Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions

By Dennis Drotar | Go to book overview

CHAPTER TWO
The Ideology of Adherence:
An Anthropological
and Historical Perspective

James A. Trostle
Trinity College, Hartford, CT

The focal point of the shrine is a box or chest which is built into the wall. In this chest are kept the many charms and magical potions without which no native believes he could live. These preparations are secured from a variety of specialized practitioners. The most powerful of these are the medicine men, whose assistance must be rewarded with substantial gifts. . . . The charm is not disposed of after it has served its purpose, but is placed in the charm-box of the household shrine. As these magical materials are specific for certain ills, and the real or imagined maladies of the people are many, the charm-box is usually full to overflowing. The magical packets are so numerous that people forget what their purposes were and fear to use them again. While the natives are very vague on this point, we can only assume that the idea in retaining all the old magical materials is that their presence in the charm-box, before which the body rituals are conducted, will in some way protect the worshipper.

-- Miner ( 1956, p. 504, "Body Ritual Among the Nacirema")

Miner paid specific attention to what Americans (Nacirema spelled backward) do with unused medicines, thereby revealing our culture to ourselves. In fact, what people do with prescribed medicines has received extensive research attention since Miner published his essay. Almost 16,000 English-language articles on how people take medicines have been published in the past two decades. Yet one of the bestknown researchers in the field recently lamented that few rigorous

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