Historical Context
Whenever possible, a folk medicine is best understood as a dynamic in a historical context. Examination
of the fate of Aztec
medicine in Mexico provides an example. Before conquest by Spain, Aztec
establishment (as opposed to folk) medicine was highly organized, with a herbarium, a zoo, an intellectual elite, and a training and certification academy. It was based on a complex theoretical structure and experimental research. Some segments of the population, however, had only limited access to this medicine. They relied instead on traditional, nonacademic medicine that would be best characterized as folk medicine.
Aztec establishment medicine was eliminated when the Spanish conquerors killed the medical personnel and intruded their own medicine based on medieval Galenic theory. This intrusive medicine became the establishment medicine among the Aztecs. The system still offered limited access. Some elements of Galenic medicine, however, were compatible with the folk medical practice of the native Americans and were therefore incorporated into a new, syncretic folk system. Mexican folk medicine thrived, albeit with regional differences, and continued to incorporate elements of the new establishment medicine.
Similar processes are at work today. Native North American systems, while not highly organized and academic, were the establishment medicine in their own societies before conquest. Europeans brought diseases that decimated populations and challenged indigenous medical systems. The social, cognitive, and moral bases of the systems came under attack by missionaries and government agencies, even as immigrant European American "folk" incorporated ideas, motifs, materials, andÑrarelyÑpersonnel from native systems. Again, this intrusive medicine became the establishment medicine, and native American medicine, incorporating some European American elements, became folk medicine.
As native Americans revitalize their cultures and assert claims to self-determination, marginalized, "folk"-traditional systems become candidates for equal status in a plural medical system. Similarly, in some parts of Africa, professional, trained indigenous medical practitioners who had been relegated to a marginal status in colonial times are now forming professional associations, developing standards and certification procedures, and challenging the establishment status of European academic medicine. The critical issue is always one of relative social, economic, and legal power.