Ethnoveterinary Medicine: "Ethnoscience" or just Anti-Science?

A Review of Dr. Constance McCorkle's Chapter 41: "Ethnoveterinary Medicine"

by Robert Imrie, DVM
 
 

Dr. Constance McCorkle begins her chapter on "Ethnoveterinary medicine" by telling us that Ethnoveterinary Research, Development and Extension (ERD&E), has emerged as a "fertile field" that promises to benefit "rural and peri-urban stockraisers" not just in the Third World, but everywhere, by virtue of the "generation (or regeneration)" of certain "animal health technologies"

She and her colleagues define Ethnoveterinary Research, Development and Extension as:

Pg. 713: The holistic, interdisciplinary study of local knowledge and its associated skills, practices, beliefs, practitioners, and the social structures pertaining to the healthcare and healthful husbandry of food-, work-, and other income-producing animals, always with an eye to practical development applications within livestock production and livelihood systems and with the ultimate goal of increasing human well-being via increased benefits from stock raising.

To her great credit, Dr. McCorkle is perhaps the only contributor to Schoen and Wynn's "alt-vet-med" opus to employ a fully rational definition of "holistic" and/or "holism." This is no mean distinction. While other contributing authors have chosen, for instance, to ignore the fact that "holistic" traditional Chinese medicine is oblivious to the existence of the nervous, the endocrine, and circulatory systems, or the fact that "holistic" homeopathy ignores both the "germ theory of disease" and modern physics, Dr. McCorkle's definition deals only with "brass-tacks factual" considerations. Bravo!

Despite my serious misgivings regarding what seem to be Dr. McCorkle's "strategic" social and political objectives, I am very much in favor of at least some of her "tactical" objectives with regard to pastoral and primitive agricultural societies. For instance, when cost or lack of availability preclude the use of more safe and effective modern pharmaceuticals, it makes sense to exploit herbal or traditional therapeutic agents likely to be safe and at least marginally effective. And who would deny the self-evident fact that the observations of pastoralists, herbalists, and folk medicine practitioners sometimes "point a finger" leading to the discovery and development of new husbandry techniques, pharmaceuticals and healthcare technologies? Certainly it would be shortsighted to suggest that the observations and ideas of witchdoctors, shamans and other traditional healers should be "dismissed out-of-hand." The very suggestion is antithetical to both the spirit and the principles of genuine scientific investigation. (And that's precisely why I suspect this message stems from the "cultural anthropology community" rather than "scientific community.")

In any case, I'm certain that advocates of scientific biomedicine share my conviction that various "traditional medical systems" merit rigorous but open-minded scientific evaluation. Who can say what treasures these resources might yield? I suspect that conventional "Western" and even "Third World" veterinarians share Dr. McCorkle's and my eagerness to "integrate what works in folk medicine" with "what works in scientific biomedicine." Where we differ seems to be in how we propose to determine "what works and what doesn't."

In reviewing Dr. McCorkle's twenty-nine-page-long chapter, I will endeavor to move from the specific to the general. That is, I'll first examine and comment on specific statements, examples and claims she raises and then consider the broader sociological, political, and philosophical implications of her work.

While Dr. McCorkle and ERD&E-advocate colleagues are clearly very keen on "studying" traditional veterinary practices and veterinary folk medicine, only once in the course of her chapter does she mention, in passing, the need to "discriminate" between effective and ineffective therapies:

Pg. 734: For local knowledge to be broadly and responsibly put to use, some means of discriminating between effective and ineffective methods is required.

Pg. 734: The problem in accurately evaluating packages of ethnoveterinary (or conventional) IDM [integrated disease-management] is one of Western scientific reductionism.

Pg. 734: The flaws of conventional science make [.] the need to scientifically validate local knowledge and practice controversial.

On page 732, Dr. McCorkle cites five circumstances in which, she concedes, ethnoveterinary medicine "may not be the best alternative." In each of these five instances, however, she is quick to point out allegedly similar failures in "conventional" veterinary medicine - lest we conclude that "ethnoveterinary medicine" and "conventional veterinary medicine" are not equally "valid" and effective healthcare delivery systems.

Under the tenets of ERD&E, when and if "ethnoveterinary science and knowledge" fail to pass rigorous scientific muster, it doesn't mean they aren't "valid" (whatever that means.) It means that the scientific method is invalid. This, of course, makes "ethnoveterinary science and knowledge" a "non-falsifiable belief system." Heads we win, tails you lose. Furthermore, while Dr. McCorkle speaks of "validating" traditional veterinary practices, she doesn't seem at all eager to advocate discarding such practices when they're shown to be ineffective, or to refine and develop those that pass scientific muster. Moreover, in this and other medical anthropological and cultural constructivist literature, what modern scientists know as "science" is consistently described as "Western science" or "conventional science," and it is generally described as having "failed" in most "Third World" contexts. Conversely, what most scientists would construe as "local religious or metaphysical belief systems" and "traditional or folk medicine" are consistently described as "ethnoscience" and "ethnomedicine."

Pg. 718: [Off-set box 41-2] Topics and Themes in ERD&E:
Ethnoveterinary Science System:

It's not immediately clear whether Dr. McCorkle and her ERD&E-advocating colleagues are suggesting that the following entities be studied in a scientific manner or that they are, in and of themselves, "sciences." I suspect the latter is the case, but it's not entirely obvious.

Ethnoveterinary semantics and taxonomies. How people name and classify diseases, treatments and other health matters.

The fact that what used to be merely the study of "veterinary folk medicine" has been transmogrified into the much more impressive-sounding "Ethnoveterinary Research, Development and Extension" speaks volumes about the proliferation of semantics and taxonomies in this field. It remains to be seen whether or not this new and ever-expanding jargon is a worthwhile invention.

Ethnopathophysiology: How people understand the interrelationship, functions, and malfunctions of different organs and systems (e.g., circulatory, nervous), often garnered from practical necropsy at slaughter or ritual sacrifice.

What about the various ways people misunderstand these things? In "ethnoveterinary science," is it ever possible to mis-understand pathophysiology? At least until the 19th century, when Western anatomical knowledge became available, Chinese medical practitioners held that the trachea communicated not with the lungs, but with the abdomen. Is this an "understanding" or a "misunderstanding" of anatomy? Are there literally no "wrong" ideas about pathophysiology? Are all such ideas "equally right"? If not, then how does one sort the "wrong" ideas from the "right" ones?. or the good ideas from the not so good? That's precisely where genuine science excels.

Is a butcher really best described as an "ethnopathologist" or an "ethnoanatomist"? What about a shaman or witchdoctor who diagnoses by means of reading the entrails of slain goats? Instead of imposing new self-descriptions on Third World practitioners, why don't Dr. McCorkle and her colleagues advocate that we simply re-define "Western" pathologists and anatomists as ethno-butchers, ethno-shamans, and ethno-witchdoctors? Wouldn't that be a far more egalitarian and far less neo-imperialist approach?

While it's true that science often employs elaborate and highly specialized jargon, it does so in the interest of precision. Some authors have suggested that, rather than enhancing the precision of the definitions in question, ethnoscientific and post-modernist jargon are really intended to advance a certain social philosophy and political agenda. More specifically, such a specialized and intentionally impenetrable language allows "insiders" to identify one another as such, and creates the impression among "outsiders" that "insiders" enjoy special knowledge and expertise, and have a deeper understanding of the pertinent issues than "uninitiated" others.

For a highly revealing and absolutely hilarious insight into the façade of post-modernist and cultural constructivist jargon and puffery, I refer readers to the "Sokal Affair."[1],[2] In the Fall of 1994, theoretical physicist Alan Sokal submitted an essay to Social Text, the leading journal in the field of "cultural studies." The piece was titled "Transgressing the Boundaries: Toward a Transformative Hermeneutics of Quantum Gravity," and purported to be a scholarly article about the "postmodern" philosophical and political implications of 20th century physics theories.[3] However, as Sokal, himself, revealed in a simultaneously published issue of the journal Lingua Franca,[4] the essay was nothing more than a hodge-podge of deliberate solecisms, scientific howlers, non sequiturs and post-modernist gobbledygook cobbled together so as to look good and flatter the ideological preconceptions of the editors. It passed "peer review" by five members of Social Text's editorial board, and was published as a serious piece of scholarship. It appeared in a April 1996 as part of a special double-issue devoted to rebutting the charge that cultural studies critiques of science tend to be riddled with incompetence.

Generally speaking, science, social philosophies and political agendas - no matter how well intentioned -- have made exceedingly poor bedfellows. Consider such examples as Social Darwinism, Creation Science, Fascist Eugenics, and Lysenkoism, among others.

Ethnoetiologic and ethnoepidemiologic theories: The causes (supernatural as well as natural) that people assign to different diseases and their understandings about disease transmission (including zoonoses).

Again, what about the ways people mis-understand disease transmission and cause? Aren't mis-understandings as important as understanding? If, as is apparently the case in some parts of sub-Saharan Africa, people believe that men can cure themselves of AIDS or HIV infection by having sex with a virgin, does that constitute an "understanding" of HIV epidemiology/etiology/ pathophysiology, or a "mis-understanding" of same? In any case, if a "theory" or "intellectual system" assumes the reality of magic or supernatural forces, no matter what you call it, it isn't "science."

Ethnodiagnostic knowledge and technique: Based on all the above factors, plus clinical observation of signs and syndromes, how people decide what the given health care problem is and thus how to treat or control it.

Believe it or not, under the tenets of ethnomedicine, "possession by demons" or "an excess of abdominal foam" are both perfectly acceptable "ethnoscientific" diagnoses for what ethno-scientifically unsavvy "Western" healthcare professionals might identify as a case of idiopathic epilepsy. If one understands that seizures are due to paroxysms of neuronal discharge, it leads one to look for ways to stabilize neuronal physiology. If one believes that seizures are caused by "an excess of abdominal foam" (as do traditional healers in Cameroon),[5] it leads one to attempt to stop or reduce "foam secretion." Are both approaches equally likely to lead to seizure control?

Is it possible for any diagnosis, other than perhaps "Western" scientific ones, to be wrong under the rubric of "ethnomedical science"? It's hard to imagine how anything could be construed as a misdiagnosis under such a system. But, if all diagnoses are "correct," and one is no more or less accurate than another, what good does it do to come up with a diagnosis at all? Do all diagnoses reflect an equally valid understanding of a disease process? If they did, wouldn't it follow that all traditional interventions should not only "work," but work just as well as "Western" (scientific biomedical) interventions. I submit that they rarely if ever work as well as scientific biomedical interventions, at least on a "level playing field." Like it or not, all things being equal, dressings made of cow feces simply don't work as well on an open wound as antibiotics and sterile dressings do. (See below.)

Pg. 720: [Off-set box 41-3] Topics and Themes in ERD&E

Local knowledge should not be dismissed out of hand just because it is sometimes couched in seemingly nonscientific or supernatural idiom; it should always be investigated further.

Seemingly nonscientific? The first couple of times I read this passage, I assumed that the author merely meant that the idiom sometimes is unscientific or supernatural. I no longer think this is the case. The author is clearly committed to the "ethnoscientific tenet" that any local belief, no matter how irrational or steeped in the supernatural, is really a "scientific concept." Of course, from a scientific or even merely a rationalist perspective, this is nonsense.

On the other hand, while they might be obliged to reject local as well as "Western" notions of supernatural or metaphysical etiology, I don't think any good scientist is likely to dismiss out-of-hand the observations that have led folk medicine practitioners to do what they do. (If some flesh-and-blood scientists in the field have dismissed such observation out of hand, it says a lot about their failings as scientists and very little about the shortcomings of science.) Local observation and local notions of metaphysical etiology are entirely separate issues, but the distinction is one that Dr. McCorkle seems to either overlook or not to understand. Paying attention to and investigating the observations of non-scientists has, historically, played a major part in the development of modern science and technology. Uncritically "buying into" or accepting the metaphysics of those making such observations has not. What many non-scientists fail to appreciate is that such informal long-term observation often provides a key impetus and essential starting point for genuine scientific investigation. For instance, pre-scientific experience with selective breeding of domestic animals played a major part in the development of modern genetics. What the "ethnoscience advocates" apparently refuse to accept is that informal observation and trial-and-error findings do not, in and of themselves, constitute a "science" - least of all when they are mixed with a hodge-podge of local magical and religious beliefs. To the contrary, rather than viewing these casual findings and local beliefs as a starting-point for genuine scientific investigation, they attempt to construe them as the end-product of a scientific process. That process, they assert, is "ethnoscience."

Pg. 725: [Off-set box 41-10] Traditional vs. Modern Pharmacology: In 1994 a set of on-station trials was mounted in Indonesia to validate local Javanese treatment for ovine endoparasitism, with the goal of making a commercial version for the market. The traditional treatment consists merely of periodically feeding the sheep whole, immature papaya fruits. On the basis of prior experiments and review of the pharmacologic literature, scientists knew the key parasitacidal constituent resided mainly in the fruit sap. Therefore they collected and administered only the sap, instead of following the farmer's practice of feeding the whole fruit. In a matter of hours, 80% of the sheep in the high-dosage experiment group and 20% in the medium-dosage group died of acute poisoning. (Anonymous, 1994).

On page 735, Dr. McCorkle cites this anonymous anecdote as an example of a "costly" and "embarrassing error" which might have been prevented had the "scientists" involved heeded the advice of local stockraisers (or, presumably, other types of "ethnoscientists"). Upon careful reading of the above passage, one notices that the mortality rate in the "low-dosage" group is not mentioned. Might it have been 0%? Dr. McCorkle seems to have overlooked the fact that this endeavor was intended to be an experiment. In real science, experimental results don't always conform to the experimenter's expectations. Did the "scientists" conducting this experiment view it as a failure? Were they eventually able to standardize the product and determine a relatively safe and effective dose? Did such a product ever reach the market? Might not the sap of the papaya or a crude extract be more stable and therefore more practical and economical for local stockraisers to use than the highly perishable whole plant? Unfortunately, since no author or source is cited for this anecdote, we'll probably never know the answers to these questions.

Pg. 732: Finally, because people are usually more familiar with indigenous medicines, they may be less likely to misuse or abuse these preparations than with alien Western drugs.

So far as I'm aware, ethnoveterinary science advocates are not lobbying Western farmers and stockraisers to forgo modern science and technology in favor of 19th and 18th century alternatives. Why not?

If Dr. McCorkle could travel back to the 1940s, would she be lobbying against the introduction in the West of antibiotics or petrochemical fertilizers and advocating that farmers, veterinarians and physicians cling to the "tried and true old ways"? If not, why not? If so, sixty years down the road would we really be better off for having persisted in using the "more familiar" old ways of treating and preventing disease or conducting agriculture? Certainly, we would now be dealing with only a very few antibiotic resistant strains, but what good would that do us? We wouldn't be using "new-fangled" antibiotics anyway, so "resistance" would be a "non-problem." And, in the meantime, how many millions of animals and people would have died from simple bacterial infections? If, in the 1930s and 40s, we in the West had chosen to eschew chemical fertilizers, we certainly would not be dealing with the nitrate runoff problems we currently face. On the other hand, we would almost certainly have far more serious problems to contend with such as nationwide famine and almost universal poverty, since industrial agriculture would be impossible. In fact, most of us would be engaged in subsistence farming, absorbed from sun-up to sun-down, seven days a week, in backbreaking manual labor, and hoping desperately to avoid starvation and survive the next epidemic of vaccine-preventable human and livestock disease. Of course, we don't have to wonder whether or not things really would have turned out that way. All we have to do is look at present day "ethnomedicine-" and "ethnoscience-dependent" societies of which Dr. McCorkle speaks. The description seems to fit them pretty well.

When unfamiliar drugs and technologies have been introduced in the West, education rather than abstinence has generally proven to be the most rewarding approach. It would seem, at best, patronizing for Western "ethnomedicine advocates" to suggest that "Third World stockraisers" might be any less capable of learning how to effectively cope with such introductions than their Western antecedents.

Pg. 732: Effective ethnopharmaceuticals may pose fewer dangers than do the more highly residual, poisonous, concentrated, and unfamiliar drugs and agrochemicals of the First World. Humans, livestock, local fauna, and the environment stand to benefit from ethnomedical alternatives.

Also, it's inaccurate and disingenuous to characterize all "'First World' drugs and agrochemicals" as "highly residual and poisonous." The fact is that many non-residual rapidly and spontaneously self-degrading pesticides have been developed and marketed in recent decades - as a direct result of just the concerns Dr. McCorkle cites. Likewise, chemical fertilizers may be more expensive than livestock manure, but they are vastly more effective on a per-unit-of-weight basis and much less likely to result in the transmission of salmonella, E. coli, and other pathogens to human or animal consumers.

Pg. 732: [Off-set box 41-16] Medicoreligious Beliefs and Practices: Quechua Indians' ethnoetiology of contagious keratoconjuctivitis in sheep is expressed partly in sixteenth-century Iberian notions of hot and cold diseases and partly in Incaic concepts of evil winds. Their ethnodiagnosis of the condition is nevertheless 100% accurate. [.]

The Quechua "ethnodiagnosis" for infectious keratoconjunctivitis is perhaps correct, if one defines correct as identifying that there is a problem in the eye of the sheep. In such a fashion, regularly identifying that a person had epilepsy, but attributing the cause to possession by the devil, would most likely be a proper "ethnodiagnosis." The problem is that, in the real world, such a diagnosis doesn't help - at least not when one is hoping to deliver effective health care. Merely recognizing that a condition exists, and being able to recognize it regularly, isn't really the problem. It's understanding why the condition exists and knowing what to do about it that really counts. While it's possible that "traditional healers" may occasionally, in their efforts to eliminate "heat" or "cold," or foil demons or "evil winds," may stumble upon therapeutic interventions that actually help, the process is haphazard at best. If one hopes to systematically investigate illnesses and efficiently develop effective therapies, there simply is no substitute for an accurate, science-based understanding of anatomy, physiology, and the etiology of disease. Other "ways of knowing" and "means of investigating the Universe" have, without exception, repeatedly proven to be horribly inefficient and inconsistent in this regard. Dressing up folk medicine as "ethnomedicine," and shamans as "ethnoscientists," then equating them with scientific biomedicine and scientists merely obfuscates these facts by means of insipid jargon.

It's curious to note that, in the previous passage, Dr. McCorkle refers to "Iberian notions" of hot and cold disease and "Incaic concepts" of evil winds. [For those non-ethno-anthropologists out there, Iberian means Spanish and Incaic means "of the Incas."] The Western idea is a "notion" while the Amerindian idea is a "concept." Do these terms denote and connote precisely the same things?

Here is report from the medical literature which casts the practices of Dr. McCorkle's Quechua "ethnoscientists" and "ethnomedical practitioners" in a somewhat different light:[8]

The data suggest a pattern of discrimination against females and younger children, especially infants under age one, despite the fact that these groups were reported to be sicker. Differences were especially significant in the allocation of biomedical treatments, the most costly in terms of parental time, effort, and money. Ethnographic data on child illness, gender, and developmental concepts help to explain why children of different genders and ages may be treated differently in the rural Andes. They provide a context in which to interpret health care allocation data, and, in the absence of a population-based study, reinforce findings based on the limited study sample. Female children are valued less because of their future social and economic potential. Females are also regarded to be less vulnerable to illness than male children, meaning that less elaborate measures are necessary to protect their health. Young children are thought to have a loose body-soul connection, making them more vulnerable to illness, and are though to be less human than older individuals. The folk illnesses urana (fright) and larpa explain child deaths in culturally acceptable ways, and the types of funerals given to children of different ages indicate that the death of young children is not considered unusual. Health care allocation and ethnographic data suggest that selective neglect (passive infanticide) may be occurring in rural Peru, possibly as a means of regulating family size and sex ratio. It is important to go beyond placing blame on individual parents or on culture, however, to address the underlying causes of differential health care allocation, such as poor socioeconomic conditions, lack of access to contraceptives, and female subordination.

Pgs. 731-2: Cautionary Lessons [.] All around the globe, whether for human or livestock ailments, urine is commonly used as a disinfectant for cuts and abrasions, and mud or animal feces as a dressing for wounds and bruises. All these materials can (and do) work as intended, but they also pose risks of secondary infection. Sometimes, however, ethnomedical beliefs are actually harmful [.]

Fortunately, there is apparently no need to subject urine therapy and mud or fecal dressings to Randomized Controlled Trials: Dr. McCorkle assures us that these therapeutic interventions "can and do work." And she apparently dismisses the idea that healing may occur in spite of the treatments offered. Unfortunately, she doesn't tell us what the "ethnomedically correct" response might be when a skeptical "Western" medical practitioner's "ethnomedical practitioner-colleague" suggests treating a lacerated patient with a cow-feces dressing. I suspect that "over my dead body, you quack" would be construed as demonstration of "hegemonic, imperialist, oppressive, close-minded, and ethnophobic" disrespect toward a "fellow health professional." I also suspect that attempting to make them aware of the "Germ Theory of Infection" would be construed as blatant ethnocentric imperialist indoctrination. Perhaps it would be more "ethnomedically correct" to suggest a poultice comprised of 50% cow feces and 50% antibiotic ointment.

Pg. 734: Ethnomedicine itself provides an excellent example of such processes [the integration of "conventional" science and "ethno" science]. It gave the world invaluable drugs such as aspirin, codeine, curare, and quinine [.]

I would be the first to concede that these are examples of non-scientist, informal observers providing science and scientists with invaluable information, but that is not what Dr. McCorkle and her colleagues are claiming. They assert that these are examples of a collaboration between just two of many "co-equal sciences," and that "Western" science plays no privileged part in the relationship and deserves no particular credit for the results.

Dr. McCorkle tells us on pages 734 and 735 that:

[.] scientific validation of local knowledge and practice has sometimes been problematic. In practice, methodological difficulties have been especially common in the study of botanicals [.]

[.] isolation of active ingredients should not be a precondition for the validation of ethnopharmaceuticals. Such research is not only costly, but reductionistic because traditional prescriptions are often intended to produce simultaneous or synergistic actions such as site-specific attack on the disease, enhanced immune response, increased cellular uptake, and repression of side effects.

Many modern paraherbalists maintain that plants are not only the safest way to administer medicine, but also the most effective. They claim that apart from their active principle, plants may contain other substances that enhance their therapeutic action by some sort of a synergistic process.

Perhaps the most persistent advocate of this doctrine has been Andrew T. Weil, M.D., who argues, "In the case of drug plants, the whole forms, being complex mixtures and therefore impure, tend to be safer than their unmixed derivatives, freed from diluents and made available in highly refined form." Weil also argues that the lesser concentration of an active constituent present in plant tissue renders such a drug safer to use. Finally, he contends that the various active constituents in a plant work synergistically to produce a total effect greater than the mere sum of the individual component activities.

Weil's first two points can be dismissed simply by pointing out that dosage, which governs a drug's safety and efficacy, is much more readily controlled with purified constituents. Synergism occasionally occurs, but for every case where a desirable action is enhanced, there are several where undesirable actions are produced. For example, cinchona bark contains some 25 closely related alkaloids, but the only one recognized as useful in the treatment of malaria is quinine. A person who took powdered cinchona bark would also ingest the alkaloid quinidine, a cardiac depressant, and cinchotannic acid, which would induce constipation.

Finally, investments in the study and application of useful local knowledge, practice and social organization can produce another important benefit: renewed respect for local cultures and technologic knowledge. As a corollary, formal-sector health care workers, extensionists, educators, scientists, and policymakers may also gain increased appreciation of the knowledge and experience that their clients, students, users and citizens already possess. All these benefits can add up to a fresh sense of local confidence and control, stronger social structures, and empowerment of people to work together at the local level - whether independently or with nonhegemonic formal-sector support - to solve more of their own development problems.

Apparently, people solving their own local development problems is ethno-politically OK, but only so long as they don't resort to "hegemonic" governmental or "Western" institutions - i.e., those institutions that depend upon real science, with its objective reality, absolute truths, and concrete facts. Why should Third World citizens care how or even who solves their development problems, so long as the problems get solved and the solutions are satisfactory to them? What if science-based medicine and animal husbandry fit this bill better than ethnomedicine and ethnoscience?

None of this is to say that ethnoscience is perfect or that conventional science must be abandoned. Rather, each has much to learn from the other. As Last (1990) observes for medical systems cross-culturally, "In theory. all systems may 'work'; in practice, all have successes and failures, with some systems scoring much higher in particular areas of medicine, depending on the social, cultural, and economic context in which they are applied, as well as on their biomedical bases.

In most "non-Western" cultures, traditional or folk medicine is an integral part of the local religion and magical/metaphysical belief systems. If that's the case, then doesn't Dr. McCorkle's defining folk medicine as "ethnoscience" mean that, in her view, science, religion and magic are inextricably interwoven? This definition undoubtedly appeals to some sociologists and cultural anthropologists, but most scientists will recognize it as nonsense. As the late Carl Sagan once said: "there is no place for magic in science." Likewise, the notion of the "supernatural" is antithetical to true science (as distinct from pseudoscience). Real science works on the "assumption of naturalism": i.e., that the universe makes sense, functions free of magical or incomprehensible influences from outside itself, and is at least potentially understandable. Which varieties of folk medicine live up to this definition?

Pg. 730: According to WHO [the World Health Organization], all appropriate human resources must be tapped if basic health services are to reach most of the worlds' humans; clearly the same can be recommended for the livestock sector. As many experts have observed, the Western model for delivery of animal health services has rarely worked well in developing countries.

Alexander Macdonald offers an interesting insight into "Western" (scientific) versus "traditional" models of medical delivery from the fountainhead of "ethnomedicine," China: [10]

[.] 60,000 people died in Manchuria of a plague between 1910 and 1911. Eighty traditional physicians were specifically selected to control the plague. They all died of it themselves. The only person who was able to help was a young Cambridge-trained doctor, Wu Lien-te, who used his scientific knowledge to direct the sanitary and public health measures required to prevent the plague from spreading further.

Pg. 737: Per capita ratios of modern versus traditional practitioners to patients underscores this point. For example, China has only one modern medical doctor for every 10,000 patients, but the tradition of traditional practitioners is 1:100 (Bodecker 1994a); for Ghana and Swaziland, these figures are respectively 1:20,000 versus 1:200 and 1:10,000 versus 1:100 (Zhang, 1994). Similar magnitudes can be assumed to hold for the livestock sector in most of the Third World. Kenyan farming communities, for example, typically boast two or three traditional healers for livestock but no formally-trained veterinary workers.

Pg. 738: The Western scientific etic is really just another emic.

Main Entry: et·ic

Pronunciation: 'e-tik
Function: adjective
Etymology: phonetic
Date: 1954
: of, relating to, or having linguistic or behavioral characteristics considered without regard to their structural significance

Pronunciation: 'E-mik
Function: adjective
Etymology: phonemic
Date: 1954
: of, relating to, or involving analysis of linguistic or behavioral phenomena in terms of the internal structural or functional elements of a particular system

Cognitive anthropology has repeatedly demonstrated a basic structural similarity in the two types of knowledge.

At least since the domestication of plants and animals some 12,000 to 15,000 years ago, farmers and stockraisers have been conducting empirical agricultural experiments and exchanging their findings (McCorkle, Brandstetter, McClure, 1988).

Interestingly, the historiography of agricultural inventions and recommendations at international agricultural research centers reveals that many of these derive directly from producer knowledge and practice.

This is not the place for an exegesis on the sociology of knowledge or the universality of the scientific method, however. [.]

[.] In short, stockraisers are mainly interested in whether a given intervention makes sense to them and works to their satisfaction (and then, of course, whether it is available, affordable, convenient, and so forth) - no matter what its source."

This leads to an interesting question. Ethnomedicine advocates insist that local medical practices and husbandry techniques offer great potential benefit to local farmers and pastoralists, and that local knowledge and expertise should take precedence over that stemming from "outside" cultures. If that's the case, why do we need an "outside" agency (based on a Western invention such as ERD&E) to teach local people what they, literally, already know? As one reads ERD&E literature, it becomes increasingly clear that the real message has little to do with instituting effective medical or husbandry techniques and much to do with "validating" status quo social and cultural conventions and practices and promoting ethnophobic anti-Western and anti-scientific sentiment in Third World countries.

At this point, I think it would be constructive to consider what scholars and scientists critical of the "ethnoscience" movement have had to say. The comments of Indian microbiologist, science and technology scholar, and science journalist Meera Nanda are particularly salient:[12]

Ethnoscience: Gift or Charity?

They say it is impolite to look a gift horse in the mouth. It is indeed doubly impolite if the gift was intended as a token of respect and solidarity. Yet it is precisely this rather delicate task of returning a well-intentioned gift that I have taken upon myself in this essay. [.]

The gift I want to return is the cluster of theories that forbids outsiders from evaluating the truth or falsity of any beliefs of other people in other cultures from the vantage point of what is scientifically known about the world and, conversely, allows the insiders to reject as ethnocentric and imperialistic any truth claim that does not use locally accepted metaphysical categories and rules of justification. These theories hold that, because modern "Western" science is but one among many ways of understanding the world and is embedded in its own cultural context of production as other knowledges are in theirs, it cannot serve as a transculturally valid source of knowledge. All sciences are ethnosciences, and none is more universally true than any other.

This gift has many names, many givers, and many presumed beneficiaries. It is variously called ethnoscience, situated knowledge, anti-Northern Eurocentric, or post-colonial science - labels that derive their force from their parental rubric of social constructivist theories of science. Its most generous sponsors are the self-consciously left and often self-described post-modern academics of North American and European universities (and increasingly also from non-Western universities as well), who see any claim of universality of modern science as the West's ploy for "disvaluing local concerns and knowledge and legitimating outside experts," as Sandra Harding put it (1994, 319).

The most aggressive consumers of ethnoscience are the equally "left" post-colonial intellectuals and activists associated with cultural/religious and other "new social movements" that aim to purge their cultures of all alien (mostly Western) elements. These intellectuals and movements openly and stridently reject the calls of earlier modernist/anticolonial "peoples science movements" in favor of postmodernist/postcolonialist "alternative science movements." Whereas the former sought to assimilate modern science into local settings as a means of cultural change and economic development, the latter see modern "Western" science as a source of all that ails non-Western societies and seek alternative "ways of knowing" grounded in their own civilizations. The Western and Third World critics of the universality of science are united in reversing the terms of respect in Sandra Harding's statement quoted earlier; that is, they want to value local concerns and knowledge and delegitimize outside experts, assuming all the while that the local and the outside are irreconcilable and that the knowledge of the "outside" experts - that is, modern science - is nothing more than an imposition on reluctant local knowers. [.]

Why should anyone want to refuse such a generous gift, least of all someone like myself whose own native Indian culture was berated for so long by the British rulers as irrational, mystical, and superstitious? How can anyone urge ex-colonial people to refuse this poultice of relativism when they are still so obviously smarting from the indignities of colonialism and when they need to affirm their identities to resist the seductions of the fast-encroaching McWorld? [.]

My reason for rejecting ethnoscience is this: What from the perspective of Western liberal givers looks like a tolerant, nonjudgmental, therapeutic "permission to be different" appears to some of us "others" as a condescending act of charity. This epistemic charity dehumanizes us by denying us the capacity for a reasoned modification of our beliefs in the light of better evidence made available by the methods of modern science. [.]

By defining the very nature of rationality and truth as internal to social practices, social constructivists do indeed give the natives their "permission" to be different - but, then, so did apartheid.

Understandably the gift givers are dismayed to have their generosity interpreted as charity, their ethnosciences seen as antiscience, and their invitation to be different read as intellectual apartheid. This is not what they meant at all, they assure us Third World ingrates. The thoughtful among them take seriously the charge of condescension and deny that respectfully understanding others' beliefs implies a suspension of critical judgment. Such a project only demands, they claim, that every society should use criteria that are internal to its own "specific historical tradition," for the criticism of its own knowledge and values. But if Western knowledge must be used to criticize non-Western practices, they insist, the critics must acknowledge that Western science is not a god's eye view, but a situated, ethnocentric, Western view of the world (see Rentlen 1988).

The gift givers thus assure us that they are not against modern science per se, but only against its universal pretensions. They wish science to confess its culture, take on an ethnic middle name (Western) and become one among many other ethnosciences. Thus provincialized, science is deemed acceptable for certain limited and purely instrumental purposes, with no claims to truth, worldviews, and social values. "Modern 'Western' science, yes, but modern universal science, no!" could well summarize the prevailing ethnoscience/postcolonial position.

One of the most fundamental assumptions of ethnomedical philosophy (if not cultural anthropology in general) is that, even though Third World peoples seem overwhelmingly eager to join in the scientific revolution and enjoy the abundant fruits of modern science and technology, they should be "spared the negative impact such fruits are certain to incur on their cultures." This "cultural anthropological viewpoint" seems incredibly -- and quite transparently - condescending and paternalistic. It is, in my view, post-modern Western neo-imperialism.

Perhaps most Maasai people want to remain "simple pastoralists." That's fine with me, and I sincerely hope they are able to do so. I'm willing to assume, at least for the sake of argument, that most Quechua people, Australian aborigines, and most other aboriginal peoples want to maintain their current lifestyles. While neither bona fide scientists nor cultural anthropologists can "command the clock to stop" for anyone, I'm all in favor of doing whatever can be done, within reason, to help pastoral, hunter-gatherer and similarly low-tech cultures maintain their chosen lifestyles into the 21st century.

Ironically, a century and a half ago in the West, New Englanders routinely took to the sea in wooden ships to harpoon and render whales, as many generations had done before them. Unfortunately for all involved (except, of course, the whales), the world changed unexpectedly, and these traditional whalers had to find another means of making a living. Things were pretty dicey for a while, but everything turned out for the best in the end. Perhaps, if this "cultural anthropology thing" really gets going, we Westerners can sharpen our harpoons and "get back into the business." I wonder what ethnoscience advocates would think of such a move. After all, the Makah Indians of Western Washington have recently attempted to do precisely the same thing. Sometimes it's neither possible, nor desirable, to maintain the cultural status quo.

And what about those Makah, Maasai and Quechua people who don't want to follow the "primitive pastoralist" or "hunter-gatherer" lifestyles their ancestors have endured for the last 750 generations or more? What of the Massai tribesmen or tribeswomen who decide they want to own a car, or live in town, or become an airline pilot, or be something other than a subsistence-level pastoralist? Must their dreams and aspirations be sacrificed on the politically correct "alter of cultural anthropology"? What about the Quechua shepherdess who wants to "get out of shepherding altogether" and learn computer programming? Should she be "shielded" from such possibilities by "Western Ivy-League anthropologists" who have decided the subsistence-farming future of her people might be threatened if some individuals learn they can opt for a high-tech future? What of the Australian aborigine who wants to learn tensor mathematics or scientific biomedicine? Do the ethnoscience-advocating cultural anthropologists have the right to tell such individuals "forget about it: you're already an 'ethnoscientist'"?

Harvard professor of Physics and History of Science, Gerald Holton, in his book "Science and Anti-science" (1993, 147) identifies what he calls ".the single most malignant part of the [anti-science] phenomenon: the type of pseudoscientific nonsense that manages to pass itself off as an "alternative" science, and does so in the service of political ambition." [Emphasis in original.]

He continues (1993, 153):

Today there exist a number of different groups which from their various perspectives oppose what they conceive of as the hegemony of science-as-done-today in our culture. These groups do not form a coherent movement, and indeed have little interest in one another; some focus on the epistemological claims of science, others on its effects via technology, others still long for a return to a romanticized pre-modern version of science. But what they do have in common is that each, in its own way, advocates nothing less than the end of science as we know it. That is what makes these disparate assemblages operationally members of a loose consortium.

Pg. 735: At another level, experiences in human ethnomedicine suggest that researchers using conventional scientific methodologies may overlook some mechanisms by which natural medicines produce their effect. This neglect probably results from a narrow conception of therapeutic action. (For a striking example from cancer research, see Bodeker, 1994b.) The larger lesson here is the need to devise new, innovative research designs rather than mindlessly cleaving to conventional methodologic dogma.

Dr. McCorkle seems convinced that, for whatever reason, "conventional Western" science is incapable of employing an "interdisciplinary" approach to medical and herd health issues in the Third World. Apparently she has spent many years in Third World countries studying such matters from an anthropological perspective, so I'm willing to assume, for the moment, that such interdisciplinary scientific efforts have either not been widely attempted or have not been particularly successful in the past. It's certainly unfortunate if such is the case, and it comes as a bit of surprise in view of the many recent triumphs of modern interdisciplinary science in other areas. On the other hand, Dr. McCorkle hasn't offered any coherent reason to assume that properly designed scientific approaches to these issues should not work. In all the examples she cites, the problems involved would seem to be entirely amenable to the skills of parasitologists, epidemiologists, agronomists, pharmacologists, phytopharmacognosists and other scientists working in concert with scientific bio-medical practitioners, economists, sociologists, and anthropologists. Dr. McCorkle seems to think that "conventional Western" scientists are inherently incapable of considering the subjective, informally gathered anecdotal data offered by indigenous non-scientist farmers, pastoralists and healers. In other words, she is suggesting that "conventional Western" scientists are destined to always overlook a significant portion of the pertinent data. The fact is that competent scientists, by their training, do their best not to overlook any pertinent data. Since bona fide science is an inherently flexible rather than dogmatic method, integrating such data and sources of information should pose no insurmountable problems.

It's ironic that, just as this chapter was coming into print, the millennia-old scourge of smallpox was finally being eliminated from the face of the Earth. Of course, in recent decades, smallpox has been almost entirely a "Third World" problem. Its eradication will ultimately save millions of Third World lives, and it was accomplished entirely by means of plain old "conventional Western" science and medicine. It would be unfair and incorrect for me to suggest that cultural anthropology and ethnomedicine played no part in the struggle to eliminate smallpox. To the contrary, these two "disciplines" have significantly impacted the effort, but not in a way most readers might anticipate.[13]

Frederique Apffel Marglin, a well-known anthropologist from a well-known American university, with the full endorsement of India's foremost social scientists, recently declared that the eradication of smallpox from India using modern cowpox-based vaccine was an affront to the local custom of variolation, which included inoculation with human smallpox matter accompanied by prayers to the goddess of smallpox, Sitala Devi. Despite her own admission that the traditional variolation is at least 10 times more likely to actually cause the disease as compared to the modern vaccine, Marglin persists in deriding the introduction of modern vaccine in India by the British (and the latter support of mass-vaccination programs by the government of independent India) as an imposition of "Western logocentric mode of thought," which treats health as a binary opposite of illness, over the "Indic" nonlogocentric, binary-denying view, which treats the goddess Sitala as both the disease and its absence (A. Marglin, 1990). Marglin defends those who resisted the modern vaccine in the name of the goddess as fighting for a form of life that does not distinguish between natural and supernatural forces.

The concept of "cultural relativism" was introduced into cultural anthropology several decades ago as a means of studying various non-western cultures without bias. The idea was that, in order to truly understand such cultures, one must examine them on an entirely "value free" basis. In other words, investigators were obliged to assiduously resist the temptation to evaluate such cultures in relation to Western culture. Prior to that time, the work of many anthropologists had been grossly tainted by their personal prejudices and Western values. In the context of cultural anthropology, cultural relativism is a rational, effective, and otherwise wonderful idea. In almost every other context, it's less than worthless, and therein lies the rub.

The far more radical notion of cultural constructivism developed from cultural relativism. Cultural constructivists insist that all science, all facts, all knowledge, and even reality itself are merely subjective "cultural constructs," and that one is no more "valid" than any other. This perspective is embodied by what philosophers of science have termed "the 'strong' program in sociology of knowledge." Professor of Philosophy, Christopher Norris, has observed that cultural relativist literature has been much more widely and enthusiastically embraced by "cultural theorists and socio-historians of science" than has positive rationalist alternatives. He attributes this trend to a couple of factors:[14]

These have to do with the current predominance of anti-realist and cultural relativist thinking in disciplines whose chief objective is to cast doubt on the truth-claims, methods, and evaluative procedures of the natural sciences. Above all, they reject [the premise] that there exists a real-world (mind- and theory-independent) physical domain whose properties are the object of scientific knowledge and whose better understanding is the prime source of technological advance.

It seems that many, if not most, cultural anthropologists (and their cultural constructivist kin, the post-modernists) have long since denied the all important distinction between the concept of "value-free examination" of other cultures as a tool and the philosophical conviction that all cultural entities are literally of equal value. (Actually, this is not entirely true: many cultural relativists and post-modernists are happy to disparage anything and everything they view as "Western" - especially science.)

The single great "Truth" cultural constructivists and post-modernists have to offer is that "Western" science is really nothing special. It's quite literally "just another way of knowing." It seems pretty obvious that Dr. McCorkle's attempt to turn folk medicine into science merely by defining it as such (and, of course, by declaring that legitimate science is not only an arbitrary "Western social construct," but merely "another way of knowing") is a clear reflection of her background in cultural anthropology. Cultural anthropology, sociology and literary criticism are among the primary vectors of cultural relativism and post-modernist anti-science in Western academia. Indeed, cultural anthropology and the sub-specialty of medical anthropology, have - to a large extent -- attempted to gain the cache (if not literally become) genuine sciences, not by actually living up to the standards of science or proceeding on scientific principles, but merely by defining themselves as sciences. (I realize that at least some cultural anthropologists have lamented and even tried to resist this "tide" within their fields. I hope these individuals will forgive me if they feel I'm painting with too broad a stroke here.) When one reads the speakers lists for symposia on medical anthropology and the names of faculty or board members of pertinent organizations, one is likely to be immediately struck by the dearth or complete absence of physicians (M.D.s), scientific biomedical health professionals and scientists.

As others have observed, this bizarre situation undoubtedly stems in large part from the fact that, in view of the stunning successes of science and technology in the decades following WWII, the subjective musing and "theories" (conjectures) of sociologists, cultural anthropologists, literary critics, and other scholars in the "arts and humanities" seemed ever more arcane and irrelevant. Starting in the 1950s and 60s, more than a few "social scientists" developed severe cases of what has been termed "physics envy," (though the malaise certainly involves similar resentment toward mathematics, chemistry, physiology, genetics, biology and virtually all other bona fide sciences). The core of the problem, of course, is that real science tends to work, and most "other ways of knowing" - including social and political "sciences" and cultural anthropology - tend not to work very well, or at least they fail to yield tangible and consistent results.

Rather than addressing the inherent deficiencies in their belief systems, some cultural and medical anthropologists have, instead, focused their energies on discrediting legitimate science under the rubric of cultural relativism. Of course, modern science has been so wildly successful that it's only feasible to effectively malign and depreciate it if one willfully mischaracterizes and misapprehends it. This is precisely what the post-modernists and cultural relativists have done. Many of the most prominent post-modernist "theorists" appear to be quite proud of the fact that they are "untainted" by any scientific training whatever - as though not learning about science from other scientists and not being able to actually do science are somehow key to truly understanding it. Ironically, some such "theorists" describe themselves as "philosophers of science."

If one really takes a close look at the "ethnoscience" and "ethnomedicine" literature, one learns that that not only are practitioners of "Western" scientific biomedicine "of no more or less benefit to patients" than shamans and witchdoctors (i.e., "ethno-medical practitioners and ethnoscientists"), they differ only in the kinds of healing magic they administer. Of course, not understanding science and believing in magic are helpful if one hopes to hold such a view. In a recent personal correspondence, one medical anthropologist told me that the notion that science has developed a more objective and accurate image and understanding of the Universe than any other system of knowing is a "discredited post-Enlightenment myth." Since the current post-modernist, cultural constructivist movement in academia is intent upon repudiating and undoing the intellectual accomplishments of the Enlightenment, I propose that we refer to their objective as the "Unenlightenment."

The consensus view among proponents of cultural constructivism, post-modernism, and ethnoscience seems to be that the "scientific revolution" was merely a Western ethnic fantasy. From this perspective, all that has really happened to Western culture since the Enlightenment is that we've traded one type of "ethnoscience" for another, and the latter version is not one whit "better" or more inherently effective than the former. (Please pay no attention to the jet aircraft roaring overhead, the electronic telecommunication devices all around you, or the fact you somehow managed not to die from smallpox or polio while growing up. These are all ethnocentric fantasies.) A few of the more avant garde intellectuals of the movement have even made the earth-shattering discoveries that all knowledge is subjective and therefore arbitrary and that objective reality, itself, is an illusion. (For reasons known only to themselves, unfortunately few post-modernist intellectuals have chosen to prove the point by jumping out of airplanes without parachutes.)

Cultural anthropology, and the subdiscipline of medical anthropology, ostensibly involve the dispassionate study of culture and medical systems. The proposed scope of ERD&E far exceeds the boundaries of mere examination and analysis. It clearly constitutes a broad, sweeping and pro-active attempt to manipulate and radically re-engineer the sociology of veterinary healthcare delivery in the Third World - putatively for the benefit of both local and international stockraisers. Moreover, the ERD&E movement seems to embody the "vision" of a small group of Western intellectuals who hope to impose a particular philosophy and dogma on said healthcare delivery systems. This philosophy seems to be deeply rooted in the anti-science and anti-rationalist tenets of cultural relativism, cultural constructivism, and post-modernism. These hold that whereas genuine science is "just another way of obtaining knowledge" and merely a "Western cultural construct," traditional and folk medical systems are not only "sciences" in and of themselves, but deserve higher status and should command greater authority than "outsider" (etic) "Western" science.

The final section of Dr. McCorkle's chapter bears the heading: "Back to the Future." Sooner or later, the intended beneficiaries of "ethnoveterinary medicine" and "ethnoscience" are going to figure out that these "disciplines," unlike their bona fide scientific alternatives, are not only examples of the "Western 'etic'" proponents so adamantly disparage, they're based on the intellectually bankrupt anti-science dogma of cultural constructivism and post-modernism. Rather than taking Third World agriculturalists "back to the future," ethnoveterinary medicine seems more likely to keep them stuck in the past.
 

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[1] Sullivan MC. A mathematician reads Social Text.
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[2] Rosen R. A physics prof drops a bomb on the faux left.
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[3] Social Text 46-47 (Spring/Summer 1996): 217-252

[4] "A Physicist Experiments with Cultural Studies," Lingua Franca (May/June 1996): 62-64

[5]Preux PM, Tiemagni F, Fodzo L, Kandem P, Ngouafong P, Ndonko F, Macharia W, Dongmo L, Dumas M. Antiepileptic therapies in the Mifi Province in Cameroon. Epilepsia 2000 Apr;41(4):432-9 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10756409&dopt=Abstract

[6]Ames BN, Profet M, Gold LS, Nature's chemicals and synthetic chemicals: comparative toxicology, in Proc. Natl. Acad. Sci. USA Classification: Medical Sciences, contributed by Bruce N. Ames July 17, 1990 Revised: August 15, 1990 http://socrates.berkeley.edu/mutagen//ames.PNASIII.html

[7] Ames BN, Profet M, Gold LS. Dietary pesticides (99.99% all natural), in Proc. Natl. Acad. Sci. USA Classification: Medical Sciences Contributed by Bruce N. Ames July 17, 1990 Revised: August 15, 1990
http://socrates.berkeley.edu/mutagen//ames.PNASII.html

[8]Larme AC. Health care allocation and selective neglect in rural Peru. Soc Sci Med 1997 Jun;44(11):1711-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9178414&dopt=Abstract

[9] Tyler VE. False tenets of paraherbalism. http://www.quackwatch.com/01QuackeryRelatedTopics/paraherbalism.html

[10] Macdonald A, Acupuncture, From Ancient Art to Modern Medicine, Allen and Unwin. London. 1982, 10

[11] Sampson W. The braid of the alternative medicine movement. The Scientific Review of Alternative Medicine, Fall/Winter 1998. http://www.hcrc.org/contrib/sampson/braid.html

[12] Nanda, M. The Epistemic Charity of the Social Constructivist Critics of Science and Why the Third World Should Refuse the Offer. In Koertge N (ed.), A House Built on Sand, 1998, Oxford University Press, New York, New York, 286

[13] Ibid, 291

[14] Norris C. Against Relativism: Philosophy of Science, Deconstruction and Critical Theory, Blackwell Publishers Ltd., Oxford, UK, 1997, 295