Talk:Culture-bound syndrome

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[edit] Eating Disorders are not 'culture-bound'syndromes

Eating disorders, while they may be more prominent in the United States, are not culture-bound syndromes. They most certainly are real, and while western standards may foster eating disorders, this is not to say they are culture-bound anymore than morbid obesity or heart attacks are "culture-bound". What one culture may see as a disease, another may see as normal or see as not existing - that's a culture-bound syndrome, which is not the case with ED. While China or other eastern countries may not create many afflicted with eating disorders, I doubt they (by they I mean a sort of collective cultural conscience here) would examine some anorexic person and find them "normal" and not suffering from a disease. For this reason, I'm removing anorexia and bullimia from the list.

[edit] Cooling effect of oil on human body

Following is a copy of the discussion that happenned at the Reference Desk, which seeded this article and Suudu

I've often felt my internal body temperature go up or at least it appeared so. The symptoms would be: feeling heat in the eyes and experiencing difficulty with urinating. One remedy that my parents (and many others here) suggest is applying a few drops of gingelly oil (sesame oil) or castor oil in the navel. I've always found immediate relief with this. What is the mechanism behind this remedy? -- Sundar \talk \contribs 04:24, July 21, 2005 (UTC)

I can't see what kind of effect they would have, other than making your belly button well lubricated (which isn't a particularly medical effect) :) ... I would guess the relief is psychosomatic in nature (see also placebo effect), and possibly the feeling of your internal body temperature rising is psychosomatic, as well. Proto t c 12:03, 21 July 2005 (UTC)
My unsure wording (like at least it appeared so) probably led you to think as above. I wish to clarify that the uncertainty was only with respect to my assessment of the cause, but the symptoms are real and the inconvenience during urination is a very objective symptom in that you can practically feel a pain as if your own urine is piercing the inner wall of the urethra (at least, for a male). Also, it is not peculiar to me. I've heard the same complaint from a number of males and some females in this part of the world (Tamil Nadu). It sometimes happens if you had to sit for sometime on a hot rock for an hour. It is so common that the Tamil language word suudu for heat is used commonly among many generations of people to describe this condition. Perhaps the relief has to do with the placebo effect, but I'm not totally convinced about the symptom per se being psychosomatic. -- Sundar \talk \contribs 12:34, July 21, 2005 (UTC)

If this is a widely recognized and named condition in your culture, ask a western trained doctor in your culture what the scientific perspective is. All cultures, including American and European, have "folk diseases" as well as folk medicine that are culture-specific and absolutely unfamiliar and strange to a scientific physician from another culture. The phenomenon is a good illustration of the cultural dimension of how we think about, categorize, and interpret disease of the sort that doesn't include unmistakably objective structural or biochemical alterations of the body. I am not referring to structural/biochemical diseases that occur in a specific locale (like ackee-fruit hypoglycemia or sleeping sickness or kuru) but diseases that occur only in a specific culture (like koro or repetitive motion injury or adolescent conduct disorder or zombification) and do not involve objective structural or biochemical abnormalities. I suspect your phenomenon falls in this category. Have you discussed it with a local doctor? And then please write us an article about it! alteripse 20:24, 21 July 2005 (UTC)

I know equivalents for say Zombie etc in our local culture and know fully well that these are myths, which sometimes are perpetrated because of vested interests like self-styled priests claiming to cure these. But, I still feel that this particular phenomenon falls under the ackee-fruit kind. Aren't you at least aware of people massaging their head with certain oils purportedly to reduce their internal "heat"? Perhaps, it's a tropical phenomenon. I would definitely talk to a local doctor here sometime soon and update. -- Sundar \talk \contribs 06:21, July 22, 2005 (UTC)
Some related links: [1] [2]. -- Sundar \talk \contribs 06:55, July 22, 2005 (UTC)
I should have left out the mention of zombies, but my understanding is that many Haitians used to be as certain of the objective reality of the phenomenon as you are. I emphasized some American and European types of culture-bound conditions and treatments so you understand that I am not characterizing your condition as superstititious, magical, primitive, or mistaken, just culture-specific. All cultures have this sort of disorder that is widely known within the culture and completely unknown in others. Note that the one relevant link you offered suggests that chinese traditional categorizations of heating and cooling substances correspond to measurable differences in ability to influence prostaglandin processes in vitro. I have no knowledge of traditional chinese medicine but would not be surprised to learn that in that culture there are disorders of hotness or coolness that do not correspond to any conditions known in other cultures. You are describing an unusual type of dysuria not recognizable to a physician from another culture and proposing that a few drops of oil in your navel can affect your sensations of micturition. I am not disputing that the oil cures your symptoms, but that both your disorder and your treatment seem to be known only in your culture. That is why I suggested that a western-trained doctor in your culture might have an explanation that would make sense outside your culture, since the rest of us can only guess. alteripse 10:52, 22 July 2005 (UTC)
Sure. I understood your intention behind the examples. Just that everyone around here (even outside of Tamil Nadu) that I asked recently seem to know this and tell that they've experienced the symptom. An additional symptom is perceivable warmth in the lower abdomen, pelvic area and the penis. It's getting more interesting for me as I learn that something very common in this culture is totally new for others. I'll definitely update you after discussing with some doctor. -- Sundar \talk \contribs 11:17, July 22, 2005 (UTC)
I had a discussion with a western-trained local doctor. Contrary to my expectations, she almost approved Alteripse's reasoning. She said the dysuria that happens is mostly due to reduced intake of water or infection and added that the apparent cure of the oil might have to do with the soothing effect of the oil and the sleep that it induces when applied on the eyes and the head. However, she said Castor oil is an anti-irritant and hence may be useful in other instances. Now, I'm compelled to believe in the placebo theory. However, let me wait for the next occurence and objectively analise the situation. -- Sundar \talk \contribs 06:59, July 24, 2005 (UTC)

Culture-specific syndromes are characterized by

  1. widespread familiarity in the culture;
  2. complete lack of familiarity of the condition to people in other cultures;
  3. no objectively demonstrable biochemical or tissue abnormalities (just symptoms);
  4. the condition usually is recognized and treated by the folk medicine of the culture.

An interesting aspect of culture-specific syndromes is how real they are-- characterizing them as "imaginary" is as inaccurate as characterizing them as "malingering", but in the English language and from a scientific perspective, we have no good way to understand them. Culture-specific syndromes shed light on how our mind decides that symptoms are connected and how we define a known "disease." Medical care of the condition is challenging and illustrates a truly fundamental but rarely discussed aspect of the physician-patient relationship: the need to negotiate a diagnosis that fits the way of looking at the body and its diseases of both parties. The physician may

  1. share the way the patient sees the disorder and offer the folk medicine treatment;
  2. recognize it as a culture-bound syndrome but pretend to share the patient's perspectives and offer the folk medicine treatment or a new improvised treatment;
  3. recognize it as a culture-bound syndrome but try to educate the patient into seeing the condition as the physician sees it.

The problem with choice 1 is that a physician who prides himself on his knowledge of disease likes to think he knows the difference between culture-specific disorders and "organic" diseases. While choice 2 may be the quickest and most comfortable choice, the physician must deliberately deceive the patient. Currently in Western culture this is considered one of the most unethical things a physician can do (a 7th circle of hell sin like having sex with your patient), whereas in other times and cultures deception with benevolent intent has been considered one of the tools of treatment. The problem with choice 3 is that it is the most difficult and time-consuming to do without leaving the patient disappointed, insulted, or lacking confidence in the physician, and may be haunted by doubts in the minds of both physician and patient ("maybe the condition is real" or "maybe this doctor doesn't know what he is talking about").

Sundar, we could still use a brief article on this condition. alteripse 12:49, 24 July 2005 (UTC)

Sure. Thanks for the detailed analysis, Alteripse. I'll try to write a stub on this soon. As for the "ethicality" of point 2, it is considered praiseworthy in our local culture. The couplet 292 from Tirukkural would illustrate that. -- Sundar \talk \contribs 07:50, July 25, 2005 (UTC)

[edit] How about lactose intolerance?

Is lactose intolerance a culture-specific syndrome too? -- Sundar \talk \contribs 12:41, July 27, 2005 (UTC)

Sort of, but not in the full definition of the article. It is characterized by demonstrable biochemical abnormalities and is widely known across many cultures. alteripse 13:41, 27 July 2005 (UTC)

Thanks. -- Sundar \talk \contribs 05:44, July 28, 2005 (UTC)

[edit] Repetitive stress syndrome

RSS fits the definition given in this article in all respects: it is nearly unknown outside American-Australian-British culture, has no objective biochemical or pathologic alterations, and the incidence has fluctuated in those societies in direct correlation to occupational health policies and fashions. If your objection is that this implies that the patient with such a condition is either imagining or malingering, I dispute the assertion as a demonstration of exactly the conceptual and linguistic difficulty we have of acknowledging any other interpretation for this type of problem and which you removed. See PMID 9646748. Ed & Ben weren't entirely delusional. alteripse 02:56, 29 July 2005 (UTC)

  • Coming a bit late to the party here... alteripse asserts here that RSS is "nearly unknown outside American-Australian-British culture". Is there a citation for that? I'm not a medical professional of any kind, just curious. It is interesting if true. Of course, the statment that RSS "has no objective biochemical or pathologic alterations" may simply mean that such alterations have yet to be discovered. There are plenty of formerly mysterious illnesses and syndromes that now have a well-established physiological basis. Come to think of it, that may be a problem with the whole concept of "culture-specific syndrome". GeoGreg 05:58, 26 October 2006 (UTC)
    • Here: [3][PMID 2976831][PMID 15271176][PMID 7626774][PMID 9646748]. Of course, we "might" find a pathological tissue process in every culture-bound syndrome. It might happen. It could. And then it gets moved out of that category. I note that our repetitive strain injury article does not provide a cross-cultural perspective and is written from the American cultural perspective. Are you arguing against the existence of any culture-specific syndromes, or are you just certain that Americans have no culture-specific syndromes, or are you sure that you couldn't have one? If so, I think you are too quick to dismiss the role of the mind and cultural expectations in the construction of a sense of having a specific disease. alteripse 11:16, 26 October 2006 (UTC)
      • I wasn't really arguing any of the above. Although, I do note a difference between "syndromes" that (theoretically) should have independently measurable manifestations (such as biochemical markers for inflammation) and those such as "fan death" that seem to fall into the category of legend, or those that seem only to have psychological manifestations. But it is typical of Western science (speaking as a Western scientist) to write off the experiences of non-Westerners and/or the less powerful (eg factory workers) as the result of ignorance or cultural inferiority, while elevating the experience of privileged Westerners. So I don't think it's that Americans can't experience culture-specific syndromes, but rather that it would certainly be in the interest of large corporations, for instance, if RSI were all "in the mind" and not a physically treatable condition for which they could be liable for workers' compensation claims. One of the PubMed sources states "Those affected by this phenomenon, a clearly defined cohort, were all employees who were highly suggestible and engaged in menial repetitious tasks with little job satisfaction." In other words, the less-privileged workers were complaining until (apparently) they were labeled as "highly suggestible" and convinced that they were making it all up. There is certainly some cultural specificity here, I'll grant that. I think the whole category of culture-specific syndrome is itself probably overbroad and contains more than one distinct phenomenon. But I'll leave that to the sociologists to sort out. Also, none of those citations (at least the abstracts I have access to) state that RSI is unknown outside Australia/UK/USA.GeoGreg 15:59, 20 November 2006 (UTC)
        • It is hard to prove a negative: that RSS is not widely recognized outside of a few English speaking cultures. You could disprove it of course by finding chinese or indian or romanian articles acknowledging RSS as a widespread problem. The relationship between social status and "disease legitimacy" is highly overrated, existing mainly in the minds of some sociologists and anthropologists. In fact, RSS can be used to argue the opposite: the subjective symptoms of lower class workers were quickly "legitimized" as an objectively diagnosable and compensable disease in a handful of western countries that are overly credulous about proletarian health beliefs. See, just as fatuous an argument? Doctors sure had no trouble legitimating miner's lung disease or cotton mill lung or lead poisoning just because they occurred in lower class workers. alteripse 01:28, 21 November 2006 (UTC)

RSI has real symptons; among them are permanent muscle and nerve damage. (For example, see Carpal Tunnel Syndrome, a form of RSI). All the cultural relativist cultural relativist and subjectivist nonsense that we see above is irrelevant as culture-bound syndromes can't explain away real inflammation, real nerve, muscle and tissue damage, and real permanent disability that has ruined lives everywhere. 67.175.167.28 17:26, 5 August 2007 (UTC)

[edit] List of syndromes

Eventually the list of syndromes ought to be detached and formed into its own page. I can do that in the future if people agree with the need to do so. --Dpr 07:25, 6 September 2005 (UTC)

I agree. -- Sundar \talk \contribs 07:56, September 6, 2005 (UTC)

[edit] Fan death

Fan death may not be a culture-bound syndrome, but it's quite intriguing. --Dpr 06:22, 14 September 2005 (UTC)


[edit] Mixed illness and mental events

This article fails to separate those syndromes which are locally described physical illness from those that are mental events.

Read the Culture Bound Syndromes page at VisionAndPsychosis.Net.

Understanding CBS's begins with grouping those in which two or more people are confined for months in too-small over-wintering cabins and those cases where many people live in a single large room; Bunkhouses in the case of Jumping Frenchmen of Maine, and Longhouses in the case of Latah and Amok.

Few people remember that there were cases of sudden violence in the snowbound cabins of fur trappers in the western mountains of the US. Cabin Fever is the same as Going Postal, Amok, and iich'aa.

A connection to this grouping should be suspected when the description of the disease includes hearing voices or seizure, Ghost Sickness, Icelandic disease, Arctic Hysteria.

An other example of this problem happened aboard the Belgian Polar expedition of 1898/99. In that case eighteen men were confined aboard a small ship trapped in polar ice. There was one death from fear, one man became a deaf mute, and one hid in small areas to sleep fearing the others were plotting to kill him. (I don't have a copy of the book about this event yet.)

The explanation is on my site and you may use any material as long as you include a link to the page or site that acknowledges my authorship. You can reach me by clicking an email link on the site.

[edit] CBS and somatoform disorders

What is the relationship between culture bound syndromes and somatoform disorders, and how should we portray it here? Are CBSs a sub-category of somatoform disorders, or the other way around? --Dpr 07:59, 27 September 2005 (UTC)

I think that there is a large overlap, and most of the culture bound syndromes are somatoform. But I don't think it is quite accurate to say that culture bound syndromes are a subset of somatoform disorders because I think there are some cbs that are not quite characterizable simply as somatoform disorders. My opinion. alteripse 10:50, 27 September 2005 (UTC)

[edit] removed paragraph

A fourth choice is to treat it symptomatically or under another rubric, while keeping an open mind as to the underlying pathology. Some culture-bound syndromes have later been recognized as "organic" disorders indigenous to a particular area, such as kuru (disease) among the Fore of New Guinea, now recognized as a form of Creutzfeldt-Jakob disease. Other psychiatric conditions common in Western cultures are relatively uncommon in other cultures or historically; anorexia nervosa and bulimia nervosa are sometimes proposed as culture-bound syndromes of the West.

I removed the paragraph because it is partly erroneous and entirely redundant. Can you cite a reference that kuru was ever considered a culture bound behavioral syndrome rather than an obvious degenerative organic brain disease of unknown cause? Anorexia and bulimia certainly belong in the list but serve no purpose as an isolated sentence in this section of the article. The first sentence is already included in the choices above: being preachy about "keeping an open mind" has no place in an encyclopedia article and the possibility of uncertainty about an organic cause is already mentioned. And I have no idea what you mean by "rubric" in this sentence. alteripse 13:13, 5 November 2006 (UTC)

[edit] Kundalini syndrome

Since I don't know enough about the classification of such syndromes, I didn't add it to the article, but perhaps that Kundalini Syndrome could also be added. 66.11.179.30 01:09, 20 April 2007 (UTC)

Absolutely. alteripse 01:38, 20 April 2007 (UTC)

[edit] Western medical perspectives:choice 2

Another drawback would be that the physician would effectively perpetuate the hoax, and thereby potentially increase the chance that other individuals contract the afflication, or decrease the chance that the affliction "goes out of fashion". Shinobu 06:27, 15 September 2007 (UTC)