Perspectives On Tuberculosis Among Traditional Chinese Medical Practitioners In New York City’s Chinatown

This article discusses the perspectives of Chinatown’s traditional Chinese medical practitioners on tuberculosis among New York City’s Chinese laborers. The practice of traditional Chinese medicine (TCM) in the United States is neither regulated nor well understood. Some public health providers have expressed their concern that the use of TCM could prevent Chinese tuberculosis patients from receiving proper, biomedical treatment. Contrary to the suspicion of public health providers, the traditional Chinese medical practitioners in the context of New York City’s Chinatown provide diverse methods of health care, many being familiar with the biomedical explanation for tuberculosis. All TCM informants in this study stated that biomedicine is more effective than Chinese medicine in treating tuberculosis. TCM in tuberculosis therapy is said to complement biomedicine and to restore bodily balance and the general health of patients. This study discusses the political–economic context shaping the explanation and treatment of tuberculosis among traditional Chinese medical practitioners and broadens our understanding of the various contexts in which TCM and biomedicine can be integrated. Furthermore, it is suggested that an opportunity exists for tuberculosis control programs to incorporate TCM practitioners in the effort to control the disease within New York City.     

Sacred Conceptions: Clinical Theodicies, Uncertain Science, And Technologies Of Procreation In India

This article argues that the rapid transfer of assisted conception technologies, such as in vitro fertilization, to India is not restricted merely to the modalities of offering potential biomedical resolution of infertility but includes, more crucially, how clinicians and infertile consumers assimilate the “Western technoscience” of conception. The article draws on a larger multisite ethnographic study of infertility and assisted conception in India’s five major cities and is principally based on narratives of clinicians and infertile couples and on clinic-based ethnographic observations. In this article I contend that the success or failure of assisted conception, when situated in the universe of Hindu faith, becomes a powerful critique of the “incompleteness” of the “Western” science of conception. Situating this contention in the broader context of a clinician’s faith, I assert that assisted conception—by conjoining seemingly disparate domains of the traditional and the modern, the sacred and the profane, the human and the superhuman, science and religion—produces clinical theodicies that help explain and contain the tentativeness permeating the conception technologies. The article concludes by arguing that this enchanted version of a thoroughly disenchanted worldview of biomedicine is part of a larger cultural process of indigenization of biomedicine in India.     

On the ethics and practice of contemporary social theory: from crisis talk to multiattentional method

Using an approach derived from the anthropology and sociology of knowledge, this article explores the historical emergence of European social theory and its contemporary place in the human sciences. I direct ethnographic attention to a sense of crisis or impasse in social theory’s capacity to frame and to analyze the complexity of contemporary relations in the world. By reanalyzing this crisis talk as a phenomenological reaction to the growing (sub)specialization of social theory, I offer a new way of thinking about social theory in terms of specialized analytical attentions. I also suggest how we can move from crisis talk to a new ethics of theoretical complementarity, inspired by Dilthey, which I term “multiattentional method.”     

Learning the Moral Economy of Commodified Health Care: “Community Education,” Failed Consumers,and the Shaping of Ethical Clinician-Citizens

Leaders of health professional schools often support community-based education as a means of promoting emerging practitioners’ awareness of health disparities and commitment to serving the poor. Yet, most programs do not teach about the causes of health disparities, raising questions regarding what social and political lessons students learn from these experiences. This article examines the ways in which community-based clinical education programs help shape the subjectivities of new dentists as ethical clinician-citizens within the US commodified health care system. Drawing on ethnographic research during volunteer and required community-based programs and interviews with participants, I demonstrate three implicit logics that students learned: (1) dialectical ideologies of volunteer entitlement and recipient debt; (2) forms of justification for the often inferior care provided to “failed” consumers (patients with Medicaid or uninsured); and (3) specific forms of obligations characterizing the ethical clinician-citizen. I explore the ways these messages reflected the structured relations of both student encounters and the overarching health care system, and examine the strategies faculty supervisors undertook to challenge these messages and relations. Finally, I argue that promoting commitments to social justice in health care should not rely on cultivating altruism, but should instead be pursued through educating new practitioners about the lives of poor people, the causal relationships between poverty and poor health, and attention to the structure of health care and provider–patient interactions. This approach involves shining a critical light on America’s commodified health care system as an arena based in relations of power and inequality.     

Teaching reading,writing, speaking and risk: dialoguing with Eades,French and Lecuna

This article compares the textual production of legal testimony with that of literary testimonio. Using the controversy sparked by David Stoll’s exposé of Rigoberta Menchú’s less than “factual” account of her life lived amidst the genocide of indigenous peoples in Guatemala, the analysis asks why Menchú should be indicted or acquitted based on cultural notions of legal testimony. I use the concept of language ideologies to explore how listeners hold narrators to standards of truth. By suggesting that there are interpretive ideologies of narrative production and function at work, the argument is made that any detractor can find a way to discredit narrative truth. I show this by examining how Latina women and state actors create legal testimony about domestic abuse. While these narratives share much with the Menchú testimonio, in particular the risks they present to their narrators, I conclude that the everyday victim in the U.S. adversarial system has much more to lose, and inevitably has far less discursive power, than Menchú. I examine these topics and themes from sociolinguistic and discourse analytic perspectives.     

Why Was Thomas A. Sebeok Not a Cognitive Ethologist? From “Animal Mind” to “Semiotic Self”

In the current debates about zoosemiotics its relations with the neighbouring disciplines are a relevant topic. The present article aims to analyse the complex relations between zoosemiotics and cognitive ethology with special attention to their establishers: Thomas A. Sebeok and Donald R. Griffin. It is argued that zoosemiotics and cognitive ethology have common roots in comparative studies of animal communication in the early 1960s. For supporting this claim Sebeok’s works are analysed, the classical and philosophical periods of his zoosemiotic views are distinguished and the changing relations between zoosemiotics and cognitive ethology are described. The animal language controversy can be interpreted as the explicit point of divergence of the two paradigms, which, however, is a mere symptom of a deeper cleavage. The analysis brings out later critical differences between Sebeok’s and Griffin’s views on animal cognition and language. This disagreement has been the main reason for the critical reception and later neglect of Sebeok’s works in cognitive ethology. Sebeok’s position in this debate remains, however, paradigmatic, i.e. it proceeds from understanding of the contextualisation of semiotic processes that do not allow treating the animal mind as a distinct entity. As a peculiar parallel to Griffin’s metaphor of “animal mind”, Sebeok develops his understanding of “semiotic self” as a layered structure, characterised by an ability to make distinctions, foremost between itself and the surrounding environment. It appears that the history of zoosemiotics has two layers: in addition to the chronological history starting in 1963, when Sebeok proposed a name for the field, zoosemiotics is also philosophically rooted in Peircean semiotics and German biological philosophy. It is argued that the confrontation between zoosemiotics and cognitive ethology is related to different epistemological approaches and at least partly induced by underlying philosophical traditions.     

Crossing the Boundaries of ‘Colonial Psychiatry’. Reflections on the Development of Psychiatry in British India,c. 1870–1940

This article explores the development of psychiatric institutions within the context of British colonial rule in India, in particular during the late nineteenth and early twentieth centuries. Existing scholarship on ‘colonial medicine’ has tended to focus on colonial power and hegemony and the British endeavour to ‘colonize the Indian body’ during the nineteenth century. It is suggested here that reference to ‘colonial’ medicine and psychiatry tends to reify the ideology of colonialism and neglect other important dimensions such as the role of international scientific networks and the mental hospital as the locus of care and medicalization. From the later period of British colonial engagement in south Asia, people’s right and entitlement to medical care and the colonial state’s obligation to provide institutional treatment facilities received increased attention. As the early twentieth-century case of an Indian hospital superintendent shows, practitioners’ professional ambitions went beyond the confines of ‘colonial psychiatry’. He practiced in his institution science-based psychiatry, drawing on models and treatment paradigms that were then prevalent in a variety of countries around the globe.     

Maynard Smith on the levels of selection question

The levels of selection problem was central to Maynard Smith’s work throughout his career. This paper traces Maynard Smith’s views on the levels of selection, from his objections to group selection in the 1960s to his concern with the major evolutionary transitions in the 1990s. The relations between Maynard Smith’s position and those of Hamilton and G.C. Williams are explored, as is Maynard Smith’s dislike of the Price equation approach to multi-level selection. Maynard Smith’s account of the ‘core Darwinian principles’ is discussed, as is his debate with Sober and Wilson (1998) over the status of trait-group models, and his attitude to the currently fashionable concept of pluralism about the levels of selection.     

Comparison of self-thinning models: an exercise in reasoning

Self-thinning of forest stands is one of the clearest and best-documented examples of natural selection. Besides their theoretical interest, understanding of self-thinning is important for forest practice because it produces estimates of stand density and stocking. There is a considerable diversity of views on the processes causing self-thinning, predicting variables, and analytical form of models. The most popular model was proposed by Reineke (J Agric Res 46(7):627–638, 1933) over 70 years ago. This study compares existing models of self-thinning and provides evidence that the virtually unknown model developed by Artur Nilson describes self-thinning more realistically than Reineke’s. While in the Reineke model the rate of mortality (the slope of self-thinning line) is assumed to be constant, it changes from 0 to −2 in Nilson’s model. As a result, Nilson’s model is slightly but consistently more accurate than Reineke’s. Although both models are empirical, their analysis suggests several general conclusions about self-thinning.     

Negotiating A Path To Efficacy At A Clinic Of Traditional Chinese Medicine

Chinese medicine emphasizes the underlying connection of the bodily, emotional, social, and environmental dimensions in illness experience and healing. The therapeutic process, characterized as tiao (attuning, balancing), targets the patient’s overall illness condition and experience including both physical and nonphysical aspects of suffering. This study, incorporating techniques of microanalysis as an ethnographic tool and using an actual recorded clinical interaction as data, analyzes how the path to effective healing is negotiated among multiple clinical realities at a clinic of Chinese medicine in Beijing. A close examination of interactive features of actual face-to-face communication between a doctor and a patient in a specific case of “stagnation of emotions” reveals that, for an illness recognized in Chinese medicine as originating from disordered emotions, adjustment of the patient’s perceptions of reality and social relations is particularly salient in the “attuning” process. Efficacy then should be understood as more than physiological changes produced by herbs, but also as emergent through an interactive event of clinical encounters. This study demonstrates empirically how the clinical process of Chinese medicine works to define and transform the patient’s emotions and experience.     

Ontogeny, anatomy, and the problem of homology: Carl Gegenbaur and the American tradition of cell lineage studies

Summary In this paper we analyze Carl Gegenbaur’s conception of the relationship between embryology (“Ontogenie”) and comparative anatomy and his related ideas about homology. We argue that Gegenbaur’s conviction of the primacy of comparative anatomy and his careful consideration of caenogenesis led him to a more balanced view about the relationship between ontogeny and phylogeny than his good friend Ernst Haeckel. We also argue that Gegenbaur’s ideas about the centrality of comparative anatomy and his definitions of homology actually laid the conceptual foundations for Hans Spemann’s (1915) later analysis of homology. We also analyze Gegenbaur’s reception in the United States and how the discussions between E.B. Wilson and Edwin Conklin about the role of the “embryological criterion of homology” and the latter’s argument for an even earlier concept of cellular homology reflect the recurring theme of preformism in ontogeny, a theme that finds its modern equivalent in various genetic definitions of homology, only recently challenged by the emerging synthesis of evolutionary developmental biology. Finally, we conclude that Gegenbaur’s own careful methodological principles can serve as an important model for proponents of present day “evo-devo”, especially with respect to the integration of ontogeny with phylogeny embedded in comparative anatomy.     

Altered Platelet Monoamine Oxidase-B Activity in Idiopathic Parkinson’s Disease

A case-control study was undertaken to investigate the status of platelet monoamine oxidase-B (MAO-B) activity in Indian cases of idiopathic Parkinson’s disease. A significant increase in the activity of platelet MAO-B was observed in Parkinson’s cases (n = 26) as compared to controls (n = 26). No significant change in the activity of the enzyme was observed while the data was analysed with respect to age, sex and duration of disease. A trend of decrease in platelet MAO-B activity was observed in Parkinson’s cases with respect to stage although the change was not significant. No correlation in platelet MAO-B activity was observed with respect to age and sex in the control subjects. Parkinson’s cases treated with L-DOPA and MAO-B inhibitor exhibited decreased platelet MAO-B activity as compared to drug naive cases and those treated with L-DOPA alone. Interestingly, Parkinson’s cases treated with L-DOPA and amantadine also had lower platelet MAO-B activity as compared to drug naive cases and those treated with L-DOPA alone. Activity of platelet MAO-B in Parkinson’s patients was increased in naive cases and those treated with L-DOPA alone or in combination with other drugs compared to controls. The results of the present study indicate that phenotypic activity of platelet MAO-B is high in Indian Parkinson’s cases. Further, action mechanism of drugs used in the treatment of Parkinson’s disease could be understood by assay of platelet MAO-B activity. It is an interesting observation and may be looked further in large number of cases.     

Foucault’s ‘Metabody’

The paper treats several ontological questions about certain nineteenth-century and contemporary medical and scientific conceptualizations of hereditary relation. In particular, it considers the account of mid-nineteenth century psychiatric thought given by Foucault in Psychiatric Power: Lectures at the Collège de France, 1973–1974 and Abnormal: Lectures at the Collège de France, 1974–1975. There, Foucault argues that a fantastical conceptual prop, the ‘metabody,’ as he terms it, was implicitly supposed by that period’s psychiatric medicine as a putative ground for psychiatric pathology. After presenting the heart of Foucault’s thought on the ‘metabody,’ the paper investigates the possibility that a contemporary version of a ‘metabody’ may operate today as a conceptual analog of the nineteenth-century psychiatric theory and practice that Foucault began to expose in the texts examined here. It speculates that we might identify a contemporary genetic version of a ‘metabody’ in a particular current conception of the gene as replicator, an item marked by an ambiguous temporal ontology.     

Human energy

In the midst of big-oil record profits and growing debate on global warming, the Chevron Corporation launched its “Human Energy” public relations campaign. In television commercials and print advertisements, Chevron portrays itself as a compassionate entity striving to solve the planet’s energy crisis. Yet, the first term in this corporate oxymoron misleadingly reframes the significance of the second, suggesting that the corporation has a renewed focus. In depicting Chevron as a green/human organization, the “Human Energy” campaign obscures from view the corporation’s more unsightly products, policies, and practices. Reflection, however, on our own complicity in sustaining energy corporations and their activities undermines binary thinking and signals that the compulsion to denounce is insufficient. This article explores Chevron’s media campaign and one organized reaction to it. This counter-campaign both redeployed Chevron’s imagery and underscored our collusion and responsibility—tactics seeking to loosen the taut inevitability-of-oil story at Chevron’s core.     

Post-Soviet Placebos: Epistemology and Authority in Russian Treatments for Alcoholism

The dominant modalities of treatment for alcoholism in Russia are suggestion-based methods developed by narcology—the subspecialty of Russian psychiatry which deals with addiction. A particularly popular method is the use of disulfiram—an alcohol antagonist—for which narcologists commonly substitute neutral substances. Drawing on 14 months of fieldwork at narcological clinics in St. Petersburg, this article examines the epistemological and institutional conditions which facilitate this practice of “placebo therapy.” I argue that narcologists’ embrace of such treatments has been shaped by a clinical style of reasoning specific to a Soviet and post-Soviet psychiatry, itself the product of contested Soviet politics over the knowledge of the mind and brain. This style of reasoning has facilitated narcologists’ understanding of disulfiram as a behavioral, rather than a pharmacological, treatment and has disposed them to amplify patients’ responses through attention to the performative aspects of the clinical encounter and through management of the treatment’s broader reputation as an effective therapy. Moreover, such therapies have generally depended upon, and helped to reinforce, clinical encounters premised on a steeply hierarchical physician–patient relationship.     

A seasonal natural history of the ant, Odontomachus brunneus

A north Florida population of Odontomachus brunneus, a species of ponerine ants, was studied for a one-year period to determine the annual cycle of reproduction and colony growth, including the foraging biology and seasonal changes in nest architecture. The life cycle of O. brunneus is strongly seasonal. Colonies produce brood for 6 months and are broodless for 6 months. Alates are produced in mixed broods at the beginning of each season, consuming much of the colony’s energy reserves. These reserves recover slowly through foraging during the summer’s worker production, and rapidly after brood production ceases in October. The foraging population was estimated to average 77% (SD 22) of the workforce. This proportion was not related to colony size and female alates were also found to forage. Nest architecture was found to change seasonally, with winter nests being more than twice as deep as the average summer nest.     

Appropriation and Dementia in India

Biomedical technologies like MRI scans offer a way for carers and people with dementia to ‘see’ pathology, as a means to reorient their perceptions of the body and functionality. Through interpretive and syncretic processes, the MRI and the diagnosis of dementia facilitate the incorporation of the clinical category ‘dementia’ into social understandings of illness and care in India. Complex shifts occur as families and providers move from socio-cultural explanations of disruption to bio-social etiologies of the disease ‘dementia’ and then to socio-ecological frameworks of causality. Both the biomedicalisation of illness and the localisation of illness occur as the clinical category ‘dementia’ is folded into local understandings of illness and care. Through elucidating how the dialectic between biomedical and local knowledge is operationalized, we offer insights into how dementia is absorbed and appropriated into Indian cultural contexts.     

From evidence-based medicine to genomic medicine

The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’.     

Are all genes regulatory genes?

Although much has been learned about hereditary mechanisms since Gregor Mendel’s famous experiments, gene concepts have always remained vague, notwithstanding their central role in biology. During over hundred years of genetic research, gene concepts have often and dynamically changed to accommodate novel experimental findings, without ever providing a generally accepted definition of the ‘gene.’ Yet, the distinction between ‘regulatory genes’ and ‘structural genes’ has remained a common theme in modern gene concepts since the definition of the operon-model. This distinction is now challenged by recent findings which suggest that, at least in eukaryotes, structural genes may in many situations have a regulatory function that is independent of the function of the gene product (protein or non-coding RNA molecule). This brief paper discusses these new findings and some possible implications for the notion of the ‘regulatory gene.’     

Sober &; Wilson’s evolutionary arguments for psychological altruism: a reassessment

In their book Unto Others, Sober and Wilson argue that various evolutionary considerations (based on the logic of natural selection) lend support to the truth of psychological altruism. However, recently, Stephen Stich has raised a number of challenges to their reasoning: in particular, he claims that three out of the four evolutionary arguments they give are internally unconvincing, and that the one that is initially plausible fails to take into account recent findings from cognitive science and thus leaves open a number of egoistic responses. These challenges make it necessary to reassess the plausibility of Sober & Wilson’s evolutionary account—which is what I aim to do in this paper. In particular, I try to show that, as a matter of fact, Sober & Wilson’s case remains compelling, as some of Stich’s concerns rest on a confusion, and those that do not are not sufficiently strong to establish all the conclusions he is after. The upshot is that no reason has been given to abandon the view that evolutionary theory has advanced the debate surrounding psychological altruism.