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Mole, Menudo, and McDonalds: Food and Wellness in Mexico

I. Uses of food -- Maslow's hierarchy, as applied to food habits:
1. Physiological needs for survival
        Most basic; supplying nutritional requirements
2. Needs for safety, security
        Storing food (or having economic resources) for future needs provides security
3. Belonging and love
        Consuming foods that are eaten by the social group, culturally familiar foods.  These foods represent comfort and happiness.
        Etiquette (approved use of food and of eating behaviors) also demonstrate belonging.
4. Esteem, Status
        Eating with a person connotates social equality.  Specific foods also define social position.
5. Self-realization
        The ultimate human need.  All previous stages have been achieved.  Personal preference takes precedence, and the individual may experiment with foods of different economic or ethnic groups.
 

II. Classifications of foods:
A.
1. Inedible (known to be poisonous, or subject to strong prejudices or taboos).

2. Edible by animals, but not by me

3. Edible by humans, but not by my kind

4. Edible by humans, but not by me

5. Edible by me
 

B. Ranking of foods:
Core foods: regularly consumed

Secondary core foods: widely, but less frequently, consumed

Peripheral foods: eaten only sporadically

Note that changes in peripheral foods are more readily accomplished than changes in core foods, e.g., when adapting to a new culture.
 

C. Health beliefs
Similar (but by no means identical) classifications found in ancient Greek medicine, in Mexican, Southeast Asian, Indian, and Middle Eastern food beliefs

Greek humoral theory of disease: Health as balance among 'humors.'
 blood (hot and moist)
 phlegm (cold and moist)
 black bile (cold and dry)
 yellow bile (hot and dry)
(Note that each humor has  two qualities, hot/cold or wet/dry.)
 

Current belief application: disease results from imbalance of "hot" and "cold."  Foods and beverages are classified as "hot" or "cold."  This quality is determined by its effect on the body, its medical use, or its association with natural elements.
examples:
 chili - hot, produces burning sensation
 ice - hot, produces burning sensation on skin
 cabbage - cold, produces gas

Examples from Mexico:
"hot" -- connotates strength; "cold" – weakness.
To maintain harmony, balance is required:  e.g.   

In addition to sensory characteristics, foods may also be classified according to a number of cultural factors, such as "hot-cold," "male-female," and "dangerous for pregnant women," which are culturally constructed from sensory data and other information. These may be the dimensions most prominent in the food proscriptions and prescriptions of nutritionally "vulnerable groups" such as infants, children, and pregnant and lactating women, and should, therefore, receive careful attention.

Among the dimensions that singly or in combination have been used in different cultural contexts to classify food and to direct food intake are: hot-cold, wet-dry, male-female, heavy-light, yin-yang, pure-impure, clean-poison, and ripe-unripe. "Flavour," "sharpness," "itchiness," and "colour" are additional terms, less frequently encountered (Reichel-Dolmatoff, 1968; Ahern, 1975; Colson, 1976; Beck, 1969; Messer, 1981; Manderson, 1981). Such categories are often termed "symbolic" in that they may not refer to easily measurably or single "objective" qualities of food or other items, and also because such classifications often bring together a number of different socio-cultural domains, such as flora, fauna, medicine, health, ritual, and social relations. They reach their greatest elaboration in Eastern, particularly Indian and Chinese cultures, where they are part of a complex system of humoral medicine and philosophy. Their meaning and nutritional significance vary according to cultural context, but also individual inclination to "follow the rules."

Ideally, the best way to learn how such cultural rules operate is during extended periods of participant observation in a culture. In this manner, one can observe what kinds of questions people ask in cases of illness, to determine medicinal and nutritional dosing of the ill, and also under ordinary circumstances in the preparation of diet. This is usually not possible in short term survey work. Therefore, careful reading of the ethnographic and folkloric literature on the food habits of the locality or region, followed by careful interviewing of key informants to arrive at appropriate questions and categories for a particular culture, are necessary. During these interviews, one should try to ascertain background information - how cultural symbolic categories operate in the particular culture or relate concepts of food, medicine, health, and other areas. Then, one can query what types of foods and medicines are administered or avoided under particular illness conditions or during physiological changes, such as those due to pregnancy. Finally, one can add questions such as: "If these are the rules, do you follow them? Why?" making it clear to the respondent that in many situations people know the rules, but do not follow them, and that "no" is a perfectly acceptable response.

If one is interested in learning to what extent food classifications and rules for applying them to consumption are shared within cultures, it is also useful to design a list of sample foods and have people classify them. Then one can analyse uniformities in classification within a cultural group and determine (1) which items are largely classified in the same category; (2) which show significant variations; and (3) what the consequences are of such differences for designing, for example, an appropriate nutrition intervention. (On variable classifications, see Mazess, 1971; for discussion of other issues see Messer, 1981, especially references to relevant sections.)

Such preliminary information can then he used, if desired, to design questions about how such classifications are formed, how they are culturally transmitted, and how people within the culture communicate, if they are not operating on the basis of the same information. Messer (1981) found that while people shared the same general structure and rules for classification, they did not necessarily judge all items equivalently, given the differences in individual experience. Also, individuals differed in the extent to which they had acquired information and applied it to their own diets and health. Similar information collected in other areas can greatly aid in interpretation of food habits that might be beneficial or harmful to a particular population or subpopulation.

Among the symbolic classifications used in different parts of the world, hot cold classifications, which bring together the domains of food, health, and social relations, are among the most discussed in the literature, partly because they appear to span the Old World and the New. The hot-cold classifications are, therefore, useful for comparing and contrasting nutritional and medical ideas from different cultures and also for tracing the diffusion of foods, medicaments, and medical systems.

In brief, this system of classification is based on hot-cold values, which refer to an intrinsic quality rather than to temperature or spiciness and are ideally present within the human body in approximate balance. Too much heat or cold, caused by overconsumption of either hot or cold substances, overexertion, overheating the body, overexposure (to climatic or other heat or chills), an illness agent classified as giving rise to heat or cold within the body, or usually a combination of these factors produces an imbalance believed to result in illness. For example, an elderly Mexican peasant, "hot" from years of work in the hot sun, avoids overconsumption of chocolate, classified as hot, because he will find it difficult to digest, a cause-and-effect sequence he describes in terms of too much heat" (Messer, 1981).

Imbalances are corrected by the principle of opposites: the individual is carefully dosed with foods and/or medicines of the opposite quality to restore a healthy balance, and the person is also encouraged to avoid exposure to the offending quality. In the Mexican case just cited. the elderly farmer may correct an imbalance of too much heat with "cooling" herbal teas, e.g. tea of lemon grass, or a diet that avoids fats and spices classified as hot. In some cases, small quantities of substances with the quality that is in excess are introduced to prevent too severe a jolt to the system, which, it is believed, would further aggravate illness.

Hot-cold classifications of foods, medicine, and illnesses have been reported from many areas of the world, but they display great variability in how they are conceived and how they operate in local dietary and health practices (see Logan, 1977, and Messer, 1981, for reviews). It is best to consult the literature and then interview intensively in one's particular ethnographic location in order to find out the specific rules for classification and application, particularly if one is interested in introducing new foods or medicines (see case-studies by Harwood, 1971: Golpades et al., 1975; and Cosminsky, 1977).

Additional folkloric factors (Appendix 6), such as reproductive status, may also condition the consumption of certain foods in particular cultures (Manderson and Mathews, 1981). In each cultural case, however, individual knowledge and use of hot-cold and other cultural information must be considered to understand if they have significance for actual dietary constructions and, consequently, nutritional significance.

Culturally relative health beliefs also affect food choices. These beliefs include concepts of "safe" or "harmless" foods (foods that do not make one sick) and concepts of 'nutritious," "vitamin-rich," and "tonic" foods, which are thought to be positively good for health and wellbeing. These categories often subsume perceptions of physiological effects; foods that are good to eat and good for you are also those that seem to elicit good appetite and promote energetic well-being. Furthermore, in children they include foods that seem to foster growth and good health.

Within the "healthful" category, foods classified as "nourishing" and "vitamin-rich" are often analysed as "neutral" categories with respect to hot-cold, in the sense that they are considered to be generally beneficial and can be consumed in quantity without harm (Cosminsky, 1977). Such neutral foods often incorporate the basic staple of the diet, the nourishing value of which is also determined according to how filling the food is, i.e. how much it produces, and sustains, feelings of satiety. Certain Latin American cultures also judge the values of foods according to their "juiciness" (Young, 1981). "Dry" foods like cheese and dried fish are considered insufficient to sustain "life-force" or "strength" over long periods of time. More generally, the "cooked" food that defines a "meal" as opposed to a "snack" in some cultures, such as "cooked rice" in the Philippines, may be categorically defined as "nourishing" and, therefore, basic to health and nutrition. Information on these health dimensions of foods must be collected by careful interviewing of key informants prior to the design of nutrition interventions and should be checked, if possible, by ongoing in-house observations of actual consumption.

Additional questions for understanding the "health factors" in food choice are how concepts of spiritual and physical health may be tied to hot-cold, yin-yang, or other cultural symbolic qualities. For example, in Indian cultures, foods classified as "cool" are generally considered more healthful than those classified as "hot." Such beliefs are tied to more general cosmological conceptions of the physiological relationships between ingestion, digestion, and health.

Health food 'faddism" in Western culture is an additional example of how people use food classified as " healthful" to control both physical and emotional well-being. In this case, natural foods" (and natural food therapies) are seen as a kind of alternative spiritual and physical health maintenance system. In contrast to Indian or Chinese conceptual systems, Western health food faddists can point to no single classification system relating foods and health or any unified philosophy, and there is great individual variation among participants (Kandel and Pelto, 1979). Needless to add, "folk" and "scientific" ideas of "healthfulness" vary considerably.

People acquire ideas about the healthfulness of foods from diverse sources. Currently, both in Western countries and the third world, information about the nutritional value of foods is derived from advertising and medical personnel, as well as from accumulated cultural hearsay. Like the hot-cold classifications discussed above, nutritional and vitamin'' categories ordinarily may have little impact on diet. Under conditions of stress, however. particularly when one is weak because of illness, people may attempt to eat more vitamin-rich" food or take vitamin tonics (Messer, 1981). Again, interview, 24-hour recall, or, better, observation records, should be designed to examine aspects of cultural transmission.

Recent attempts to quantify the nutritional knowledge, beliefs, and attitudes that characterize food choices seem to indicate that the nutritional knowledge of the food provider is insufficient for predicting decision-making. (For additional methodologies see Sims, 1978; Worseley, 1980; Caliendo et al., 1976.) Even with adequate scientific nutritional knowledge, considerations of flavour and cost seem to take precedence over criteria of healthfulness (DeWalt and Pelto, 1976). Foods that are sweet and/or fatty are still preferred in many areas despite growing evidence that high intakes of either are unhealthful, and despite dissemination of nutritional information to this effect.

However, the reasons for such preferences are rarely reported, and careful interviewing might again reveal what taste or cultural factors people are selecting for in their food choices. Concentrated sugar consumption, for example, produces a rush of energy, which some people find pleasant and which motivates them for work. Fatty portions, in both developing and developed countries, may be considered more tasty and filling. High salt intakes may accompany cultural folk wisdom that certain foods, even water, are "unhealthful" without it (McCullough, 1973), particularly after exertion and sweating. Finally, people may also be disinclined to believe that there are negative health effects of particular diets unless they or close relatives have personally experienced the cause-and-effect relationships between particular foods and illness, such as diabetes, which is scientifically associated with high sugar intake.

People thus tend to select diet in large part on the basis of taste and appeal, rather than reputed nutritional value and the larger health consequences, unless confronted with the immediate spectre of supposed nutrition-related illness. To develop educational instruments showing intrinsic relationships between nutrition and disease, detailed examinations are still needed of the indicators by which people evaluate etiology in nutrition-related disease.

Foods are also judged to be more or less appropriate for certain classes of individuals and for certain occasions. Again, a combination of interviews with key informants and observations of conditions and situations are the methods by which to record such data, which include the "rules" as well as inclinations to follow the rules. Such preliminary information can then be incorporated into a questionnaire on food habits.

Certain foods, for example, are judged to be especially good for or only edible by children. They are usually those that are observed to be pleasing to children; often they are bland (not overly spicy) and easy to digest. Since they do not make children sick, they are believed to foster growth. An interesting question is whether these are mainly food preparations not ordinarily consumed by adults. If a culture is used to preparing special foods for infants and young children, it may be more possible to target nutrition interventions, either special foods or education on special preparations of local foods, to them. Not all cultures, however, provide food prepared especially for children, a feature that often makes it difficult for the children to take in sufficient calories and may also create hardships for the nutrition planner trying to introduce special foods or food preparations for youngsters.

Restrictions on some foods for very young children are almost universal, although the particular foods and the rationales for withholding them differ from culture to culture. Such restrictions may have their basis in ideas of indigestibility; for example, whole grains of rice and beans are never served to children in certain cultures because people observe that whole grains pass undigested through the digestive tract into the stools. Or, hot cold classifications may influence ideas about which foods are deemed healthful for children; for example, young children in Mexico and elsewhere are classified as predominantly cool and their intakes of cold foods restricted, particularly if they are ill (Messer, 1981) (see Appendix 6.) While ordinarily they are allowed freely to imbibe "cold" liquids and sauces, these are restricted if the children exhibit signs of indigestion due to excess "cold" (e.g. loose, "green" atolls). In South-East Asia, young boys may have "cool" foods restricted, since their cool qualities are believed to interfere with growth and maturation. Because green, leafy vegetables and most fruits - major dietary sources of vitamin A - are classified as "cool," and because such foods are restricted, male children may suffer from vitamin A deficiency (Van Veen, 1971). In this case, the investigators sought and found other sources of vitamin A in the food environment that were not classified as cool and recommended that these be fed in larger quantities. In other parts of South-East Asia, such nutrition-health interventions are unnecessary as the food rules seem to be losing force (Manderson, 1981).

In addition to these types of food practices, more complex beliefs about and attitudes toward children at the household level - e.g. systematic favouring or neglect of children of one sex or at one position in the birth order - may affect infant and child nutrition and health. In such cases, rules for intra-household distribution of food as well as actual practices must be examined to see if there is systematic discrimination, or whether such practices vary according to other socio-economic and cultural factors.

Points in the female or male reproductive cycle, physiological stages, and advanced age may also be marked by food prescriptions and proscriptions in many cultures (Manderson and Mathews, 1981; Mathews and Manderson, 1981). Perceptions of body image or cultural ideals of altruistic behaviour, particularly for women, also affect general levels of intake at different points in the life-cycle. Indian women in the past were advised to restrict intake when pregnant to avoid difficult delivery; such denials also conformed to cultural expectations of personal sacrifice for the well-being of the family. Similarly, Indonesian women were known to restrict intake even when breast-feeding, in accord with cultural values that encouraged them to be selfsacrificing and slender. There may also be special food prescriptions and prohibitions for old age.

In each cultural case knowledge and attitudes and adherence to categories must be analysed, since there may be significant intra-cultural variation in beliefs and practices, and since what people say they do or do not eat may differ from what they actually consume. Such differences may he substantial even within cultures

Similarly illnesses, particularly those believed to be related to superhuman contacts-possession by spirits - may result in special food demands and privileges. More generally, culturally recognized "illness" is marked by alteration in eating behaviour as part of "social behaviours" in most of the world. Unwillingness to eat and lack of appetite or occasional overindulgence are signs of illness; restoration of "normal" appetite is the sign of a renewed health state. Background information on the culturally recognized illnesses and their possible treatments can be ascertained from the ethnographic literature of an area. Interviews should establish which illnesses elicit special dietary behaviours. In particular, it is important to understand general rules for handling respiratory and digestive disorders through diet. There is a growing literature on particular problems, such as diarrhoea-dehydration syndromes and methods of treatment and the possible pharmacological rationale for certain dietary-medicinal regimes (Etkin and Ross, 1982).

Attributes of "male" versus "female" foods, their symbolism, and how they affect actual consumption are usually included in ethnographic reports, but additional interviews can help sort out which features of foods make them particularly good or bad for one or the other sex. A general methodology for assessing the significance of gender factors in food selection and nutrition is presented in Appendix 7. Symbolism in division of foods may follow closely the more general male-female divisions of labour and dominant-subordinate relationships in a society. O'Laughlin (1974) provides an excellent example of how to proceed in a symbolic-socioeconomic analysis of gender and dietary restrictions. First, she examined the complete domains of male and female activities and dominant-subordinate relationships. Next, she analysed male and female dietary restrictions (particularly restrictions on women from eating most animal protein sources and white refined-grain porridge) in symbolic terms, which, with adequate dietary intake data, could also be used for a nutritional analysis of women. A similar analysis of male and female foods was made for the Chagga in Tanzania (Swantz, 1975, cited in Pelto and Pelto, 1983).

Ritual and economic status may also direct food intakes and avoidances. Members of a particular society mark totemic, caste, and religious group affiliations by sharing food avoidances, festival foods, and ordinary food preparations and consumption in common. Prestige factors also affect food choices and concepts of what is culturally "appropriate" for one of a given socio-economic status (or pretensions to that status) to consume. Thus, in Latin America, ethnographers report an increasing tendency for people to forgo ''wild" greens in favour of cultivated vegetables because consumption of wild foods is considered to be a sign of poverty (Messer, 1978; DeWalt et al., 1979). The problem of making low-cost foods, designed or aimed toward the poor, acceptable to them is also well-known (Gershoff, 1971). On the opposite end of the budgetary spectrum, relatively expensive foods may be consumed out of proportion with expenses for other food items because they are of high cultural value, as in the case of carbonated beverages in developing countries.

The various dimensions of personal status - biological, social, and economic - can positively or negatively affect nutrient intake. In large part these aspects of status supply the contexts in which other symbolic factors in food classification and selection operate, and thereby condition the nutritional impact of these other cultural food rules.

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Source: Research Methods in Nutritional Anthropology, Edited by Gretel H. Pelto, Pertti J. Pelto, and Ellen Messer, © The United Nations University, 1989

Humoral theory has had a profound impact on the culture of food. Its modern day usage creates challenges for nutritionists and health practitioners in the countries where it is still practiced, most notably the Chinese, Indian, and Latin American cultures. While its fervor has relaxed through the centuries, its greatest modern-day implications are seen during times of illness, pregnancy, post-partum, and infancy, which everyone can agree are among the most critical times for nutrition. Therefore, it is important for professionals in a variety of disciplines to understand the history of the humoral theory, how it compares and contrasts between the three cultures, and how it is followed today so that we may be better equipped to support the nutritional needs of these cultures while remaining sensitive to their folk beliefs.

Defining Humoral Theory

The humoral theory is based on the idea that four major fluids dominate the body: blood, humoral.htmlor melancholy). Each "humor" is composed of two basic elements: heat and moisture are the constituents of blood, cold and moisture for phlegm, heat and dryness for choler, and cold and dryness for melancholy. When a person is healthy, it is thought that the four humors are balanced. It is also believed that each person has a unique constitution where one humor is dominant and influences the person’s bodily functions, character, and intelligence. Those people that believe in the theory judge the state of their bodies’ vital signs and try to correct imbalances through the regulation of external influences such as sleep, exercise, air quality, sexual activity, and most importantly for this discussion, diet (Albala, 2000; Montanari, 2000).

It is believed that each food has a dominant trait that promotes a particular humor in the body when eaten. The classification of foods as hot or cold has nothing to do with the actual temperature of the food, nor to any other observable or taste-related factor, but rather specifies innate qualities of a substance (Foster, 1994; Mazess, 1968; Rizvi, 1986; Simoons, 1991; etc.).

The humoral theory may be regarded as a kind of medical science since it explains the causes of many natural diseases and suggests ways of treating and preventing them (Queiroz, 1984). An imbalance in the body’s humors is thought to lead to illness and likewise, when the body is in a state of health, the humors are said to be balanced. Therefore, when a person is ill, they should ingest foods with qualities that oppose those of the illness, which is based on the premise that imbalances among the humors could be corrected by administering drugs or foods with appropriately opposite properties (Estes, 2000). For example, when a person becomes overheated, the prescription includes a cold, acidic drink (Albala, 2000; Tan and Wheeler, 1983).

A person’s dietary needs differ according to activities undertaken, age, sex, environment, and season. The aim of the diet is to counter the environmental imbalances that may have taken place and bring the body back to perfect equilibrium (Montanari, 2000). A carefully chosen diet can rectify and prevent disturbance in the balances of heat, cold, dryness, and moisture caused by changes in one’s external circumstances (Estes, 2000). Essentially, the ultimate aim of the diet is to maintain equilibrium by choosing the right foods on a day-to-day basis (Kislinger, 2000). Most often it is used as a means to return the body’s equilibrium when compromised by illness (Montanari, 2000). The right food, chosen specifically for the complaint, preserves or reestablishes balance, compensating where necessary for deficient or corrupt humors.

It is believed that food and drink can promote or restore good health as long as they contain features enabling them to combat the excess or shortage that had produced the imbalance, and therefore sickness in the human body (Mazzini, 2000). Each foodstuff is associated with the qualities of hot, dry, moist, and cold with each of the four humors possessing two of these qualities (Kislinger, 2000). Cuisine and dietetics are thus part of the same semantic universe. Criteria of taste are intertwined with those concerning health (Montanari, 2000). It is important to note though, that in times of health, people often eat what they like and all but disregard the warnings that certain foods cause bad humors.

A food’s characteristics help to determine how it should be combined with other foods. For example, cold foods should be served with hot foods, like serving melon with prosciutto and pork with mustard. Herbs and spices have often been used to counter a food’s natural humoral balance (Flandrin, 2000). In fact, many culinary traditions that we enjoy today can trace their roots to humoral theory. Consider salad; cold lettuce is combined with hot herbs and hot salt and cold vinegar further balance the dish, as does hot oil (Albala, 2000).

There is more to the theory than simply balancing flavors. The season must also be taken into account because each engenders a particular humor. Also important is the diner’s age and gender which affect the humor of their body (Albala, 2000). It is also interesting that the theory originally allowed for differences in social class by prescribing coarser, darker, and denser foods for the working class, which, supposedly, had hotter stomachs. And for the upper class and their leisurely lifestyle, more subtle foods such as chicken, white bread, and refined sweets were suggested (Albala, 2000).

Emergence of the Theory

Historians recognize three major humoral traditions: the Hippocratic-Galenic (or Graeco-Persian-Arab), the Ayurvedic of India, and the Chinese. While the three systems are not entirely identical, they do conform to an equilibrium model where in health, the humors are balanced and when the balance is upset, illness follows. Therapy in each of the three systems seeks to restore the lost humoral balance (Foster, 1994).

Hippocrates’ description of disease in the Hippocratic Corpus - the collection of treatises that bears his name - makes it clear that this equilibrium model of health was fully developed and generally accepted in Greece by the fifth century BC. He also discussed the "principle of opposites" where a physician should suggest remedies in opposition to the nature of a person’s illness: "Diseases caused by overeating are cured by fasting; those caused by starvation are cured by feeding up. Diseases caused by exertion are cured by rest; those caused by indolence are cured by exertion." However, the theory was yet to be developed wherein foods, herbs, and other remedies could be categorized into the binary fashion of hot or cold. This evolution was an essential outgrowth of Alcmaeon’s formulation of the doctrine of humors. A few centuries later, the writings of Galen further categorized foods as having degrees of heating or cooling (Foster, 1994).

Diet was defined as rules to be applied to everyday life and included cooking techniques, seasonings, and ways of combining food and drink. It was believed that all of these factors affected the combination of the four humors in the body (Montanari, 2000). As a legacy of Greek science, nutritional theory survived through the early Middle Ages of Europe in a more or less threadbare form to later be further developed by the Moors of Spain and saw a revival early into the Renaissance period (Montanari, 2000).

Similar views of health and illness have prevailed in India since before the time of Christ and characterize Ayurvedic medicine, an indigenous Indian system that first appeared in the Vedic writings of the last years of the second millennium and the early years of the first millennium BC (Foster, 1994; Achaya, 1994). Although the early beliefs are couched in terms of disease caused by demons, sorcerers, and enemies, by the fifth or sixth century the theory had developed into a system similar to its surviving form. In this system, as with the Greeks’, the human body is marked by humors, or dosha. A person enjoys good health when the doshas are in equilibrium, and illness when one or more is not functioning correctly (Foster, 1994; Achaya, 1994). According to Ayurveda, illness occurs if there is any derangement in the body humors caused by either excessive or inadequate interactions (Udupa, 1975).

The similarities between the Indian Ayurvedic medicine and the Greek humoral theory suggest significant contact occurred between the systems, both during their development, and in subsequent centuries (Foster, 1994). While it is unclear which theory was developed first, it is well established that each has its own unique merits and very distinct cultural histories. In any case, the theory saw a rapid and thorough penetration through much of Europe and Asia, and later the Americas.

Although scholars refer to traditional Chinese medicine as "humoral," specific humors are less clearly identified than in the Greek and Indian systems. In general, the cold and hot categorizations are associated with the concept of yin and yang, respectively. According to most authors referenced in this paper, a fully developed humoral medicine appears in China considerably later than in India and Greece, and is believed to be derived, in part, to influences from one or both of these countries (Foster, 1994).

Whatever the time of the hot-cold dichotomy in the Chinese dietary and medical system, current research reveals a pattern very similar to that found in cultures around the world. The research shows that a balance between hot and cold is believed essential to physical well being, and that hot and cold qualities of foods and medicines must be considered in maintaining a proper balance in treating illness (Foster, 1994; Tan and Wheeler, 1983). This is true in mainland China as well as its associated islands including Hong Kong and Malaysia and of their migrants to the western world.

By the middle of the seventeenth century, discoveries in human physiology, such as the process of digestion, began to question the theory of the humors. In the nineteenth century the humoral theory was almost completely abandoned when Justus von Liebig proposed the role of proteins, carbohydrates and fats, and the twentieth century ushered in the discovery of vitamins, which further undermined the validity of the theory (Albala, 2000). And while these nutritional systems are generally accepted around the world today, this culturally based theory still survives in the public consciousness and becomes especially notable in times where good nutrition is critical, such as during illness, pregnancy, post-partum, and infancy.

In spite of the deterioration of humoral medical belief and practice in modern times, considerable vitality remains in the system in all of its variants: Latin American, Ayurvedic, and Chinese. In describing the findings of his research, Eugene Anderson explains the reasons for the persistence as "the theory’s basic simplicity coupled with near-infinite flexibility." George Foster states that, "in spite of the general acceptance of modern biomedicine for most medical problems, an astonishingly high percentage of illness episodes, including most of those treated by physicians, is explained ex post facto in terms of hot and cold experiences. Moreover, preventive medicine, other than what has been learned in school or via radio or television, is based largely on humoral principles" (Foster, 1994).

Latin American Findings

In Latin American culture it is believed that hot foods are more easily digested than cold foods. Richard Currier explains this in his article by pointing out that the stomach is warm and therefore it is believed that all food must become warm in the body before it can be digested.

An excellent book on the subject of the hot-cold theory that focuses primarily on the Latin American culture is George Foster’s Hippocrates' Latin American Legacy: Humoral Medicine in the New World. It states that this system has been reported in all mainland Spanish-American countries, as well as in Brazil, Haiti, Puerto Rico, among Puerto Ricans in New York City, in the American southwest, Trinidad and Tobago and, as an offshoot of Mexico, in the Philippines (an excellent source list is given by this author). Foster also states that the most remarkable thing about this medical system is that the minute local details all conform to a comprehensive theory whose most noticeable characteristics are simplicity and uniformity, from one community to the next, from one country to the next, from one continent to the next.

In the article by Queiroz, he found that from the people’s perspective, traditional medicine is an inexpensive and readily available resource that is more effective than modern medicine for certain diseases. That is why this system is able to survive in certain areas – modern medicine does not find competition profitable.

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Rizvi, N. Food Categories in Bangladesh and its Relationship to Food Beliefs and Practices of Vulnerable Groups. Food, Society, and Culture: Aspects in South Asian Food Systems. RS Khare and MSA Rao eds. Carolina Academic Press. 1986.

Simoons, FJ. Food in China: A Cultural and Historical Inquiry. CRC Press. 1991.

Tan, SP; Wheeler, E. Concepts Relating to Health and Food Held By Chinese Women in London. Ecology of Food and Nutrition, 13:37-49. 1983.

Udupa, KN. The Ayurvedic System of Medicine in India. Health by the People. KW Newell, ed. Geneva: World Health Organization. 1975.

Wandel, M; Gunawardena, P; Oshaug, A; Wandel, N. Heaty and Cooling Foods in Relation to Food Habits in a Southern Sri Lanka Community. Ecology of Food and Nutrition, 14: 93-104. 1984.

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source: Bogumil, Connie. 2002June10. Humoral Theory In Cultural Food Beliefs. Writen for NFM406.

Folk Medicine: Mexico and Mexican-Americans

Curanderismo is a folk system used in Latin America and among many Hispanic-Americans in the United States. Hispanic-American refers to Americans of Spanish or Spanish-American descent; in the United States most trace the roots to Mexico (63 percent), Puerto Rico (12 percent), and Cuba, but increasing numbers of immigrants are arriving from Central America (Wright, 1990). The population of Hispanics is rapidly growing in the United States, and today about 22 million people call themselves Hispanic. More than half this population lives in Texas and California, and large populations are al in Colorado, Arizona, Florida, Illinois, New Jersey, New Mexico, and New York.

Curanderismo typically includes two distinct components, a humoral model for classifying activity, food, drugs, and illness; and a series of folk illnesses such as "evil eye," "fright," "blockage," and "fallen fontanelle." Curanderismo as described herein is most characteristic of Mexican-American especially those who are little assimilated; variants on the humoral compon typify most of Latin America, while the folk diseases and the treatment modalities reflect national background. Thus the Cuban-American folk system not curanderismo, but santeria, and it is African influenced.

Although no formal effectiveness studies seem to have been done on this system, its wide popularity and the research suggesting the relevance of the folk diagnoses for biomedical practice indicate the need for further demographic and effectiveness studies.

In the humoral component of curanderismo things could be classified as having qualitative (not literal) characteristics of hot or cold, dry or moist. (Harwood, 1971; Messer, 1981; Weller, 1983). According to this theory, good health is maintained by maintaining a balance of hot and cold. Thus, a good meal will contain both hot and cold foods, and a person with a hot disease must be given cold remedies and vice versa. Again, a person who is exposed cold when excessively hot may "take cold" and become ill.

While this model is simple in theory, how people perceive in practice the hotness or coldness of substances varies greatly by region. Thus, while most can be expected to classify chili peppers as "hot" and milk as "cold," the classification of pork or penicillin is not so predictable.

The second component, the folk illnesses, is actively in use in much of Mexico and among less educated Hispanic U.S. citizens (Rubel, 1960, 1964; Rubel et al., 1984; Young, 1981). Trotter (1985) did more than 2,000 clinic interviews in Texas, Arizona, and New Mexico and found that 32 percent to 96 percent o Mexican-American households (more frequent in the less Americanized communities) treated members for Hispanic folk illnesses. Baer and colleagues found similarly high use patterns among Mexican migrant workers in Florida Mexico (Baer and Penzell, 1993; Baer and Bustillo, 1993).

Four important Mexican-American folk illnesses are mal de ojo, susto, empac and caida de mollera. Mal de ojo, or evil eye, is a worldwide disease concept in which a person can make another sick by looking at him or her. The one w gets sick, typically an infant, is usually "weak." The one who causes the illness is usually thought not to do it on purpose--the person just has the misfortune to have a "piercing" glance. Typical symptoms of mal de ojo include fussiness, refusal to eat, and refusal to sleep. Infants are protected from evil eye with amulets or by having their faces covered in the presence strangers. Treatment is primarily symbolic.

Caida de mollera, or fallen fontanelle, is an illness of infants before the anterior fontanelle (crown of the head) closes. Common symptoms include diarrhea, excessive crying, fever, loss of appetite, and irritability. Usua folk treatments focus on raising the fontanelle by, for example, pushing up the palate.

Empacho is thought to be caused by something getting stuck in the intestine causing blockage. Common symptoms are diarrhea, constipation, indigestion, vomiting, and bloating. The commonest treatment is massage along with herbal teas; the former is for dislodging the blockage, and the latter is for wash it out.

Susto, or fright (sometimes called magical fright), develops when a person had a sudden shock--a mother may develop fright if she sees her child nearly drown, or someone may experience fright after participating in an unusually intense argument. The sick person experiences such symptoms as daytime sleepiness combined with nighttime insomnia, irritability and easy startling palpitations, inability to stop thinking about the shocking event, anxiety that it will be repeated, and sometimes a sense of loss or a sadness that w not leave. The mild form is treated with herb tea; more severe cases are treated with ritual cleansings (barridas) to restore the harmony of body an soul.

When mild, these folk illnesses are commonly treated at home, but if they persist, the help of specialists--curanderos (men) or curanderas (women)--is sought. The training of curanderos and curanderas varies widely. Most practice a combination of shamanic healing and herbal or practical first aid healing Most are also astute at manipulating symbols and "reading" the prevailing psychological and social indicators. Some curanderas specialize in midwifery and infant care. In some areas, becoming a healer is a matter of inheritance; the skills are passed from mother to daughter or perhaps aunt to niece. In some areas it is a matter of being called. Typically, curanderos and curanderas spend several years in apprenticeship; their subsequent reputation depends on the number of their patients and how successful their patients judge them.

Treatment techniques, usually a combination of the shamanic and the naturalistic, vary widely; interested readers should consult specialist text. An issue of concern is that some curanderismo treatments, particularly for empacho, involve feeding lead-or mercury-based remedies. Investigators' efforts to test whether the amounts ingested were causing medical complications were inconclusive. Although curanderas were found to be large aware of the danger of the remedies and used them sparingly, intervention programs to limit use of these remedies were begun (Baer et al., 1989; Trotter, 1985).

Trotter (1985) collected symptomatology lists from more than 2,000 interviews and submitted symptom clusters to medical doctors for "blind" diagnoses. He found, for example, that caida de mollera appears to be symptomatic of serious dehydration secondary to gastroenteritis or respiratory infection. Trotter also found that people who are sicker than average are more likely to be diagnosed with susto. Baer and Penzell (1993) similarly report that migrant workers most affected in a pesticide poisoning incident were also those mos likely to report suffering from susto. Susto fits the pattern of "soul loss" (Ingerman, 1991), a shamanically recognized disorder known worldwide that resembles several serious psychotherapeutically recognized conditions, including depression and posttraumatic stress syndrome. Therefore, people being treated for folk diseases could be considered to have conventional illnesses that are being treated outside the conventional biomedical health care system.

The information in this Section is from "Alternative Medicine, Expanding Medical Horizons," a report to the Office of Alternative Medicine in National Institutes of Health on Alternative Medical Systems and Practices in the United States, 1992. (Charts and footnotes not included.)

BOOK REVIEW

Hippocrates' Latin American Legacy: Humoral Medicine in the New World. By George McClelland Foster. Langhorne, Penn.: Gordon and Breach, 1994. Pp. xvii+242. Theory and Practice in Medical Anthropology and International Health, Vol. 1. $40.00 (cloth). ISBN 2881246109 (cloth); ISBN 2881246117 (paper).

Source: Nahua Newsletter No. 27 (1998)

internet URL: http://www.ipfw.edu/soca/Nahua27.html#anchor800937

McDonalds in Mexico web sites

http://www.mcdonalds.com.mx/

http://www.mcdonalds.com/countries/mexico/