Pollock - Personhood and Illness Among the Kulina

Personhood and Illness among the KulinaAuthor(s): Donald PollockSource: Medical Anthropology Quarterly, New Series, Vol. 10, No. 3 (Sep., 1996), pp. 319-341Published by: Blackwell Publishing on behalf of the American Anthropological AssociationStable URL: http://www.jstor.org/stable/649125Accessed: 13/07/2009 21:27

Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available athttp://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unlessyou have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and youmay use content in the JSTOR archive only for your personal, non-commercial use.

Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained athttp://www.jstor.org/action/showPublisher?publisherCode=black.

Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printedpage of such transmission.

JSTOR is a not-for-profit organization founded in 1995 to build trusted digital archives for scholarship. We work with thescholarly community to preserve their work and the materials they rely upon, and to build a common research platform thatpromotes the discovery and use of these resources. For more information about JSTOR, please contact [email protected].

American Anthropological Association and Blackwell Publishing are collaborating with JSTOR to digitize,preserve and extend access to Medical Anthropology Quarterly.

http://www.jstor.org

http://www.jstor.org/stable/649125?origin=JSTOR-pdf

http://www.jstor.org/page/info/about/policies/terms.jsp

http://www.jstor.org/action/showPublisher?publisherCode=black

ARTICLES AND COMMENTARIES

DONALD POLLOCK

Department of Anthropology University at Buffalo

Personhood and Illness among the Kulina

This article offers both a contribution to the ethnography of ethnomedicine among the Kulina Indians of western Amazonia-a region in which there has been little ethnomedical research-and an extended illustration of the value of the concept of "personhood" in the analysis of ethnomedical beliefs and practices. I argue that the current medical

anthropological fixation on the Body is neither good ethnography nor

productive theory, and I use the Kulina example to illustrate how the cultural dimensions of personhood provide a more satisfactory framework for the understanding of illness. Kulina conceptions of illness are

closely linked to the substances and processes through which personhood is acquired, expressed, and transformed. I consider the two major cate-

gories of illness in Kulina ethnomedicine, andfocus special attention on the more serious of these: potentially fatal illnesses that are linked to

witchcraft and to the violations of prohibitions. I suggest how these illnesses serve as languages for the simultaneous negotiation of social issues and personhood. [ethnomedicine, Amazonian Indians, personhood]

ne of the more conspicuous gaps in the ethnography of indigenous lowland South America is the broad category of ethnomedicine, including notions about the cause, nature, and treatment of illness. While the more dramatic

and publicly ritualized aspects of shamanism are described in many ethnographic accounts, only a few anthropologists working in this region have explored in detail indigenous understandings of sickness as an experience, or cultural categories that correspond more or less roughly to "illness" or "medicine" (e.g., Conklin 1989, 1994; Langdon 1974; Mussolini 1980; Pollock 1988, 1994; Von Martius 1979). Nonetheless, it is clear from various accounts that, for South American Indians, illness forms a highly public, multipurpose discourse for various states of personal

Medical Anthropology Quarterly 10(3):319-341. Copyright ? 1996 American Anthropological Asso- ciation.

319

MEDICAL ANTHROPOLOGY QUARTERLY

and social distress, a powerfully meaningful code through which the mundane interactions of people can take on deep significance.

In this article I present an overview of Kulina notions about sickness and illness-Kulina ethnomedicine-focusing on both the cultural dimensions of illness beliefs and practices, and the social contexts in which illness is recognized and its treatment is undertaken. My perspective is that Kulina beliefs and practices related to illness are closely linked to Kulina conceptions of "person," of the fundamental nature of bodies, souls, and social practices that are held to comprise persons. And because Kulina persons are eminently social beings, emerging in and defined by social contexts, Kulina ideas about illness are not limited to beliefs about bodies and souls as aspects of individuals; bodies and souls are believed also to share substances and qualities of social processes.

Personhood and Illness

The notion of "personhood" has been used in a variety of ways in the anthropological literature, from Mauss's (1950) analysis of the emergence of conscious self-awareness to Kirkpatrick's (1983) ethnosemantic analysis of Mar- quessan categories of humanness. My own use of the term is closer to that proposed by Grace Harris in her conceptual reformulation of the field comprising a variety of analytically ambiguous concepts such as "self' and "individual" (Harris 1989). Moreover, although I adopt the notion of personhood as an analytic device, my use of the term incorporates an explicitly cultural dimension in that the Kulina themselves use a comparable notion.

I consider "persons" to be agents of meaningful action or, perhaps more precisely, beings who are assumed to possess the capacity to be agents of meaningful action. I assume that this agentive capacity is at least implicit in every culture's evaluation of sociability, the potential for certain beings to be authors of meaningful action.

My use of the concept of person is also a tactical response to an ethnomedical literature that threatens to become overwhelmed by perspectives of "the Body" or, alternatively, "the Self." I capitalize these terms to indicate the striking essentialism that saturates much of the writing about them.' Perhaps most notable is the assumption, often implicit, that the Body is a kind of precultural given that serves either as a repository of potential signifiers (or signifieds) in social tropes (Douglas 1966, 1970b; T. Turner 1995), or as the locus of authentic experience whose "embodied" reality is supposedly hidden or distorted by such cultural practices as mind/body dualism (e.g., Csordas 1990, 1993; Lock 1993). The difficulty with such a perspective is the suspicion one gains from the ethnographic literature that there is no single pancultural notion of the body, that even if all cultures endow their members with bodies, these bodies differ from culture to culture. Fortes noted, in a seminal article on the notion of the person among the Tallensi, that some kind of body was required for access to the status of "person," but it could be a crocodile body as easily as a human body (Fortes 1973). Much of the literature on the Self presents a related but opposite difficulty, denying the universality of a Western notion of the Self as a unitary, bounded thing, and even challenging the universality of self-other distinctions (Kondo 1990; but see Spiro 1993). My concern about this literature is not that it promotes a single, universalized notion of the Self, but that

320

PERSON AND ILLNESS

it so often conducts the discussion of the Self outside of the context of specific cultural conceptions and specific forms of practice. As David Murray has recently argued, any assumption that one can draw a simple contrast between a Western Self and a non-Western Self is inherently suspect (Murray 1993; see also Munck 1992), and Spiro has cautioned that anthropological descriptions of various forms of selfhood tend to confuse several notions of the Self: as a cultural conception of the person or individual; as a cultural conception of some inner psychic state or process within the individual; as reflexive self-awareness; and so on (Spiro 1993:114).

My tactic is thus to shift the analytic discourse to the notion of personhood, which requires focusing attention on the ways persons are understood and constructed in any particular culture. While a discourse of the Body implies an essentialist, precultural materiality, and a discourse of the Self implies an essentialist, precultural phenomenology, a discourse of personhood requires only the possibility of a cultural semantics of action. Moreover, a discourse of personhood, far from generalizing a particular cultural ontology of action, necessarily implies multiple cultural ontologies, in which bodies, minds, selves, personalities, or souls may have salience, certainly will have variable salience, or may not exist at all. Laderman's work on Malay conceptions of illness and its treatment nicely illus- trates the extreme variability of such cultural ontologies of personhood. She notes that her Malay informants conceive of persons not only as possessing bodies and minds, but also multiple spirits (Laderman 1991, 1992), and the particular cultural salience accorded to these spirits in illness undermines any simplistic reduction of Malay persons to the Body or the Self.2

I propose that, for the Kulina, illness is a particular condition of persons. That is, Kulina understand illness to be a condition that affects those aspects of their culturally constituted essential being that comprise the culturally constituted ground for their qualification as persons. Indeed, I suspect that ethnomedical beliefs about and approaches to illness have this character in any culture, and though the comprehensive pursuit of this point is beyond the scope of this article, the point can be illustrated in a tentative way through a brief discussion of familiar Western ethnomedical conceptions of illness.

The fundamental bifurcation of persons in American culture into bodies and minds surely forms the cultural and historical ground for the parallel fundamental bifurcation of illnesses into the physical and the mental, and of professional medical specialties into physical medicine and psychiatry/clinical psychology. Within each of these spheres of medicine, conceptions of illness as well as forms of practice tend to reflect and reproduce basic aspects of American personhood. This point has been made in a slightly different form with regard to American assumptions about the mental makeup of persons. Lutz, for example, has noted that Americans posit an essential difference between emotion and thought, a cultural assumption that is elevated to "scientific" salience as "affect" versus "cognition" (Lutz 1988). This cultural bifurcation not only attributes to persons certain qualities that in turn shape the social fields in which those persons are ordered (as in gender difference), it also achieves pathological salience as the difference between affective disorders and thought disorders, two major categories of psychiatric illness whose differences seem to emerge primarily within the cultural settings of Western, and especially American, psychiatry.3 And while the increasing reduction of physical illness to a

321


molecular biological level may seem to argue against any direct relationship to American notions of personhood, it should be noted that American cultural assumptions about the nature of behavior are undergoing a parallel reduction. The belief that, for example, alcoholism is a genetic disease, that violent crime can be attributed directly to hormonal changes during PMS or to extra Y chromosomes, or that chronic fatigue must be caused by a viral infection, suggest how the increasing biologization of illness draws upon a broader discourse for the biologization of behavior. As a component of personhood, the Western "mind" is a bifurcated array of qualities that are differentially ascribed to kinds of persons. Similarly, the Body is not a single, undifferentiated field for the inscription of status, oppression, or resistance; bodies are also a complex, swarming stew of genes, microbes, hormones, organs, and fluids that comprise much of a single lexicon for our modern discourse on both behavior and illness: that is, on personhood and its transformation in illness (Martin 1987, 1991). Indeed, the postmodern notion of a Body-without-Organs, a pure exteriority serving only as a field for inscription (Deleuze and Guattari 1988), seems to be merely the (ironic) reification and fetishizing of the body as a product of Western intellectual work (cf. T. Turner 1994).

Thus my intention in this article is, first, to describe Kulina notions of personhood briefly, at least at a level of detail that, second, allows me to indicate how Kulina ethnomedical beliefs and practices may be read as particular kinds of conditions of the fundamental features of kinds of Kulina persons.

The Kulina

The Kulina are an Arawak language-speaking group totaling between 2,500 and 3,000 individuals living in villages scattered along the banks of rivers in western Amazonia, the majority in Brazil, several hundred in two villages in eastern Peru. The research on which this article is based was conducted in the village of Maronaua on a bank of the upper Purus River in Acre, western Brazil, in the Area Indigena (AI) Alto Purus. At the time of my original research in 1981-82, this village was composed of approximately 160 people who subsisted on hunting and slash-and-burn horticulture supplemented by fishing and gathering. The AI Alto Purus now comprises roughly 12 Kulina villages, and the population of Maronaua is approximately 60-70 individuals; the decline in population resulted from many former village members' moving to other villages, particularly the Sobral, a former rubber-tapping camp (seringal) near Maronaua. My research in 1981-82 was conducted over a 14-month period, 12 of which were spent in Maronaua proper; I returned in 1990 and 1992 for short visits of 1 month each. My original research focused on Kulina shamanism and ethnomedicine in the context of a broad ethnographic study of this group. I used standard participant-observational methods supplemented by extensive interviews with several well-informed informants. My work in 1990 and 1992 focused more narrowly on the health consequences of environmental change in the region; the complex of Kulina ethnomedical beliefs and practices I discuss here remained intact.

As I have described elsewhere (Pollock 1988), the overall health of the adult population at Maronaua appeared to be fairly good at the time of my original research, and remains so. The village enjoys access to relatively abundant game in

322

PERSON AND ILLNESS

the surrounding forest, adequate gardens, and fish. The AI Alto Purus is not in a malarial area, and so village members do not suffer from chronic or recurrent malaria. Two individuals appeared to be suffering from tuberculosis in 1981, and a local Kulina man (not a resident of Maronaua) was treated for gonorrhea. But while the health of adults is good, the health status of children is often compromised by nutritional deficiencies. Eating patterns allow adult men first access to meat; women normally have sufficient leftover meat, but children often get little or none and are not thought to require meat as much as adults. Nursing infants are healthy and well fed, but their older siblings often struggle with diets based mainly on manioc and plantains, which provide more bulk than nutrition. Extended bellies, a combination of protein insufficiency and occasional parasitic infestation, are common in children from about age three to ten (Pollock 1988).

The health of the population at Maronaua is generally good, particularly in contrast to that of the other major village of Kulina in the AI Alto Purus, Santo Amaro. Although I lack precise data or measures of health status for that village, my impression from several short visits is that children and adults at Santo Amaro suffer more severe, chronic protein shortages. This circumstance is the result of the proximity of Santo Amaro (which is at the confluence of the Chandless and Purus rivers) to a settlement of Brazilians (locally called "Os Peruanos" from their historical origins before Acre was annexed by Brazil), whose aggressive hunting and commercial fishing has depleted much of the game and fish in the area. I was told that the primary source of animal protein at Santo Amaro was fish, and that larger fish were becoming increasingly difficult to find due to intensive net fishing by local Brazilians. The shortage of protein appeared to have opened the Kulina population to higher rates of illness, especially among children, but also among adults (Pollock 1988:29).

Kulina Persons

I translate the Kulina term madiha as "person," recognizing that its polysemic nature unfolds through successively wider ranges of semantic contrast: Kulina persons versus nonpersons; Kulina versus other Indians (indio); indio versus non-Indian (karia); human versus nonhuman; and so on. At each level of contrast the notion of madiha conveys the sense of being an agent of meaningful action. But I will use it here, for convenience, in the marked sense in which it refers to Kulina as opposed to other kinds of human beings, and to what might be called potential persons, especially Kulina infants, whose capacities for meaningful action are developing. This sense of the notion of madiha excludes beings whose actions fail to conform not simply to Kulina standards of propriety but to fundamental conditions of meaningfulness. I will outline a few important aspects of the Kulina notion of personhood, and will allow a deeper discussion of Kulina persons to emerge in the context of illness beliefs and practices.

Kulina, in their talk about persons, refer to two concepts they contrast as "wild" (wadi) and "sociable" (ettedi, the verbal form also meaning "domesticate"). The distinction is expressed in the contrast between, for example, the wild forest and the sociable village, solitary versus collective activity, hunting and gardening, men and women, silence and speech. Wildness and sociability are associated with and to some extent attributable to the possession of bodily substances. The wildness

323


of men, for example, is attributable in part to their possession of semen, while the sociability of women is related to their breast milk,4 and life-cycle stages are ordered partly by reference to these substances. Adolescence, for example, is signaled for Kulina by the development of semen in boys, and for girls by the appearance of breasts. Semen, being a particularly wild substance, causes adolescent boys (dzabitso) to act in especially wild ways, and Kulina grant adolescent boys considerable license for behavior that would be unacceptable in both children and adults. Adolescent girls (dzuato) are also felt to exist in a state of more or less substantial imbalance, and consequently they too are expected to behave improp- erly, even wildly, though not so much as boys.5

The principle manifestation of the impropriety of these adolescents is their sexual behavior, which is felt to be unregulated, vaguely animalistic, and wild. Marriage tames or domesticates both adolescent boys and girls by regulating and legitimating their sexual conduct, but also by creating food production, preparation, and exchange relations that are the preeminent displays of proper sociability. The regulation of sexual behavior for adolescent boys who undergo training to become shamans actually begins before marriage. Toward the end of adolescence, boys have implanted in their flesh a mystical substance called dori, the dori of senior, adult shamans, a substance that comes to permeate their own flesh and links them to the spirits called tokorime, which are themselves spirit forms of dori possessed by various animals. The complex symbol dori might in this context be considered an objectification of the wild natures of men, a view that is also consistent with the Kulina belief that the novice shaman must remain celibate; he would lose his newly acquired dori, along with his semen, in illicit sexual relations. In my discussion of illness I will focus on the manner in which notions such as wildness and sociability, core symbols of personhood for Kulina, underlie a wide variety of ethnomedical beliefs and practices, and I will expand on Kulina notions of personhood in that context.

Kulina persons also possess spirits (kurime), which they acquire during the period of infancy through the consumption of meat. Briefly, the kurime of a deceased individual journeys to the underground realm of spirits (nami budi), where it is eaten by and becomes transformed into a white-lipped peccary. These peccaries are called up into the forest by shamans, where they are hunted, and the consumption of their meat, saturated with the kurime spirit, is reincarnated, in a quite literal sense, as the kurime of the living consumer (see Pollock 1993). It is the interface of Kulina bodies and kurime that comprises the locus of agency for persons, and it is at this interface that illness manifests itself in various forms. It is notable, in this cultural ontology of persons, that there is no distinct category or concept of "mind" or the "mental," no "mental illness," no "embodied minds and mindful bodies" (Scheper-Hughes and Lock 1987).

Kulina Sickness and Illness

Kulina are regularly afflicted by a variety of sicknesses, from small skin sores that are usually ignored to life-threatening witchcraft attacks treated by shamans. However, Kulina lack a general term that could be translated unambiguously as "illness," one that would provide a gloss for the full range of these conditions. Kulina understand the Portuguese term doenca to encompass a wide range of bodily

324

PERSON AND ILLNESS

disorders, but do not themselves synthesize varied forms of sickness into a single concept of illness. The term kidza, for example, refers to the subjective state of feeling "sick" but not to the causes of that sick state. Bodily pain is identified by the root kuma and may be further qualified by mention of the specific body part, for example, owede kumatani, "back pain." But while pain may be a sufficient condition for being sick, it is not a necessary one. Indeed, other signs may indicate the presence of illness, the most common being diarrhea (mimihi) and fever (dzamakuma).

The lack of a general Kulina category for the range of experiences and conditions we would label illness is consistent with what might be termed the "practice of sickness" for Kulina. In particular, Kulina sicknesses are of two general sorts, distinguished by different causes and treatments. The first variety of sicknesses are those that are felt to occur on the outside of the body, in particular on the skin; I call this category external illness. The second category is composed of those illnesses that occur within the body and have a "mystical" origin, such as witchcraft illness. I call this category internal illness. Although Kulina lack specific terms to label and distinguish such categories, it appears clear that some differen- tiation between two broad types of illness is made, in ways that I describe below.

External Illness

The class of external illness consists of those that are believed to affect the skin. In general they are considered to be mild, and are cured with relative ease. The major exception to this generalization is poisoning from snake bite; although life threatening, it is nonetheless included in the category of external illness because its mode of sickening and its appropriate treatment are identical to other external illnesses. Indeed, snake bite might be viewed as the limiting case defining this category, an illness that might be placed in the more dangerous category of internal illness, except for its similarity to some of the basic features of the milder class of external illness.

External illnesses include a wide range of conditions, including insect bites, cuts, boils, rashes, and sores that, because they appear externally, have an overt, public quality. There is often little speculation on the causes of these illnesses; either the cause is obvious, as in a wasp sting, or it is assumed that people simply contract them without excessive speculation on the immediate cause. External illnesses are treated with plants, usually the leaves, either by chewing the leaves into a kind of poultice or by soaking or boiling them to make an infusion that is applied directly to the affected area. Plants are selected on the basis of their smell; plants that are said to have a good smell (maho bika) are assumed to be curative. Indeed, it is the smell of the plant that is curative, because smells are believed to have the ability to penetrate the skin and transform the individual.

In general, good smells moderate wildness (wadi), while bad smells intensify wildness. People wear good-smelling leaves to make themselves attractive to the opposite sex, not simply by becoming good smelling themselves, but by undergoing the more fundamental transformative effect of good smells. Corpses, for example, are rubbed with good-smelling substances to reduce the dangers posed by a body after its soul has permanently separated from it-a body that has, in effect, withdrawn from social life (Pollock 1993).

325


The use of good smells in curing thus suggests an association between illness and wildness; good smells transform both. This association may be related to at least two characteristics of external illness. First, the sick role itself is described as a temporary, asocial, wild state in the sense that it entails a withdrawal from normal social interactions and a rejection of the gregarious sociability normally expected of persons. Thus the conceptual wildness of the sick role is symbolically "cured" through good smells. In this sense, curative plant smells not only affect the physiological condition of the sick person, they also transform the antisocial sick role.

The second association between illness and wildness is suggested by the nature of those things that are presumed to cause external illness. These things, including members of the category of "poisonous, biting, stinging things" (wasps, snakes, scorpions, stingrays, spiny fish, thorny plants, etc.), are manifestations of the wildness of the forest beyond the sociable village. From this perspective, external illnesses might be viewed as a form of penetration of the wildness of the forest into the skin of the victim.

Poisonous snake bites produce the one serious illness among these otherwise benign and nonthreatening illnesses. For Kulina, the snake is an ambiguous creature, possibly a member of the category of things causing external illness, but exhibiting characteristics of things associated with more deadly internal illness. For example, Kulina debated the locus of the illness produced by the snake's bite; some of my informants argued that the snake's fangs penetrate through the skin and lodge their poison in the flesh of the victim. Others argued that it was the skin itself that was the site of the poisonous damage. They pointed to the fact that snake bites often occur on the soles of the feet, where heavy calluses often prevent the bite from harming the victim. Kulina agreed, however, that plant medications were the only available cure.

Another part of the ambiguity of snake poisoning lies in the nature of the animal itself. Snakes are thought to pass freely through holes between the earth and the underworld, the nami budi associated with spirits of the dead who reside there. Snakes thus have some of the dangerous properties of spirit beings and substances that move between these two realms. Moreover, snakes are especially wild crea- tures; they eat meat and are unable to produce sounds (that is, they lack speech, even of an animal variety), and they are solitary hunters. Such a creature is essentially ambiguous, dangerous, and threatening for Kulina, and snake bite is treated as equally ambiguous and dangerous.

The primary locus of external illnesses is the skin, the most public portion of the body, and one that reflects and displays the social status of the person (cf. T. Turner 1980). Although I cannot develop the argument in great detail here, I suggest that Kulina understand these external illness conditions to reflect improper contacts with the threatening, wild nature of the forest. A woman who develops a sore or rash may recall a recent time when she stepped off of a well-defined path in the forest. A man may recall an encounter with a "prohibited" animal species. The transgression of such boundaries between sociable and wild spaces is the interpretive framework of many external illnesses, just as their locus-the skin-is the boundary between the sociable outside of persons and their mystical interiors. Nonetheless, it should be emphasized that virtually all external illnesses are

326

PERSON AND ILLNESS

considered mild and transitory, and the transgressions with which they are associated are comparably mild. They serve as an interpretive framework for understanding the wide range of commonly experienced mild but irritating conditions that regularly afflict Kulina.

Internal Illness

The category of illnesses I call internal includes two major types: dori and epetuka'i. The first strikes children and adults while the latter afflicts infants only. They are caused by intrusive life-threatening substances, also called dori and epetuka'i. Dori is said to be caused by witches, hostile shamans who inject some of their own dori substance into the bodies of their victims. Epetuka'i is not caused by witches but, like dori, is provoked by a supernatural or mystical cause in the violation of food taboos.

Infant Internal Illness: Epetuka'i

Kulina attribute epetuka'i in infants to the consumption of male animal meat by parents. The signs of the illness are variable and include diarrhea, abdominal swelling, or constipation; in short, virtually any gastrointestinal distress can be interpreted as epetuka'i. However, the diagnosis of epetuka'i relies less upon the overt symptoms experienced by the infant-who may display the same symptoms without a diagnosis of epetuka'i-than it does upon social circumstances within the infant's household. I will describe the cultural logic of the illness first and then discuss the social logic of its context.

Kulina attribute epetuka'i to the consumption by the infant's parents of certain kinds of male animal meat. Male animals of many species are said to have the epetuka'i substance in their flesh, which can harm the infant when the meat is eaten by its parents. Eating the meat of male animals of other species is said to cause infant diarrhea. Consequently, Kulina prohibit the eating of male animal meat by parents during the child's infancy. The taboo lasts, at its ideal extreme, until the child is capable of producing speech and is walking, a time at which it is no longer considered an infant (nono) but rather a "child" (ehedeni). To understand this prohibition it is necessary to consider how children are "formed" in the process of reproduction, a process that is conceptually divided into two phases separated by the birth event. In the first phase the fetus is formed exclusively of male semen that accumulates in the mother's womb; in the second phase the newborn infant is "completed" through the consumption of mother's milk and other mild and good- smelling foods such as the cultivated plant foods grown by women. During each of these two phases the fetus/infant is subject to potentially harmful influences from its parents. Indeed, that it is subject to harm through such indirect means is an indication of the infant's lack of the capacities of personhood, and this danger disappears only after the child has consumed sufficient mild substances to be completely formed as a person. The ethnophysiological process parallels the social process, requiring that the child not only display the social signs of personhood- competent hearing and understanding, speech, and mobility-but also that the child be formed of properly male and female substances. During infancy, the consump-

327


tion of male animal meat thus endangers the child, producing illness through the excess of male substance.

Epetuka'i is said to be "like having a dung beetle in the abdomen."6 The image of the dung beetle is apt: it forms small balls of fecal matter that it uses to block the entrance to its burrow in the ground. In the same way, epetuka'i is conceived to be a substance that disrupts the passage of foods and feces through the abdomen, either inhibiting the process and causing constipation and abdominal swelling, or speed- ing it up and causing diarrhea and wasting away.

The minimal substances that form the child are semen and mother's milk, the primary exemplars of the two categories of substances that also include male animal meat eaten during pregnancy, and female animal meat and cultivated foods eaten after birth. The characteristics of these categories also link the ethnophysiological process of reproduction to the social character of marriage and to the households in which it takes place. Exchange of foods is a central metaphor of marriage for Kulina. Men hunt to provide meat; women tend gardens to provide cultivated plant foods. Marriage itself is thought of as a commensal arrangement and is often termed "eating together." Moreover, marriage implies a process in which men bring wild, "strong-smelling" substances into households and women transform these through cooking into "mild," good-smelling edible substances. Marriage also implies a comparable process in which women "tame" adolescent boys, transforming them into sociable adult men.

The process of forming a child is thus similar to that of forming a marital relationship. But while the former involves a kind of single pair of contributions made over a long duration, and is focused on the child, the latter involves a kind of repeated direct exchange focused on meals. The terms of the exchange are nonetheless similar inasmuch as both relationships draw upon the metaphors of substances that comprise contrasting categories of male and female substances. The Kulina metaphors of marriage and intrahousehold relations as exchanges or provision of appropriate types of food imply that improper marriage relations are equivalent to the provision of inappropriate foods. The provision of male animal meat is said to be inappropriate when an infant is present in a household, and the illness that is caused by this improper food also signals the presence of improper marriage relations or intrahousehold relations. Conversely, improper marriage or intrahousehold relations create a context in which infant illness can be interpreted as the provision of inappropriate food.

An examination of cases of infant internal illness-epetuka'i-shows this to be the case. In the 12 cases about which I have detailed information, each was attributed to and explained as the improper consumption of male meat by parents, and each was preceded by some disruption of relations within the infant's household. These disruptions took several forms, and all were recognized and commented upon publicly. They included charges of adultery and habitual neglect of duties by husbands/fathers or wives/mothers, but also included open conflicts between sons-in-law and fathers-in-law.

Interestingly, Kulina do not, as far as I have been able to determine, draw a conscious connection between intrahousehold conflicts and the epetuka'i that afflicts an infant within the household. The illness is always attributed to the

consumption of male animal meat by the parents. The cure of the illness by a shaman

328

PERSON AND ILLNESS

consequently leads to greater caution on the part of the parents, who more scrupu- lously than before avoid prohibited foods. The public nature of the social disruption that provided the context for the illness leads also to enough open censure and comment that the parties involved resolve their dispute, or at least try to hide it more successfully.

Although Kulina do not explicitly link epetuka'i among infants to intrahousehold conflicts, it may be speculated if they nevertheless recognize this relationship implicitly. Parents of infants do not in my experience avoid eating the meat of male animals for more than a few days or a week following the birth of a child. When I suggested that this violation of the normal prohibition could cause epetuka'i, informants usually replied casually that a shaman could easily cure the illness, and that parents did not need to be concerned about the foods they ate. This attitude was possibly conditioned by a sensitivity to the relationship implied between food prohibitions and intrahousehold strife: in the absence of conflict, food prohibitions lost their significance, and a healthy infant was a sign of proper parenting.7

To complete this discussion of infant internal illness, I should point out that Kulina sometimes attribute simple diarrhea (mimihi) to the eating of male animal meat and do not diagnose the condition as epetuka'i. Again, both cultural and social issues inform this condition. When diagnosed only as mimihi, infant diarrhea is considered relatively mild, and the child is not treated by a shaman. Although simple diarrhea is also caused when the infant's parents eat the meat of male animals, epetuka'i results only when parents eat the meat of male animals that are considered tokorime spirits. Animals that are not the manifestations of these spirits do not cause epetuka'i, but only the milder condition, diarrhea. My data suggest that there is a sociological difference between the contexts of simple diarrhea and epetuka'i. It is my impression that epetuka'i is diagnosed when parents of a sick infant are charged with adultery. However, when parents of a sick infant are charged with some neglect of duties, simple diarrhea is diagnosed. Thus Kulina associate most serious breaches of marital relations such as adultery with serious illness, epetuka'i (and the ethnomedical theory of epetuka'i points to male animals that have an essentially powerful supernatural nature). Less serious breaches of marital responsibilities such as laziness, unproductivity, or failure to be appropriately deferential to in-laws are associated with the less serious illness of diarrhea (and the ethnomedical theory of diarrhea points to male animals that are not spirit beings).

Adult Internal Illness: Dori

The etiology of dori, in the Kulina view, is relatively simple; the illness results when a witch, an evil shaman (dzupinahe), injects a portion of his dori substance into the body of the victim. Witchcraft attacks are not entirely random, but witches need no special motives for attacking a victim, and anyone is a potential victim. But, for reasons that I discuss below, dori is more likely to be diagnosed among adult men than women, and is not common among children.

As simple as the dori illness etiology may be, it is nonetheless a complex concept. Dori is a substance that permeates the flesh of shamans, giving them the ability to cure as well as to injure others. It is notable that among the Kulina, shamans are always men, and though only about half of the adult men in Maronaua

329


today are shamans, Kulina said that in the past all men were shamans. The ideological association of men and shamanism has at least one important implica- tion for contemporary Kulina: any adult man can be considered a shaman or, more important, can be considered a witch. This possibility allows Kulina to consider any adult man, particularly those from other villages, to be potential witches. Although witchcraft accusations are most often leveled against well-known shamans in neighboring villages, certain circumstances require that Kulina discover a witch within their own village. The view that any adult man can be a witch allows accusations to be brought against individuals who are socially marginal, and thus vulnerable.8 The substance dori is also possessed by tokorime spirits. In one sense it is the possession of dori that makes a tokorime spirit, and thus even human shamans may be spoken of as tokorime, the adzaba tokorime, just as all spirits may be called dzupinahe, or shaman. The term tokorime normally refers to the spirit as such, while the term dzupinahe refers to the physical embodiment of the spirit, normally human, but sometimes animal.

Dori causes illness by lodging in the flesh of the victim, sometimes by growing there, and in the most serious, life-threatening cases, by growing faster than it can be extracted. The severity of the illness is associated with different varieties of dori. For example, dori makoko, "very red dori," is the most dangerous. All shamans/witches possess all types of dori, and they are said to use each type depending upon whether their intention is to kill or simply to sicken.

As in the case of infant internal illness, dori is diagnosed as an illness only in certain social contexts. Invariably, these involve open hostility or conflict between members of different households. And, as in the case of infant illness, Kulina do not consciously make the association between this conflict and the dori illness. Conflicts between members of different households typically take the form of violent arguments or fighting between men, often between potential affines, but occasionally also occur between closer kin, even brothers who reside in different households. There appears to be no relationship between the nature of the conflict and the nature of the subsequent illness; rather, conflict between households is regularly followed by the diagnosis of some sickness of unknown cause as dori. Moreover, the severity of the sickness is largely irrelevant to dori diagnosis; even a very mild sickness will be diagnosed as dori following public interhousehold conflict. Moreover, sicknesses are not diagnosed as dori in the absence of public interhousehold conflict.

Two cases illustrate the social context of dori. Alfredo was a man roughly between 55 and 60 who experienced recurring

stomach pains and periodically vomited blood, caused by what I believe to have been a gastric ulcer. His sickness was of long duration, beginning well before my first arrival in Maronaua. When there were no public hostilities between households in the village, most residents ignored Alfredo's attacks of pain and vomiting. He often requested Western medications for his sickness, but during times of village peace no one suggested that his condition could be treated by a shaman. However, following virtually every case of open, public tension in the village, Alfredo's sickness was interpreted to be the result of witchcraft, and he was treated by shamans in the traditional curing ritual. Thus episodes of the same sickness were variably diagnosed as dori and not dori. The variable that accounts for the different

330

PERSON AND ILLNESS

diagnoses was the social context-hostility or harmony between households in the village.

In a second, notable case, a child contracted what I believe to have been the mumps: she had a painful swollen gland in her throat and swallowed with difficulty. Although the swelling in her neck was consistent with the culturally prescribed effects of dori, village shamans dismissed the possibility that she was the victim of a witchcraft attack. No other diagnosis was made, and her parents requested Western medications. No tensions or hostilities existed among village members prior to her illness. I thus suggest that dori was not an appropriate or meaningful diagnosis.

The process of dori diagnosis incorporates a feature that is absent in other illness diagnoses: the identification of a witch. Kulina identify first a witch in another village, normally a headman or other village leader. In Maronaua the witch most often accused was Doho, a headman of the village called Santo Amaro, a village with which the residents of Maronaua had frequent interaction. If the illness is successfully cured, the accusation is validated, but no additional action is taken. This process resembles witchcraft accusations in a number of other societies, where the accusations serve to define and maintain group boundaries (e.g., Douglas 1970a). Such an explanation is relevant to the case of Santo Amaro, where close interactions with Maronaua, including regular intermarriage, may threaten to blur the distinctiveness of each group. Such extragroup witchcraft accusations also direct village residents' hostilities outward and project feelings of outrage or revenge onto members of other villages beyond the range of reprisal. Doho was not really threatened in any serious way when he was accused of causing dori in Maronaua, but the residents of Maronaua assured themselves that they would never harm each other.

When dori illness proves fatal, the focus of accusations shifts to an individual within the village. The following example is illustrative.

Katore was an elderly man who contracted a respiratory infection that declined into pneumonia; he died following lengthy efforts of village shamans to save him. At the outset of his illness his condition was diagnosed as dori, and Doho was accused of bewitching him. As Katore's condition worsened, however, and it became obvious that he would soon die, the accusation shifted to another elderly man who had been visiting Katore from a village on the Envira River. On the day following Katore's death, this witch was killed in retaliation. Significantly, Doho had been informed of the impending death, and in an effort to assert publicly that he would never use his witchcraft actually to kill the members of another village, he came to Maronaua with a group of followers and assisted the local shamans in treating the epidemic of secondary dori that broke out after Katore's death.

Again, when dori is fatal, the witch is sought within the village of the deceased. Typically, a socially marginal man is identified, either a nonmember/non-kin of the group (as in the case of Katore's killer), or an individual who is "worthless" (tabakora, someone who consistently ignores social obligations).

The ritual process of curing dori offers some insight into the nature of the illness. Dori is treated in a ritual called tokorime, during which shamans, who appear as various tokorime spirits, suck out the dori from the body of the patient. The curing ritual takes place at night and may last for hours, or even until dawn. A

331


successful cure is followed by a second ritual (or a second phase of the same ritual) the following night in which the entire village dances in a large circle and sings songs about beauty and harmony in the world, thereby signaling the end of the witchcraft threat.

The tokorime ritual normally takes place in the center of the village, in the ritual area between the two rows of houses. The ritual begins when the village women form a small semicircle and sing to the shamans/spirits to come into the village to treat the patient, who sits nearby on a stool or in a hammock. The shamans emerge from the forest in the guise of tokorime spirits. They wear palm fiber costumes consisting of long veil-like headdresses that cover their head and upper body, and a skirt extending from the waist to the feet. Facing the semicircle of women, the shamans sing one at a time and dance in small, stylized steps. Women give each shaman tobacco snuff, which he inhales nasally. The shaman then feels the afflicted area of the patient's body and, upon discovering the dori, sucks strongly on the site. The dori may also be extracted by suction from the cupped hands, which the shaman then rubs on his chest. In both techniques the shaman takes the dori into his own body and then vomits and spits it out. He retires to the forest, and the second shaman takes his place. The shamans alternate, repeating the performance until the dori is felt to be extracted fully.

Tobacco is a vital part of the curing ritual. In one instance, when tobacco was unavailable in the village, a particularly long curing ritual was interrupted while several men set out on a canoe trip of several days to find tobacco from local Brazilians. In Kulina myth, inhalation of tobacco causes death, where upon the dead person is transformed into an animal, the animal form for a tokorime spirit (see, e.g., Adams 1962:125-131). The effect is similar in curing ritual: the tobacco snuff causes the shaman to become transformed into the tokorime spirits that will suck out the patient's dori. Tobacco is one of two cultivated plants grown by men; the other is a variety of hot pepper. Both are cultivated by men because they are very strong smelling; indeed, the very strong smell of tobacco is only moderated by a comparably extreme form of "cooking"-the reduction of tobacco to an ash that forms the snuff. The smell of tobacco thus works in a manner similar to that of other smells, penetrating the body to produce a change in the person, in this case a kind of symbolic death and transformation into a spirit.

All tokorime spirits sing in the curing ritual, but only some of these spirits are said to actually cure; the others are said to "help sing." Singing itself is an important aspect of the ritual. Shamans take pride in the beauty of their songs, and they compose new songs regularly. Singing has two related characteristics that are central to its role in curing ritual. First, singing is a particularly compelling form of verbal display for Kulina, among whom speech styles have directive force. The most potent style of normal speech is used by adult men in communal meetings. Singing may be viewed as an especially enhanced form of directive speech, used, for example, by village women to "order" men to hunt when meat is scarce in the village (Pollock 1985, 1992:35; Ruf 1972; cf. Siskind 1973:96-104). The songs used in curing rituals are maximally compelling in their directive force, consonant with the seriousness of the curing task. Second, singing creates or defines rituals. Every Kulina ritual revolves around singing; songs are felt to form the core of the ritual. Thus songs define an event as a ritual and compel action during it.

332

PERSON AND ILLNESS

Curing ritual songs have several general themes and components. First, they often employ sounds characteristic of the animal spirit that is supposed to be singing the song; these sounds publicly identify the tokorime spirit. Second, these songs tell about a search by the spirit for urucu (achiote) or genipapo for facial decoration. The spirit may sing that his face is painted, or that he has come to find facial paint. Third, they often describe the consumption or search for the manioc drink koidza.9 The spirit sings that he is drinking koidza, or that he has come to find it. In many songs these themes are intertwined; a song may begin with the sounds of the animal spirit and then describe his painted face as he tells of coming for the manioc drink.

Koidza is symbolically the primary female food product for Kulina on the Purus River. Manioc (po'o) is the principle cultivated food and the primary subsistence contribution a woman makes to her household. While other cultivated foods are seasonal or are eaten more or less according to whim, manioc accompa- nies every meal year-round. In this regard, manioc is similar to meat, the most important male contribution. The symbolic role of koidza is also linked to the process through which it is produced, in which cooked manioc is chewed by women and spit back into the pot, where it ferments slightly; koidza is not only cooked, which produces good-smelling, "tamed" food, it is also mixed with the saliva of women, which enhances the taming effect.

I have elsewhere drawn attention to the role of food and food exchanges for creating and displaying sociability and amicability among Kulina (Pollock 1985). The reference to koidza in the curing ritual also draws upon the social implications of such exchange by engendering sociability through the offering and consuming of this food in song. In the curing ritual it is the tokorime spirits who are enjoined to enter into amicable relations with the village through the medium of food, obliging the tokorime spirits to cure the sick individual. The spirits also offer themselves as food; the curing ritual calls forth spirits from the underworld realm of tokorime, and their physical embodiments later remain in the forest as animals that are hunted for meat.

This interpretation of the Kulina tokorime curing ritual links two conceptual domains that are separate in the West: the subjective state of the sick person and the relational state of the community. I have suggested that in many cases the subjective states of individuals-here, the sensations of feeling sick-have little or no relevance to the identification of dori in the community and performance of the tokorime ritual. In this regard, Kulina conceptions of sickness and illness may resemble Ndembu notions of illness and "affliction" discussed by Victor Turner (1967, 1968), in which sickness served primarily as a sign of such deep social relational disorder within a community that individual illness was sometimes ignored as the illness discourse shifted to a social level. Since much of the medical anthropological literature in recent years has subtly (and sometimes explicitly) incorporated the Western assumption that illness is "about" the experience of individuals and the individual experience of sickness, it may be useful to contest this taken-for-granted point of view with a few additional comments about the social contexts of curing.

I have stressed that the tokorime is not performed merely because an individual experiences the subjective pains or discomforts that might be signs of dori. The inverse also appears to be true, that the tokorime can be performed even when no

333


individual is experiencing the pains or discomforts that might be the signs of dori. On at least two occasions during my research among Kulina, mock curing rituals were held without a specific individual patient. As I have noted, Kulina are not explicit about a relationship between the performance of the tokorime and the disruption of social relations within the village, and so in neither of these two mock tokorime rituals did people account for the performance in a way that overtly linked interhousehold tensions and the ritual. In the first case, when I asked who was sick, the village headman responded that the tokorime was being performed to "practice" new songs, a response that I later understood to be a way of deflecting prying questions from a nosy visitor. In the second case, when I raised the same question, several men explained simply that it was "against dori," and their bewilderment at my failure to understand why there needn't be a specific sick individual suggested that it was my Western assumption about the nature of illness that was the problem.

In short, if the sickness of individuals needn't be diagnosed as dori illness, neither does dori illness need a sick individual to be diagnosed. Or, to put it in mildly functionalist terms, if the relationship I have suggested between the tokorime curing ritual and interhousehold tensions is productive, then the presence of such tensions will provoke the ritual response, even in the absence of sickness that can be diagnosed as dori. I have elsewhere suggested that our inability to concep- tualize "social" disorders within a disease discourse yields discursive practices that locate "illness" within individuals and distinguishes "social disorder" as a different kind of condition, as merely metaphoric illness (Pollock 1992). The Kulina conception of personhood does not yield the radical separation of individual and social fields. In their case, the social and the individual are mutually inscribed, so to speak, through the sharing of corporeal substance and spirit (cf. Seeger et al. 1979).

If illness and personhood are mutually constituted through the same signifying practices, at least one additional discursive field remains to be explored. For the Kulina, illness reveals a moral dimension to personhood in which individuals become the victims of social disorders and the exemplary, if unnecessary, locus of the dori illness that social disorder provokes. I have described the inverse of this relationship, in which illness and its cure take place without a sick individual. It is possible to identify several additional forms of reversal of this relationship as well. In these, the practices that cause illness can be transformed into practices that cure metaphorical illnesses.

Shortly after dawn one morning early in my fieldwork, I found a group of Kulina in the center of the village, milling around a large frog that had been tied, spread-eagled, to four stakes about two feet off the ground. Underneath the frog was a pile of glowing coals, and as the frog slowly roasted, alive and squirming, it exuded a thick, milky white fluid from its skin.10 Mara, a prominent village leader, dragged his son-in-law Awano over to the frog. Awano was a young man, about 22, married with two children who lived in his father's house. Mara touched the end of a piece of rope to the hot coals until it smoldered; he then touched Awano's arm with the burning rope, scraped some of the milky sweat from the skin of the frog, and rubbed it into the burn. The frog's poisonous secretions had an almost immediate toxic effect on Awano, who began sweating within a couple of minutes. His eyes bulged out, he started hyperventilating, and he kneeled over and began vomiting violently. He complained of his body aching for the rest of the day. Awano

334

PERSON AND ILLNESS

was not the only victim of this peculiar treatment; several adolescent boys were also brought forward, burned, and poisoned by the senior men in the village.

My informants described this procedure as a technique to improve the victim's hunting ability or luck, using a term-dzukenainanaihini-that I understood to mean literally "acquire the ability to kill." It may be evident why adolescent boys would be subjected to this treatment, but I was not aware of any deficiency in hunting skill on Awano's part, and he was clearly the major focus of the treatment. As I became more deeply acquainted with the community I realized that Awano was a paradoxical figure who presented a social dilemma that the community tried to resolve in several ways, including the use of the frog poison. Awano was in many regards an overly successful young man, whose rubber tapping was highly productive, and who had developed sufficient understanding of the economic practices of local traders to convert the surplus products of his labor into a quantity of trade goods that was locally remarkable. But his accumulated wealth was not used for the benefit of the village; resentments drifted from household to household with successive acts of stinginess. His hard work and productivity, however, protected him from suffering the ultimate sanctions that might have been pressed against a lazier man. Among these Kulina it is normally expected that young men will live with their fathers-in-law, who have a claim on their labor and political support. Awano lived with his father. But Awano's father-in-law lived in a kind of self-im- posed exile on the opposite bank of the river across from the village. For every charge that Awano was not fulfilling his obligations as a son-in-law, there was a grudging recognition that Mara's household was itself not fulfilling the broader obligations of community sociability.

My informants discussed Awano's moral failings as less the intentional evil performed by a witch than as lapses of proper judgment and performance, lapses that were attributed to his having become too Brazilianized. The primary community focus of concern over his behavior derived from activities that were considered specifically Brazilian in nature and excessive in degree-rubber tapping, possession of a battery-powered record player, residence with his father. The cure for this Brazilianization was a kind of reinitiation as an adult Kulina man. The treatment to which Awano was subjected must be understood within the set of practices that include shamanism and witchcraft, and the treatment of internal illness. The insertion of a wild, poisonous substance through the skin, into the flesh, parallels the acquisition of dori by adolescent boys as they become shamans (Pollock 1992); the paradoxical nature of dori, which represents the special wildness of men that renders them potentially dangerous witches and successful hunters, parallels the paradoxical character Awano presented to the village. Awano's resocialization as a proper adult man began with the reacquisition of the dangerous, poisonous, powerful dori substance all adult men possess, in this case in the very dramatic form of the frog exudate. Note too that the appearance of the viscous white frog poison is neatly consistent with the Kulina association of dori and semen.

The second case of a metaphorical illness that extends this interpretation of Kulina ethnomedicine is infertility. I have discussed infertility in the broader context of Kulina shamanism (Pollock 1992), but a discussion of this example in the context of Kulina ethnomedicine and notions of personhood may be useful. Briefly, infertility is said to be a condition that women themselves cause by having

335


a substance called awabono placed at the entrance to the womb, where it blocks the flow of semen into the womb and thus prevents the accumulation of semen that forms a fetus. A woman wishing to avoid pregnancy solicits the assistance of a shaman, who places the awabono in her through a kind of reversal of the tokorime curing ritual. Married women who are completely infertile are guilty-at least in the view of Kulina men-of intentionally failing to perform as proper female persons, and the shamans who assist women in avoiding their reproductive obligations are felt to be acting essentially in the antisocial manner of witches.' Infertility thus draws upon the same cultural logic as illness. Even though it involves taking into the body a mystical shamanic substance that produces a condition that is not an illness in our conventional Western sense, it is nonetheless conceived by Kulina to be a kind of social illness: a refusal ofreproductivity. The treatment for infertility, should a woman wish it, is the familiar process of shamanic extraction in the context of the tokorime ritual, which again suggests that infertility is linked to the Kulina notion of illness by forms of social performance rather than individual subjective states.

Western Medicine

Although traditional Kulina curative techniques are based on plants and shamanic extraction, Kulina have been receptive to the medications provided by local Brazilians, government agents, missionaries, and anthropologists. The use of such medications, collectively called hemedzi (from the Portuguese term remedio), confirms for Kulina their view of illness, and thus warrants a brief discussion.

Western medications are normally sought for external illnesses or for internal pains at an early stage, before they might be diagnosed as dori or epetuka'i. Once an illness has been identified as dori or epetuka'i, Western medications are felt to be ineffective. Kulina understand Western medications to work in the same way as their own traditional curative substances, although in ways that may not be obvious. For example, local Brazilians prefer injectable medications, and Kulina have been quick to embrace injection as the primary mode of medication delivery; in the Kulina view needles penetrate the skin and deposit medication directly at the precise site where many illnesses are believed to occur: in the flesh. Oral medications are felt to be less effective because they are thought to undergo a change in the gastrointestinal system. On one occasion, an Italian missionary organization sent a shipment of antibiotics that ultimately were delivered to Maronaua; the Kulina were puzzled by their form-they were all anal suppositories-and were at first amused and then rather horrified when I explained how they were used. If oral medications are felt by the Kulina to be ineffective, their anal counterparts are thought to be perverse.12

Several particular medications are highly valued, particularly for external illnesses on the skin. Both mercurochrome and gentian violet are said to be strong and good-smelling substances, and thus to have curative properties (cf. Conklin 1994). Moreover, each of these substances colors the skin to match the red urucu and blue/black genipapo that are applied to the face and arms during periods of liminality. The coloration of the skin resulting from the use of these medications is thus also consistent with, and becomes a sign of, the liminality of the sick role.

336

PERSON AND ILLNESS

Otherwise, Kulina tend to view Western medications as largely undifferentiated. The term penisilina covers virtually all injectible medications, and the term hemedzi is used for these and all other medications without further categorization. Thus Kulina tend to treat Western medications on the model of curative plants, all of which derive their curative properties from generalized characteristics such as a good smell (Pollock 1988). The presumption of basic similarity among all medications is also suggested to the Kulina by the practice of the Brazilian government pharmaceutical supplier of distributing all drugs in identical packages, bottles, and vials. (Kulina could not read the labels that distinguished these drugs.) The claim made by Brazilians that some of these medications are illness specific does not challenge the basic Kulina belief that they are all similar. Kulina assume that, like some plants, certain medications are merely stronger versions of others, and therefore appropriate for more serious illness.

One additional aspect of Western medicine that also reinforces traditional Kulina views about the nature of illness is worth mentioning here. My informants mentioned that local Brazilians suffer high rates of infant mortality, and speculated that these non-Kulina were not aware of the food prohibitions that new parents must obey. Brazilian infants, in other words, are assumed to be dying of epetuka'i, an illness that Kulina understand and know how to cure. I do not have comparative data to confirm the Kulina impression of high infant mortality among local Brazilians, but several Brazilian visitors to Maronaua have volunteered the same view, and speculated that "Indians" were better adapted to the forest environment, and thus had greater reproductive success. Indeed, although local Brazilians ridi- culed many traditional Kulina beliefs, they occasionally brought sick infants to the village for curing.

Finally, it should be noted that Protestant missionaries of the Summer Institute of Linguistics (SIL) at the Kulina village of San Bernardo on the Peruvian side of the Purus River are reported to have banned the practice of traditional shamanism for curing, and have trained a Kulina man as a "nurse" or sanitdrio for the village.'3 The ban on shamanistic curing appears to have had little effect on local practices; at the very least, individuals who need traditional treatment by shamans come to Maronaua or another village on the Brazilian portion of the river. Surprisingly, however, the infirmary created by the SIL for dispensing Western medications requires village members to pay for their treatment. The interest of Protestant missionaries in creating small-scale market economies in indigenous communities is well known; the purchase of health care is obviously rational from this western capitalist perspective. However, the notion of paying for the treatment of illness is so antithetical to fundamental Kulina ideas about the imperatives of kinship and village coresidence that residents of San Bernardo participate in this system largely I believe because they do not yet understand the nature of money or its role in mediating social relations. Conversations with members of the San Bernardo village also suggest the possibility that the sale of illness treatments may serve to dramatize the fact that the SIL missionaries are not truly village members.

Conclusions

In this article I have provided an overview of Kulina ethnomedical beliefs and practices, emphasizing how they derive from and articulate with their conceptions

337


of personhood. If traditional Kulina beliefs have a very tenacious quality, it is because they are so closely connected to Kulina ideas about bodies and spirits, how these are made or acquired, and how they are transformed in a wide variety of social contexts from birth to death. In short, there is a cultural logic to Kulinaethnomedical beliefs and practices that links them closely to the broader context of the practice of personhood. I have also emphasized that Kulina ethnomedical beliefs and practices are played out in a kind of dialogue with a variety of social processes. In this regard Kulina illness beliefs are an "idiom of distress" with social as well as bodily and spirit referents. As in many other cultures, illness among the Kulina is not merely a social commentary on bodily states and processes, it is also a kind of commentary bodies and spirits make on social processes.

NOTES

Acknowledgments. My research among Kulina has been supported by a variety of sources, most recently by a Research Development Fund grant from SUNY-Buffalo (1990) and a MacArthur Foundation grant (1992).

1. Thus I distinguish the Body from a body. The capitalized entity has emerged in the literatures of anthropology, sociology, history, and literary theory, among others, as a single abstract thing, usually (if implicitly) with universal applicability to all cultures at all times. The lowercased body is of variable composition, extension, and social significance both cross-culturally and across history.

2. Marina Roseman's work on Temiar ethnomedicine makes a parallel point (1991); in a discussion of that work, Roseman commented that Temiar notions of personhood are more accurately described as "ensoulment" rather than "embodiment" (personal communication, 1990), a point that nicely challenges the cultural generalizability of the notion of embodiment.

3. I have in mind research that indicates that American psychiatrists are more likely to diagnose schizophrenia than are psychiatrists in other cultures, even other Western cultures. Other research that suggests that the difference between schizophrenia and affective, especially bipolar, disorders may be more a matter of degree than of kind.

4. I have elsewhere described how the attribution of these and other qualities to foods rationalizes the Kulina division of labor and indeed constructs gender in practice.

5. In my article on food and sexual identity among the Kulina (Pollock 1985) I pointed to the difference that my informants stressed for me between the wildness of men and the relative tameness of women. Claire Lorrain has reminded me that all Kulina, men as well as women, consider themselves "wild" (wadi), and so I want to emphasize that my formulation of the difference between men and women in this regard is one of degree, not of absolutes.

6. Claire Lorrain (personal communication, 1992) reports that among the Kulina of the Jurua River, epetuka'i is said to be associated with the presence of a real dung beetle in the infant's belly just below the skin.

7. An alternative, cultural ecological explanation for this failure to obey the food prohibition might argue that when game animals are relatively abundant, as they are in the forest surrounding Maronaua, the prohibition is not necessary to regulate the use of otherwise scarce protein resources. Although this may be the case, my interest here is on the cultural understanding of the prohibition proposed by Kulina.

8. See my article on Kulina shamanism (Pollock 1992) for an extended description. 9. Claire Lorrain informs me that among the Kulina on the Jurua River, koidza (there

called patsini) is actually consumed by shamans during the curing ritual.

338

PERSON AND ILLNESS

10. The frog (akawa in Kulina) was the large Dendrobates histrionicus Berthold. Katharine Milton (1994) has discussed a similar use of frog skin exudate among the Peruvian Mayoruna, using the tree frog Phyllomedusa bicolor.

11. I should note that women who have had numerous pregnancies sometimes seek out awabono as a form of birth control, with the approval of their husbands and without community disapproval. Indeed, menopause is interpreted as the result of awabono, understood to be a consciously intentional end to reproductivity rather than a "natural" process beyond intentional control.

12. At least a couple of my informants, in an effort to understand suppositories, asked me if Italians were "upside-down."

13. Thomas Headland (1994) of SIL has objected to my description of the San Bemardo village, though as far as I am aware he has never visited the village and has not offered an alternative characterization. In view of the sensitivity of such SIL members to what they take to be criticism of their work, I want to emphasize that my comments about San Bernardo are based on reports from numerous residents of that village, including a Kulina lay pastor, and not on my own firsthand research.

REFERENCES CITED

Adams, Patsy 1962 Textos culina. Folklore americano 10:93-222.

Conklin, Beth Ann 1989 Images of Health, Illness and Death among the Wari' (Pakaas Novos) ofRondonia,

Brazil. Ph.D. dissertation, University of California, San Francisco. 1994 O sistema medico Wari' (Pakaan6va). In Sadde e povos indigenas. R. Santos and

C. E. A. Coimbra, eds. Pp. 161-186. Rio de Janeiro: Editora FIOCRUZ. Csordas, Thomas J.

1990 Embodiment as a Paradigm for Anthropology. Ethos 18:5-47. 1993 Somatic Modes of Attention. Cultural Anthropology 8(2):135-156.

Deleuze, G., and F. Guattari 1988 A Thousand Plateaux. London: Athlone.

Douglas, Mary 1966 Purity and Danger: An Analysis of Concepts of Pollution and Taboo. New York:

Praeger. 1970a Witchcraft Confessions and Accusations. ASA Monographs, 9. London: Tavis-

tock. 1970b Natural Symbols: Explorations in Cosmology. New York: Pantheon.

Fortes, Meyer 1973 On the Concept of the Person among the Tallensi. In La notion de personne en

Afrique noire. G. Dieterlen, ed. Pp. 283-319. Paris: Editions du CNRS. Headland, Thomas

1994 Missionaries and Social Justice. Paper read at the 1994 annual meeting of the American Anthropological Association, Atlanta.

Harris, Grace G. 1989 Concepts of Individual, Self, and Person in Description and Analysis. American

Anthropologist 91(3):599-612. Kirkpatrick, John

1983 The Marquesan Notion of the Person. Ann Arbor: University of Michigan Re- search Press.

Kondo, Dorinne K. 1990 Crafting Selves: Power, Gender, and Discourses of Identity in a Japanese Work-

place. Chicago: University of Chicago Press.

339


Laderman, Carol 1991 Taming the Wind of Desire: Psychology, Medicine and Aesthetics in Malay

Shamanistic Performance. Berkeley: University of California Press. 1992 Malay Medicine, Malay Person. In Anthropological Approaches to the Study of

Ethnomedicine. M. Nichter, ed. Pp. 191-206. Amsterdam: Gordon and Breach Science Publishers.

Langdon, E. Jean 1974 The Siona Medical System. Unpublished Ph.D. dissertation, Tulane University.

Lock, Margaret 1993 Cultivating the Body: Anthropology and Epistemologies of Bodily Practice and

Knowledge. Annual Reviews of Anthropology 22:133-155. Lutz, Catherine

1988 Unnatural Emotions. Chicago: University of Chicago Press. Martin, Emily

1987 The Woman in the Body: A Cultural Analysis of Reproduction. Boston: Beacon Press.

1991 The Egg and the Sperm: How Science Has Constructed a Romance Based on Stereotypical Male-Female Roles. Signs 16:485-501.

Mauss, Marcel 1950 Une cat6gorie de l'esprit humain: La notion de personne, celle de "moi." In

Sociologie et anthropologie. Pp. 333-362. Paris: P.U.F. Milton, Katharine

1994 No Pain, No Gain. Natural History 103(9):44-50. Munck, Victor C. De

1992 The Fallacy of the Misplaced Self: Gender Relations and the Construction of Multiple Selves among Sri Lankan Muslims. Ethos 20(2):167-191.

Murray, David 1993 What Is the Western Concept of the Self? On Forgetting David Hume. Ethos

21(1):3-23. Mussolini, Gioconda

1980 Ensaios de antropologia indigena e caicara. Sao Paulo: Editora Paz e Terra. Pollock, Donald

1985 Food and Sexual Identity among the Culina. Food and Foodways 1(1):25-42. 1988 Health Care among the Culina: Western Amazonia. Cultural Survival Quarterly

12(1): 28-32. 1992 Culina Shamanism. In Portals of Power: Shamanism in South America. E. Jean

Langdon and G. Bear, eds. Pp. 25-40. Albuquerque: University of New Mexico Press. 1993 Death and the Afterdeath among the Kulina. Latin American Anthropology

Review 5(2):61-64. 1994 Etnomedicina Kulina. In Saide e povos indigenas. R. Santos and C. E. A. Coimbra,

eds. Pp. 143-160. Rio de Janeiro: Editora FIOCRUZ. Roseman, Marina

1991 Healing Sounds from the Malaysian Rainforest: Temiar Music and Medicine. Berkeley: University of California Press.

Ruif, Isabelle 1972 Le 'dutsee tui' chez les indiennes Culina du Perou. Bulletin de la soci6et Suisse

de americanistes 36:73-80. Scheper-Hughes, Nancy, and Margaret Lock

1987 The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. Medical Anthropology Quarterly (n.s.) 1(1):6-41.

340

PERSON AND ILLNESS

Seeger, Anthony, et al. 1979 A construeao da pessoa nas sociedades indigenas Brasileiras. In A construaeao da

Pessoa Nas Sociedades Indigenas. Y. Leite, ed. Pp. 2-19. Boletim do Museu Nacional. Anthropologia 32.

Siskind, Janet 1973 To Hunt in the Morning. New York: Oxford University Press.

Spiro, Melford E. 1993 Is the Western Conception of the Self "Peculiar" within the Context of the World

Cultures? Ethos 21(2):107-153. Turner, Terence

1980 The Social Skin. In Not Work Alone. J. Cherfus and R. Lewin, eds. Beverly Hills: Sage.

1994 Bodies and Anti-Bodies: Flesh and Fetish in Contemporary Social Theory. In Embodiment and Experience. T. Csordas, ed. Cambridge: Cambridge University Press.

1995 Social Body and Embodied Subject: Bodiliness, Subjectivity, and Sociality among the Kayapo. Cultural Anthropology 10(2): 143-170.

Turner, Victor 1967 The Forest of Symbols: Aspects of Ndembu Ritual. Ithaca: Cornell University

Press. 1968 The Drums of Affliction. Oxford: Oxford University Press.

Von Martius, Karl 1979 Natureza, doeneas,medicinae remedios dos indiose brasileiros (1844). Brasiliana,

154. Sao Paulo: Companhia Editora Nacional.

341

Pollock - Personhood and Illness Among the Kulina

Documents

Transcript of Pollock - Personhood and Illness Among the Kulina