An interpretive solution to the problem of humoral medicine in Latin America

The hot-cold categorization of humoral medicine has been referred to as the 'basic cognitive principle' of traditional medicine (TM) in Latin America, and it has been suggested that this 'dichotomy,' 'pathology,' or 'syndrome' could interfere with the delivery of western health care. Such reification and medicalization of humoral ideology and practice is the result of field methodology. By designing eliciting-frames with but two terms along the hot-cold continuum, investigators have produced lists of hot or cold foods, medicines, and illnesses. Behind the use of these reductive techniques is a belief that individuals in a culture--regardless of life experience or special training--share underlying 'emic' or 'native' taxonomies. This premise blinds researchers to differences between the medical epistemologies of lay persons and curers. Inconsistent categorizations from community to community, consultant to consultant, and even from day to day with the same consultant result from the reduction of a continuum to a dichotomy which native consultants then consciously use in a keying-out process. But 'native etic' categorizations are unproductive in constructing 'native emic' taxonomies. These difficulties can be avoided by considering medicine as a local cultural system of symbolic meanings anchored in institutions and interpersonal interactions, and by separating the medical beliefs and activities of laypersons from those of curers. The author, who combines depth interviewing in highland Guatemala, elicitation of curing texts, participation in medical contexts, and formal training in healing, demonstrates that healers do not include hot-cold categories in their explanatory models of illness etiology, and that their treatments are based on empirical knowledge of herbs rather than on humoral reasoning. The use of such reasoning, ranged along an eight-term hot-cold continuum, takes place when individuals engaged in self-treatment are uncertain concerning proper diagnosis or treatment, or when anthropologists ask questions couched in humoral terms.