Pain is a biological and subjective phenomenon. Clear understanding of its features is essential. Wierzbicka’s analysis accomplishes this. This comment discusses the relevance of her approach for the study of early evolution of medicine. The comment has six parts: (a) Wierzbicka’s theory and method; (b) its application to pain; (c) relevance of pain for the study of ethnomedicine, the cultural understanding of sickness and healing; (d) significance of natural semantic metalanguage (NSM) for understanding the evolution of human thought and behavior; (...) (e) relevance of NSM for studying biological and cultural evolution of early medicine; and (f) summary and conclusion. (shrink)

Ethnomedicine is the field that analyzes medical traditions comparatively. An ethnomedical approach is used in the essay to analyze the topic of medical ethics. General properties of medical ethics as realized in different societies are outlined. These pertain to the healer's relations with clients, with other healers, and with the group or society. The conditions of medical practice and the influence of social and political factors that affect them are discussed in relation to medical ethical questions. Unique developments of contemporary (...) medical science that affect and condition practice and raise new ethical questions are examined in light of ethnomedical generalizations. The essay aims to clarify the cultural bases of medicine generally and ethical aspects of medical practice and care more specifically. (shrink)

Summary and ConclusionsThis paper presents the argument that the character of illness in psychiatry requires embracing phenomena which falls outside the area of concern of basic biologic sciences. The argument is developed by introducing the idea of a “theory of illness,” a cultural trait of a society, and by examining features of our biomedical theory of illness. The disease “depression” is then examined in terms of this theory. A basic point made is that an appraisal of any medical system involves (...) dealing with social factors and cultural conventions. Another one is that the effective and prudent application of biomedical knowledge requires dealing with neurobiologic as well as social and cultural factors that in a complementary fashion provide understanding about the organization and meaning of behavior. An emphasis on the organization and meaning of behavior, with the aim of uncovering illness conditions which can be effectively controlled, is and very likely will continue to be a central concern of psychiatry. (shrink)

Fully interpreted, Lewis's dynamic systems modeling of emotion encompasses psychological-adaptation thinking and individual and group differences in normal and abnormal behavior. It weakens the categorical perspective in evolutionary psychology and the clinical sciences; and suggests continuity between “normal” or “abnormal” behavior in whatever way this is self and culturally constituted, although culture/linguistic factors and selfhood are neglected. Application of a dynamic systems model could improve formulation of clinical problems.

Arbib offers a comprehensive, elegant formulation of brain/language evolution; with significant implications for social as well as biological sciences. Important psychological antecedents and later correlates are presupposed; their conceptual enrichment through protosign and protospeech is abbreviated in favor of practical communication. What culture “is” and whether protosign and protospeech involve a protoculture are not considered. Arbib also avoids dealing with the question of evolution of mind, consciousness, and self.

In the case of religion, explanations based on emotion should be privileged over those based on “cold” cognition. The origins of religious beliefs are as critical to understanding religion as are the group phenomena which sustain them. In addition, religion's relationship to the growth of knowledge is neglected by the target authors. The balance between the costs and benefits of religion will vary depending upon the phase of an individual society's cultural evolution.

Erdelyi grants emotional and cognitive qualities that can modulate consciousness and probably overlap with what is typically attributed to Such a broad appellation of repression explains virtually all behavior and lacks specificity. Repression and attention elucidate behavior in different clinical, cognitive, and cultural contexts. Refining these influences, we identify a few lacunae in Erdelyi's account.