, culture and well being has an element of science in it and when we talk in this context of sociology it has a social science also.

Science cannot be separated from human beings or from the world as such. So there are science of nature, science of sociology, science of human being and culture becomes the binding force of all the three. Culture carries its own influence on the human being wherever the human being travels. Maybe we can call it science of culture or cultural heritage as is popularly known as.

The    study of nature in detail can be called the natural science which encompasses  everything that exists around the human being. In all these factors there is a principle , and one needs to follow the principle of nature, principle of culture and well being.

Philosophy makes one conscious of the principle and a scientist who is philosophical  grows up with an attitude to look beyond and in future, that means the scientist always experiences and enjoys a science of reflection which other people can never enjoy. It gives a depth in this thinking, in his attitude and  his persuade for his new achievement. Today philosophy has been separated from the scientific world but still it belongs much to the campus of science. I  may be crossing my limit but still I feel,the human being has totality of philosophy of science.
Here I would like to quote the Greek thinker, who regarded the presence of mind in nature as the source of that regularity or orderliness in the natural world whose presence made a science of nature possible.

The world of nature they regarded as the world of bodies in motion. The motion in themselves , according to Greek idea were due to vitality or “soul”; but motion in itself is one thing, they believed, and orderliness another. They conceived mind, in all its manifestations, whether in human affairs, or elsewhere, a ruler, a dominating or regulating element, imposing order first upon itself and then upon everything belonging to it, primarily its own body and secondarily that body’s environment.
The world of nature is not only alive but intelligent and has a mind of its own. All the creatures inhabiting the surface of the earth represent a specialized local organization of the al pervading vitality and rationality. In other words, plants or animals participate psychically in the life process of the world’s “SOUL” and intellectually in the activity of the worl’d “MIND”, and materially in the physical organization of the world’s “BODY”

Greek natural science was based on an analogy between macrocosm nature and microcosm man, as man is revealed to himself in his own self- consciousness; as Renaissance natural science was based on analogy between nature as God’s handiwork and machines that are handiwork of man. To the present day the modern view of nature is based on analogy between the processes of natural world as studied by natural scientists and the vicissitudes of natural world as studied by historians.

Species of living organisms are not a fixed repertory of permanent types, but begin to exist and cease to exist in time. Same is man and there are also changing and unchanging elements in world of nature.

CULTURE : (LATIN : Cultura)
Mostly used in three basic senses-
–    Excellent of taste in the fine arts and humanities, also known as high culture
–    Integrated pattern of human knowledge, belief and behavior that depends upon the capacity for symbolic thought and social learning
–    The set of shared attitudes, values, goals and practices that characterizes an institution, organization or group.
18th and 19th century Europe – cultivation or improvement, as in agriculture or horticulture.
19th century- betterment or refinement of the individual, specially through education.
Mid nineteenth century – used as universal human capacity
20th century- culture emerged as a concept.

Central to anthropology, encompassing all human phenomena that are not purely results of human genetics.

In English culture is based on a term used by Cicero, who wrote of a cultivation of the soul or “Cultura  animi”, or development of a philosophical soul. Many writers refer to culture as “all the ways in which human beings overcame their original barbarism, and through artifice, became fully human”.
German philosopher IMMANUEL KANT
“Enlightenment is man’s emergence from his self-incurred immaturity”
Immaturity comes not from a lack of understanding but from a lack of courage to think independently.
Sapere Aude “Dare  to be wise”
Urban culture
Rural , French , culture, American, corporate,Indian youth culture
Medically to grow in on a controlled or defined medium
The sum of attitudes, customs and beliefs that distinguishes one group of people from another. Culture is transmitted through language, material objects, ritual, institutions, and art, from one generation to the next.
Anthropologists consider that the requirements for culture(language use, tool making and conscious regulation of sex) are essential features that distinguishes human from other animals
Culture- refined music, art and literature , one who is well versed in these subjects is considered “cultured”.

Culture is a stream flowing down through the centuries from one generation to another.

Each generation contributes to the stream, but in each generation something is left behind, some sediment drops to the bottom and is lost to the society.
What we lack in physical attributes and strength, we make up for in our ability to communicate and learn culture from one generation to the next.
This is why sociology is important. It is human kind’s almost total reliance upon socially transmitted patterns of behavior that enable it to survive.
Society and culture are the subject matter of sociology.

Sick Building syndrome

Hegel put it, “a country that has existed for millennia in the imaginations of the Europeans.”

Culture syndrome, culture-bound syndrome
Rave rash   afflicted young women who went to “raves”, dance parties that went on all night long.  Aggressive dance motions without wearing a bra sometimes led to a painful rash on their nipples–hence “rave rash.”
Toasted skin syndrome-  Excessive use of laptop computers resting on the lap causes  mottled discoloration of skin on the legs due to the heat generated  from these devices.

Kuru  is a fatal culture specific disease of the brain and nervous system. It was thought to becaused by a virus but now its cause is prions( a protein that has the ability to cause the cells that it invades to repeatedly duplicate it.  Apparently, prions are not effectively attacked by their host\’s immune system nor can they be killed with existing antibiotics, extreme heat, cold, or other normally lethal conditions.  The word prion comes from”proteinaceous infectious particle).”
This disease is also called “trembling sickness” and “laughing sickness.” because the face muscles of victims were constricted in a way that looked like a smile.  Death almost always occurs within 6-12 months of the onset of symptoms.
Mad cow disease

The human form of “mad cow disease” has been connected to eating beef from cattle that had acquired the disease as a result of eating food supplements made from ground up dead sheep and perhaps other farm animals.
Recently in Mumbai during Holi celebrations in Dharavi slums,170 persons, majority being children, suffered from poisoning following use of spurious colour.

They were admitted to the hospital after they complained of vomiting and nausea after they played with colours in the morning. As per reports, spurious colour, containing chemicals, had caused poisoning.  Some of the kids had to  be shifted to the ICU.

Brain fag is an example of a culture-bound syndrome. Once a common term for mental exhaustion, it is now encountered almost exclusively in West Africa. Seen predominantly in male students, it generally manifests as vague somatic symptoms, depression, and difficulty concentrating.[1]
Dhat syndrome is a condition found in the cultures of the Indian subcontinent in which male patients report that they suffer from premature ejaculation or impotence, and believe that they are passing semen in their urine.
In traditional Hindu spirituality, semen is described as a “vital fluid”. The discharge of this “vital fluid”, either through sex or masturbation, is associated with marked feelings of anxiety and dysphoria. Often the patient describes the loss of a whitish fluid while passing urine. At other times, marked feelings of guilt associated with what the patient assumes is “excessive” masturbation are noted.
This is based on an old Hindu belief that it takes forty drops of blood to create a drop of bone marrow and forty drops of bone marrow to create a drop of sperm.
Dhat is a folk diagnostic term used in India to refer to anxiety and hypochondriacal concerns associated with the discharge of semen, with discoloration of the urine, and feelings of weakness and exhaustion.

Ghost sickness is a culture-bound syndrome which some Native American tribes believe to be caused by association with the dead or dying. It is considered to be a psychotic disorder of Navajo origin. Its symptoms include general weakness, loss of appetite, a feeling of suffocation, recurring nightmares, and a pervasive feeling of terror. The sickness is attributed to ghosts (chindi) or, occasionally, to witches or witchcraft. It is sometimes associated with a coffin linked to the common Native Americans practice of burying the dead above ground.
The evil eye is a look that is believed by many cultures to be able to cause injury or bad luck for the person at whom it is directed for reasons of envy or dislike. The term also refers to the power attributed to certain persons of inflicting injury or bad luck by such an envious or ill-wishing look.

Taijin kyofusho (対人恐怖症 taijin kyōfushō, TKS, for taijin kyofusho symptoms), is a Japanese culture-specific syndrome. The term taijin kyofusho literally means the disorder (sho) of fear (kyofu) of interpersonal relations (taijin). Dr. Shoma Morita described the condition as vicious cycle of self examination and reproach which can occur in people of hypochondriacal temperament.

An example of a relatively harmless culture specific medical condition was “rave rash” in England during the late 1990\’s.  This afflicted young women who went to “raves”, or large-scale pop music dance parties that went on all night long.  Aggressive dance motions without wearing a bra sometimes led to a painful rash on their nipples–hence “rave rash.”  Another more recent culture bound syndrome is “toasted skin syndrome”.  This is a result of excessive use of laptop computers resting on the lap.  The heat from these devices over time can cause a mottled discoloration of the skin on the legs.

Kuru  is a fatal culture specific disease of the brain and nervous system that was found among the South Foré  people of the eastern New Guinea Highlands.  Until recently, it was thought that kuru is caused by a virus with a prolonged incubation period.  Evidence now points to prions as being the cause.  The symptoms include palsy, contracted face muscles, and the loss of motor control resulting in the inability to walk and eventually even eat.  Kuru victims become progressively emaciated.  The South Foré called this disease “trembling sickness” and “laughing sickness.”  The latter description was due to the fact that the face muscles of victims were constricted in a way that looked like a smile.  Death almost always occurs within 6-12 months of the onset of symptoms.

Kuru is closely related to two other well known fatal diseases that affect the brain and nervous system.  They are scrapies  in sheep and goats and Kreutzfeld-Jacob  disease in humans.  The latter disease is now popularly referred to as “mad cow disease” since it is a variant of the disease in cattle (bovine spongiform encephalopathy  ).  Beginning in 1986, there was a minor epidemic of it among cattle and people in Western Europe, especially in Britain.  More recently, there were several cases among cattle in Western Canada.  The human form of “mad cow disease” has been connected to eating beef from cattle that had acquired the disease as a result of eating food supplements made from ground up dead sheep and perhaps other farm animals.  The official response has been the isolation and slaughter of several hundred thousand cattle and other farm animals in Europe and Canada.  This drastic measure apparently has prevented a widespread epidemic.  Variants of “mad cow disease” are known to exist in at least 10 wild mammal species including deer, elk, bison, kudu, oryx, mink, and cats.  In these species, the disease is commonly referred to as “chronic wasting disease.”

What a culture defines as abnormal behavior is a consequence of what it defines as a modal personality.  People who exhibit abnormal behavior in western societies are usually labeled as being eccentric, mentally ill, or even dangerous and criminal.  Which label is assigned may depend on the subculture, gender, and socioeconomic level of the individual exhibiting abnormal behavior.  In North America, the public acts of poor mentally ill males are sometimes seen as being criminal.  This is especially true if they are ethnic minorities or living on the streets.  In contrast, similar abnormal behavior by rich males is likely to be viewed as being only eccentric.  In the former Soviet Union, important people who publicly opposed government policy were sometimes considered mentally ill and were placed in mental institutions where they were kept sedated “for their own good.”
DSM-IV list of culture-bound syndromes
The fourth edition of Diagnostic and Statistical Manual of Mental Disorders classifies the below syndromes as culture-bound syndromes[10]

•    Caída de Mollera
•    Cólico
•    Embrujamiento[11]
•    Empacho – food forms clumps during digestion, causing pain[12]
•    Hysteria
•    Mal Puesto
•    Mal de Latido
•    Mal Aire
•    Melancholia
•    Medical anthropology is an interdisciplinary field which studies “human health and disease, health care systems, and biocultural adaptation”.[1] It views humans from multidimensional and ecological perspectives.[2] It is one of the most highly developed areas of anthropology and applied anthropology,[3] and is a subfield of social and cultural anthropology that examines the ways in which culture and society are organized around or influenced by issues of health, health care and related issues.

•    The term “medical anthropology” has been used since 1963 as a label for empirical research and theoretical production by anthropologists into the social processes and cultural representations of health, illness and the nursing/care practices associated with these.[4]

•    Furthermore, in Europe the terms “anthropology of medicine”, “anthropology of health” and “anthropology of illness” have also been used, and “medical anthropology”, was also a translation of the 19th century Dutch term “medische anthropologie”. This term was chosen by some authors during the 1940s to refer to philosophical studies on health and illness.[5]
Historical background

The relationship between anthropology, medicine and medical practice is well documented.[6] General anthropology occupied a notable position in the basic medical sciences (which correspond to those subjects commonly known as pre-clinical). However, medical education started to be restricted to the confines of the hospital as a consequence of the development of the clinical gaze and the confinement of patients in observational infirmaries.[7][8] The hegemony of hospital clinical education and of experimental methodologies suggested by Claude Bernard relegate the value of the practitioners\’ everyday experience who was previously seen as a source of knowledge represented by the reports called medical geographies and medical topographies both based on ethnographic, demographic, statistical and sometimes epidemiological data. After the development of hospital clinical training the basic source of knowledge in medicine was experimental medicine in the hospital and laboratory, and these factors together meant that over time mostly doctors abandoned ethnography as a tool of knowledge. Most, not all because ethnography remained during a large part of the 20th century as a tool of knowledge in primary health care, rural medicine, and in international public health. The abandonment of ethnography by medicine happened when social anthropology adopted ethnography as one of the markers of its professional identity and started to depart from the initial project of general anthropology. The divergence of professional anthropology from medicine was never a complete split.[9] The relationships between the two disciplines remained constant during the 20th century, until the development of modern medical anthropology in the 1960s and 1970s. A large number of contributors to 20th Century medical anthropology had their primary training in medicine, nursing, psychology or psychiatry, including W. H. R. Rivers, Abram Kardiner, Robert I. Levy, Jean Benoist, Gonzalo Aguirre Beltrán and Arthur Kleinman. Some of them share clinical and anthropological roles. Others came from anthropology or social sciences, like George Foster, William Caudill, Byron Good, Tullio Seppilli, Gilles Bibeau, Lluis Mallart, Andràs Zempleni, Gilbert Lewis, Ronald Frankenberg, and Eduardo Menéndez. A recent book by Saillant & Genest describes a large international panorama of the development of medical anthropology, and some of the main theoretical and intellectual actual debates.[10][11]

Popular medicine and medical systems
For much of the 20th century the concept of popular medicine, or folk medicine, has been familiar to both doctors and anthropologists. Doctors, anthropologists and medical anthropologists used these terms to describe the resources, other than the help of health professionals, which European or Latin American peasants used to resolve any health problems. The term was also used to describe the health practices of aborigines in different parts of the world, with particular emphasis on their ethnobotanical knowledge. This knowledge is fundamental for isolating alkaloids and active pharmacological principles. Furthermore, studying the rituals surrounding popular therapies served to challenge Western psychopathological categories, as well as the relationship in the West between science and religion. Doctors were not trying to turn popular medicine into an anthropological concept, rather they wanted to construct a scientifically based medical concept which they could use to establish the cultural limits of biomedicine.[12][13]
The concept of folk medicine was taken up by professional anthropologists in the first half of the twentieth century to demarcate between magical practices, medicine and religion and to explore the role and the significance of popular healers and their self-medicating practices. For them, popular medicine was a specific cultural feature of some groups of humans which was distinct from the universal practices of biomedicine. If every culture had its own specific popular medicine based on its general cultural features, it would be possible to propose the existence of as many medical systems as there were cultures and, therefore, develop the comparative study of these systems. Those medical systems which showed none of the syncretic features of European popular medicine were called primitive or pretechnical medicine according to whether they referred to contemporary aboriginal cultures or to cultures predating Classical Greece. Those cultures with a documentary corpus, such as the Tibetan, traditional Chinese or Ayurvedic cultures, were sometimes called systematic medicines. The comparative study of medical systems is known as ethnomedicine or, if psychopathology is the object of study, ethnopsychiatry.

Under this concept, medical systems would be seen as the specific product of each ethnic group\’s cultural history. Scientific biomedicine would become another medical system and therefore a cultural form which could be studied as such. This position, which originated in the cultural relativism maintained by cultural anthropology, allowed the debate with medicine and psychiatry to revolve around some fundamental questions:

1.    The relative influence of genotypical and phenotypical factors in relation to personality and certain forms of pathology, especially psychiatric and psychosomatic pathologies.
2.    The influence of culture on what a society considers to be normal, pathological or abnormal.
3.    The verification in different cultures of the universality of the nosological categories of biomedicine and psychiatry.
4.    The identification and description of diseases belonging to specific cultures which have not been previously described by clinical medicine. These are known as ethnic disorders and, more recently, as culture bound syndromes, and include the evil eye and tarantism among European peasants, being possessed or in a state of trance in many cultures, and nervous anorexia, nerves and premenstrual syndrome in Western societies.

Since the end of the 20th century, medical anthropologists have had a much more sophisticated understanding of the problem of cultural representations and social practices related to health, disease and medical care and attention. These have been understood as being universal with very diverse local forms articulated in transactional processes. The link at the end of this page is included to offer a wide panorama of current positions in medical anthropology.

Applied medical anthropology

In the United States, Canada, Mexico and Brazil, collaboration between anthropology and medicine was initially concerned with implementing community health programs among ethnic and cultural minorities and with the qualitative and ethnographic evaluation of health institutions (hospitals and mental hospitals) and primary care services. Regarding the community health programs, the intention was to resolve the problems of establishing these services for a complex mosaic of ethnic groups. The ethnographic evaluation involved analyzing the interclass conflicts within the institutions which had an undesirable effect on their administrative reorganization and their institutional objectives, particularly those conflicts among doctors, nurses, auxiliary staff and administrative staff. The ethnographic reports show that interclass crises directly affected therapeutic criteria and care of the ill. They also contributed new methodological criteria for evaluating the new institutions resulting from the reforms as well as experimental care techniques such as therapeutic communities.
The ethnographic evidence supported criticisms of institutional custodialism and contributed decisively to policies of deinstitutionalizing psychiatric and social care in general and led to, in some countries such as Italy, a rethink of the guidelines on education and promoting health.

The empirical answers to these questions led to anthropologists being involved in many areas. These included: developing international and community health programs in developing countries; evaluating the influence of social and cultural variables in the epidemiology of certain forms of psychiatric pathology (transcultural psychiatry); studying cultural resistance to innovation in therapeutic and care practices; and studying traditional healers, folk healers and empirical midwives who may be reinvented as health workers (the so-called barefoot doctors).
Also, since the 1960s, biomedicine in developed countries has been faced by a series of problems which demand that we inspect the (unfortunately-named) predisposing social or cultural factors, which have been reduced to mere variables in quantitative protocols and subordinated to causal biological or genetic interpretations. Among these the following are of particular note:
a) The transition between a dominant system designed for acute infectious pathology to a system designed for chromic degenerative pathology without any specific etiological therapy. b) The emergence of the need to develop long term treatment mechanisms and strategies, as opposed to incisive therapeutic treatments. c) The influence of concepts such as quality of life in relation to classic biomedical therapeutic criteria.

Added to these are the problems associated with implementing community health mechanisms. These problems are perceived initially as tools for fighting against unequal access to health services. However, once a comprehensive service is available to the public, new problems emerge out of ethnic, cultural or religious differences, or from differences between age groups, genders or social classes.
If implementing community care mechanisms gives rise to one set of problems, then a whole new set of problems also arises when these same mechanisms are dismantled and the responsibilities which they once assumed are placed back on the shoulders of individual members of society.

In all these fields, local and qualitative ethnographic research is indispensable for understanding the way patients and their social networks incorporate knowledge on health and illness when their experience is nuanced by complex cultural influences. These influences result from the nature of social relations in advanced societies and from the influence of social communication media, especially audiovisual media and advertising.