Medical Systems

A medical system is an analytical concept used to describe forms of organization that are constituted [Page 1138]of interconnected, dynamic sets of relationships brought together to respond to health-related matters. Medical systems are not just conceptual models but also represent organizations of human social reality that individuals navigate as health issues arise. Medical systems include, but are not limited to, the relationships between sufferers and those recognized as providing approaches for coping with, if not relieving, suffering. For human groups, these medical relationships form a matrix or a system that also includes relationships between and among environmental conditions and resources, as well as all the organisms, including human groups and individuals that inhabit or come to exist within an environment.

Humans have introduced myriad technologies to address health-related matters. In the case of medical systems, resources that have either medical or pathogenic value prompt human action. In any medical system, what follows as a medical response are uses of, as well as the distributions and exchanges of, medical resources. Even in the case of self-care, the use of medical resources always involves the ongoing systems or networks of relationships in which the use of medical resources takes place. Therefore, medical systems for human groups are simultaneously ecological, social, and cultural systems that assemble these internal local elements together into a system as a response to health misfortune. Medical systems are systems of organization that reflect a particular historical conjuncture of these domains of human life in a locale and, at the same time, determine the shape of locally derived responses to top health issues.

Several prominent scholars involved in cross-cultural research on medical systems have described a wide range of medical systems. For example, John Janzen (1978) in “The Quest for Therapy,” a study of medical practice and perception in Lower Zaire, refers to the medical system as a “therapy managing group” (p. xviii). Each of these therapy management groups is a system of interconnected “practices, illness and therapy concepts, and practitioner roles” (pp. xviii-xix) that can be “recognized”—by practitioner, sufferer, and analyst—as a “subset of the social system” (Janzen, 2002, p. 215). Arthur Kleinman (1980), an important figure in the field of medical anthropology, argues that, because medical systems are used to address many nonmedical issues, it is more useful to think of medical systems as “social organized responses to disease that constitute a special cultural system: the health care system” (p. 24). Kleinman and others note that health care systems per se revolve specifically around sufferers and practitioners—the “dyadic core” (Baer, Singer, & Susser, 1997, pp. 8–9) that forms the basis of Janzen's “therapy management group.” Frederick Dunn differentiates medical systems into several categories: local, regional, and cosmopolitan medical systems. Other scholarship on medical systems have focused on theories of disease causation as the foundational characteristic by which to classify medical systems as “personalistic,” in which integrated health practice and perception is seen to be the product of health beliefs that center on agentive action, human or otherwise, believed to be the source of illness and disease, or “naturalistic” theories that explain health misfortunes as an “imbalance” of elements, forces, and energies in and around the human body (Baer et al., 1997, p. 8; see also Foster, 1976). These theories of disease causation are recognized in the kinds of health care available in a medical system and play a role in the organization of a socially and culturally relevant system of medical theory and practice.

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