Applying the Methodology and Practice of Microhistory: The Diary of a Confucian Doctor, Yi Mun-gon (1495-1567) / 의사학

Since microhistory's approach to the past is based on an understanding of and a sympathy for the concrete details of human lives, its area of interests overlaps with the history of medicine and medical humanities, which examine illness and health. If we put a specific region and society in a specific period under a microscope and increase the magnifying power, we can understand the numerous network connections among the body, illness management, and medicine and how multilayered were the knowledge and power applied to them. And this approach of using microhistory to illuminate medical history can be more effective than any other historical approach. This article focuses on Yi Mun-gon's extensive volumes of Mukchaeilgi (Mukchae's diary) in approaching medical history from the perspective of microhistory. Simply defined, this work is a Confucian scholar-doctor's diary. Its author, Yi Mun-gon, played the role of a Confucian doctor, although not professionally, during his 23-year exile, after serving in a high governmental office on the senior grade of the third court rank. Thanks to this extensive and detailed diary, we can now get adetailed andthorough picture of his medical practice in the Songju region, 270 kilometers southeast of Seoul, where he was exiled. This article aims to understand the state of medical practice in the Songju region in the 16thcentury through the"zoom-in" method adopted by microhistory. In particular, I will focus on the following three aspects: 1)Yi Mun-gon's motivation for and method of medical study, 2)the character of Yi Mun-gon'spatient treatment as hwarin (the act of life-saving), and 3) the plural existence of various illness management methods, including pyongjom (divination of illness), sutra-chanting, exorcism, and ch'oje (ritual toward Heaven). All three aspects are closely related to Confucianism. First, Yi Mun-gon decided to acquire professional-level medical knowledge in order to practice the Confucian virtue of filial piety. He sharpened his medical knowledge during the process of caring for his ill mother. In Confucian Choson society, a patient was encouraged to be deeply involved in the process of his or her medical treatment and the space of clinical treatment was not an exclusive domain for the doctor, but for public discussion, where both doctor and patient participated in making the best medical choices. In this atmosphere, a patient's family members would also naturally learn the clinical process, not unlike today's interns learning from renowned doctors. Second, after studying medicine up to a professional level, Yi Mun-gon administered the "life-saving" medicine to many people, yet he did not open his doors to all individuals. His medicine was practiced within his social network of blood, regional, and intellectual relations, where priority was established according to the level of closeness to himself, according to Confucian ideology. Nevertheless, because he did partially accept patients outside of these networks, his practice setin motion the symbolic system of Confucian ideal of universal "life-saving." Third, in the Songju region during the 16thcentury, various methods of treating illnesses-such as medicine, divination, sutra-chanting, exorcism, and kumyongsisik (life-saving, food-offering ritual)-co-existed and were selected according to individual conditions. Confucianism did not want to either acknowledge or outright reject most of these methods, except for officially acknowledged medicine, at that time. In fact, this co-existence was inevitable because there was not one entirely effective means of curing illness at that time. Also, the system of Confucian ideology was not powerful enough to enforce what it championed. On the contrary, behind the outer austerity of Confucian society, people sought out unorthodox methods, such as exorcism, Buddhism, and Taoism-ironically, in order to practice the important Confucian values of filial piety and patrilineage in the face of their parents' or sons'illnesses. It was only after the emergence of modern ideology and methodology of hygiene, which had the ability to control epidemics and prioritize the preservation of the life of individuals and the population, following the opening of the port in the late 19th century, that this pluralistic culture for illness management became much less prevalent.

A Concrete Psychological Investigation of Ifá Divination / Una Investigación Psicológica Concreta de la Adivinación de Ifá / Uma Pesquisa Psicológica Concreta da Adivinhação de Ifá

Divination -the consultation of an oracle in order to determine a course for future action- has long been considered a practice characteristic of "primitive mentality." We describe research with the babalawo of Santería, who are expert in the divinatory system of Ifá. Our first goal is to offer an example of what Vygotsky called "concrete psychology": the study of particular systems of psychological functions in the concrete circumstances of specific professional complexes. Our second goal is to explore the character of divination as psychological and social process, given the somewhat negative views of divination expressed by many social scientists, including Lévy-Bruhl and Vygotsky himself. Analysis of a recorded consultation identified features characteristic of institutional discourse. We argue that the institutional facts of divination may constitute an unfamiliar ontology, but the epistemology –the appeal to logic and to empirical evidence- is a familiar one.

La adivinación -consulta de un oráculo con el fin de determinar acciones futuras- se ha considerado una práctica característica de la "mentalidad primitiva". A continuación se presenta una investigación con los babalawos de la santería: los expertos en el sistema de adivinación de Ifá. El primer objetivo fue dar un ejemplo de lo que Vygotsky llamó "psicología concreta": el estudio de sistemas de funciones psicológicas particulares dentro de las circunstancias concretas de complejos profesionales específicos. El segundo objetivo fue explorar la adivinación como proceso psicológico y social, examinando las nociones, un tanto negativas, que han expresado algunos científicos sociales sobre este concepto, incluyendo a Lévy-Bruhl y al mismo Vygotsky. Algunos rasgos característicos del discurso institucional se identificaron a través del análisis de registros de audio de consultas al oráculo por parte de los autores. En este trabajo se argumentó que los aspectos institucionales de la adivinación pueden constituir una ontología poco común, pero una epistemología familiar.

A adivinhação -consulta de um oráculo com o fim de determinar ações futuras- tem sido considerada uma prática característica da "mentalidade primitiva". A continuação, apresenta-se uma pesquisa com os babalawos da santería: os especialistas no sistema de adivinhação de Ifá. O primeiro objetivo foi dar um exemplo do que Vygotsky chamou "psicologia concreta": o estudo de sistemas de funções psicológicas particulares dentro das circunstâncias concretas de complexos profissionais específicos. O segundo objetivo foi explorar a adivinhação como processo psicológico e social, examinando as noções, um tanto negativas, que têm expressado alguns científicos sociais sobre esse conceito, incluindo Lévy-Bruhl e o próprio Vygotsky. Alguns traços característicos do discurso institucional se identificaram por meio da análise de registros de áudio de consultas ao oráculo por parte dos autores. Neste trabalho, argumentou-se que os aspectos institucionais da adivinhação podem constituir uma ontologia pouco comum, mas uma epistemologia familiar.

Saúde e doença em Moçambique / Health and illness in Mozambique

Baseando-se num longo período de observação directa e entrevistas, este artigo aponta como principal obstáculo às pouco frutuosas tentativas de diálogo entre biomedicina e "medicina tradicional", em Moçambique, o desconhecimento e/ou desvalorização das noções locais acerca da doença, vertentes sociais da sua etiologia e suas implicações para a noção e processo de cura. Assim, a par da caracterização dos tinyanga (terapeutas putativamente possuídos por espíritos) e das terapias que utilizam, o artigo expõe o sistema localmente dominante de interpretação dos infortúnios, em que as causas materiais (como aconteceu) se combinam com factores sociais ou espirituais (porque aconteceu àquela pessoa). Daí decorre que o processo de cura não se esgota no debelar da enfermidade, implicando também a resolução do problema social do qual ela é uma manifestação - o que constitui uma das especialidades destes terapeutas. Por isso, nem o recurso a tinyanga resulta sobretudo de falta de alternativas de cuidados de saúde, nem é concebível, para estes terapeutas, que o seu entrosamento com o sistema de saúde oficial pudesse restringi-los à sua faceta de herbalistas. Contudo, o debate e negociação do seu espaço, papel e estatuto dentro de futuros quadros gerais de prestação de cuidados de saúde não deverão ser feitos através de "tradutores culturais" bem intencionados, que lhes pretendam "dar voz". Os próprios tinyanga dispõem das capacidades e competência para o fazer, assim tenham interlocutores.

Based on a long process of direct observation and interviews, this article states that the main barrier to the unfruitful attempts of dialog between biomedicine and "traditional healers", in Mozambique, is the ignorance and/or undervaluation of the local notions about illness, the social aspects of its aetiology, and their implications for the notion and process of cure. Therefore, together with the characterization of the tinyanga (healers putatively possessed by spirits) and their therapies, the article presents the locally dominant system of misfortune interpretation, in which the material causes (how it happened) are combined with social and spiritual factors (why it happened to that person). As a consequence, the cure is not only the healing of the illness; it includes and demands as well the resolution of the social problem that caused it - and this second aspect of the cure is one of the tinyanga's expertises. For that reason, consulting such healers seldom results from the absence of health care alternatives, and they cannot accept the idea of being limited to their herbalist expertise, in order to be integrated into the official health care system. However, the debate and negotiation about their space, role and status in future general health care systems should not be made through sympathetic "cultural translators". The tinyanga have the abilities to do it with their own voice, as far as they have available interlocutors.