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To the Instructor

Teaching medical anthropology is both exciting and examples of such work. At times we have included
challenging. Undergraduates are able to relate to sick- two or more selections on a similar topic in order to
ness and healing because they have had some lim- enhance in-class discussions. Thus the organization of
ited experience with them. Of course, many of your this book suits a heterogeneous approach to a medical
students are thinking of careers in the health care anthropology course.
industry. Learning about the multiple causes of dis- As far as we can tell, there is no agreement about
ease and the cultural variation in healing practices how a basic course in medical anthropology should
makes students examine their own lives and culture be taught. Almost 35 years ago, the first special pub-
with a fresh perspective; one of the real satisfactions lication of the new Society for Medical Anthropology
of being a teacher comes from watching students get (SMA) concerned teaching medical anthropology; the
excited by such an intellectual journey. It is also sat- volume included nine different model courses (Todd
isfying when students become increasingly aware of and Ruffini 1979*). The diversity of those courses—
the health problems of others, especially the poor at ranging from ethnomedicine, to biomedical anthro-
home and around the world. At the same time, teach- pology, to family structure and health—was impres-
ing medical anthropology is challenging because of its sive. Today, the SMA website has a section on teaching
amorphous nature and the astounding growth of the resources that includes more than 50 syllabi.
body of theory and knowledge. How does a profes- Theoretical diversity has been a continuing hall-
sor organize such a course? How do you decide what mark of medical anthropology, and its importance is
examples to use? reflected in most of the edited textbooks of the field.
This book is divided into two main parts. Part However, the relatively few regular textbooks in the
I illustrates the variety of theoretical and analytical field have had, by necessity, a more narrow theoreti-
approaches used by medical anthropologists. Part II cal focus, such as the ecological approach (McElroy
provides examples of those approaches as they relate and Townsend 1996) and the cultural aspects of heal-
to a variety of health issues and problems; hence the ing and medicine (Foster and Anderson 1978; Helman
title of the reader—Understanding and Applying Medical 1994; Strathern and Stewart 2010). Recently some new
Anthropology. The first part of the book makes apparent books have provided a synthesis of medical anthro-
that we hold a very broad view of the scope of medical pology, even as the discipline has expanded and the
anthropology and that we are committed to the tradi- theoretical basis of research has become more sophis-
tional four-field approach of general anthropology. We ticated (Anderson 1996; Hahn 1995; Janzen 2001;
believe that the application of anthropological knowl- Joralemon 1999; Nichter 2009; Singer and Baer 2012:
edge—the job of making our research useful—is part Wiley and Allen 2008; Winkelman 2008).
of the responsibility of all anthropologists. Aspects of The first and second editions of this book were
nearly all anthropological work are relevant to under- well received. There is a need for a reader in medical
standing and solving human problems. That is why anthropology that includes original research articles
we use the term applying medical anthropology rather that can accompany the texts, ethnographies, and
than the narrower and more specific applied anthropol- case studies that we use in such courses. As we have
ogy (in both this and other edited readers). The latter collected course syllabi from other medical anthro-
term refers to anthropological work done by an applied pologists over the years, we have been struck by
anthropologist for a client on a problem identified by the diversity and richness of the teaching resources
the client. We think students want to read about anthro- available. For the first edition, we thought it would
pological research and analysis on relevant topics, and be easy to assemble such a reader, but it turned out
the second part of the collection provides some good to be quite a difficult task—partially because of the

*The reference listings for all citations in To the Instructor, To the Student, and all chapter introductions and Conceptual
Tools sections are in the References section at the end of the book.
8 To the Instructor

expanding breadth of the field and partially because anthropology are not represented here, including eth-
there are so many fascinating articles available. Our nopharmacology, health policy, childbirth, gerontol-
first list included more than 220 articles, and when we ogy, embodiment, phenomenology, and specific clini-
asked colleagues to help cut them down, they simply cal cases. We hope that instructors using this book feel
suggested more titles. The list got much longer for the free to contact us with their opinions about selections
second and third editions. It was a long and painful that work (or do not work) and with suggestions for
process to make the selections. future editions.
In the end, we selected the readings with five cri-
teria in mind:

n Readability: reading levels appropriate for upper- NEW TO THE THIRD EDITION
division undergraduates who have already taken
a basic anthropology course One of the main challenges in revising this reader has
n Diversity: a mix of classic articles and more recent been to update it without completely changing a text
contributions that has been warmly received. The combination of
n Different theories: a range of orientations newer articles and “classics” was designed for maxi-
n Level of difficulty: a range of theoretical difficulty mum pedagogical benefit. We believe that the new
or sophistication selections are great vehicles for teaching and encour-
n Ethnographic variation aging class discussion. Many new articles are original
to this reader, written with an undergraduate audi-
Many selections are from the standard professional ence in mind. We think that these new chapters—writ-
journals in the field, including Medical Anthropology ten by many of the field’s leaders, including a number
Quarterly; Medical Anthropology; Social Science and Med- of Margaret Mead Award winners—convey clearly to
icine; Human Organization; Anthropology and Medicine; undergraduates the current vitality and relevance of
and Culture, Medicine, and Psychiatry. medical anthropology.
To add to the pedagogical value of this collection, We have reorganized the section and subsection
we have included section and reading introductions. headings to fit current themes in medical anthro-
In section introductions, we emphasize the “concep- pology. In addition to section and article introduc-
tual tools” that are put to work in each kind of medi- tions—with thought questions for your students—a
cal anthropology. Students should be reminded of the context box appears at the end of the introduction
central concepts before they start reading the details to each selection; these short pieces are intended
of a particular case. In selection introductions, we for more advanced students interested in knowing
describe the context for the problem at hand by rais- where the articles fit within the intellectual history
ing related issues and by listing some questions for of medical anthropology—and they often describe
discussion. Most introductions and conceptual tools the author’s larger research agenda and discuss why
sections include bibliographic suggestions for further this particular article was written. This background
reading, which are listed at the back of the book. These information can help students to appreciate the read-
references may be useful for undergraduates who are ing more fully. (The article’s original source citation,
writing term papers or for graduate students who are when applicable, appears on the bottom of the chap-
developing a stronger grasp of the field. There are, ter-opening page, along with the book’s copyright
of course, a great many other resources in medical statement.)
anthropology, many of which are available through Over the years we have heard positive feedback
the Society for Medical Anthropology. about the conceptual tools introduction, especially from
We are painfully aware that, owing to space students. Therefore, we have updated and expanded
constraints, many important topics in medical these bullet points where appropriate.
To the Student

What initially sparked your interest in medi- will also see this book as a resource for independently
cal anthropology? The prospect of studying other exploring other approaches.
medical systems, such as shamanism? The thought We have selected the readings with you, the stu-
of discovering what made disease rates increase in dent, in mind. Primarily, we picked selections that
ancient societies? Your concern about the serious contain interesting case studies or that are controver-
health problems in the United States and through- sial and might help to spark class discussions. But
out the world? An interest in how people are affected we also wanted the selections to reflect diversity—in
by chronic disease, or in the culture of Biomedicine? terms of both sophistication and the areas of the world
All these topics—exotic and mundane—are related represented. Some readings are classics in the field
to medical anthropology. Or maybe your interest is written by famous anthropologists. Although these
related to your career ambitions or current work in articles may be older, they usually make for wonder-
the health care field. Whatever the case, you will find ful reading. Most of the articles are from professional
the study of medical anthropology to be intriguing scholarly publications (for example, Medical Anthro-
and intellectually rewarding. pology Quarterly; Medical Anthropology;
We also hope that you find the study of medi- Social Science and Medicine; Culture, Medicine, and
cal anthropology to be relevant to your life—if only Psychiatry; and Anthropology and Medicine), and they
because disease, illness, healing, and death are uni- will, on occasion, require concentrated reading on
versal in the human experience. All cultures have your part. You may want to skim the article first to
medical systems. Whether you participate in a medi- familiarize yourself with the overall structure of the
cal system as a patient or a healer, there is real value argument. “Prereading” for the main ideas is not a
in understanding the big picture of how and why that substitute for the real reading, but it can prepare you
system works. But, as the title of this book suggests, to understand the article when you do read it.
you first need to understand medical anthropology In the introductions we have provided orientations
before you use it to make a difference in the world. to the general context and framework of the material.
As you skim through this book, notice the Section introductions provide important “conceptual
extremely wide variety of topics included within tools”; put these concepts and vocabulary tools into
medical anthropology. This diversity is based on the your own personal intellectual toolbox and “own”
broad, holistic approach that anthropology takes to them. Each selection introduction also includes ques-
the study of human biology and cultures. In the United tions to ponder. These questions will help you to place
States, anthropology traditionally includes four fields; a particular selection into the larger scheme of things,
biological or physical anthropology, archaeology, cul- to get you to think about the broader (and sometimes
tural anthropology, and anthropological linguistics. unanswerable) questions involved. At the end of each
Medical anthropology is not one of the four fields; introduction, you will find a “context box” that will
rather, it involves the use of anthropological concepts tell you something about the selection’s author and
and methods from all four fields in the study of health, why the article was written.
disease, and healing. One of the hallmarks of medical Because medical anthropology is such a diverse
anthropology, therefore, is the theoretical and practi- field, we have divided this book into two main parts.
cal diversity within the field. Part I introduces you to the multiple approaches used
Most medical anthropologists, like most anthro- by medical anthropologists in their research and other
pologists in general, concentrate on the cultural end work. Part II is about applying medical anthropology.
of the field. Many courses in medical anthropology This part covers a variety of different problem areas—
do not deal with evolutionary or biological questions. from doctor-patient communication to global health
Your course instructor will likely pick and choose programs—and presents selections that illustrate how
selections according to his or her orientation to the anthropological analysis can be relevant to under-
field. That is as it should be, but we hope that you standing and solving those real problems.
10 To the Student

Note that there is an important field called “applied Encyclopedia of Medical Anthropology by Ember and
anthropology” in which people, including medical Ember (2004), and A Companion to Medical Anthropol-
anthropologists, do research, program implementa- ogy by Singer and Erickson (2011). If you are thinking
tion, and program evaluation for particular clients who about graduate study, you may want to consult the
hire them to work on particular problems. The writings website of the Society for Medical Anthropology
of these applied anthropologists are often in reports for (www.medanthro.net). The major academic journals
their clients. The selections in Part II do not all fit neatly in the field include Medical Anthropology Quarterly;
within the domain of applied anthropology. Although Medical Anthropology; Social Science and Medicine;
many discuss particular solutions to a problem— Culture, Medicine, and Psychiatry; and Medicine and
such as the AIDS epidemic or social stigma related Anthropology.
to disease—the main purpose of other selections is We hope you enjoy the selections here and that
to get readers to rethink the problem in a new way. you learn a lot from your study of medical anthro-
This rethinking is what is meant by “applying” medi- pology. What you learn in this course will encourage
cal anthropology (Podolefsky, Brown, and Lacy 2011). you to think more broadly about disease, healing,
If you are interested in learning more about illness experiences, and medical systems at home and
medical anthropology, you may want to consult one around the world.
of its handbooks. They include the classic collection
by Sargent and Johnson, Medical Anthropology: Con- Peter J. Brown and Svea Closser
temporary Theory and Method (1996), the two-volume September 2015
Part I
UNDERSTANDING MEDICAL ANTHROPOLOGY
Biosocial and Cultural Approaches
Page Intentionally Left Blank
 1
Medical Anthropology: An Introduction
Peter J. Brown
Svea Closser

Chances are you just started taking this course in medi- paradigm or model. For example, medical anthropology is
cal anthropology, and you are not sure what exactly it not limited to the study of exotic, non-Western medical sys-
is going to be about. Chances are also that one of your tems, even though the description of religion and healing
friends—or your roommate or even your parents—will systems is as old as anthropology itself. The field now also
ask: “Sounds interesting, but what is medical anthropol- has other areas of research, such as the cultural analysis of
ogy?” The purpose of this selection is to help you to be pre- biomedicine and the understanding of the globalization of
pared to answer that question. As you will see, it is not an biomedical technologies.
easy one to answer. Many medical anthropologists have As you read this selection, consider these questions:
this problem, for example, at cocktail parties. Part of the
problem is that many people—even well-educated ones— n What do anthropologists mean by culture, and
do not really know what anthropology is. Therefore, when how is it related to health and healing?
some people ask the question, they have a preconception n Why is the distinction between disease and ill-
that anthropology means only archaeology. In this situa- ness important in medical anthropology? Why
tion, your challenge is to gently help them out by saying might this difference not be very important to
something like this: “Although some medical anthropolo- physicians and other health care providers?
gists do study the health of prehistoric populations, most
n Which of the different approaches in medical
medical anthropologists use a cultural orientation to study
anthropology seems most interesting to you?
health and medicine in contemporary populations, espe-
Why?
cially multiethnic ones like our own.” But long definitions
are not always useful. Therefore, to keep the conversation
interesting, have a few examples of medical anthropologi-
cal research at hand. Chapter 1’s selection provides some
Context: The following article, updated by Peter
interesting ones.
Brown and Svea Closser, was originally provided
Medical anthropology studies human health prob-
for this reader by Ron Barrett, Mark Padilla, and
lems and healing systems in their broad social and cul-
Erin Finley. Peter Brown is a professor of anthro-
tural contexts. Medical anthropologists engage in both
pology and global health at Emory University;
basic research on issues of health and healing systems
Svea Closser is an associate professor of anthropol-
and applied research aimed at improving therapeutic care
ogy and global health at Middlebury College. In
in clinical settings or improving public health programs
the years since the first (much different!) version of
in community settings. Drawing from biological, social,
this article was written, medical anthropology has
and clinical sciences, medical anthropologists engage in
grown exponentially, developing into a rich and
academic and applied research, contributing to the under-
varied field. It is a measure of the field’s diversity
standing and improvement of human health and health
and ongoing evolution that not all medical anthro-
services worldwide.
pologists will agree with the structure of the disci-
Medical anthropology is inherently interdisciplinary—
pline as it is presented here.
meaning that it is not characterized by a single theoretical

Understanding and Applying Medical Anthropology: Biosocial and Cultural Approaches (3rd ed.) by Peter J. Brown and Svea Closser, 13–24 © 2016
Taylor & Francis. All rights reserved. Chapter 1 original article source: P. J. Brown and S. Closser. 2015. Medical Anthropology: An Intro-
duction to the Fields. In P. J. Brown and S. Closser (Eds.), Understanding and Applying Medical Anthropology (3rd ed.).

13
14 Part I—Understanding Medical Anthropology: Biosocial and Cultural Approaches

WHAT IS MEDICAL ANTHROPOLOGY? differences, the academic discussions between the

M
subfields of anthropology have gotten scarce. Such
edical anthropology is the application of anthropo- trends are unfortunate, because the compartmentali-
logical theories and methods to questions of health, zation of anthropology often undermines the disci-
illness, medicine, and healing. pline’s greatest strengths: its holistic approach and
The Society for Medical Anthropology uses a interdisciplinary nature.
more lengthy definition: Culture is, of course, a central concept in
anthropology—although its definition is contested.
Medical Anthropology is a subfield of anthropology One definition of culture is “the learned patterns
that draws upon social, cultural, biological, and lin- of thought and behavior shared by a social group.”
guistic anthropology to better understand those fac- Culture includes not only belief systems but also the
tors which influence health and well-being (broadly economic systems and social structures that affect
defined), the experience and distribution of illness, how people live. Many selections in this book show
the prevention and treatment of sickness, healing pro-
how culture has profound influences on health.
cesses, the social relations of therapy management, and
But because health is influenced not only by cul-
the cultural importance and utilization of pluralistic
medical systems. The discipline of medical anthropol- ture and social structure but also by evolution and
ogy draws upon many different theoretical approaches. biology (and in fact we argue in this book that biol-
It is as attentive to popular health culture as bioscientific ogy and culture are inseparable), medical anthropolo-
epidemiology, and the social construction of knowl- gists often draw on more than one subdiscipline. For
edge and politics of science as scientific discovery and example, some selections in this reader show how the
hypothesis testing. Medical anthropologists examine biology, growth, and development of human beings
how the health of individuals, larger social formations, are historically and currently shaped by cultural
and the environment are affected by interrelationships influences. Human biology and culture are intimately
between humans and other species; cultural norms and related, and so we should adopt a holistic perspective
social institutions; micro and macro politics; and forces
when we are studying human health and sickness.
of globalization as each of these affects local worlds.
In regard to the four traditional subfields of
(Society for Medical Anthropology 2015)
American anthropology (cultural anthropology,
physical or biological anthropology, anthropologi-
This definition can be daunting to someone coming
cal archaeology, and anthropological linguistics), the
to anthropology for the first time, but its essential
most common type of anthropologist is a cultural
point is as we stated: Medical anthropology is the
anthropologist. And most practicing medical anthro-
anthropological study of health and healing. Medi-
pologists were trained in cultural anthropology. But
cal anthropology takes the tools of anthropology and
medical anthropology, a relatively new area of spe-
applies them to human illness, suffering, disease,
cialization, is not really a subfield, partly because, as
and well-being.
we mentioned, subfields of anthropology generally
To understand what medical anthropology is,
have a central theoretical paradigm. In contrast, medi-
then, one must understand anthropology as a whole.
cal anthropologists use a wide variety of theoretical
Introductory anthropology courses usually begin
perspectives—and they often do not agree on which
with some variation of the short and classic definition:
ones are best. As you will see, medical anthropolo-
“Anthropology is the study of humankind.” Although
gists apply a range of theories and methods to issues
a bit vague, this definition underscores that anthro-
of human health, sickness, and healing.
pology is a holistic and interdisciplinary enterprise
that uses many different approaches to understand
important human issues. In the broadest sense, these
approaches are usually categorized into four major BASIC CONCEPTS
subfields: cultural anthropology, physical or biologi-
cal anthropology, anthropological archaeology, and As is the concept of culture, the notion of health is
anthropological linguistics. difficult to define. According to the charter of the
These days, however, introductory courses are World Health Organization, health is “a state of com-
often the first and last places where anyone gives much plete physical, mental and social well-being, and not
thought to the relationships among these four sub- merely the absence of disease or infirmity” (World
fields of anthropology. In recent decades anthropol- Health Organization 2015a).
ogy has gone the way of many academic disciplines. What constitutes well-being in one society, how-
Its subfields have become increasingly specialized, ever, may be quite different from another. The ideal
each with its own dictionaries and theoretical orien- of a lean-figured body—a sign of health in the West—
tations. As a result of these increasingly specialized may indicate sickness and malnutrition in sub-Saharan
 1 Medical Anthropology: An Introduction 15

Africa (Brown 1981). In the fishing villages that line about the approaches sometimes called critical theories,
Lake Victoria, the parasitic disease schistosomiasis is including postmodernism and Marxism. In general,
so prevalent that the bloody urine of young males is these approaches require people to critically exam-
considered a healthy sign of approaching manhood ine their own intellectual assumptions about how the
(Desowitz 1987). In the United States, the “elegant pal- world works; the basic idea is that our ideas of reality
lor” and “hectic flush” of consumption (tuberculosis) are shaped by our culture and that sometimes these
were often imitated by healthy people at the turn of ideologies conceal complex political relationships.
the 20th century because of the disease’s association These debates influenced cultural anthropology
with famous writers and artists (Sontag 1983). Any in general and medical anthropology specifically. An
conceptualization of health must therefore depend important outcome was the development of critical
on an understanding of how so-called normal states medical anthropology, a perspective that coalesced in
of well-being are constructed within particular social, the 1980s and 1990s (Singer 1989). These days, the per-
cultural, and environmental contexts. spectives of critical medical anthropology are main-
stream within medical anthropology. Most medical
anthropologists agree with two broad critiques that
Core Concepts critical medical anthropology made of earlier work.
The first critique was that many medical anthro-
Medical anthropologists use two terms to talk about pologists had incorrectly attributed health disparities
states of ill health: illness and disease. Disease refers to to cultural differences without examining the influ-
the clinical manifestations of altered physical function ence of global political-economic inequality on dis-
or infection. It is a clinical phenomenon, defined by ease distribution. In the past, medical anthropologists
pathophysiology. Illness, in contrast, encompasses the had tended to view illness as existing within local
human experience and perceptions of alterations in cultural systems, and they neglected the larger politi-
health, as informed by its broader social and cultural cal and economic context within which these cultures
dimensions. are found. Critical medical anthropologists described
This distinction helps in understanding many how large-scale political, economic, and cognitive
important phenomena, such as interactions between structures constrain individuals’ decisions, shape
patients and healers. For example, a doctor using a their social behavior, and affect their risk for disease.
disease model may see the patient’s symptoms as Readings in this book that exemplify this approach
the expression of clinical pathology, a mechanical are in Chapter 11 by Paul Farmer and Chapter 14 by
alteration in bodily processes that can be “fixed” by a Merrill Singer.
prescribed biomedical treatment. From the patient’s One example of this kind of thinking was
perspective, however, an illness experience may Meredeth Turshen’s analysis of the political-economic
include social as well as physiological processes. The dimensions of disease in Tanzania. Turshen described
physician’s diagnosis may not make sense in terms how a history of colonialism drastically affected
of the patient’s understanding of her illness, and the the country’s nutritional base, altered its kinship
doctor’s “cure” may not take into consideration the structure, and imposed constraints on its health
patient’s family dynamics, the potential for social care system. She questioned previous studies’ focus
stigma in the community, or lack of money to follow on local culture and emphasized an alternative she
through with treatment. called the “unnatural history of disease” (Turshen
Healing practices that humans use range from 1984). Critical medical anthropologists made similar
cardiac bypass surgery, to amulets worn for protec- arguments concerning health disparities in wealthier
tion against the evil eye, to conflict resolution between countries like the United States.
kin groups. Shamans, priests, university-trained phy- Because of their interest in macro-level forces
sicians, and members of one’s family may assume a (such as world capitalism), critical medical anthro-
healing role at any given time in a person’s life. All of pologists were generally skeptical of health policies
these, including biomedicine, are aspects of ethnomedi- that proposed local solutions. Thus critical medical
cines, medical systems firmly tied to cultural systems. anthropologists not only challenged the local focus of
traditional medical anthropology but also criticized
the narrow focus of health interventions that did not
A Critical Perspective address the large-scale factors influencing disease
(Morsy 1990).
In the last part of the 20th century, medical anthropol- The second critique made by critical medical
ogy experienced a significant break from its past. Dur- anthropology centered on the questioning of underly-
ing this period, there were intense intellectual debates ing epistemologies (ways of knowing) and conceptual
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16 Part I—Understanding Medical Anthropology: Biosocial and Cultural Approaches

categories of medicine and Western culture in general. Many medical anthropologists, then, have a
For example, the 16th-century French mathematician, practice orientation (Inhorn and Wentzell 2012), even
scientist, and philosopher René Descartes articulated as they think theoretically. Unlike other social scien-
a fundamental cultural model of the separation of tists, medical anthropologists generally think they
mind and body. This is a “culturally constructed” have an obligation to act to improve human health
idea that many people take for granted in everyday (Fassin 2012). This belief, however, doesn’t mean
thought and talk. But your own experiences of emo- that they agree on what action is appropriate. Medi-
tional states—not to mention recent discoveries in cal anthropologists’ critical perspectives indicate that
neuroscience—make it clear that the body/mind dis- they are very aware that the institutional structures
tinction is not quite true. Similarly, there are many of biomedicine and public health sometimes entrench
notions embedded in everyday clinical medicine that inequalities rather than alleviate them. Most medical
are culturally constructed and often based on meta- anthropologists are constantly reflecting on whose
phors. For example, low blood pressure is consid- interests their involvement in these structures serves
ered a dangerous sign of heart problems in Germany, (Singer 1995).
while in the United States it is considered a marker of Some medical anthropologists are very actively
excellent health (Payer 1988). The ideas and practice of engaged within biomedical and public health institu-
medicine cannot be separated from culture. tions. For a significant period of its history, medical
From our perspective, the mainstreaming of the anthropology dealt with the health beliefs and prac-
critical perspective within medical anthropology has tices of ethnic minorities. Margaret Clark’s Health in
led to many important developments, including an the Mexican-American Culture (1959) is a good exam-
energetic engagement with social justice and health ple of such work. Her analysis emphasizes, for exam-
disparities. Paul Farmer, a physician and anthropolo- ple, that it is insufficient simply to translate medical
gist who also directs the nonprofit organization Part- instructions when the patient population has limited
ners in Health, has been highly influential in this area. literacy and biomedical language (in any language)
Farmer’s most famous work highlights the impact of is unfamiliar to them. Medical anthropologists have
global inequality on the emergence of such infectious often been called to assist in improving communi-
diseases as HIV/AIDS and multidrug resistant tuber- cation across both language and cultural barriers
culosis (Farmer 1999, 2004). In providing a critical between patients and their health care providers. Such
perspective on global inequalities in health, Farmer problems in communication have been described
and many others have effectively highlighted how in Anne Fadiman’s book The Spirit Catches You and
socioeconomic and political factors cause profound You Fall Down (1998), which deals with the conflicts
inequalities in health and disease. between the family of a Hmong child and her Ameri-
can doctors. Some perspectives on “cultural compe-
tency” training programs in medical schools can be
A Practice Orientation found in Part II in the section titled “Working with the
Culture of Biomedicine.”
Medical anthropologists engage in research on issues Not all anthropologists agree that these training
of health and healing systems, as well as research programs are a good thing. Several medical anthropol-
aimed at the improvement of therapeutic care and ogists have argued that such programs reinforce racial
public health programs. Sometimes these types of stereotypes rather than dealing with power inequities
research are labeled as “basic” or “applied,” respec- that are at the root of poor health outcomes (Carpenter-
tively, but because medical anthropologists study Song, Schwallie, and Longhofer 2007; Gregg and Saha
human health, most “basic” research has obvious 2006). Such active debate and reflection—both engaged
practical relevance, and many of the field’s core the- with and critical of practice—is a hallmark of medi-
oretical concepts were developed by people actively cal anthropology. A critical analysis of such a cultural
engaged in clinical and public health work. There is competency course at Harvard Medical School can be
a great deal that we do not know about the causes of found in the selection in Chapter 35.
sickness and the processes of healing; anthropologists Anthropologists working within clinical settings,
can contribute to the growth of human knowledge in however, do much more than talk about culture and
these important areas. At the same time, anthropolo- communication. Anthropologists within the Veterans’
gists contribute to the design and implementation of Administration (VA), for example, work on a variety
programs alleviating complex health problems. This of issues, including the root causes of substance abuse
back-and-forth between engagement and reflection and homelessness in female veterans (Cheny et al.
energizes the discipline. 2013; Hamilton, Washington, and Zuchowski 2013)
 1 Medical Anthropology: An Introduction 17

and the improvement of mental health services for The first two of these approaches emphasize the inter-
veterans with posttraumatic stress disorder (PTSD) action of humans and their environment in a way
(Besterman-Dahan, Lind, and Crocker 2013; Finley that we consider biosocial—that is, with a focus on
2013). the interaction between biological/health questions
In addition to clinical settings, many anthropolo- and socioeconomic and demographic factors. The last
gists work in public health policymaking, program three of these approaches to medical anthropology are
development, and intervention. Anthropological per- cultural—they emphasize the concept of culture (the
spectives are relevant at all levels of the public health patterns of thought and behavior characteristic of a
process, from the interpretation of disease trends to group) and how people experience life.
the design, implementation, and evaluation of pro- For all the diversity of the field, nearly all medical
grams. For example, medical anthropologists working anthropologists share four essential premises: (1) that
on the Ebola response did research on topics from the illness and healing are best understood in the com-
role of informal health workers in the Ebola response plex and varied interactions between human biology
to the long-term investments needed for stronger and culture; (2) that disease is influenced by culture,
health systems and the reasons why some people economics, and politics; (3) that the human body and
might resist interventions aimed at stopping Ebola symptoms are interpreted through cultural filters;
(Ebola Response Anthropology Platform 2015). They and (4) that the insights of medical anthropology have
also argued compellingly in international venues that important pragmatic consequences for the improve-
public health agencies should stop conceptualizing ment of health and health care in human societies.
culture as a barrier and a source of misinformation
and should instead focus on designing responses the
desires and needs of recipient populations in mind 1. Biological Approaches in Medical
(Chandler et al. 2015). Anthropology
Yet other medical anthropologists think that ana-
lyzing and writing, often from within the academy, is Much research in biological anthropology concerns
the best way to create positive change. These medi- important issues of human health and illness. Many
cal anthropologists believe that it’s hard to think and of the contributions of biological anthropologists help
write critically about health institutions if one is too to explain the relationships between evolutionary
close to them (or working for them), so they advocate processes, human genetic variation, and the differ-
speaking truth to power from outside such structures, ent ways that humans are sometimes susceptible, and
often from academic positions. other times resistant, to disease.
Through work both practical and theoretical, The evolution of disease in ancient human popu-
medical anthropologists contribute to our under- lations helps us to better understand current health
standing of issues with life-and-death consequences. trends, a concept described in more detail in Chapter
They approach these issues from a wide variety of 8’s selection by George Armelagos, Peter Brown, and
theoretical perspectives, all rooted in anthropology. Beth Turner. For example, the recent global trend of
emerging and reemerging infectious diseases, such
as tuberculosis and AIDS, is influenced by forces of
natural and cultural selection that have been pre-
FIVE BASIC APPROACHES TO sent throughout modern human evolution. During
MEDICAL ANTHROPOLOGY the time of the Paleolithic (about 2,500,000 to 200,000
years ago), early human populations lived in small
The scope of anthropological inquiry into issues of bands as nomadic hunters and gatherers. The low
human health, sickness, and healing is very diverse— population densities during this period would not
so diverse in 2015 that writing this introduction, have supported the acute infectious diseases found
which characterizes the field, is intimidating. None- today; instead, chronic parasitic and insect-transmitted
theless, we’ve identified five basic approaches to med- diseases were more prevalent.
ical anthropology: The shift toward sedentary living patterns and
subsistence based on plant and animal domestication,
1. biological sometimes called the Neolithic Revolution (about
2. ecological 10,000 b.c.e.), had a profound effect on human health.
3. ethnomedical Skeletal evidence from populations undergoing this
4. experience-near transition shows an overall deterioration in health con-
5. studies in and of biomedicine. sistent with the known relationship between infectious
18 Part I—Understanding Medical Anthropology: Biosocial and Cultural Approaches

disease and malnutrition. New infectious diseases differences in cranial size between these populations
emerged, a result of increasing population density, were used to support a theory of racial hierarchy based
social stratification, decreased nutritional variety, prob- on hereditary differences in brain size. By careful com-
lems of clean water and sanitation, and close contact parisons between first- and second- generation groups
with domesticated animals (Armelagos, Goodman, from these immigrant populations, Franz Boas (the
and Jacobs 1991; Cockburn 1964). These changes had founder of American Anthropology) was able to dem-
a disproportionate effect on women, young children, onstrate that these differences were attributable to
the elderly, and the emerging underclass, who were environmental influences on body size (Boas 1940).
most susceptible to infections in socially stratified Subsequent analyses have discredited previous stud-
societies (Armelagos and Cohen 1984). ies relating measurements of intelligence to those
Currently, great threats to human health come of cranial capacity (Gould 1981), and categories of
from chronic degenerative conditions. These so- human races have been shown to have little validity
called diseases of civilization, such as heart disease, in the study of human variation (Goodman, Moses,
diabetes, and cancer, are the leading causes of adult and Jones 2012).
mortality throughout the world today. Many of these Some biological anthropologists also contribute
diseases share common etiological (causative) fac- to the field of ethnopharmacology. Anthropologists
tors related to human adaptation over the last 100,000 in this field consider not only the physiological prop-
years. For example, obesity and high consumption of erties of plant substances but also issues related to
refined carbohydrates and fats are related to increased their selection, preparation, and intended uses within
incidences of heart disease and diabetes. Human sus- particular social settings and broader cultural frame-
ceptibility to excess amounts of these substances can works (Etkin 1996).
be explained by the evolution of human metabolism Biological anthropology plays a central role in
over millions of years in contexts of relatively large the field of evolutionary medicine, which considers
amounts of exercise, seasonal food shortages, and how survival pressures over the course of evolution
diets low in fat (Konner and Eaton 2010; Weil 2008). may have shaped human biology. Health research-
A related theory of “thrifty genes” was pro- ers who incorporate an appreciation of the ongoing
posed to explain relatively shorter-term evolution- effects of natural selection on the physiology of peo-
ary changes that account for genetic variation in the ple and other organisms may be equipped to develop
susceptibility to chronic diseases between different more sophisticated approaches in their efforts to
contemporary populations (Neel 1982). Some popula- treat or prevent disease (Nesse and Williams 1996).
tions have significantly higher prevalences of adult- For example, research on SIDS (sudden infant death
onset diabetes and hypertension than others. The syndrome) and children’s sleeping arrangements has
thrifty-gene hypothesis proposes that genes affecting shown that despite statements by many officials in the
insulin physiology were selected for, allowing people United States that infants should always sleep alone,
to adapt to an irregular food supply. This adapta- mother-infant cosleeping (the evolutionary norm)
tion arose during times of “feast or famine” for cer- may be the safest choice for babies in particular social
tain populations, including some Native Americans, and economic contexts (McKenna and McDade 2005).
oceangoing Pacific Islanders, and African Americans Biological anthropology’s appreciation for the inter-
descended from slaves. In the context of modern diets, connectedness between genes and environment has
however, these genes add to the burden of chronic led to many developments in the field of evolution-
disease (Lieberman 2008). ary medicine and holds promise for many more. The
But variation in human susceptibility to chronic reading selection in Chapter 3 deals with this topic.
diseases cannot be accounted for by genetic explana-
tions. Environmental and sociocultural factors play
a primary role. Health disparities between ethnic 2. Ecological Approaches
groups in the United States are a result of discrimi-
nation leading to poorer living environments and Ecology refers to the relationships between organisms
increased stress, among other causes of poor health and their total environment. Within medical anthro-
(Dressler 1996; Williams 1999). pology, the ecological perspective focuses on the inter-
Some biological contributions to medical anthro- actions between environmental contexts and human
pology critique the misapplication of biological con- health. An ecological approach to medical anthro-
cepts. During the late 19th century, measurements pology emphasizes that the total environment of the
of cranial size were taken of Jewish and Southern human species includes the products of large-scale
European immigrants to the United States and com- human activity, as well as “natural” phenomena, and
pared with those of Anglo-American residents. The that health is affected by all aspects of human ecology.
 1 Medical Anthropology: An Introduction 19

It includes attention to how people survive in varying that multiple ecological variables—biological, cul-
environments, how they find food, how they distrib- tural, political, and economic—interact to influence
ute resources, how they deal with disease, and how the prevalence of particular diseases in a given envi-
the demographics of their population are changing ronmental context. In recent years—marked by the
over time (McElroy and Townsend 2014). Pathogens advent of climate change—more areas of the world
that cause infectious disease, such as the malaria par- have become vulnerable to malaria; this is a political
asite, and factors that affect risk for chronic disease, ecological phenomenon.
for example, diet, are closely tied to humans’ relation- Schistosomiasis, a parasitic disease spread by
ships with their environments. The term medical ecol- snails, provides a dramatic example of the relation-
ogy has been used to describe this approach. ship between political ecology and disease. For dec-
Two broad levels of analysis inform this approach. ades, economic development programs throughout the
At the micro level, cultural ecology examines how cul- world have often focused on the building of dams to
tural beliefs and practices shape human behavior, prevent seasonal flooding, improve irrigation, and pro-
such as sexuality and residence patterns, which in vide hydroelectric power (Heyneman 1979). Enormous
turn alter ecological relationships between host and dams, such as the Aswan High Dam on the Nile River,
pathogen. At a broader level, political ecology exam- have dramatically altered the ecology of surrounding
ines the historical interactions of human groups and areas by preventing seasonal flooding and creating one
the effects of political conflict, migration, and global of the largest man-made bodies of water in the world.
resource inequality on disease ecology (Brown, Smith, A byproduct of such changes, however, is an altered
and Inhorn 1996). Many ecological approaches to relationship between human populations and certain
medical anthropology include some aspects of both water-borne parasitic infections, such as schistosomia-
cultural and political ecology. Malaria and schistoso- sis. The small snails that carry schistosomiasis thrive
miasis provide two useful examples. in the numerous irrigation canals emanating from the
Malaria is a disease caused by a microscopic dams, increasing human exposure to the parasites. This
Plasmodium parasite that is transmitted to human exposure has led to an increased risk of contracting
hosts through contact with mosquitoes of the genus schistosomiasis, an infection that primarily affects chil-
Anopheles. These mosquitoes breed and multiply in dren, in people that live close to some kinds of dams
stagnant pools of water in warm climatic regions of and irrigation systems. But the way this relationship
the world. Malaria has a long and sordid history in plays out depends on the larger ecological context of
many societies, and it continues to be a major cause of the dam, as well as the socioeconomic status of people
human morbidity and mortality today (Brown 1997). at risk (Steinmann et al. 2006).
At a cultural ecological level, adaptations to malaria The story of schistosomiasis demonstrates that
include highland Vietnamese building practices, in political-economic forces, such as dam development
which stilted houses allowed people to live above the programs, can dramatically shape the relationship
10-feet mosquito flight ceiling (May 1958). In another between host and disease in human populations.
ecological context, although malaria had been eradi- Thus, medical ecology’s definition of “environment”
cated in the southern Italian island of Sardinia, Brown includes the political-economic consequences of col-
discovered that many cultural practices functioned lective human activity. In this globalizing world
to reduce contact with malaria-carrying mosquitoes characterized by out-of-control carbon emissions and
(Brown 1981;) see the selection in Chapter 7). These climate change that will have serious health effects
included settlement and land-use patterns, whereby (Chapter 10), there is no doubt that political-economic
nucleated villages are located in highland areas and policies directly influence local disease ecologies.
flocks of sheep are taken to the lowlands in the winter,
thus minimizing contact with the mosquitoes during
peak malaria seasons. 3. Ethnomedical Approaches
At a political ecological level, however, these
adaptive cultural practices were probably motivated All societies have medical systems that provide a
by historical threats of military raids and expropria- theory of disease etiology (causation), methods for the
tion of land by foreigners. Furthermore, wealthy diagnosis of illness, and prescriptions and practices for
Sardinians had less contact with mosquitoes because curative or palliative (calming, soothing) treatment. The
they did not have to leave the safety of the village to initial development of medical anthropology derived
work in the fields as did the laborers, nor did they from anthropological interest in the healing beliefs and
have to stay in the village during peak malaria sea- practices of different cultures (Wellin 1978). These
son when they could afford to take summer vacations beliefs and practices related to healing are often referred
abroad. Thus, the example of malaria demonstrates to as ethnomedicine. Anthropological approaches to the
20 Part I—Understanding Medical Anthropology: Biosocial and Cultural Approaches

study of ethnomedicine have always included not institutions, and supplement their ancient therapies
only understanding how people think about health with antibiotics, X-rays, and other tools of biomedi-
and disease but also studying the social organization cine (Nichter and Nichter 1996). Likewise, many
of healing practices (Fabrega 1975). In the simplest Indian physicians trained in biomedicine use Indian
sense, all ethnomedical systems have three interre- categories to explain health issues to their patients.
lated parts: As another example, in her comparison of biomedi-
cal systems in Europe and North America, Lynn Payer
1. a theory of the etiology of sickness found considerable variability in the health beliefs
2. a method of diagnosis based on the etiological and practices that constitute biomedicine (Payer
theory 1988). Because of these issues of cultural diversity
3. the prescription of appropriate therapies based on even within biomedicine, it is more useful to consider
the diagnosis. ethnomedicine as the study of any form of medicine
as a cultural system. In other words, biomedicine is
Health systems, from a cross-cultural perspective, one of many ethnomedical systems.
generally fall into two categories: Patients often draw on the ideas of one or more
ethnomedical systems in their own understanding of
1. personalistic systems that explain sickness as the illness. They develop an explanatory model (EM), a
result of supernatural forces directed at a patient, personal interpretation of the etiology, treatment, and
by either a sorcerer or an angry spirit outcome of sickness by which a person gives meaning
2. naturalistic systems that explain sickness in terms to his or her condition. Although EMs are personal,
of natural forces, such as the germ theory of con- they are also learned cultural models, so that an EM
tagion in Western biomedicine and the imbalance shared by a group might be considered a folk model of
of humours in many forms of Chinese, Indian, disease. There is often disparity between the explana-
and Mediterranean systems (see the selection in tory models of patients and healers, which may lead
Chapter 16). to problems of communication and nonadherence to
prescribed therapies (Brown, Gregg, and Ballard 1997;
At the beginning of the 20th century, anthropo- see the selection in Chapter 34).
logical studies of medical systems were confined to While stated health beliefs may influence treat-
ethnographic descriptions of “exotic” practices within ment decisions, explanatory models alone are not
non-Western societies. Many of the observations good predictors of people’s observed patterns of health
about sickness and therapeutic rituals were analyzed seeking—because significant differences often exist
as a window on underlying cosmological beliefs and between cultural “ideals” (what people say they do)
cultural values within comparative studies of myth and “real” behavior of observable action. For example,
and religion. Some aspects of these works have been a study of Nepalese patients found that people often
criticized for a tendency to sensationalize the differ- sought multiple medical resources for a single illness
ences of “primitive” people in comparison to their despite verbal claims to the contrary (Durkin-Longley
readership in Western industrialized societies (Rubel 1984). Many different factors may weigh on decisions
and Hass 1996). concerning when and where to seek treatment, such as
The term ethnomedicine was first defined as the influence of family members (Janzen and Arkinstall
“beliefs and practices related to disease which are the 1982), social networks, and geographic access to health
products of indigenous cultural development and are resources (Kunitz 1989; Mumtaz et al. 2013). In many
not explicitly derived from the conceptual framework cases, economic resources can severely limit treatment
of modern medicine” (Rubel and Hass 1996). In recent options. Even with great strides made in lowering the
decades this arbitrary distinction supposedly “indig- cost of antiretroviral therapy, for example, nearly two
enous,” “traditional,” and “nonscientific” medical thirds of HIV-positive people in low- and middle-
systems and supposedly “Western,” “modern,” and income countries do not have access to these lifesaving
“scientific” medical systems has been abandoned by drugs (World Health Organization 2015b).
nearly all medical anthropologists. Medical anthro-
pologists challenge the idea that biomedicine is an
empirical, law-governed science unbiased by cultural 4. Anthropology in and of Biomedicine
premises. They understand that all medical systems
are constantly changing, and all are closely tied to In recent years there has been an increased focus
their cultural contexts. on studying biomedicine as an ethnomedical sys-
In India, for example, many Ayurvedic practition- tem of knowledge and social practice. Although this
ers receive university training, practice in commercial approach has a lot in common with the study of other
 1 Medical Anthropology: An Introduction 21

ethnomedicines, it has become such a large part of the available to describe it. Chapter 31’s selection by Erin
subfield of medical anthropology that we are giving it Finley provides an excellent case study of PTSD in the
its own section here. contemporary VA system.
One classic example of this approach is an article Increasingly, medical anthropologists have exam-
by Nancy Scheper-Hughes and Margaret Lock (1987). ined the cultural and political dimensions of public
They critically examined the idea that the mind and health and global health bureaucracies. Like scholars
body are separate entities, a fundamental premise of who frame studies of biomedicine as a cultural sys-
biomedicine. They suggested that the dominance tem, anthropologists are increasingly turning their
of biomedicine had made the concept of separation attention to the cultural beliefs, norms, and implicit
of mind and body so pervasive that people lacked a premises on which public health funding and admin-
precise vocabulary to express the complex interac- istration are based (Biehl and Petryna 2013; Chandler
tions between mind, body, and society. et al. 2015; Justice 1986). These medical anthropolo-
The excellent text An Anthropology of Biomedicine gists study a variety of public health agencies, from
(Lock and Nguyen 2011) examines the “technologies UN agencies to NGOs to governments, and they pay
of the body in context,” including the human transfor- attention to the complex power relations between
mations (through transplants, and so on) that stretch these entities. Examples of this approach are in the
our moral boundaries. This focus includes an empha- selections in Chapters 44 and 45, which explore the
sis on biotechnologies such as genetic testing, the contexts and complex effects of public health pro-
use of pharmaceuticals, assisted reproduction, organ grams in Pakistan and Mozambique.
transplants, genomics, plastic surgery, and other sci-
entifically derived treatments. In viewing how such
new technologies are taken up (or rejected) within 5. Experience-Near Approaches
existing biomedical systems, we can observe how
they come to be associated with different social cir- In 1988, renowned anthropologist and psychiatrist
cumstances across different cultural settings. Repro- Arthur Kleinman published a book titled The Illness
ductive technologies such as in vitro fertilization, for Narratives, in which he advocated paying close atten-
example, may come to epitomize one set of concerns tion to how people make sense of their illness experi-
among women in the United States and a very differ- ences through narrative (Kleinman 1988). He pointed
ent set among men in Egypt and Lebanon. Chapter 27’s out that the stories people tell about their illnesses
article by Monir Moniruzzaman provides an example can provide great insight into how they cope with
of this kind of anthropological work. disease and suffering. Since then, what can broadly
The study of biomedicine sheds light on the epis- be called an experiential approach in medical anthro-
temology of scientific and medical knowledge. Medi- pology has become increasingly resonant through-
cal anthropologists study the processes by which out the other subfields. Anthropologists using this
these forms of knowledge acquire their status as approach frequently put illness-related suffering—
“authoritative knowledge” rather than as “beliefs,” whether due to pain, disability, or the awareness of
the word often used to describe the knowledge sys- one’s own mortality—at the center of their analysis.
tems of other ethnomedicines. As such, the distinction They focus on three aspects of illness, in particular:
between knowledge and belief can be seen as arbitrar- (1) narrative—the stories that people tell about their
ily reflecting differences in social power and therefore illness; (2) experience—the way that people feel, per-
as being highly questionable (Good 1994). ceive, and live with illness; and (3) meaning—the
Studying the processes of knowledge creation in ways that people make sense of their illness, often
biomedicine has provided important insight into how linking their experience to larger moral questions. For
“gold standards” of care and evidence come to be. example, in Chapter 23’s selection Linda Hunt con-
Medical anthropologist Allan Young, for example, has siders narratives from two individuals with cancer in
shown how PTSD became accepted in the late 1970s southern Mexico; although these two have different
as a distinct mental illness (Young 1997). It was not a cancers and face different life situations, both explain
process of psychiatrists suddenly discovering a new their illness in relation to the disappointments and
disorder. Instead, PTSD came to be included in the obligations they have borne in their social lives.
Diagnostic and Statistical Manual for Mental Disorders Experiential (experience-near) approaches often
(DSM), psychiatry’s official list of accepted diagnoses, explore the links between sickness and problems in
when a group of psychiatrists came together and— the social world. Illness narratives in particular may
urged by a vocal lobby of Vietnam veterans and their demonstrate how a symptom is experienced as trou-
advocates—agreed that PTSD should be recognized bling because of its impact on relationships with oth-
despite a lack of medical and epidemiological research ers, as when pain or fatigue interferes with a mother’s
22 Part I—Understanding Medical Anthropology: Biosocial and Cultural Approaches

ability to care for her children. Narratives may also normative ways (Desjarlais 1997; Jenkins and Barrett
provide a venue for negotiating the meaning of an 2003). In addition to helping social scientists rethink
illness, particularly in the social space between fam- the cultural boundaries between what is considered
ily members, patients, healers, and so forth. Kohn normal verses pathological, these studies have the
writes of how care providers treating children with potential to explore the relationship between body
facial disfigurements in Northern California create and mind in a more holistic way.
“therapeutic emplotments”—essentially, complex Anthropologist Joao Biehl, for instance, has traced
narratives—that are intended to help the children to the paths by which ongoing socioeconomic changes
feel more comfortable with their appearance. In try- in Brazil, accompanied by an increasing medicaliza-
ing to transform the children’s narratives of them- tion of illness and infirmity, have resulted in families
selves and their appearance, the care providers are leaving their mentally and physically disabled mem-
in fact trying to shift the children’s experience of bers to live in ragged communities on the margins of
their disfigurement from one of embarrassment and society (Biehl 2013). Following this social progression
shame to one of acceptance and confidence (Kohn to its outcome at the level of individual experience, he
2000). Narrative, then, is not just a story of what has describes how mentally ill individuals in Brazil per-
happened, or is happening, or might happen. It can ceive and make sense of this social abandonment.
also represent an active attempt to negotiate or con- The experience of illness is something that evolves
struct both individual selfhood and social relations in the space between body and mind, and between
amid sickness and suffering. individuals and those in their social environment; it
A central theme in ethnographic descriptions may change over time as the disease progresses or
of illness and suffering is stigma. People who are resolves. In understanding how illness is experienced,
different—either physically, mentally, or in social medical anthropologists gain insight into how peo-
skills—are often subjected to negative judgments and ple endure and make meaning in some of the most
discrimination from so-called normal people; that vulnerable moments of their lives, and thus they can
is, they are stigmatized. The originator of this idea better appreciate how these processes play out in peo-
in medical social science, Erving Goffman (1963), ple’s explanatory models, care-seeking behaviors, and
referred to this type of social disapproval as creating coping strategies.
a “spoiled identity.” The archetype of a stigmatized
disease is leprosy (Hansen’s disease), which despite
its terrible reputation is not very contagious at all. CONCLUSION
There are both visible and invisible conditions
that are stigmatized. With visible conditions, such as Medical anthropology, like its parent discipline, is a
being extremely short-statured, people end up being holistic and interdisciplinary enterprise. We began this
stared at and ostracized; this situation is described chapter quoting the definition of this subfield offered
in Chapter 36’s selection by Joan Ablon. Invisible by the Society for Medical Anthropology. This defini-
conditions—for example, having depression or herpes, tion includes so many topics covering such a diverse
or having had an abortion—are usually conditions set of questions that some readers may think that it
that people prefer to keep secret; disclosing such a was written by a committee. In the simplest sense,
condition is difficult and often socially dangerous. medical anthropology refers to studies of health and
A great deal of medical anthropological research healing from biosocial and cross-culturally compara-
has been done on HIV/AIDS since the beginning of tive perspectives. In this regard, healing refers to all
the pandemic. In some ways HIV/AIDS has been an medical systems, including modern biomedicine and
epidemic of discrimination and stigma; however, the its sophisticated technologies, as cultural products.
availability and antiretroviral drugs has changed this Because there is such a remarkable diversity of
slightly (see Chapter 45). theories and methods used in medical anthropology,
The experiential approach has been applied most we can appropriately talk about it as having subdisci-
often in the exploration of illnesses that are highly plines of its own. In this article, we have outlined five
subjective, such as chronic pain and mental illness. major approaches that medical anthropologists use
These experiences, internal as they are, may be dif- to better understand issues of human health, healing,
ficult to share or explain. Medical anthropologists and sickness: biological and ecological (biosocial), and
attempt to understand conditions such as psychosis ethnomedical, experience-near, and studies in and of
from within, interacting closely with and listening to biomedicine (cultural). When we explore the specific
those who might otherwise be ignored because of their examples, however, it becomes clear that the five cat-
difficulties in behaving and expressing themselves in egories overlap.
 1 Medical Anthropology: An Introduction 23

Part I of this book—the part devoted to under- Ebola Response Anthropology Platform. 2015. http://www.ebola-
anthropology.net, accessed May 13, 2015.
standing medical anthropology—contrasts biosocial Etkin, N. 1996. Ethnopharmacology: The Conjunction of Medical
approaches and cultural approaches; this seems to Ethnography and the Biology of Therapeutic Action. In Medi-
be a fundamental distinction. Yet on closer examina- cal Anthropology: Contemporary Theory and Method. Westport, CT:
Praeger.
tion, even this simple distinction is artificial, because Fabrega, H. 1975. The Need for an Ethnomedical Science. Science
the culturally oriented analyses focus on biological/ 189(4207): 969–75.
medical processes, and the biological approaches Fadiman, A. 1998. The Spirit Catches You and You Fall Down: A Hmong
Child, Her American Doctors, and the Collision of Two Cultures. New
almost always emphasize the role of human (cultural) York: Macmillan.
behavior. Within all this theoretical and methodologi- Farmer, P. 1999. Infections and Inequalities. Berkeley and Los
cal diversity, there are essential commonalities in an Angeles: University of California Press.
Farmer, P. 2004. Pathologies of Power: Health, Human Rights, and the
anthropological study of health, illness, and healing. New War on the Poor. Berkeley and Los Angeles: University of
These commonalities all stem from an anthropologi- California Press.
cal view of the world. Fassin, D. 2012. That Obscure Object of Global Health. In Medical
Anthropology at the Intersections. Durham, NC: Duke University
Press.
Finley, E. P. 2013. Empowering Veterans with PTSD in the Recovery
Era: Advancing Dialogue and Integrating Services. Annals of
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Biosocial Approaches in Medical Anthropology
Evolution and Human Biological Variation: Chapters 2–7

CONCEPTUAL TOOLS

n Evolution is the central theoretical concept in the genotypic variation affects patterns of morbidity (the
biological sciences, including anthropology. Evolu- state of being diseased) and mortality (the number
tionary theory is able to explain literally millions of of people who died). Differences in stature (height),
biological observations of the natural world. The fact for example, may reflect the adequacy of childhood
that scientists argue about specific cases or that there diet, whereas genetic differences are involved with
are parts of the evolutionary record that we know lit- predispositions to a wide variety of diseases (Frisancho
tle about should not detract from our appreciation of 1993).
this important concept. In 2003, because of advances in molecular biol-
ogy, scientists sequenced the entire human genome.
n A driving force determining the direction, char- This was an amazing feat, but it also highlighted how
acter, and speed of evolutionary change is natural much we do not know. Gene frequency differences
selection. Evolutionary change depends on the inter- usually reflect historical forces of natural selection
action of organisms and their environment. That or migration. Comparative studies of anthropologi-
interaction results in differential rates of morbid- cal genetics can help in reconstructing prehistoric
ity (sickness), mortality, and fertility for individuals patterns of population movement—for example, the
with different traits. Genetic evolution works when movement of Siberian people to North America. Dif-
there is variation in a population based on inherited ference in gene frequencies among populations can
characteristics. In the process of natural selection also reflect historical exposure to particular factors
some inherited traits affect the ability of individuals in natural selection—including diseases and food
to survive and reproduce; thus, over generations of shortages.
individuals living and dying in a particular ecological Phenotype refers to expressed biological features
context, traits that enhance reproductive fitness tend resulting from the interaction of genes and environ-
to increase. And genetic traits that make it more likely ment. People living for a long period at high eleva-
that individuals or their offspring will have fewer off- tions, for example, can physiologically adapt to the
spring tend to decrease. Evolutionary change includes shortage of oxygen by developing greater hemo-
the possibility that, over generations, a species can globin density as well as greater lung capacity. Babies
change into another species. Geographic isolation can born in higher altitudes tend to be smaller than babies
accelerate this process. born at sea level. Probably the most important mech-
anism for phenotypic variation involves nutrition.
n There are other forces in evolution besides natu- Biological anthropologists studying human growth
ral selection. These include mutation, gene flow or and development have shown that poor growth—
migration, and genetic drift. stunting and wasting—is a sensitive measure of lack
of adequate food in childhood. Other kinds of mal-
n Variation can be genetic (in the genes) or pheno- nutrition, such as deficiencies in the micronutrients
typic (in observable characteristics). Some biologi- iodine and vitamin A, may have permanent effects
cal variation among contemporary humans is related on mental capacity. Therefore, observed biological
to health—either phenotypic variation is the result variations among groups often reflect environmental
of different health and nutritional experiences or rather than genetic difference.

25
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But although so dark, the forest is not silent. Its great pulses throb
and murmur with the pleonastic signs of tropic life. There comes
upon the ear the thousand tiny voices of insects and of birds,
swelling and dying in a soft-toned lullaby chorus, which, like the
murmur of the coast-waves ten miles to the eastward, is never
ceasing.
It does not require a second glance at the lonely figure at the little
rocky pool to ascertain that it is that of an aboriginal. He is dressed
in the ragged remains of a coarse woollen shirt and trousers, both of
which garments are so torn with the thousand thorns of the thickets
their wearer has just traversed that the wonder is that they still cling
to his thin and emaciated body.
Presently the black raises himself from the ground, where he has
been reposing at full length upon his back, with his arms extended
at right angles to his body, after the fashion of aboriginals who have
undergone excessive fatigue, and totters towards the little water-
hole. First examining the sand upon its banks for footmarks, he next
proceeds to bathe his bruised and bleeding limbs. The man before
us is Billy, the late Dr. Dyesart’s “boy,” and he is almost in as bad a
plight as when we saw him on the eventful morning by Paree River’s
side, when the explorer saved the wounded child from the uplifted
axe of the squatter’s tracker. Billy is now a young man of twenty-four
years of age, well-built, active, and handsome for an aboriginal; but
the privations and trouble he has lately undergone have pulled him
down considerably. After refreshing himself at the pool, he sits down
on a fallen tree, and, feeling in his pockets, smiles to himself as he
finds that he still possesses a pipe, tobacco, and matches. He is too
fatigued to search for food yet awhile, and here is something to
stave off the feeling of hunger for a time. Odd as it may appear to
those of our readers who do not know Australia intimately, Billy,
although a native, and born a warragal, or wild native, was almost
as helpless as a white man in this “scrub” country, as regards finding
the means of sustenance. Take an aboriginal from the semi-desert
interior of Australia, and place him in the coastal jungles of the
north-eastern shores of the great island, and he is hardly more
capable of getting his living there than a European, who then saw
the “bush” for the first time, would be under similar circumstances.
The fauna and flora were all new to Billy; even the snakes were
different. This was bad enough, but, in addition, he had only just
escaped from remorseless enemies, who might even now be again
upon his tracks. The dependent life he had led for sixteen years with
his old master was much against him, now that he was thrown upon
his own resources. Much of his late life had of course been in the
“wilds,” but they were very different to those that now formed his
hiding-place. And, besides, there had generally been flour galore for
“damper” and “Johnnie-cake” making, and always plenty of powder
and shot as a dernier ressort with which to procure a meal.
The young man sits smoking and thinking for a while, and then
falls to digging away at the rotten wood upon which he is seated,—a
small, toothsome luncheon of fat, oily grubs rewarding his
operations. Suddenly he stops, and withdrawing the pipe from his
mouth listens intently. His marvellous powers of hearing have
detected a distant sound that, falling on the tympanum of a
European’s ear, would have become jumbled up and lost amidst the
confusing buzz of flies and other myriads of tiny noises around him.
What the sound is caused by Billy cannot tell, but it is a stationary
one, and in a different direction from that by which any of his
pursuers are likely to approach. It may be natives chopping down a
tree for honey, but it is almost too sharp in tone for that. After
listening awhile the young man rises, and, having determined to
ascertain the cause of the phenomenon, begins to crawl down the
bed of the little rocky creek nearby in the direction of the curious
sounds.
Ragged fragments of basalt, straggling tendrils of sharp-toothed
lawyer-vines, and other impediments, make his progress slow and
painful; but after creeping along the half-dried-up course of the
torrent about a quarter of a mile, where hundreds of mosquitoes
and leeches combined, in a sort of guerilla warfare, to attack the
black’s arms, legs, and face, he at last finds himself on the edge of a
cliff, above one of those curious, circular, crater-lakes that abound in
one part of the great uplands of the wild coast range.
Black walls of basalt rise more or less perpendicularly around the
dark, indigo water at their feet. Here and there the ancient lava has
crystallized into prismatic columns, or weathered into picturesque
battlements and projections, which stand up, like the ruins of some
old abbey, above the feathery palms and undergrowth that struggles
down the precipitous cliffs in places in avalanches of sunlit emerald
or shady o’erhangings of brown and purple.
The dark mountain tarn is some two hundred yards across, and
opposite to where the stream, whose bed has hitherto been Billy’s
road through the jungle, joins it, the surrounding wall of cliffs seems
to fall away, as far as one can make out in the shadows, as if the
waters of the lake there found a means of exit.
Cautiously peering through the prickly palms and brushwood, our
black friend endeavours to find an open space through which he can
proceed on his way; but so dense is the mass of vegetation on all
sides that there appears but one road to take, that offered to him by
the lake itself.
It speaks well for the superstitionless training Billy had received at
his late master’s hands that he at last determined to take water, as a
means of continuing his journey towards the sounds that still,
intermittently, make themselves heard above the various voices of
the forest. For little in nature can surpass the awful, supernatural
look of these black, silent jungle lakes, and there was something
particularly “uncanny” about the appearance of this one. And when,
in addition to this, there was the certainty of those dark waters
being the abode of more or less numerous swimming snakes, also
the grim possibility of some frightful veengnaan—the local Australian
edition of a Scotch “water-kelpie”—lurking in those gloomy depths,
we may safely say that it showed Billy to be possessed of a cool
courage of no ordinary sort when he determined on trusting his
fatigued and wounded body to its inky bosom.
 Quickly making up his mind, he wriggles through the springy mass
of steaming vegetation upon the edge of the cliff before him,—losing
quite a number of square inches of his fast-disappearing garments in
the process,—and emerges from the shadows into the fierce midday
heat of a tropical winter day.
A drop of twenty feet only has to be made to reach the silent
waters at this point, for the storm creek has cut through the brim of
the crater basin a dozen feet or more; and Billy is just about to make
the necessary dive—as the prickly vines around offer no friendly
chance of descending by their means—when he pauses to listen
once more.
There are two sounds now audible above the ordinary murmurings
of the forest. The clink! clink! of the noise he has followed now
comes clearly upon the ear, and he recognizes it as proceeding from
the pick of some prospector or miner working a creek or gully below,
and beyond the lake. There is a cheerful ring about it that strikes a
pleasant chord of remembrance in the mind of the poor, hunted
wretch who now hears it; for it reminds him of happy, hopeful days
with his old master. But the other sound that is upon the air, and
whose purport Billy recognizes as easily as that of the unseen
worker’s blows,—there is no mistaking those musical whisperings
that are just audible, and seem to come from that broken mass of
piled-up grey and purple rock that towers above the scrub a little
distance off upon his right hand. The “banked-up fires” of Billy’s
savage nature burst up into an energetic blaze as he hears the
voices of a party of natives arranging themselves into a half circle,
with the intention of surrounding and capturing some prey they have
discovered. Billy correctly guesses the purport of these signals, but
does not understand the exact meaning of the words, for he knows
little or nothing of the coastal languages. What the natives on the
rocky hill have in view is evident: it is the busy worker in the gully
beyond. Billy forgets his fatigue as he glances round and satisfies
himself that he has the start of the hunters, and then plunging into
the water, with marvellously little noise considering the height from
which he has descended, swims after the manner of a dog rapidly
round the lake, keeping close to the cliffs on the side nearest to the
approaching blacks.
The natives of most countries situated in the southern
hemisphere, ere foreign civilization has crushed them in her deadly
embrace, are good swimmers, but some of the inland tribes of
Australian aborigines are perhaps able to produce the best of these,
—men who can beat even the marvellous aquatic feats of Tongan,
Samoan, and Maoris. The blacks of some portions of the central
wilds have a fish-like proclivity for swimming and remaining for a
long time under water that is simply marvellous.
In the muddy water-holes of the great, intermittently-flowing
rivers of Northern Australia, we have seen aborigines successfully
chase the finny denizens of the deep pools, and bring them otter-like
to the shore in their white-toothed jaws. And many a hunted black
has saved himself from the cruel rifle of squatter invaders of his
native land by pretending to fall as if shot into a river or water-hole,
and remaining, apparently, at the bottom. They manage this artifice
in various ways: sometimes by swimming an incredible distance
under water to a sheltering weedy patch or bed of rushes, where
they can remain hidden; but more often by plastering their heads
and faces with mud, and remaining, sometimes for hours, with only
their nose above water, in some corner where floating leaves, grass,
or the like, afford a temporary blind to baffle their relentless foes.
Billy, although by no means as perfect a swimmer as some of his
countrymen, showed great skill in the way in which he noiselessly
moved through the water to the opposite side of the black lake, and
hardly a ripple disturbed its placid surface, above which his dark,
glistening head only thrice briefly appeared during his swim.
Arrived at the point he had started for, the young man slowly
raises his face again into the hot sunshine behind the leafy cover of
a fallen mass of enormous stagshorn ferns, and carefully
reconnoitres the summit of the opposite cliffs for any enemies who
may be watching him.
 None are in sight, so Billy leaves the water and proceeds to climb
the rough side of the old volcano crater, and as the rocks are lower
and less precipitous than at the place where he dived into the lake,
he soon reaches the shelter of the scrub once more. A kind of
rugged giants’ staircase, which the overflow from the lake has cut in
the ancient lava covering of the mountain, now leads Billy down into
a wide, wild-looking gorge, about two hundred feet below the
surface of the dark tarn above. Through the centre of this deep
gully, and flanked with a dense growth of gracefully festooned trees,
runs a clear, silver stream, with a cool, refreshing, rushing voice,
amongst the smooth, rounded bounders in its course. Taking its rise
in some limestone formation in the unknown depths of the jungles
beyond, it has painted its rocky bed of a pine white with a
calcareous deposit, that stands out in strong relief to the sombre
hues of the overhanging cliffs that here and there jut out boldly from
the verdure on either side.
Each recurring wet season sees the whitened boulders swept off
towards the sea-coast by the angry brown waters of the “flushed”
river, in company with the like that has collected during the interval
since the previous rains, and then the fierce torrent, gradually
settling down once more into the bubbling little stream as we now
have it, sets to work again to paint a fresh strip of white through the
twilight forest glades.
Kneeling by the side of one of the chain of snowy pools that
stretches into the misty vista of graceful palms and dark-leaved
trees, beneath the afternoon shadows of the gorge, is a strange-
looking figure, quite in keeping with the wild surroundings,—a thin,
elderly man, with a ragged, unkempt beard and deeply bronzed and
furrowed face, shaded by the most dilapidated of soft felt hats. The
spare figure that Billy is now watching is covered with clothes so old,
patched, and repatched that one would hesitate to pronounce an
opinion as to which of the frowsy fragments formed part of the
original garments. A certain yellow tone of colour, something
between that of a nicely browned loaf and the lighter tints of a
Cheddar cheese, pervades the “altogether” of the old man, for the
iron-rust and clay-stains of years of lonely toil amongst the
mountains have dyed both skin and rags of one common colour.
A thin but muscular left hand holds the outer rim of a brown,
circular iron pan,—called by miners a “prospecting dish,”—and
presses its other edge against the ancient’s open-bosomed shirt, so
as to keep the vessel firmly in position, as the keen old eyes
examine its contents for the cheering yellow specks with a small
pocket-lens.
Billy stands looking at the old prospector for a minute, and rightly
guesses that he is one of those mining recluses, called “hatters” in
Australia, some specimens of which class our dark friend has met
before. In fact, Billy’s curiosity as a miner himself makes him nearly
forget the approaching natives, in his eagerness to ascertain if the
dish now being “panned off” shows the presence of the precious
metal in the locality. But this hesitation on his part is not for long.
Billy has retained his European raiment at some considerable
inconvenience in his flight through the scrub, for the same reason
that chiefly prompts Australian aboriginals to put such value upon
the sartorial signs of civilization, and now he is to reap the fruits of
his forethought.
Many an Australian bushman will shoot a native at sight, without
compunction, if in puris naturalibus, and it is a fact that many make
it a rule to do so when meeting a “nigger” alone in the bush; but the
same individuals would hesitate to pay this attention to a black
sheltered in that badge of servitude, an old shirt or ragged pair of
inexpressibles whose wearer may possibly belong to a neighbouring
squatter or police inspector.
Billy trusts now implicitly to his torn clothes to serve as a flag of
truce till he can get a hearing from the man whose life he is
probably about to save; and careless of the fact that the old miner
has a revolver hanging in the open pouch at his belt, and that a
fowling-piece lies by the pick within a yard of the thin, hairy right
arm, he girds up his tatters and commences to whistle loudly as he
makes his way over the hot boulders towards the curious, propensic
figure by the stream-side.
The old prospector turns suddenly as the shrill notes of Billy’s
musical trilling echo along the rocky sides of the glen, and, dropping
his dish, snatches up the brown old “Manton” by his side.
“Hold on, boss!” shouts Billy, thinking for the instant that perhaps
he had been too rash after all, in leaving his shelter amongst the
rocks before holding a parley with the stranger.
“Hold on, boss; you’ll want your powder for warragal blacks
directly, and better not waste it on ‘good fellow’ like me.”
“Who the devil are you? Move a step an’ I blow your brains out,”
responds the old man, lowering the piece, however, from his
shoulder.
“I’m white fellow’s boy,” explains Billy, sitting down on a boulder in
order to show his faith in the miner’s good sense, and also to give
that dangerously excited old individual a chance to examine him and
cool down. “I’m white fellow’s boy, and I see black fellow coming
after you. They make a circle to catch you. See, I have swum the
lake to bring to you this news. I was hidden when I saw them first.
They will try to get me now as well as you; you must let me go with
you.”
“Where’s your boss?” asks the old miner, glancing round on all
sides for any signs of approaching foes.
“My boss is dead. His name was Dr. Dyesart, Dyesart the explorer.
Perhaps you’ve heard of him? But you had better clear before the
Kurra (vermin) reach us.”
The old “hatter’s” eyes gleam suspiciously at Billy as he speaks
again.
“Yer may be a good nigger. But yer too durned well spoken fur a
nigger fur my thinkin’. I knew Dyesart once, and I’ll soon find out if
ye’re trying ter fool me. But here, take the pick an’ dish, and go on
ahead of me down past the rock there.”
 Billy picks up the utensils mentioned, and, summoning up all the
remainder of his strength, totters along the bed of the stream in the
direction indicated by the skinny finger of the dirty old solitary, who
comes shuffling along after him.
The part of the ravine the two men are now entering is even
wilder than that where they first became acquainted with each other.
The ground sinks rapidly, as the increasing noisiness of the brawling
streamlet indicates, as it leaps from rock to rock on its way, as if
rejoicing upon its approach to freedom and the sea. Some way down
the gorge, the steamy haze of a cataract climbs up the cliff sides and
blots out further view in that direction, and the soft thunderings of
falling waters come up the gully at intervals, as the evening breeze
begins to stir the topmost branches of the stately trees.
Great black cliffs tower skywards on the left-hand side, and their
grim fronts yawn with numerous caves, the cold husks of what were
once enormous air-bubbles in that awful flood of molten rock that in
the far-off past poured down these mountain slopes from the
Bellenden Ker group of ancient volcanoes.
A few more words have passed between Billy and the ancient
“hatter,” which have apparently fairly satisfied the latter as to the
goodness of the dark-skinned younger man, when the clamour of
shouting voices behind them makes both turn round.
The sight that meets their eyes is by no means a pleasant one.
Halfway down a part of the cliffs that the two men had passed only
a minute or so before, a party of natives has just arrived, all of them
naked, and carrying long spears, probably with the intention of
cutting off the old digger’s escape down the gully. These sable
hunters, seeing that their quarry has, for the time, escaped them,
are shouting to their friends up the gorge to join them, for a fresh
effort to surround the object of their hatred and suspicion.
“Only just in time, boss!” exclaims Billy, his white eyeballs glowing
like coals from their dark setting of swarthy skin, as he watches the
rapid movements of the enemy, who are moving along the summit
of the cliff towards them. “Those devils got you safe enough, ’spose
they’d kept you up there till dark,” pointing to the open part of the
gorge.
“But where will you camp? I’m tired. In fact, just ’bout done. I
have walked many miles to-day, and have eaten little since three
days.”
“This is my camp,” answers the “hatter,” climbing up to one of the
aforementioned caves with an agility that a far younger man might
have envied. “We can keep out of the niggers’ way here.” And the
old man coolly began to collect some sticks and leaves that lay about
the entrance to the cavern, in order to start a fire, just as if two or
three score of howling savages, all thirsting for his destruction,
within a couple of hundred yards of him, was a matter of every-day
occurrence to him, and therefore one of no importance.
Night falls quickly, and outside the cave the darkening forest
begins its night chorus of many voices, day-choristers retiring one by
one. The mountain teal whistle and “burr” in answer to each other;
owls and night-jars scream and gurgle in the trees; boon-garies
(tree-kangeroos) squeak and bark to their mates, as they leave the
branches for a night stroll in the scrub; and every crevice of the
caves gives forth its dark legions of flitting bats, some of enormous
size, who vociferate shrilly, with ear-piercing notes, as if thousands
of ghostly slate pencils were squeaking in mid-air on an equal
number of spectre slates.
Inside the cave, which is much larger than its small, porthole-like
entrance might lead one to imagine, the two men speedily make
themselves as comfortable as they can under the circumstances.
There is ample room for the fire that soon lights up the concave
roof, of the cavern with a cheerful, ruddy glow, and the smoke
rolling out of the doorway keeps the place clear of mosquitoes, who
are getting pretty lively outside already.
The old “hatter” has used this retreat as his camping ground for
the last few days, whilst prospecting this part of the upper waters of
the unnamed creek, that can be heard in the darkness flowing past
his temporary abode, and a small but sufficient supply of flour, tea,
and sugar is to be seen carefully suspended from the stalactite-like
projections from the ceiling of the cave. This provender, with the
remains of a couple of pigeons, half a dozen wild turkeys’ eggs and
some coohooy nuts give promise of a good “square meal,” at last, to
the exhausted and half-famished Billy.
“Yer’ve done me a good turn, and though yer are a nigger, yer
welcome ter what I’ve got here,” remarks the grey-headed old gold-
seeker after a long silence, during which he has disinterred some of
the aforementioned viands from an anti-wild dog pyramid of stones
in one corner of the cave.
“Them blarmed devils outside hain’t seen a white face up here
afore I’m thinking, and I guess they’ll not bother us till morning.
What do you think, Charlie, or Jackie, or whatever yer name is?”
“My name’s Billy, boss,” replies our dark friend, who is
endeavouring to keep himself awake by frantically chewing some of
the sodden tobacco he has discovered in his pocket. “I think these
fellows throw spear into cave by-an-by, p’r’aps. I think best keep up
here,” pointing to a buttress of rock that, projecting from the walls of
the cavern, provides a substantial shield against any missiles flung in
at the cave entrance. “But I know little of these fellow-blacks. I
come from the flat country, this time, out by the Einsleigh River
way.”
“Ugh,” grunts the old man in reply, and telling Billy to “have a
‘doss’ (sleep),” whilst his namesake, the billy, is boiling, the “hatter”
proceeds to cut up a pipe-full of very foul-smelling tobacco, looking
thoughtfully at the fire meanwhile.
Billy, on his part, is not slow to avail himself of his host’s invitation,
and sinking down upon the cold rock floor goes immediately to
sleep.
If it should appear, to any of our readers to border upon the
incredible, that two men should thus calmly sleep and smoke in the
face of danger, that to one inexperienced in the wilder phases of
bush-life would appear to demand the utmost vigilance, we can only
reply by offering as our defence, firstly, the old saying that “truth is
oftentimes stranger than fiction;” and, secondly, that in this scene,
as in each of our main incidents, we have endeavoured to sketch
from memory a faithful if humble representation of an actual
occurrence, in preference to indulging what latent talents we may
possess in the walks of imaginative scene-painting.
Mais revenons à nos moutons. The old “hatter” sits silently
smoking; sometimes glancing upwards towards the roof of the cave,
where the almost obliterated representations of white and red hands
—the work of previous aboriginal occupants of the retreat—are still
discernible, and at others fixing his ferret-like, bloodshot eyes upon
the dark, hardship-lined face of the slumbering Billy, as the firelight
dances upon its swarthy surface. Nothing appears to disturb the
well-earned repose of the two men, save a small black snake that
comes wriggling in to enjoy the warmth of the blazing branches, and
meets with a warmer reception than it had anticipated. Then the
billy at last splutters out its welcome signal, and the old digger and
his companion proceed to indulge that taste that has made
Australians the greatest consumers of tea, per head, in the world.
“Them Myalls (wild natives) don’t seem to mean business to-
night,” observes Billy’s host, when the silent meal is finished, as he
hands our black friend a piece of “nailrod” with which to charge his
evening pipe.
“I think they wait, boss. Watch an hour, perhaps two or three,
then throw spears.” Billy leans forward as he speaks to heat a piece
of tobacco in the embers, in order to soften the flinty morsel, and
thereby facilitate the operation of cutting it into shreds.
“I think those beggars,” jerking his black thumb towards the
darkness outside the cave entrance, “I think those beggars come by-
and-by. Urraurruna (take care); I think they come presently.”
 Then both men relapse again into silence, each engaged with his
own unpleasant thoughts. The “hatter,” although somewhat
favourably prepossessed with Billy’s appearance, and glad of a
companion for the time being, has that instinctive distrust of a
“nigger” common to most Australian bushmen. He does not care
altogether for the presence of his new acquaintance in the cave, and
even considers, for a moment, what would be the easiest way of
getting rid of him, and making him seek another shelter for the
night. But the feeling of gratitude to Billy for the service he has
rendered that day finally prevails, and the old man determines to
hear the “boy” further explain his appearance in the gorge before he
acts.
Billy, on his part, although naturally of a sanguine turn of mind (as
indeed all his race are), and little given to ruminating upon the
sorrows of to-morrow, is trying to puzzle out a plan of future
operations, whose main object is to discover the nephew of his late
employer. He notices the half-concealed, suspicious glances of his
dirty old host, and is almost tempted to offer to seek other lodgings,
when the latter breaks the silence once more.
“’Spose you’re a runaway nigger? Station or police?”
“Yes, boss, I’m a runaway. But I’ve never worked on station.
Always with the doctor. All my time mining and cooking for the old
man.”
“Thought yer was,” grunts the old prospector, taking his pipe from
between his yellow teeth for an instant; “noticed the way yer carried
the pick, and guessed yer knew something about ‘breaking down a
face.’”
“Yes, I can do that much, anyhow,” remarks Billy quietly.
“Well, that bein’ so, lad, I ain’t the man as would turn dog on a
poor beggar, let alone a miner, be he black or white. I ain’t built that
way.” The old man stops speaking to listen to a slight noise outside
the cave for a moment, and then continues: “If yer like to camp here
longer me till I’ve done this gully, yer can. But just sling me a yarn
about how yer came to this hole in the ranges.” The speaker turns
towards the fire, that has burnt itself low, and commences to rake it
into renewed brightness. As he does so, his head and right arm
leave the shelter of the projecting rock before-mentioned, and come
between the luminous background of flames and the cave entrance.
Then Billy’s prognostications are fulfilled; for some natives, who
have been silently watching for an opportunity to attack the
occupants of the cavern, immediately take advantage of the
appearance of the old digger, and the fire embers are scattered right
and left by three spears, which, however, luckily all miss their human
target.
The two men leap to their feet, and Billy, snatching up the old
“hatter’s” shot-gun, without waiting a moment to ask the permission
of its owner, glides noiselessly into the darkness, and is lost to the
view of his startled host. Presently the latter proceeds to collect the
scattered fire-sticks, and adding to them the spears, which he
breaks up into pieces, he relights his pipe and waits for the return of
his guest. Half an hour passes in silence, and then two loud reports,
followed by the rain-like pattering of bouncing shot about the
entrance to the cave, and the screams of a number of agonized
voices, proclaim the successful accomplishment of Billy’s plucky plan
of retaliation upon the enemy outside.
“No more trouble to-night,” observes that individual, with a
complaisant grin, as he presently returns into the cavern, striking the
butt of the gun he carries, as he walks, so as to give a jangling
signal of his approach to the man by the fire, who, revolver in hand,
might otherwise mistake him for an enemy. “Shot guns better at
night than a rifle for this kind of work. The beggars have all cleared.
None killed, I think.”
“All the better, lad. All the days I’ve knocked about the bush, I’ve
never shot a black yet, though I’ve seen a many bowled over. But
they warn’t bad in the old days, as they are now. These beggars
here, though, are a bit koolie (fierce); and I don’t blame them. They
don’t like to see a white face,”—the old man’s countenance was
about the tone of colour of a new pig-skin saddle,—“they don’t like
to see a white face hereabouts, for the scrub’s the only place in this
part of Queensland where the poor beggars ain’t hunted.”
The night passes without further cause for alarm, and next day,
and the one after, and for several weeks Billy remains with the old
prospector. And the latter, being a sensible man, and finding himself
thus brought into contact with a mind in no ways inferior to his own,
—albeit housed in corporal surroundings of that dark tint that has
hitherto placed the unfortunate aborigines beyond the pale of
civilized law in Australia,—soon makes a companion and partner of
Billy, instead of treating him as a mere animal, as has hitherto been
his custom with those black “boys” he has had occasion to employ.
Moreover, in our dark friend the ancient “hatter” finds his ideal of
what a model “mate” should be,—strong, cheerful, plucky, frugal,
and, above all, lucky. And sometimes, as the strange pair smoke
their evening pipes together in the firelit cave, and the thoughts of
the “boss” go flying back into the dim vistas of memory, and the
cruel swindles perpetrated upon him by this and that white partner
of his younger days are re-enacted in his mind’s eye, he cannot help
contrasting them unfavourably with his present mate, whose coming
departure, although he is “only a nigger,” the old man begins to
dread with a fear that surprises himself.
“Swelp me,” the poor old solitary soul sometimes ejaculates to
himself, as the chilling thought of once more being a lonely “hatter”
in these awful wilds goes like an ague-shiver through his spare and
bended form, “I suppose I’m getting too old for this kind of work;
and if I had had a mate like Billy when I was young I would have
been doing the ‘toff’ in Sydney by this time, like that rascal Canoona
Bill that swindled me on the Crocodile, and not have had to work up
to my knees in water, with the pan and shovel, at my time of life.”
But it is not approaching age or failing bodily strength that is the
cause of this change in the old miner’s feelings, as he tries to
persuade himself it is, for he cannot find it in his mind to confess he
feels any attachment or affection for a “nigger.” It is something very
different that begins to make him feel disgusted with the idea of a
return to his solitary mode of life.
Billy’s new friend, like most of his class of old “hatters,” became
disgusted with the world owing to having been unfortunate in his
choice of partners, and now that he at last finds one to suit him, his
view of life becomes correspondingly fairer than heretofore.
“Billy!” one evening said the old man,—who has lately informed
our black friend that he is known at Geraldtown and Herberton by
his patronymic of Weevil,—“Billy! you ain’t told me yet how you
come to clear out from the station where you left the doctor’s letter.
What station was it?”
Billy, who is shaping a new pick-handle by the light of the fire,
does not reply for a minute or two. When he does look up at the
lean figure on the other side of the flames, he betrays a little of that
sulky, spoilt-child demeanour generally exhibited by members of his
race when recounting any occurrence that has been a source of
annoyance to them.
“I ran away, boss, because they try and get me to show them the
way back to where I planted the doctor. Mister Giles, who owns the
station——”
“Who?” Old Weevil leans across the smoke towards Billy. “It warn’t
Wilson Giles, were it?” he asks in a low, hoarse voice, looking at the
black with ill-concealed anxiety.
“Yes, Wilson was his front name. D’you know him?”
The old man withdraws into the semi-obscurity of a shadowy pile
of firewood against which he is standing at the question, much like a
sea-anemone shrinks into its rock cleft before an obtrusive human
finger.
“Yes, I know him,” growls the old man in the darkness, exhibiting
an amount of hatred in the tone of his voice that makes Billy look in
the direction of the wood stack with open eyes and mouth. Weevil,
however, does not appear likely to be communicative, so Billy
presently continues: “The doctor’s last words almost were, ‘Don’t let
any one know where you left me save my nephew,’ and so it wasn’t
likely I was going to tell the first man as asked me. Was it likely?”
“Burn him! No!” ejaculated Mr. Weevil, in parenthesis.
“Giles tried me with one thing and then another. Offered me
anything I liked, at last, to take him to the grave. Thought I was
only like a station black, I suppose!” and the speaker scrapes angrily
at the wooden handle between his knees, with a black splinter of
obsidian (volcanic glass) that he is using as a ready-made draw-
knife.
“Then Giles has a talk with his niece,—she bosses it at
‘Government House’” (is mistress at the head-station),—“and she
says ‘Flog the nigger! flog him!’ And a house-gin who belongs to my
Mordu Kapara (class-family), which is Kalaru, hears all this as she
sets cloth in the parlour. She come and tells me. Then me run away.
Then me turn wild beggar again!”
Billy, who by this time is gesticulating excitedly with his hands,
curiously relapses, slightly,—as he always does when highly agitated,
—into the remarkable “station-jargon” to which we have already had
occasion to refer.
“Me run and run. An’ Giles, he borrow the big dogs with the red
eyes and thin flanks (bloodhounds) from Bulla Bulla station.”
“I know ’em,” interrupts old Weevil; “that fellow on the Mulgrave’s
made a good thing out of breeding them for the squatters.”
“Well, boss, I made for the scrub. But I get tired, and the stinging-
tree blind me, all but. The dogs come up close. I hear them howl,
and the men calling to them. But the big dogs badly trained; they go
after young cassowary, and I drown my tracks in a creek, and then
‘possum’ (hide in a tree) all the day.”
After Billy has thus graphically given his account of his marvellous
escape from the clutches of Mr. Giles, the conversation turns upon
the subject of going down the creek to the nearest township, which
we will christen Meesonton, after a well-known Australian explorer
living in the district.
“We’ll both go as far as the low scrub range, over the Beatrice
creek,” observes old Weevil, “and yer can work the old sluice there I
was telling yer of yesterday if them cursed Chinkies ain’t found it. I
won’t be more nor a week or so away. I wouldn’t advise yer,”
continues the old man, “ter show yer face near the store yet awhile.
That beggar Giles is well in with the perlice, and they’d knab yer like
enough.”
So very early next morning Billy and the old miner set out; just
about the time when that earliest of early birds, the crow, has begun
to think it time to commence his matutinal robberies, and long ere
the sun has risen to dry the fern and scrub sufficiently for any
natives to be out hunting who might notice the two men’s departure.
By midday our friends have followed for eight miles that only road
possible through the dense jungle,—the rough, white bed of the
merry little creek. Here, after a rest and a smoke, the men left the
stream and clambered up the dark, clayey banks, when they found
themselves on a broken, open piece of country, across which they
steered, Weevil leading, in a north-easterly direction, passing
numerous little trickling creeks trending eastwards on their way.
Here and there the recent footprints of aborigines were to be seen in
the rich, volcanic soil; and once Billy detected the voices of natives,
but said nothing to his companion about it. Late in the afternoon,
after crossing some level tablelands, thinly covered with scrub,
several large gunyahs (native dwellings) were discovered, and, as
the evening began to look stormy, the two men took possession of
one of the largest of them. These huts were similar to beehives in
shape, like those of the village on the Paree river that we described
in Chapter VIII., and were substantially thatched with fern fronds
and that coarse kind of grass that grows in the open spaces in the
scrub called “pockets” by northern bushmen. These “pockets” are
treeless spots circular in form, and generally half an acre in extent,
and are used by the aborigines for boorers (native tournaments) and
dances. One of these native Champs de Mars, on the upper Barron
river, covers quite fifteen acres, and is also a perfect circle.
It was still dark, the next morning, when Billy and old Weevil
started once more on their journey; and the latter, in consequence,
fell into a two-foot hole near the gunyah in which they had slept,
and found himself lying on a mass of loose, rattling objects, which
his sense of touch quickly told him were human skulls,—the remains,
doubtless, of by-gone picnics of the good people whose village the
two men had appropriated during the previous night.
Pushing onwards, our friends spent the first half of the day in
climbing rocky peaks, and crossing the dark, rugged sources of
creeks, wrapped in their primeval gloom of frizzled, intricate masses
of thorny vines and dangerous stinging-trees; and, after making only
three miles in six hours, were forced to rest awhile in a ragged gully,
walled in by grey slate cliffs, and strewn with glistening blocks of
white and “hungry” quartz.
The stinging-tree, which we have twice mentioned in this chapter,
is worthy of a few remarks, for it is perhaps the most terrible of all
vegetable growths, and is found only in the scrub-country through
which Billy and his friend are now forcing their way.
This horrible guardian of the penetralia of the Queensland jungle
stands from five to fifteen feet in height, and has a general
appearance somewhat similar to that of a small mulberry-tree; but
the heart-shaped leaves of the plant before us differ from those of
the European fruit just mentioned in that they are larger, and
because they look as if manufactured from some light-green, velvety
material, such as plush. Their peculiarly soft and inviting aspect is
caused by an almost invisible coating of microscopic cilia, and it is to
these that the dangerous characteristics of the plant are due. The
unhappy wanderer in these wilds, who allows any part of his body to
come in contact with those beautiful, inviting tongues of green, soon
finds them veritable tongues of fire, and it will be weeks, perhaps
months, ere the scorching agony occasioned by their sting is entirely
eradicated. Nor are numerous instances wanting of the deaths of
men and animals following the act of contact with this terrible lusus
naturæ.
Billy and Weevil make more progress during the afternoon, the
country being more level and the scrub less thick; but, although
both men are inured to fatigue and discomfort of all sorts, they are
forced to camp early, after doing another six miles. Ragged, weary,
and barefooted,—for even the most imaginative mind could hardly
recognize the flabby pieces of water-logged leather that still adhere
to the men’s feet as boots,—the two travellers fling themselves down
on the dry, sandy bed of a mountain torrent, and scrape the clusters
of swollen leeches from their ankles, which are covered with clotted
blood, and pick the bush-ticks and scrub-itch insects from their flesh
with the point of the long scrub-knife the old digger carries.
As our friends are engaged in this painful but necessary toilet of a
voyager through the Queensland scrub, a wild turkey comes
blundering by in all the glories of her glossy, blue-black feathers and
brilliant red and yellow head,—not the Otis Australasianus which is
known to southern settlers as a “wild turkey” and is in reality a
bustard, but a true scrub turkey (Telegallus).
Billy is not long in tracking the footprints of the bird back to its
enormous mound nest. For this ingenious feathered biped, like her
smaller contemporary the scrub hen (Megapodius tumulus), saves
herself from the monotonous duty of sitting on her eggs by
depositing them in a capital natural incubator, formed of rotting and
heated leaves, which she collects into a pile, and arranges so as to
do the hatching part of the business for her.
A meal of turkey eggs and roasted “cozzon” berries, whose red
clusters are to be seen hanging from parasitic vines upon the great
stems around in plentiful profusion, and then the men retire to rest
upon their wet blankets, beneath a great ledge of granite, upon
whose surface some aboriginal artist has delineated in different
colours the admirable representations of immense frogs in various
attitudes.
 But trouble commences with the morrow; and when old Weevil
raises his stiff and patchwork form from the hard couch upon which
he has passed the night, he finds Billy, gun in hand, watching
something on the dim summit of the cliffs opposite their camp.
“Sh!” observes that individual, without turning his head; “plenty
black fellow all about here. D’you see that beggar’s head?”
“Bust ’em!” yawns the old digger, stretching; “they won’t interfere
with us. Let’s have tucker, and ‘break camp’ as soon as we can.”
The frugal repast is soon silently completed, but half a mile down
the creek, where the aborigines have constructed an ingenious weir,
armed with conical baskets in which to catch what fish may pass
that way, Billy and his companion find a small army of copper-
coloured natives collected on the opposite side of the stream, who
wave and beckon to the two travellers to return whence they came.
Their gesticulations and fierce yells not having the desired effect, a
series of signals are given by them to other natives in ambush on
the jungle-fringed precipices that rise with lycopodium-tasselled
ledges above the heads of the intruders.
“We’re in fur it now!” grunts the older man, who has done some
prospecting in New Guinea, amongst other places. “Them yellow
niggers is Kalkadoones, and as like Papuans as may be; and they’re
devils to fight. Keep close under the cliff.”
Billy guesses the mode of attack which the old digger’s experience
teaches him to anticipate, and which prompts his advice to his mate
to seek the shelter of the rocks as much as possible. The wiseness
of this precaution is soon seen. For when our friends are fairly
started on their way past the rapids in the gloomy gorge, the natives
commence hurling down great boulders of conglomerate. These
would speedily have crushed the adventurous twain below, had they
not been sheltered by the overhanging base of the precipice, which
was worn concave by the river’s action during floods. As it was many
of the rocks bounded horribly close to the men’s heads.
 “I can’t use my gun here, that’s sartin,” presently observes the old
man, as he puts fresh caps upon his old companion of many years.
“We’ll have to clear them beggars off before we go any further.”
Then springing from his shelter with his rags and tangled grey locks
flying in the air, Weevil makes for a rocky reef that juts out into the
river, which is deep at this place, with the idea of peppering the
enemy from this point of vantage.
But the Fates are against him, and sable Sister Atropos snaps her
weird scissors on poor old Weevil’s thread of existence. A shower of
stones descends upon the wild-looking figure as it hurries towards
the river, and the old miner falls an uncouth, bleeding object upon
the strand, groaning heavily.
Happily, the gun has escaped destruction, and by its aid Billy, who
rushes forward to defend his friend, performs prodigies of valour
that on a field of civilized warfare would certainly have gained him
some such coveted distinction as the Victoria Cross.
A hurried shot at the yelling figures that are clinging to the trees
overhanging the edge of the cliff in an appalling manner, and one of
them comes spinning down with a sickening thud upon the rocks
below. A second wire cartridge sent in the same direction is equally
successful, and another of the enemy tumbles forward on to a
jagged rock that projects from the precipice; while his friends,
horrified at the sudden illness that has thus overtaken two of their
number, stop short in the middle of a diabolical yell of triumph, and
clearing off are seen no more.
Billy bathes the crushed features of the old man, whose
stentorious breathing shows how badly he is injured, and the cold
water revives him somewhat.
“I’m busted in my inside, lad,” he murmurs raspily. “Gimme me
pipe. I can’t see to——How blind I’m gettin’!”
After a pause, during which he has tried to smoke in vain, he asks
to be raised in a sitting posture.
 “Billy,” he says, when this is effected, “you’re a good boy. I’m goin’
fast. Listen ter me afore I chuck it up altogether. Me legs is dead
already.”
The dying man has a crime upon his soul, and dreads to take the
secret of it with him into the unknown which he is about to enter, so
he fights gamely against the dissolution that is fast approaching till
he has told it to Billy.
“Remember what I tell ye, lad. ’Twas I as stole Wilson Giles’s only
son. Giles had ruined my life, and (gasp) I tuck revenge. I marked
the boy blue star an’ W. G. on near shoulder. Then I cleared out an’
tuck him (gasp) ter Sydney.”
Silence for a time follows, after which the expiring flame of life
flickers up, and the last words Weevil speaks on earth are gasped
out.
“God furgive me! Intended to return boy after a bit. Lost him in
Sydney. God furgive me! (gasp). Goo’-bye, ole man. Let’s have
’nother——(gasp). Oh God! Jane! Jane! come back ter me!”
The old man stretches out his wounded hands as he wails the last
sentence in tone of wild entreaty, and Billy feels, by the suddenly-
increased weight in his arms, that he is holding a corpse.
 CHAPTER XIII.
CLAUDE’S LETTER TO DICK.

“We have at various times had stories told us of the treatment

the blacks are subjected to in the bush, and it behoves the
Government to make strict inquiry into the whole question. By
the way, where is the Protector of Aborigines, and what has he
got to say in the matter?

“Oh it’s only a nigger, you know;

It’s only a nigger, you know;
A nigger to wallop, a nigger to slave,
To treat with a word and a blow.
“It’s only a nigger, you know;
A nigger, whose feelings are slow;
A nigger to chain up, a nigger to treat
To a kick, and a curse, and a blow.
“It’s only a nigger, you know;
It’s only a nigger, you know;
But he’s also a brother, a man like the rest,
Though his skin may be black as a crow.”
“Bacca.”

From the “Lantern,” South Australia, 1889.

“Mount Silver,
“August 8th, 1889.

“Mr. Richard Shaw, Te Renga-renga, Drury, New Zealand.

AR DICK,—In my letter to the ‘Mater’ I have set forth all those of my
experiences, up to date, that I consider of most interest to the gentle
female mind, and have omitted certain others of a more painful
character. For you, old man, I preserve the honour of participating in
the ‘noble indignation’ which at present suffuses the soul of ‘yours
regardfully,’—the outcome of my present surroundings of many most
 un-English institutions. For my pericardiac
region is sickened and disgusted with certain
‘goings on’ in this fair colony of the British
Crown, and I would fain burst into poetry—after
the Whittier style—only that I am well aware
that my knowledge of the properties of the
hexameter is considerably less than my
acquaintance with those of the lactometer.
“But ere I launch into these matters, I will
roughly sketch out my doings since I posted my
last letter, which I wrote at the pretty, sand-
surrounded, and ‘quite too awfully’ tropical little
port of Cairns.
“Australian hospitality is proverbial, but I have to withdraw myself
as much as possible from the ‘here’s-a-hand-me-trusty-fren’ kind of
thing, as I find it means participating in an unlimited number of ‘nips’
of ‘stringy bark,’—a curious combination of fusil oil and turpentine,
labelled ‘whisky,’ or of a decoction of new and exceedingly virulent
rum, much patronised by the inhabitants of these sugar-cane districts.
However, whilst arranging the necessary preliminaries for my journey
at this little inland township, I have made several acquaintances. One,
a Mr. Feder,—the manager of a German-Lutheran mission station
about fifty miles from here,—who, it appears, knew my Uncle Dyesart
some few years back, and may prove useful to me in my search after
Billy. I have also come across an Inspector of Police, by name John
Bigger, who, although I have certainly not returned his advances with
much warmth, for I think him a silly old swiper, is everlastingly
thrusting his companionship, upon me; and, although he is apparently
doing his best to make my stay here agreeable, one can have too
much of a good thing, especially when the said good thing suffers
rather from ‘furor loquendi,’ in other words, is a confounded old bore.
“This inspector introduced himself to me as a friend of one
Inspector Puttis, whom he says was a friend of uncle’s. This Puttis
sends word that Billy has disappeared from Murdaro station; but as I
never mentioned the fact that I wanted to find Billy to any one here
till after I received this message, I am rather at a loss to understand it
altogether.
“Now my other acquaintance here—the missionary cuss I
mentioned—curiously re-echoes the last words in uncle’s letter,
namely, to distrust the police. And in faith I believe they’re a bad lot
entirely, although I suppose there are some exceptions.
“It is partly in consequence of this that I have not accepted an
invitation to go shooting with the inspector to-day, and am writing to
you instead.
“My old miner friend got bitten by a large poisonous black spider at
Cairns, and is hors de combat. So I have been obliged to leave him
behind for a time with Don, who is turning out a grand little fellow.
These two will follow me to Mount Silver next week, when I shall start
for Murdaro station immediately. I am not wasting my time in the
interim, although I itch to start, but am making myself acquainted
with the ways of station-life and mining matters in this wild part of
the world. If Billy arrives at the mission station, as Mr. Feder thinks he
probably will, I shall be communicated with at once. But ‘how do I
manage without my little henchman Don?’ you’ll be after asking. Well,
that brings me to the main subject matter of this epistle. I have a
second ‘boy Friday’ now; and what is more, he’s black as a crow, and,
moreover, I bought him. Yes, in the year of our Lord, 1889, in the
civilized street of a town in an English colony, I followed the custom of
the place, and purchased the little black specimen of humanity that is
now amusing a party of his aboriginal friends, over there by the town
well, by imitating with a piece of stick the way I brush my teeth of a
morning, which operation I noticed has amazed him muchly, and is
probably indulged in by few of the whites about here.
“I travelled alone as far as this place, being anxious to get on here;
and my obliging host—who talks broad Scotch, although he is by two
generations a colonist—advised me to get a ‘boy,’ as all black
servants, regardless of age, are called here, to look after my two
horses. Well, to cut the story short, I paid £2 for little Joe to a carrier
whom ‘mine host’ informed of my wants. Joe is a great help, and
according to the unwritten law of the place,—which appears to be
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