became a primary focus of exchange. Even though the Spanish used the Galenic binary structure of hot and cold, whereas the Aztecs classified plants by their uses, both groups found plants useful as food, medicine, and ornament. Aztec epidemiology and pharmacology fused with Greek and Galenic views; in time, the Mexican folk-medicine system emerged, perhaps the most fully syncretic medical system known.
In contrast, in the Admiralty Islands (Manus) of New Guinea during the 1960s, curative practices appeared to involve a critical usage of Western medical resources that fell into patterns of acculturative and counteracculturative sequences (see Romanucci-Ross 1977). For the more traditional Manus, Western medicine excelled in lower-level descriptions of disease; it was, however, incomplete and did not admit to multiple etiology in a bio-socialmoral frame. One could predict which cures would be selected by knowing where the family or individual stood on the acculturation gradient. There was also a general attempt to match "whiteman's medicine" with "whiteman's diseases."
Crandon-Malamud gives us an illustration of illness and medicine as a trope to make statements about social relations. Medical dialogue occurring in a pluralistic and stratified society may often provide a context for the construction and negotiation of ethnic identity among Aymara Indians and mestizos in a rural Bolivian village on the altiplano. Diagnostic opinions are simultaneously statements about a condition, the sick person, the person delivering the opinion, and nosological and etiological categories deriving from the various medical traditions in the culture (Indian, folk, and Western).
These cases represent a range of medical interactions. The Mexican case represents a fully syncretic system; the Italian case represents a stable, unshakable one; and the Bolivian case demonstrates that medical choices are often driven by narratives that affirm or create ethnic identity. Exactly what determines the ultimate outcome of the interaction of medical systems is not yet clear. However, it is clear that this interaction is a complex and difficult one, not susceptible to facile prediction.
Martin C. 1978. Keepers of the Game: Indian-Animal Relationships and the Fur Trade. Berkeley: University of California Press.
Romanucci-Ross Lola. 1977. "The Hierarchy of Resort in Curative Practices: The Admiralty Islands, Melanesia". In Culture, Disease, and Healing. David Landy, ed. New York: Macmillan, 481-86.
Tanner Adrian. 1979. Bringing Home Animals: Religious Ideology and Mode of Production among Mistassini Cree Hunters. New York: St. Martin's Press.