the shaman's needle: development, shamanic agency, and intermedicality in Aguaruna Lands, Peru

SHANE GREENEUniversity of Chicago

Medicine has played a complicit role in European imperial expansion since the very beginnings of colonial ventures around the globe (see Comaroff and ComarorY 1992; Fanon 1978; Latour 1988:111-145; Macleod and Lewis 1988; Paul 1978). Such complicity, termed a "medical conquest" by Kay (1987), is historically present in Latin America. There is evidence in even the earliest Spanish efforts aimed at facilitating the containment, control, and conversion of native populations of the New World through royal ordinances demanding the creation of nucleated "orderly" townships, termed reducciones, in the colonies.' As with cathedrals, hospitals were centrally located, physically and socially constructed monuments integral to establishing a sense of Spanish colonial order and facilitating the subjugation of native populations. In the modern era, the existence of Western-style, biomedically based health centers and services that are often overly specialized for what "developing" countries are permitted to afford in the global economy points to the influence Western societies hold: it is, concomitantly, political, economic, cultural, and medical. A recent manifestation of the continuing collusion between medicine and Western neocolonial, capitalist interests is the role that medicine plays in Western development schemes for the so-called Third World. As a whole, development is in fact often conceptualized in overtly medicalized terms; health and sickness are employed as analogies for "developed" and "underdeveloped" or "developing" countries respectively (Escobar 1995:30; Nandy and Visvanathan 1990:146). Western biotechnologies and biomedical practice take on the same internationally valued status in development as have science, high technology, and capitalism more generally. During the late 1970s and early 1980s, the status of ethnomedicine in developing countries underwent simultaneous reexamination on two fronts: in the development of medical anthropology and in the medical sphere of "development" of the Third World. A consideration of the former is necessary for a reconsideration of the latter.

In this article I juxtapose and integrate three distinct but interrelated lines of analysis: (V a critique of "development" with respect to its (misconceptions of ethnomedicines as epistemologically and practically (that is, culturally) static; (2) an explication of how shamanic curing epitomizes such perceived stasis; and (3) an ethnographic analysis of a specific shamanic session (originally presented by Brown [1988]) conducted by an Aguaruna shaman whose discourse and practice, when contextual ized and fully explored, undermine (misconceptions of stasis. The article employs a notion of intermedicality to examine medical development, demonstrating the important social agency executed on the part of native practitioners. I discuss implications for theorizing indigenous culture and the importance of an ethnographic approach, [development, shamanism, ethnomedicine, culture change, medical anthropology, Amazonia]
American Ethnologist 25(4):634-658. Copyright 1998, American Anthropological Association.

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developing a medical anthropology of development

A proliferation of publications over the past 20 years has contributed to the development of a specifically anthropological cross-cultural approach to medicine (see Young 1982). Foster and Anderson's Medical Anthropology in 1978 was a pioneering publication, synthesizing modern medical anthropology as a distinct social scientific subdiscipline. Anthropological investigation before the mid-to-late 1970s had by no means overlooked indigenous medicines.2 These early accounts of then so-called "primitive medicine," however, were almost invariably discussed in very well-trodden anthropological categories (now cliches): ritual, religion, witchcraft, magic, supernatural ism, and so forth (Foster and Anderson 1978: ch.1). Because of a sole concentration on "primitive medicine" as essentially a magico-religious phenomenon based on local traditions conceived as being culturally and historically static, these earlier investigations effectively ruled out the possibility of finding any type of medicality present in these medicines. Always in contrast to Western biomedicine, "primitive medicine" was considered pre- or nonmedicine in typical socioevolutionist fashion.3 A familiar Western indulgence in asymmetric binaries was the template to these early anthropologies of ethnomedicine:
bio- or modern medicine science modern versus versus versus primitive medicine magic/religion traditional

all of which fall directly in line with:

progress versus stasis

The rise of medical anthropology, however, generated a recognition of ethnomedicines (the term presently in vogue for what was glossed as "primitive medicine" 25 or 30 years ago) as alternative and culturally legitimate medicines (or medical systems). Medical anthropologists acknowledged healing and sickness beliefs in indigenous cultures as phenomena that could be understood as more than solely ritualistic and magical beliefs and practices. Medical anthropology deemed ethnomedicine "worthy" of the status of a legitimate medicine. I do not mean to imply that ritualistic or magical accounts of ethnomedicine have been rejected or even neglected; indeed, they are still integral to much work on ethnomedicine. Rather, in this inchoate development of medical anthropology scholars were refuting banal conceptions of ethnomedicine as simply "abracadabra": futile magical or ritualistic actions based on ostensibly static mythic beliefs in native communities which were essentialized as therefore nonmedical. Conceptions of medicine (or medical systems) were expanded by anthropologists taking heed of the cultural and historical context in which a medicine exists. Because ethnomedicine is recognized as more explicitly social in nature, it meant that the social aspects of sickness and its treatment became important in understanding how medicines operated in particular contexts. This, in turn, inevitably meant that Western biomedicine would also come under anthropological scrutiny. Medical anthropology turned to uncovering the social implications of biomedicine which remain largely concealed by biomedicine's explicit technological focus, its proclivity to maintain an unmediated distinction between the natural and the social, and its excessively narrow focus on the individual patient. Leslie's editorial synthesis in Social Science and Medicine sums up this analytical development:
Our first analytical task [as medical anthropologists] is to realize that the concept of a medical system, which appears simple and straight-forward, is in fact loaded with historical assumptions. The concept is an artifact of the division of labor in nation states with Departments and Ministries of Health, and of legislators, physicians and other specialists who claim the legal responsibility for supervising the health status of populations. The generic conception of a medical system is thus based on a single, historically recent system: a bureaucratically ordered set of schools, hospitals, clinics, professional associations, companies and regulatory agencies that train practitioners and maintain facilities to conduct biomedical research, to prevent or cure illness and to care for or rehabilitate the chronically ill. From this perspective

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other forms of health care are outside the medical system and they are usually ignored. When they are not ignored they are derogated as curiosities, or as fringe medicine, quackery and superstition. (1980:191 ] This epistemological shift sanctions a new kind of anthropological analytic. Viewed from this new ground, medical systems are always and everywhere complexes of knowledge and practice which are media for ideological and symbolic expression (Comaroff 1982) and as such are inseparable from socioideological interests (Young 1981), as well as from the transformational processes of cultural change (Comaroff 1981). Thus the reconceptualization of "primitive medicine" facilitated a dismantling of the ideology implicit in biomedicinethat peculiarly Western mystification that reifies sickness and medicine as components of an exclusively technical and thus nonsocial and noncultural ("natural") process (Taussig 1980). As Young insists, "the proper study of African medicine is simultaneously the study of our knowledge about medicine. To forget this is to accept what is perhaps the most influential ideological belief of our time, that is, that scientific inquiry gives access to ideology-free knowledge" (1981:386). Within this shift from "primitive medicine" to ethnomedicine are the necessary roots of a concept that logically followed and then quickly became (and remains) a central analytical trope in medical anthropology, virtually all discourses of medical development, and cross-cultural research of healing systems: medical pluralism.4 Biomedicine was no longer conceived as the only viable medical system. The legitimation of ethnomedicine helped pave the way for new waves of research aimed at determining the nature of this medically plural context and exploring possibilities for employing ethnomedicines as alternative health care resourceswhat would be termed the "integration" or "collaboration" of ethnomedicine and biomedicine (Akerele 1987; Bastien 1982, 1992a; Neumann and Lauro 1982).

medical development and the myth of collaboration

This medical anthropological perspective, both on ethnomedicine and reflexively on biomedicine, affords a critical analysis of the problems of medical development. An expanded understanding of medicines as implicated in ideology and situated sociocultural and historical processes is necessary in order to examine critically how medical development conceives ethnomedicineand to determine to what social effects that conception is liable. In roughly the same period in which medical anthropology established its status as a new approach, Western developers' conventional wisdom about medicine and health care improvement changed as well, partly as a result of the cognizance of anthropological literature on ethnomedicine. Development discourse, however, did not follow the same direction as the critically minded medical anthropology to which I have alluded. This analysis of medical development requires attention to political economy and its intersections with medicine, given that the language of economy and capital drive the ideology behind Third World development in virtually all its forms (Escobar 1995: ch. 3). Clearly, the problems of medical development are inseparable from the economic asymmetries extant between world regions (see Bastien 1982; Bryant 1980; Elling 1981 a, 1981 b; Frankenberg 1980; McDonald 1981). Early 20th-century Rockefeller Foundation public health programs served as models for medical development in Latin America. It is clear that certain neocolonial and capitalist interests were part of these programs (E. R. Brown 1978). As Cueto (1994) demonstrates, such interests, along with a history of missionization, produced the asymmetric "developmental" vision to which the United States adhered throughout its involvements in Latin America. In a critique of the expansion of biomedicine in Third World countries, Ashis Nandy and Shiv Visvanathan (1990:146) argue that development, as ideology and practice, entails extirpating ethnomedicines and replacing them with biomedicine. Perhaps this rings true for the period before the changes I have discussed, when Western interests conceived development as a full

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replacement of indigenous with Western culture. Medical developersinternational public health researchers (see Neumann and Lauro 1982) and global health policy makers of the World Health Organization (WHO) (see Akerele 1987)nevertheless began to recognize medical plurality and also began to call for an integration between ethnomedicine and biomedicine. Unfortunately, developers continue to embrace a very old and misguided set of conceptions about ethnomedicines (and, by implication, about indigenous cultures and peoples). The most urgent questions now concern when and on whose terms this collaboration is to take place, and what political role these misconceptions play. In 1978 the W H O declared a policy of "Health for All by the Year 2000," citing the need for worldwide access to a comprehensive primary health care system (Bryant 1980). Implicit in this policy is the assertion that the "macrosystem" of primary health care, to use Bryant's term, should and will be provided under biomedical-bureaucratic supervision. Under this policy, further medical development should be organized, directed, regulated, and controlled by an extensive (international and national) systemization of health care resources in developing countries with the W H O as ultimate overseer. The WHO'S call for "integration" in conjunction with the "Health for All" effort requires close scrutiny. A critical distinction must be made between biomedical resources (services, products, biotechnologiesexpensive health care items) and biomedically based international political influence (health policy, organization, and research). The former may be limited (as in South American countries) while the latter continues to expand (especially in South America). Perhaps another way of articulating the distinction is to differentiate between biomedical medicine and biomedical power. In the Third World, biomedical resources are relatively scarce and of poor quality (because of economic relations); international biomedical and scientific political influence and interest, however, are not. Collaboration may indeed be seen as a way to utilize all health care resources available and as an attempt to further legitimate ethnomedical practices that have for so long been demonized or disregarded. Officially employing ethnomedicine in the "Health for AH" development effort, however, also becomes a way of circumventing the problem of providing more extensive biomedical resources that arises from economic constraints while continuing with "development." Summarizing some of the fundamental ideas that led to the "Health for All" concept, Bryant writes,
Appropriate technology, that is, recognition of the limitations and disadvantages of high technology and the importance of less complex, lower cost technology appropriate to local needs and capabilities. Awareness of the distorting effects of an over-emphasis on curative medicine, especially on hospital-based, specialty-oriented, technologically sophisticated care, and consequent emphasis on more balanced approaches to prevention and to lower cost, technologically simplified modes of medical care. . . . The emergence of primary health care, emphasizing preventive, promotive and curative services available at or very close to communities in culturally acceptable patterns, and at locally affordable costs. [1980:383]

Bryant repeatedly constructs oppositions between "high technology" and "technologically sophisticated" health services (of the kind one would find in urbanized highly industrialized countries) and "less complex" and "lower cost technology" health services that are "appropriate to local needs and capabilities" (of the kind one would find in underdeveloped countries). Within these oppositions lie the beginnings of an ideology according to which the "cost" of medical development is an issue that can no longer be denied, allied to a complacency with the idea that nothing can be done. This implicit realism about economic constraint on medical development points toward the restricted role that biomedical resources will necessarily play in future medical developmentand opens up a space for an alternative, a "less complex," more "technologically simplified" alternative health resource in the guise of ethnomedicine. The prose of public health researchers calls attention to this ideological shift explicitly:

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Thus, for some planners and international health workers who formerly disdained any perpetuation of traditional medicine, some linkage of the two systems may become essential. For the moment, one thing that is made clear by an assessment of the money and biomedical resources at hand is that modern medicine and all its trappings simply cannot be made available to all the world's people in the foreseeable future. [Neumann and Lauro 1982:1818]

Ethnomedicine is viewed as a medical resource that permits the W H O and other developers to continue expanding Western development policy making and biopolitical supervision without any commitment to address the global economy's serious asymmetries even though these directly affect any health effort that might provide improved biomedical resources to developing countries. Such a commitment further mystifies the capitalistic yearnings of biomedicine; it allows organizations such as the W H O to continue expanding political influence over medical issues with the understanding that nothing can or will be done about the economic factors influencing the distribution of health care resources among world regions. Further, Akerele instructs that the W H O "is fulfilling its constitutional responsibility to act as the directing and coordinating authority" on all efforts to link ethnomedicine into the health care system with biomedicine in developing countries (1987:177). "The most needed field of endeavor" in this regard, Akerele says, is to subject ethnomedicine to a thorough "evaluation" in order to place it on a "scientific basis" (1987:1 78); scientifically competent health researchers (those sufficiently familiar with the biomedical view) should determine what elements of ethnomedicine are worthy of inclusion and which should be discarded. It becomes clear later in the article that this scientific "evaluation" essentially means ethnomedicine is best used as a resource for pharmaceutical research: "the examination of all these [ethnomedical systems] shows that they hold great promise of a rich harvest that can benefit mankind, especially in the field of ethno-pharmacology" (Akerele 1987:178-179, emphasis mine). Akerele does not address the issue of how a harvest of indigenous plant knowledge and resources will benefit all of mankind. (Will it benefit mankind or the capitalist kind of man?) Three things become clear: (1) no mention is made of indigenous resource or intellectual property rights, nor economic (or any other kind of) compensation of indigenous peoples, for their knowledge of medicinal plants; (2) the W H O encourages developing nations to scientifically research and utilize such plants; and (3) the W H O itself will keep abreast of all such research and will "stand ready to be an active partner" (Akerele 1987:179).5 What should become clear from all of this is that the idea of collaboration between ethnomedicine and biomedicine is for health developers a result of the realization that replacing the former with the latter (as was assumed would happen) is economically impossible. The inherently capitalist commitment of biomedicine restrains the proliferation of costly resources, but does not then preclude opportunistic expansion of biomedical political influence (emanating from the West) through control, regulation, direction of and scientific research on ethnomedicine. Nor does it preclude opportunistic exploitation of indigenous medical knowledge and resources (much less protect against it) through international ethnopharmaceutical researcha Western biomedical-capitalist practice that has really only been brought to international attention in the 1990s and no doubt remains unresolved (Greaves 1994; Posey 1990). Ethnobotanical research on medicinal plants, utilizing indigenous knowledge resources and labor in various capacities, proliferated during the 1980s and has expanded further in the 1990s. Following earlier discourses of the W H O and others which predicted its importance in further development, medical ethnobotany, though often academic in practice, has fallen into the development discourse and is now simultaneously gaining renewed support from private (and powerful) pharmaceutical interests (see Cox and Balick 1994). As one can easily gather from recent compilations of summary literature, ethnobotanical research represents for many the key to this development style of "collaboration" between indigenous and Western medicines: shamans helping scientists in the "search for new drugs" (Prance et al. 1994). Due to many recent protests from indigenous groups around the globe, the source countries of research

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(usually Third World), and some political advocates within the West, it is now more difficult for developers, ethnobotanists, and pharmaceutical companies to ignore indigenous rights to some form of property protection and economic compensation for the use of their medical knowledge. It is not necessarily more difficult for them to side-step practices, however, that address the issue in good faith. Formed in 1992, the International Cooperative Biodiversity Croup (ICBC) is a National Institutes of Health (NIH), National Science Foundation (NSF), and United States Agency for International Development (USAID) partnership administrated by NIH that helps fund five large-scale ethnobotanical projects. Rosenthal's (1996:2) summary of ICBC goals demonstrates clearly that the ideas of collaboration, compensation, and international development are neatly woven together in its ethnobotanical projects. To give deserved credit, ICBC rhetoric is progressive in some respects, intending a mutual benefit for researchers and indigenous groups, and intending bioprospecting to recirculate benefits to support development of the communities involved. Yet one must also note the ultimately corporate control over the implementation of such mutually beneficial "partnerships." In this regard, it is worth nothing that all of the ICBC researchers are also funded by private sponsors with capital interests. Further, the federal government agencies involved "are prohibited by U.S. Federal law from stipulating specific contractual terms" (Rosenthal 1996:3). We must look more closely at what happens on the ground to determine if practice follows from rhetoric. Let me be specific to the Aguaruna.6 An ethnobotanical team from Washington University, St. Louis, currently holds funds from the ICBC program for an ethnopharmaceutical project among the Aguaruna in the Alto Maranon region of Peru. Further funding is being provided by the research and development giant Monsanto-Searle Company (a pharmaceutical interest) so that Monsanto-Searle may acquire sample extracts to test for bioactivity. Despite the progressive rhetoric of the ICBC program, the ICBC-Aguaruna project has in fact involved three years of tense and highly politicized negotiations, which resulted in an international conflict with one Aguaruna federation, the Consejo Aguaruna y Huambisa (CAH), and the salvage of the project with another, the Confederation de Nacionalidades Amazonicas del Peru (CONAP). The details of the conflict remain murky and vary according to the interests of the person relaying the story. Nevertheless, several of the details have been made public knowledge by the Rural Advancement Foundation International, a watchdog group on indigenous rights issues (RAFI 1995). What is clear about the conflict is that after a preliminary agreement the Consejo became dissatisfied with the manner in which they were being treated. The Consejo eventually leveled a host of strong accusations at Washington University's team, one of the more serious being the team's refusal to translate the contract to be signed with Monsanto-Searle from English to Spanish. A letter of Aguaruna accusations, together with the demand that the team withdraw from Aguaruna territory, was sent to the director of the Washington University team and the NIH office that administrates the ICBG program in March of 1995/ NIH decided to temporarily freeze the project (see RAFI 1995). The political turmoil is now abating following the renegotiation of the ICBC project with CONAP, an interethnic indigenous federation often in competition for Aguaruna member support. The intensity of political problems stemming from the ICBC project, notwithstanding the fact that the Aguaruna are hardly politically unified under their current system of competing indigenous federations, points to a web of political complexities and controversynothing so simplistic and egalitarian as medical "collaboration." The current political climate in Peru and elsewhere is one of indigenous protest against past expropriation of medical knowledge and present demand for equitable treatment in current ethnopharmaceutical prospecting, issues which continued to surface even in the "successful" renegotiation of the ICBC project with CONAP. This climate is further complicated by the legal, economic, and ethical commitments of ethnobotanists and especially their private sector sponsors. These commitments remain

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unresolved and mostly unarticulated, especially when viewed in practice. In such a climate, a "collaborative" medical development project in which the true interest isethnopharmaceutical prospecting (that is, potential profit making) will necessarily entail as much conflict as collaboration, if not more. The problem of medical "collaboration" is another instance of thedisjuncture between rhetoric and action, policy and practice, so common to the development domain. It is essential to note the way in which this process of collaboration is conceptualized by the development sector. The resurgence of familiar Western constructions of cultural progress (represented by science, highly "developed" nations, Western culture itself) and cultural stasis (represented by tradition, "underdeveloped" nations, indigenous cultures) emerges. Akerele writes,
Traditional medicine comprises those practices based on beliefs that were in existence, often for hundreds of years, before the development and spread of modern scientific medicine and which are still in use today. . . . Generally speaking, however, traditional medicine has been separated from the mainstream of modern medicine. A basic approach, therefore, has been to promote the bringing together of modern scientific medicine with the proven useful traditional practices within the framework of the local health care system. [1987:177-178]

The nuances of contraposition in this passage are worth examining. Traditional medicine is predicated as a static phenomenon that is "in existence" continuously over some unexplored past of at least "hundreds of years," well before the "development" and "spread" (note the active terms) of Western biomedicine. The conception that guides Akerele's statement is that traditional medicine is a dormant and passive phenomenon (it is "in existence" and continuous with the past), whereas modern medicine is an agential and active phenomenon (it "develops" and "spreads" and transcends tradition): stasis versus progress. With this cultural stasis counterposed to progress construction as a template to his understanding, Akerele invokes the need for the scientific evaluation and manipulation of ethnomedicine by biomedical researchers. "The proven useful traditional practices" constitute those practices that biomedical researchers deem "scientifically" worthy as a health resource. Here too there is an element of passivity (stasis and tradition) versus activity (change and science) corresponding, respectively, to ethnomedicine and biomedicine. This conception imbues biomedicine and science with a necessarily hierarchically superior cultural-symbolic position, as the agent of change that activates (through scientizing) an otherwise stagnant (and necessarily unscientific) ethnomedicine. In and of themselves, ethnomedicines (indigenous peoples) are devoid of agency; only biomedical and scientific influence (Western peoples) can activate ethnomedicine. It is this culturally constructed biomedical-scientific activation of ethnomedicine, this "bringing together" of the medicines, that leads to Akerele's revealing phrasing of what collaboration in medical development means, which is, in his own words, "bringing traditional medicine up to date" (1987: subtitle of article).8 Ethnobotanists fall prey to the same misconception. Walter Lewis, the principal investigator of the ICBC project with the Aguaruna, is a prominent example. His own understanding of the Jivaro ethnic groups (including the Aguaruna) posits their way of life as "culturally intact," implicitly denying the obvious influence of the West in Jivaro cultures, and conceives of jfvaro medicine as a body of knowledge in stasis, stating that they "use plants now as they have for perhaps thousands of years" (Lewis and Lewis 1994:61). But this language is typical of that used by ethnobotanists to represent indigenous culture and medicine. I am suggesting that such language reflects a limited understanding of the people with whom ethnobotanists "collaborate." Development ideas about integration are caught in a morass of Western constructions that erase ethnomedical practitioners' (and indigenous peoples') social agencythe ability to effect social and cultural, thus medical, changevia the maintenance of this ideology that defines stasis as the negative counterpart of progress. This ideology, in turn, bolsters the very justification of further development and valorizes development as the sole embodiment of "progress" itself. Although acknowledgment that ethnomedicine has not died out (as previously expected) is widespread, ethnomedicine is rarely understood explicitly in terms of acf/ve indigenous cultural

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survival. Although ethnomedicine is derided less and to a certain extent legitimated as an alternative and useful medical resource, it is done so only to the extent that it is manipulable by the actions, governance, and economics of the Western biomedical science research and health policy community. Ethnomedicine is useful in development only insofar as it is scientized into action through biomedically centered means. The flourishing medical research of Western ethnobotanists, inevitably backed by corporate pharmaceutical interests, is a preeminent example of a very Western, asymmetric style of collaboration. Meanwhile, the "progress" on indigenous rights to and just compensation for appropriated medical knowledge flounders at the level of rhetoric. This should make us aware that the problems with the idea of "collaboration" are problems of great consequence for indigenous populations. I further address these shortcomings by challenging their underlying (rigid) premise that values the progressive agency of "scientific" medicine by devaluing the agency of indigenes through construction of ethnomedicine as a category resonant with stasis and passivity. I suggest, instead, the notion of intermedicalitya contextualized space of hybrid medicines and sociomedically conscious agentsin South America. For this, we must understand why shamanism makes an appropriate ethnomedical example and then turn again, with more detail, to Aguaruna medicine.

shamanism and the Western ante-self

Virtually all of the characteristics of earlier anthropological attitudes toward ethnomedicine discussed abovethe perceptions of ethnomedicine as chicanery and superstition, the concentration on ethnomedicine as essentially a magico-religious phenomenon, the delegitimated "medical" status of ethnomedicineare particularly true of shamanism's reception in the West because shamanism is predicated on a "nonempirical" worldview. South American shamans are healers who address sickness as more than a physical condition of the individual body (though this is also the case); they address it as an inherently sociopolitical and cosmological condition. Shamans are consulted as a means of determining the presence of infracommunity and intercommunity sorcery-caused sickness as well as afflictions caused by the actions of spirits, deceased ancestors, and natural forces. These causes are not seen as mutually exclusive but intersecting. Shamanism has often been viewed as that ethnomedicine most radically alter to Western biomedicine, especially when compared to other more "scientifically" plausible ethnomedical practices in South America like herbalism (Bastien 1992a:93). As pleas for collaboration with ethnomedicine continue to surface, however, shamanism too is invoked as a possible health care resource and to some extent legitimated as a medical practice (see Bastien 1992a, 1992b; Mehl 1988). The last 15 years have seen a tremendous expansion of the New Age movement with Michael Harner's "shamanic renaissance" (1990:xi) playing no small part. Further, the climate of therapeutic intrigue surrounding the possible efficacy of "alternative" healing methods, a multimillion dollar industry operating in the United States, has even the NIH interested and distributing research monies (Trachtman 1994). Certain breeds of New Age exoticism, romantic environmental ism, and government-sanctioned research into "alternative" healing continue to intermingle with conceptions of ethnomedicine that are true holdovers from a "development" vision and the colonial vision before; at least, all share the vision of primitive stasis. Such related conceptions are ultimately conflated in a two-page article about efforts to "recover" the ancient medical and plant lore of the shamans before the indigenous people disappear. This article was published in the New York Times under the headline "Shamans and Their Lore May Vanish with the Forests" (Coleman 1991). More generally, in making predictions for the integration of biomedicine and ethnomedicine, Neumann and Lauro hypothesize that "governments will give more attention particularly to the classification and analysis of herbal and other traditional remedies while the study of the practice of indigenous medicine will remain of interest primarily from an anthropological point of view"

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(1982:1824). Once again, we see what is truly of interest to developers: ethnopharmacological benefit from the materia medica known and employed by indigenous peoples. No attention will be paid by developers to ethnomedical practices as sociocultural institutions. If this must be done it shall remain of marginal interest to that esoteric group of academics, the anthropologists. My point is that it is precisely an anthropological understanding of ethnomedicine as a complex of knowledge and practices already developing (with its own agency) that is needed to promote the right type of development. A more politically and culturally sensitive medical development would gauge and promote the agency of ethnomedical knowledge and practice as already in place, rather than presuppose it as culturally and historically static. As Akerele's (1987:178) article intimates, nonempirical practices like shamanism would come under the most stringent scrutiny and manipulation in the WHO'S aims to scientize ethnomedicine. The distinction between herbalism and shamanism is not an altogether tidy one; though herbalists may not typically cure through appeal to otherwordly sources of power, shamans often have a vast knowledge of plants used for herbal curing. This is something that ethnobotanists and developers interested in the benefits of including shamans in medical "collaboration" realize. There is a strong scientific compulsion to validate shamanic knowledge and practice when it deals with empirical plant knowledge but to discourage it when it deals with causation that Western health researchers do not acknowledge as legitimate, for example, other-natural or sorcerous sickness. Such confrontations of knowledges reveal their vulnerability to distortion and fracture.9 Farquhar (1994:17-19) argues that Western scientizing of traditional Chinese medicine arbitrarily and necessarily fragments it in a way that is inconsistent with its own historically and culturally developed knowledge and practice. The same might be said of South American shamanism. For example, Jean Jackson (1995:313-314) analyzesin terms similar to Farquhar'sthe failure of a Tukanoan shaman workshop intended by its organizers to evaluate and discuss shamanic knowledge and practices. Jackson argues that attempts to evaluate shamanic medicine in "objective" terms are apt to decontextualize shamanism and fragment the multiple integrated social roles that the shaman plays in South American Indian societies. Further, the shaman is often mythologized by Western health researchers, anthropologists included, as a necessarily culturally conservative figure of indigenous societies. The shaman remains essentialized as an indigenous preserver of cultural tradition in many forms: as resister to Christian influence, as upholder of (unchanged) pre-Columbian traditions, and, importantly, as resister or obstacle to biomedicine and medical "progress." These common Western perceptions of shamanism as a static cultural form engender a pattern consistent with that of health development researchers' views of ethnomedicine generally, discussed above. Again and again, studies of shamanism substitute the past for the present. This perspective looks beyond the modern practices of shamans to find a trace of, not that mythical first shaman imagined by the shaman himself, but that primordial, mythological first shaman of the Western imagination. And so the shaman becomes the quintessential embodiment of pre-Westernness, pre-modernness: what I termin contrast to Taussig's (1987) shaman as colonial "antiself"the West's historically and temporally subordinated ante-self, that perennial prior self doomed to the temporal stasis of primitivity.

(Western) mythologies of the shaman

Mircea Eliade's (1964) essentialist cross-cultural account is emblematic of the Western reception of shamanism. He emphasizes the uniqueness of the shaman as that highly esoteric, individualistic figure in "primitive" societiesmystic, magical healer, ecstatic technician of an archaic tradition, and so on. Although Eliade discusses the fact that the shaman engages in radical interactions with the sacredmagical flight, communication with spirits and the dead,

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battles with sorcerers and the likehe nevertheless conceives the shaman as a conservative mystic, or, perhaps better said, a conserver of the mystic: keeper of the "archaic" traditions. The shaman, as he says, "guards" the very "soul" of the primitive community (Eliade 1964:8). It is this Western-conceived first shamanprimordial and culturally static on all accountswho makes only slightly variant appearances again and again in shamanic studies. Holger Kalweit's representational strategy is an example of this familiar maneuver. In his opening chapter, titled "The First Shamans of the Golden Age," Kalweit (1992:9) recounts local mythologies behind the first shaman among various "traditional" peoples from around the world in order to assert the necessary connection that these mythical beings have with current-day shamanic practitioners in these same communities. It is by no means misguided to think that societies with practicing shamans perceive them as individuals with the ability to make contact with other-natural forces, ancestors from the past, and so forth. Rather, what is problematic here is the way shamans generally are cast in a timeless and mythic role to serve Western mythologyor to say the same thing another way, to reproduce Western ideology. This overemphasis on some essential connection that shamans might share with the pasta past constructed as timeless, primordial, mythicrepresents shamanism as a culturally stagnant form: not only connected to some timeless past but exemplifying it (see Fabian 1983). It is precisely this mythological first shaman of the Western imagination that many anthropologists and developers alike take as their archetypean archetype that effaces the actual social and historical contexts in which shamans exist and act (Flaherty 1992:208-212). Ironically, this representation has been reproduced and remystified by a series of anthropological researchers attempting to account for the obvious foreign (that is, colonial European) elements present in extant South American shamanism (Kreimer 1988; Ramfrez de Jara and Pinzon Castano 1992; Wright and Hill 1992). These researchers assert that these neocolonial elements (often allusions to Christian icons and imagery, but also to Western medicine and technology) are simply a superficial and superimposed veneer atop an underlying indigenous cultural form that remains part of a stable foundation of preconquest Indian cultures. Kreimer illustrates this general position:
The presence of Catholic and other western symbols in the ritual of Peruvian shamans has resulted in the characterization of this culture as a new syncretic product. In the course of my research into traditional medicine I have encountered in shamanic discourse and ritual practice, a philosophy of the development of events and a way of interpreting socio-political processes, which would lead us to question syncretism as an explanatory category for contemporary Andean culture. Furthermore, it takes us to think about Andean Traditional medicine in terms of a reservoir of cultural identity and continuity against the syncretic interpretation of today's Andean shamanism. [1988:22]

This line of analysis posits shamanism as a cultural "reservoir." Kreimer (1988) argues for this line of reasoning with terms like cultural survival, while Ramirez de Jara and Pinzon Castano call it the preservation of "traditional content" through the guarding of "cultural specificity" (1992:287). Practicing shamans come to embody this reservoir of preconquest ethnic identity, precolonial traditions, pre-Western culture, and pre-Columbian Indiannessagain, as if timeless, mythic, prehistoric, primordial. All of these aspects of identification are in metonymic relation to this Western-imagined cultural stasis of shamanic practice they simultaneously construct. These researchers present themselves as explorers of a still intact native worldview by refuting syncretic arguments and those popular laments of the (assumed) inevitable decline of the shaman (and the "primitive" more generally).10 They are at least attempting to move away from the idea that shamanism has been corrupted by Western influence and is therefore necessarily doomed to extinction in the wake of Western expansion. The result, however, is a replication of the same familiar, very Western, mythic-ideological view of indigenous cultural formsas static, nonagential, and closed-off systems: that ideological myth that simultaneously bolsters the very viewthey claim to be refuting. Both sides propel their arguments, in like fashion, through a silent quest for rediscovery of the "pristine archaic phenomenon," as Flaherty phrases it

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(1992:208): the one through lamenting shamanism's corruption and decline from a "pure" primitive state; the other through denying the significance of change in shamanic complexes under European colonialism.

medical mythologies and shamans as textual tools

Just preceding an evolutionary contrast to "modern" medical practices in Western cultures, Krippner summarizes the primordial role of the shaman: "shamans were the world's first healers, first diagnosticians, first psychotherapists, first religious functionaries, first magicians, first performing artists, and first storytellers" (1988:101, emphasis added)." Clearly, the mythic ideology surrounding shamanism as specifically a medical practice is fueled by persisting conflations with virtually all of the expansive Western-imagined aspects of primitivism, traditionalism, primordialism, and the nonmedicalnessofethnomedicines I have thus far described. This is by no means only a recent process. As Flaherty (1992:97-98) notes, it is part of a Western history of medical fascination with the shaman stretching at least as far back as the 18th century. This Western fetishization of the primordial shamanic healer is precisely the target of Taussig's (1987, 1992) massive postcolonial critique. Although interesting, his account, too, provides only a (decon)textualized presentation of shamanic healing. Evidently primarily concerned to deconstruct colonial representations of shamanismassuming the few "actually existing" shamans he discusses constitute some disorderly, anticolonial force (and possibly little else)he constructs a reading of colonial texts and shamanism in literary Marxist terms. Having destroyed "our" old colonial representations of shamanism, Taussig then gives us the opportunity to construct a new one, this time with the shaman as anticolonial (and disorderly postmodern) hero. But to which shaman is he referring? What of the local social contextthe ethnographic "there," as Ceertz would say? There is no "there" there (as Gertrude Stein might say). He fails to provide a fully invested ethnographic understanding, that is, a project that takes seriously the everyday social context in which shamanism is socially produced and locally understood by specific actors. Although Taussig presents a textually interesting portrayal of shamans as critics of colonialism (agents ofdisorder disrupting the ostensible colonial order), his analysis falls short in providing the ethnographic details of the local, social, and cultural logic according to which shamans practice their craft and patients seek it. His play with the text dominates his ethnographic sensibility for the context. In this article, I take issue with that void, proposing ways of bridging critique of discursive misrepresentations of shamanism as a static form with an ethnographic concern for contextualized local understandings of shamanic practice. I offer this by turning now, with strict attention to the voiceand to the contextual ized knowledge and practiceof one significant lowland South American shaman: an Aguaruna Jivaro shaman whom anthropologist Michael Brown (1988) calls Yankush.

shamanism in lowland Peru

Before delving into the presentation and analysis of Brown's transcript of one of Yankush's healing sessions, a few preliminary remarks must be made about Jivaro shamanism. I do not intend to make a comprehensive review of shamanism.12 Rather, my aim is to highlight a few features of the shamanic complex extant in this area of Peru and salient in my analysis. Most of these features are applicable to shamanism throughout northwest Amazonia. Shamanism and sorcery are fused components of a complex that socializes sickness and health for Amazonian Indians. The shaman is important for his ability to appropriate effectively power from places distant from the social world (Harner 1972:119-125; Taylor 1981:672-673): 13 principally the natural world, the otherworld (spiritual and ancestral realm),

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and from other sorcerers and shamans. Jfvaro shamans also call on the power of forest spirit shamans (called p&i//r by the Aguaruna). Shamans channel appropriated power into a socially constituted system of ideas about the reasons for, etiology of, and answer to illness. This co-opted shamanic power, however, is more appropriately described as a form of power and knowledge according to Jean Langdon (1992). Increased shamanic knowledge is increased shamanic power. This is no analytical abstraction; the shaman's power and knowledge are beatable. Langdon says that the amount of power shamans have is directly correlated with the amount of experience they have had with hallucinogenic trance states and specifically the intensity of the hallucinogenic agent (1992:46-47). This power and knowledge (called tsentsak by the Jfvaro) is also actively traded between shamans, typically through shamanic apprenticeships. Tsentsak acts as a number of spirit helpers in shamanic healing. When projected from the shaman's body these materialize in various forms, as animals, insects, stones, and teeth, but most often in the form of darts (like the darts hunters use in blow guns). Thus, sorcerers (who have similar powers but use them antisocially instead of positively) cause sickness by propelling these sorcerous darts into the body of the intended victim. In curing rituals, the shaman attempts to extract the darts from the patient, sucking on the afflicted body part and purging them from his mouth, using his own tsentsak for protection. Although he is not always able (or willing) to expose the responsible sorcerer, the shaman is nevertheless fully conscious that an attempt at doing so is part of the curing endeavor. Brown (1988, 1989) argues that the analytical notion of a strict distinction between benevolent curing shamans and nefarious sorcerers is an oversimplification. What becomes clear from his analysis is that in shamanic healing sessions where the curing shaman is ostensibly reintegrating the social world by combatingthe antisocial forces of a sorcerer, the curing shaman does not necessarily escape social scrutiny. There is potential for both harm and good given that the shaman's power is derived from the same sources as the sorcerer's; either can be co-opted. Shamans are understood not as fixedly beneficial agents of society, but rather as sociopolitical agents who must negotiate continually to prove themselves benevolent actors in local social relations. Their successes in times of crisis increase social faith in their personal cu/ing powers and thus add to their credibility. Because shamanic healing is antisorcery, however, curing also must revalidate social belief in sorcery as the cause of sickness. Thus there persists an ambivalence between shamanism and sorcery within the shaman's own curative practice.

Yankush in practice: the healing session

The particular healing session I examine in this section occurred on January 18, 1978, and was recorded by Michael Brown during his fieldwork among the Aguaruna (see Brown 1986, 1988,1989).14 In addition to Yankush, the presiding shaman, two female patients (Chapaik and Yamanuanch), their respective husbands (Katan and Shimpu) (all four distantly related to Yankush), Yankush's wife (Tumus), and several other interested community members and relatives were present. Also present were two anthropologists: Michael Brown and Margaret Van Bolt. I use the ethnographic present as does Brown. During the session, Yankush is in contact with his shamanic power and knowledge (pasuk), but this does not preclude ongoing interaction among Yankush, the patients' husbands, and certain other people present. Yankush is engaged in a performance for which shamans are renowned, a multileveled discursive practice that includes talking, chanting, and singing in various shamanic "registers," as Brown calls them:
Yankush's utterances encompass several distinctive styles or, as I shall call them, "registers": 0 ) a normal discursive register consisting of simple declarative statements; (2) a normal shamanic register, performed as song, which includes divinatory and metaphorical statements presented in a compressed style still

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intelligible to other participants; and (3) a cryptic shamanic register, also sung, employing an esoteric lexicon. [1988:105] This shamanic singing or chanting in both socially intelligible and unintelligible languages is, as Brown notes, not unlike that described by Sherzer (1983) in his discourse analysis of Cuna healers who perform chants while curing. These registers are important because they actually increase the efficacy of shamanic power and knowledge: "verbal control is magical control" (Sherzer 1983:133). But this verbal and magical "control" is by no means incontestable, as the "polyphonic" nature of Brown's transcript illustrates (1988:105). In reading the transcript, close attention should be paid to the manner in which biomedicine is invoked by Yankush and what relation he draws between biomedicine and the acknowledged presence of sorcery. Brown introduces the transcript with an evocation of the scene. After a series of informalities, Yankush "yawns in a drawn-out fashion, indicating that pasuk are entering his body. He begins to shake the fan [of sampi leaves]. He takes off his sweater, then combs his hair, still facing away from the participants" (1988:106): 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 Yankush: "I, I, I, I, I. With Tsunki [spirit being of aquatic realm and ultimate source of shamanistic power] / am seated." He falls silent. He spits, then shakes his fan while breaking into wordless song. He stands up, still facing the wall. Katan, shouting: "Let's listen! He's intoxicated now, so let's listen!" Yankush sits down again, still singing. His daughter brings him a small bottle of an unidentified liquid. He rubs this liquid on his neck. Katan: "Sing to your own body so that others won't bewitch you." Utijat: "Others know you are curing. They can hurt you. Be careful.1" Yankush faces participants. Katan brings in two large banana leaves. Shimpu moves the lantern to put Yankush in shadow. Yankush [to Katan]: "Mother's brother, bring your wife." Both patients come forward and sit in front of Yankush. They take off their dresses but remain covered with blankets below the waist. One woman turns over to lie on her stomach. Katan: "Take the darts out. See where the sickness is!" Shimpu [indicating Yamanuanch]: "She can't eat. Her throat hurts." Utijat: "Think powerfully!" Yankush looks at Chapaik, sucks on her back, and spits. He drinks from a bottle [later identified as kistian ampi, "mestizo medicine"], faces toward wall, and vomits. Katan: "If you can't cure her, tell me the truth. Throw it [the sorcery substance] out! . . . Look, stand up to the intoxication. If you cure her, I'll always receive you well in my house. Throw it [sorcery substance] away!" Yankush turns to face Yamanuanch. Shimpu and other begin to shout. Various: "Show him where it hurts!" Yankush appears to suck on chest of Yamanuanch. Yamanuanch: "My throat hurts too." Yankush: "You'll get well." Yankush takes off his shirt, facing the wall again. He turns to look at Yamanuanch. Katan: "Sit well, think well!" Yankush [shaking fan in direction of Yamanuanch]: "Her chest is bad [i.e., diseased]." He sucks the afflicted spot and spits noisily. He turns quickly to Chapaik. Various men: "Tell him where it hurts!" Yankush: "You can give her an injection." Katan: "Nephew, look at all the places that hurt!" Yankush: "Give her an injection. She will recover. She is not sick with sorcery, but a cold in her throat." He sucks on Chapaik's back, spits, then sings above Chapaik. He yawns noisily, then kneels to suck on her back. He hawks noisily and spits. Yankush: "You can give her an injection of wichu [unidentified; probably a corruption of the name of a pharmaceutical product]. You can give her three injections. She will get well." Katan: "Tomorrow I'll get the medicine." Yankush: "With various injections she'll get better." Turns to Yamanuanch. "She has sickness in her stomach." Shimpu: "Is she going to die? If so, tell me!" Yankush leans over Yamanuanch, sucks, and spits. Katan: "Why would they want to bewitch me? I always give people food when they come to visit. Why bewitch my wife? I'm angry." Yankush [stands singing over Yamanuanch. He drinks from the bottle of "mestizo medicine." He sings over Yamanuanch for several minutes]: "If my enemies want to bewitch me, here I am. They can't hurt me. f see everything. She had darts in her stomach, and I took them out." Utijat: "See well in order to cure!" Yankush:" Your throat is sore from vomiting. I will heal you. Your stomach hurts right there. I'll heal it. When I first began curing, few people came. Now many come because I can cure. If they are weak, I can heal them. If they have rheumatism, I can cure them. You will return to your

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48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 91 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114

bouse. I see your soul dancing there, getting drunk at parties. Perhaps you've been given an injection. This makes your stomach hurt. There are a few darts there." Chimi: "If there are any darts there when she gets back home, they may say that Yankush put them there. So take them all out!" Katan: "There are no sorcerers there [in the patient's community]. Who will have done this bewitching? If my wife dies, I could kill any man out of anger. Little nephew, cure my wife well. I don't want to be bothering you here. I live far away." Ajues: "Why hasn't Uyum [a kinsman in a distant community] come? Is he making war?" (Here Ajues is calling on the shaman's visionary powers to see events in a distant location.] Yankush: "Did your wife ever have colic [kuliku] before?" Shimpu: "No, never." Yankush: "Now colic wants to grab her. You can give her ten drops of a medicine for colic . . . [still singing over Yamanuanch]. Colic wants to grab her. Her body is weak, sick." He sucks noisily, spits. "Colic does not heal quickly. It gets better, then comes again. I will cure it completely. In this part {indicating throat?] there is no sickness. You vomited so much that a piece of a sorcery dart is stuck in your throat. I'll remove it." He sucks on her throat and spits. "How have you been bewitched!' Sometimes it is done so that a person will be sick for years but not die. / can cure this. If you have a piece of dart in your throat, the vomiting has made it more painful. / can take it out." [Speaking now] "Before you had much sorcery inside you. Now I'm taking it all out. You are better. Receive an injection, and you'll get better." He sucks and spits. Utijat: "Make her well! You are a good curer." Yankush: "I'll see everything. Nothing will remain." Katan: "\i she has a lot of illness and you can't take all of it out, take out half so that I can cure her easily with medicine. You are a curer, you can do this for me." Yankush sucks on Chapaik and spits. He yawns loudly, and looks at Chapaik. Yankush: "In Achu they killed a person. A sorcerer was killed." Others: "Who could it be?" Yankush drinks from the bottle of "mestizo medicine," then puts it down on the floor. He looks at Chapaik, touching her with his left hand. He sucks, spits, then vomits. Katan: "Cure well! You are a shaman!" Yankush: "When I'm intoxicated, I cure well. Don't say that I wasn't intoxicated enough." Katan: "There are others who are not as brave as I" [alluding to his anger if his wife dies of sorcery]. Yankush: "On a piece of iron I walk on tiptoes . . . " (rest of segment of curing song is inaudible]. Katan: "Cure well! Don't let her be sick!" Yankush stands over Chapaik, fanning her with his leaf-fan. He touches her back with his left hand. He sucks and spits noisily, then begins to sing. [Segment is indecipherable on tape.] Katan: "Blow the sickness away!" [To Chapaik] "You said that your head and neck hurt. Tell him where so that he will cure you." Yankush [turning to Yamanuanch, shaking his leaf-fan]: "If she has illness, I will see it and take it out."He sucks on Yamanuanch's stomach and spits. "She can't die. I will heal her." Katan: "She can't die, because I have few family left. We will be few if she dies." Yankush: "Tumus [Yankush's wife] is sick [with natural illness], not bewitched." Utijat: "Once I was sick like that, but after taking medicine I got well. I almost died." Utijat and Katan: "Fan her! Blow the sickness away!" Yankush: "Her stomach is stuck together inside. I'm going to loosen it. /'// take out the sickness." Sucks, spits. "Sickness has hit several times, but I've removed it so that it will heal." He begins to sing, facing the wall behind his stool. Katan: "You all, don't talk so much! If you speak, the healer won't be able to see. Be quiet, or he'll make a mistake!" Yankush: "There is a war in another place and they've killed someone. His kinsmen return crying." He faces Yamanuanch and begins to sing. "This person is weak inside. I'll make her well and strong. The earth never dies. When I heal her, she will be the same, never dying. You are well. You lack only a little treatment to be completely healed. I'm taking out the darts. Afterwards you should have an injection, but you will recover slowly. Take off your blanket so that I can see your chest. Stains or wounds come out on your breast. Have you had this before?" Yamanuanch: "Yes." Yankush: "Can you give her an injection?" Shimpu: "Yes, I can." Utijat: "See how the birth of the woman's child will be." Yankush: "I can't see that." To the patient: "I'll return to you again." [Turns to Chapaik.] Utijat: "Look at me to see if I should take the name 'Tobacco.' " [People laugh because Utijat is known in the village by several humorous nicknames, some of which he invented for himself.] Katan: "Look there! She says that her liver hurts. Show him where it hurts. In her stomach it is hard. There's a line of pain there. Look there first, look where the ya/; tells you. Her chest is tight. It won't let her breathe." Yankush sucks on Chapaik's stomach, then spits. Those present remark that there is much kaag [the sorcerer's special saliva] in the saliva that Yankush spits out. Katan: "It's understandable that a stranger might want to fight with me, but why bewitch my wife? Yankush says that there is something in her body. Since he has strength, he shouId look carefully

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115 and blow away the sickness." To Yankush: *ff there's only a little, take it out. If there is sickness, 116 see it. Look to see what will cure her as fast as possible. Cure it! Cure it! See what will happen 117 next! This woman came far to be cured. Some women don't want to live, and they take their 118 own lives with poison. She doesn't want to die. Who can cure her? Look at them [i.e. the 119 patients]. Many come here and leave recovered. Sometimes shamans can't see. But look 120 carefully anyway! Look!" 121 Utijat: "Look to see if my soul is married to a mestizo woman!" [laughter] 122 Katan: Show him where it hurts in your liver." 123 Yankush: "She could get well fast, but the "tobacco" [i.e. curer] hasn't discovered the sickness yet 124 Her body is weak." 125 Katan: "Now that you are with yaji, look well! Throw out the sickness!" 126 Unidentified woman: "She says she has tsuak [a powerful hallucinogen, Brugmansia sp., sometimes 127 used for self-cures]. Can she take it?" 128 Yankush: "You can take two injections, then you can take tsuak" 129 Katan: "After looking into her, you should tell us what medicine to buy." 130 Yankush [indicating Chapaik]: "She doesn't have much, just a little sickness." 131 Katan: "Can I give her injections for her liver?" 132 Yankush: "Yes, that's all right." To Chapaik: "Mother, I'll fan you. I'm concentrating to throw out 133 sickness, like a tireless jaguar. My song continues, continues. With my help she will become 134 like the tapir, which doesn't know how to refuse any kind of food." 135 Katan: "It's true that tapirs never reject food. When I eat tapir it tastes good. Delicious!" [Tapir is 136 traditionally a prohibited food item for the Aguaruna, though it is now increasingly eaten in 137 the Alto Mayo because game is scarce.] 138 Yankush: "When she gets well she can eat the monkey wajiam. The pains in your stomach have made 1 39 you weak. But with this fanning you will get better. We'll see how it will turn oul. I speak to 140 you like the mankup [species of bear], which never gets sick." 141 Katan: "Tell him if you don't have pains in your head. Little nephew, she says that her head seems 142 to swell, then her ears close up tight." 143 Yankush: "From here in her head I took out darts and threw them away. Tomorrow I will see all, and 144 then we can leave this curing." 145 Chapaik [getting up]: "I want you to see into me again on Saturday, and when I come again." 146 Yankush: "When you come again, bring me a gift of cloth. With another healing session you will 147 recover." 148 Yamanuanch: "What kind of injection should I get?" 149 Yankush: "An injection for colic. You can take drops of Diafa [apparently a commercial medicine] 150 in water several times. You can take drops of Diafa without an injection. This is the only sickness 151 that is hurting you." [ToShimpu] "There was something sticky in her body, but I took it all out. 1 52 Only a little colic remains there. She'll get well soon. This colic made her body weak." 153 Shimpu: "Can she eat wajiam [a species of monkey]?" 154 Yankush: "She can eat it when she's better, after a week. Through her body I say the sickness will not 1 55 continue. The agile dog never tires, hopping about. She could be this way. I say that her stomach 1 56 should never reject food, as the tapir never rejects food. It's all right. She won't die. It's nothing." 157 Katan: "How are the grandchildren I left behind in Shimpiyacu?" 158 Yankush: "All right. They're fine." 159 Katan: "Will I arrive home safely?" 160 Yankush: "Yes. Don't worry any more." Mariana helps Tumus lie down in front of Yankush. Others 161 are saying goodbye and leaving. 162 Mariana: "Tell him to fan your head. Lie down. Show him where your liver hurts most." 163 Yankush: "She has sugku. [In this context, sugku means "natural" or "epidemic" illness as opposed 164 to sorcery-induced illness.] After much suffering, she'll get better." 165 Others: "Surely she will die of suffering!" 166 Yankush: "Her other sickness is gone. Now another illness has grabbed her, the same that infected 167 the others. The offspring of the tapir never becomes ill. Be like this." Chimi and Utijat take their 168 leave. All the others have left except Yankush, his wife Tumus, and Tumus's mother Mariana. 169 The anthropologists leave. It is 9:05 p.m. [Brown 1988:106-111]

reanalysis: the presence of a hybrid knowledge and practice

The presence of Western biomedical elements is abundantly clear in the transcript. For my purposes, the most important elements are: Yankush demonstrates an ability for dual diagnosis. He determines the source of sickness as either sorcery or a natural nonsorcerous process, made explicit when he refers to his wife's affliction (line 163). An essential part of his healing task is to determine the presence or absence

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of sorcery. Sorcery is referred to by Yankush in its materialized form as "darts" (lines 43, 49, 65, 99), as a "sticky" substance (line 151), and alluded to by the onlookers by reference to kaag, the sorcerer's saliva (line 112). Yankush does not take the presence of sorcery for granted but rather actively searches for the sorcerous substance in light of other possible causes of the affliction (lines 25-31). Yankush tacks back and forth continually throughout the session, trying to see into the patient, to discern the source(s) of this sickness as either sorcerous, natural, or both (lines 59-66, 149-152). The coexistence of sorcerous and nonsorcerous sickness in patients is well noted for other South American Indians (see Langdon and MacLennan 1979:214). Especially interesting in the transcript is the manner in which these dual diagnoses take on associations with biomedical remedies. Yankush makes persistent prescriptions for biomedical products and procedures for these patients' conditions. He makes reference to pharmaceuticals (lines 33, 149) and it becomes clear from both Katan's (lines 129,131) and Yamanuanch's (line 148) statements that his clients and community respect him as medically competent in the prescription of biomedically derived medicines. He also repeatedly mentions or prescribes injections for his patients (lines 28, 30, 33-34, 36, 67, 100,103, 128, 149), sometimes in conjunction with the prescription of pharmaceuticals (lines 149-152). 15 Further, as Brown (1988:106) records, Yankush has taken the hallucinogen yajito arrive at his shamanic trance state.16 However, as Brown witnesses throughout the session, Yankush also drinks from an unidentified substance referred to as kistian ampi, "mestizo medicine" (lines 16, 41,74). Unfortunately, we do not know the nature of this particular bottle of "mestizo medicine," but from Brown's (1986:175-176) discussion of medicines that fall under this rubric, it appears to be a generic reference to all medicine originating from contact with whites (hence the cognative Aguaruna term kistian for Christian [often interchangeable with white] or mestizo [Christianized Indian]).17 The category kistian ampi incorporates all biomedically derived products and procedures that the Aguaruna community acquire in trade with non-Aguaruna, or that they purchase themselves; pharmaceuticals and injections fall into this category. Yankush's ingestion of this medicine during healing sessions indicates that not only is yaji important to his shamanic trance state but also "mestizo medicine," as Brown translates it in the transcript. While combating sorcery to heal patients through shamanic trance, shamans are particularly vulnerable to the attacks of sorcerers themselves. This is evidenced in the text when Katan (line 7) and Utijat (line 8) both warn Yankush to be mindful of the fact that other sorcerers are cognizant of his curing and might decide to challenge his shamanic power. Indeed, it is necessary to understand the significance and power that Yankush and the Aguaruna generally attribute to "mestizo medicine." I interpret Yankush's repeated ingestion of some type of "mestizo medicine" throughout the session as indicating that this medicine is meant to bolster his shamanic power, perhaps even protect him against possible sorcerers' attacks. This is evidently a hybrid healing session; however, the significance at its core can be appreciated only with an understanding of shamanic appropriation and the power of the hypodermic needle.

reanalysis: needles, power, ambivalence

Yankush's constant reference to injections and pharmaceuticals, and the various clients' requests for Yankush's advice on such matters reflectthe generally "high regard" of the Aguaruna toward biomedicine, or Christian medicine (Brown 1986:174). Biomedicine is ascribed a role of culturally symbolic import by the Aguaruna, and this points to the ways in which pharmaceuticals, injections, and shamanism are imbricated in the practice of a hybridized ethnomedicine. Brown writes:

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Christians also introduced a powerful symbol of therapeutic intervention, the hypodermic needle. Injections mesmerize the Aguaruna. Hypodermic kits are found in every Alto Mayo village, where they are used with appalling frequency. Traditional illness theories link the intromission of substances into the body with sorcery and sudden death. Perhaps because injections so dramatically invert traditional knowledge (just as Christian norms invert Aguaruna customs in so many ways), they possess great symbolic force. Kisticin impi, "Christian medicine," is meant to be injected, and whenever possible it is. Injection instantiates its power. To use a syringe is to perform an act at once unquestionably instrumental and profoundly expressive. [1986:175-176, emphasis added]

The profound symbolism of the biomedical procedure of injecting medicines into the body as an enactment of medical power is not restricted to the Aguaruna (or even to South Americasee Reeler 1990); nor is it a restricted notion that injection resembles a sorcery dart that becomes lodged beneath the sick person's skin. Bastien notes that the Andeans in Bolivia make similar parallels (1982:801,1992a: ch. 8). Yankush prescribes pharmaceuticals and injections in a professional tone: pharmaceuticals and injections become shamanized in his discourse. Recalling Brown's distinction between the three shamanic "registers," we see occasions when the references to injections occur in the sung (second or third) register (lines 36, 48-49). The fact that Yankush pays discursive attention to injections not only in his spoken responses and recommendations to his clients but also in his personalized shamanic singing leaves little room for doubt that Yankush is conscious of the presence of Western medicine as more than simply a practically useful product or procedure.18 By chanting about injections {"With various injections she'll get better" [line 36]), instead of simply prescribing them, Yankush incorporates biomedicine into his exclusive shamanic discourse. Using verbal as magical control, he appropriates the foreign power that biomedicine holds for the Aguaruna, channelling that power into his own shamanic repertoir of knowledge and practice. If, as Brown says, injection instantiates the power of biomedicine, and if, as Bastien says, the hypodermic needle is perceived as "the ultimate tool" (1992b:138) of the biomedical profession, then Yankush has determined a means of actively tapping into the source of that power for the express purpose of empowering his own shamanic technique. This power is attributed to biomedicine precisely because it is a foreign medicine that does not originate within the Aguaruna social world. As is evidenced in Yankush's sung discourse, socially distant (that is, natural and supernatural) beings constitute the source of shamanic power. The session begins with his calling on the progenitive power of Tsunki, the aquatic originating source of shamanic power for the Aguaruna (lines 1-2). Later he calls on the power of the jaguar (line 133) and the mankup (line 140). All of these beings reside at the periphery of the Aguaruna social world, and it is for precisely that reason that they are conceived as powerful. Shamans do retain a sense of this power and knowledge inside their bodies as Langdon (1992) notes in her discussion of Siona shamanism. Yet, the origins of shamanic power lie in sources not within but without: in sources "outside" of or at a distance from the particular shaman's social world. Indeed, shamans deal in distant power: they are mediators between the inside and outside and the social and natural continuums that construct Aguaruna life. Searching for a means to channel curative power from the realm of the socially distant into the realm of the socially near is the shaman's specialty. We would do well to juxtapose Sherzer's insight (cited above) that "verbal control is magical control" with Yankush's appropriation of biomedical power through the shamanizing of injections in his personalized discourse. Shamanic appropriation is facilitated by hallucinogenic trance but is enacted or activated in shamanic singing and chanting. Drawing on several distant powers of the natural realm, Tsunki, the jaguar, and the mankup, Yankush also recognizes the power socially ascribed to Western medicinethe medicine of social outsiders (such as mestizos, Christians, and whites)and activates these through a similar co-opting maneuver in his shamanic chanting. Brown claims (in quote above) that the power of injections lies in the fact that injections "invert traditional knowledge" about sorcery-sickness causation. This would mean that the Aguaruna revere injection because it is a practice that is procedurally similar to sorcery (in that

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both introduce a substance into the body without damage to the skin) but results in the opposite effect of sorceryassuaging maladies whereas sorcery inflicts them. I find, however, that there is something a bit more subtle yet vitally important in the Aguaruna social and shamanic awe of this biomedical procedure. Bastien's work attests to the fact that the injection procedure is received ambivalently in Bolivia: both revered and feared. Andean Indians, he says, are prone to "feel cheated unless they get an injection" (Bastien 1982:801) because they ascribe such power to the procedure. Yet, he notes in another text that Andeans also believe "these injections ma[ke] people sick and sterile, a not uncommon belief" (Bastien 1992b:139). Suspicion and fear of biomedicine in South America is further evidenced by the widespread belief in pishtacos, creatures that manifest as gringo phantasms, missionaries, the occasional anthropologist, and, significantly, as "doctors . . . who, with their instruments, [remove] the fat from people" (Bastien 1992b:141). A pishtaco attack causes at the least a dreadful affliction, sometimes leading to death, at the worst immediate death alone in the forest.19 The Aguaruna have imported this same notion, traceable to the era of conquistadors, and applied it to a most interesting set oi Westerners: "Fear of pishtacos has moved down from the sierra, doggedly following development projects throughout the Peruvian jungle. A group of scientists involved in medical research among the Aguaruna were rumored to be taking blood samples to determine people's body-fat content" (Brown 1986:183). No need to wonder what doctor's instrument was used in collecting those blood samples. Suspicions about gringos-bearing-needles in search of Indian blood and fatthe vital sources of strength, beauty, and intelligence for the Aguarunawas recently reconfirmed during my visit to Aguaruna communities in 1997. Consider this simultaneous reverence and suspicion of the needle with respect to Yankush's healing discourse. Throughout the session, Yankush's many references to injections are typically offered as prescriptions (lines 28, 30, 33-34, 36, 67, 100). Yankush makes explicit that the injection is a curative measure: "Receive an injection, and you'll get better" (line 67). However, at one point he overtly gestures to the belief that injections not only cure but also cause sickness, and that this sickness can in fact be attributed to sorcerous actions: "Your throat is sore from vomiting. I will heal you. Your stomach hurts right there. I'll heal it.. .. Perhaps you've been given an injection. This makes your stomach hurt. There are a few darts there" (lines 45-49). This is sung shamanic discourse and thus is not necessarily intelligible to the listeners. Yankush is not in the midst of a simple statement about the affliction but in a state of communication with a shamanic power source, searching for the possible causes of this patient's condition. In these three short lines, he divines that there are signs of sorcery (darts) present in her stomach, and that the reason her stomach hurts is because she was given an injection. Injections do not simply cure pain; they can also cause it. And the pain these injections cause may well manifest signs of antisocial sorcerous actions. Thus, the connection between injections and sorcery is even more inextricable than Brown may have at first indicated. Yankush's shamanized discourse here illustrates that this connection between injections and sorcery may in fact be not an inverse relation but a parallel one. And this parallel relation depends precisely on the profound ambivalence ascribed to needle injections themselves. The sources from which shamans appropriate power are generally attributed an ambivalent qualitythe power to create and destroy, integrate and disrupt, and hence, the power both to heal and afflict. This is why a sorcerer is able to appropriate power from the same sources as a curing shaman. The power source is raw, socially unformed, and thus ambivalent. Its moral and political (that is, social) direction is determined by the moral and political action ofthe social (shaman) or antisocial (sorcerer) agent. Determining how that power will be socially channeled and socially directed is the appropriative skill of both the shaman and the sorcerer. Further, shamans may also invert power sources considered to be predominantly destructive or disintegrative in order to channel them for positive curative means as a

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social act. Sorcerers, on the other hand, drawing from a similar source, would simply direct it with its already destructive potential to cause sickness as an antisocial act. In other words, both sorcerers and shamans draw power from common sources that can be appropriated for antisocial intentions just as for socially positive ones. Western medicine, epitomized in the injection procedure, stands out as another raw power source to which shamans may appeal, but one with particular medical-symbolic significance (because of the way injection analogizes sorcery) and particular sociopolitical resonance (because of the culturally powerful West with which this medicine is inextricably identified). The Aguaruna are in awe of injections partly due to "the efficacy of vaccinations," as Brown argues (1986:175). Yet the explicit terms of that medical efficacy must be defined fully in anthropological analysis. Freed from a narrow biotechnological view, medical efficacy does not have to mean efficaciously curative. The efficacy of medical procedures is simultaneously symbolic and political because it is socially produced as such in Yankush's practice. Arguing otherwise is to remain complicit with a biomedical view that effaces the social by positing medicine as an exclusively (asocial) technical knowledge and practice, isolating it as a narrowly defined, one-way, cause-effect process that transcends or obviates the symbolic and sociopolitical elements of medicine and sicknesswhich shamanism clearly does not do. From Yankush's session we can see the necessary connection between medical efficacy, the medical-symbolic, and the ethno-politics of the Aguaruna social situation vis-a-vis their powerful non-Aguaruna neighbors. The needle's medical efficacy is defined ambivalently by the Aguaruna. It is revered to the extent that it is socially constituted as a power that is amenable to being directed in a socially positive manner, as when shamanically prescribed as a curative measure by Yankush. The needle's medical efficacy is feared and suspect to the extent that it is socially constituted as a power that is also amenable to being directed in an antisocial manner by the surreptitious actions of a sorcerer or some other malicious agent: pishtacos, Western medical researchers included. This is made explicit when Yankush expresses a cognizance of sorcerers who may use the needle's power to cause sickness. What is important then to understanding this shamanic appropriation of a biomedical procedure is contextthe socially ascribed symbolic and political meaning of the needle's ambivalent power. This is crucial to realizing that this shamanic appropriation, this (re)creation of a hybrid shamanic medicine, actually revalidates social belief in both shamanism and sorcery among the Aguaruna. Yankush has proven a way to appropriate biomedical power and rework it for the purposes of his shamanic healing craft. The existence of these biomedical elements in Yankush's shamanic knowledge and practice does not threaten his shamanism with extinction, as those observers obsessed with the idea that Western culture and medicine corrupt a static and unchanging shamanism (and primitivism) might insist. Instead, Yankush's session demonstrates that a hybrid ethnomedicine can in fact reinforce the social validity of shamanism. It can do so because of the way in which this type of shamanic appropriation of outside power is understood by the Aguaruna, and the way this shaman constructs socially relevant and overlapping symbolic, political, and medical meanings for a medicine that his community understands as sociopolitically other. It highlights the fact that Yankush's shamanism is part of an agential expansion of Aguaruna social consciousness, a hyperawareness of the interethnic and intermedical political situation in which they find themselves. Further, it is precisely through acting on this awareness that Yankush advances the likelihood of the successful social reproduction, through active sociocultural readjusting, to indigenous knowledge and practices.

postcolonial hybrids, intermedical spaces, and (re)developed places

While developers contend that ethnomedical practices are actively useful to the extent they can be scientized by biomedical research and policy, I present for radical contrast the knowledge

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and practice of Yankush who shamanizes science (in the form of biomedicine) by appropriating the ambivalent power of the needle and incorporating pharmaceuticals into his curing. I have argued that implicit in development efforts to scientize ethnomedicine is a misconception that fuels a culturally and medically exploitative ideology, even when presented as a call for "collaboration." I justify my interest in exploring shamanic ethnomedicine by exposing a further misconception, central to mainstream Western representations, that places shamans at the apex of this cultural stasis. Drawing on critical ethnography, I develop a radical juxtaposition between this knowledge and these practices, reanalyzing one particular shaman's discourse with attention to the ethnographic detail of his local context, as guided by my earlier critique. Yankush's shamanism takes on a significance that must be understood in light of what neocolonial contact has engendered in South America, and that is a historically constituted intercultural, interethnic, and what I call intermedical relation. The significance is that Yankush and many other shamans now appropriate much of their shamanic power from what are ultimately Western sources, including scientific biomedicine. Taylor explains this type of shamanic appropriation among the Achuar (an Ecuadorian Jivaro group):
The shaman, uwishin, is a specialist in symbolic relations with the outside.. . Shamans mediate symbolic bonds and seek to control other groups... . Nowadays such power is derived primarily from white spheres.... The ideological basis of prestige and value ascribed to foreignness is today epitomized by the "white world." [1981 -.672-673]

We must realize that indigenous South American societies, including their shamans, understand biomedicine in relation to a socially distant, at times nefarious, and powerful foreign identity (connected to the West) that postcolonial history has made an everyday part of their social consciousnessjust as Westerners understand ethnomedicine and shamanism, particularly in relation to a subjected indigenous South American identity.20 That identity has been continually misconceived ideologically facilitating further impositionfurther capitalist-inspired development, including biomedical domination. Exploring Yankush's shamanic appropriation of Western culture, however, opens up a potentially new conception of shamanism and ethnomedicine generally, as well as the intermedical space it shares with biomedicine. To some extent, I agree with Kreimer (1988) that the continuing practice of shamanism can be understood as a means of indigenous "cultural survival," but our agreement is superficial. I disagree with her conceptualization of that cultural survival and the ideological assumptions underlying it, which posit shamanism as a passive "reservoir" of pre-Columbian traditions (Kreimer 1988:22). I also disagree with the idea that shamanism is a "traditional" medicine meant to passively "preserve cultural institutions" (Neumann and Lauro 1982:1817), and an unchanged resource of "culturally intact" (Lewis and Lewis 1994:61) plant knowledge, as so many health developers and their ethnobotanical partners understand it to be. Yankush demonstrates that shamanism is a creative and dynamic ethnomedical knowledge and practice, not a static conservative one. His shamanism shows his keen acknowledgment and understanding of the realities of his interethnic and intermedical social situation. He acts from within that situation to renegotiate what shamanism is for the Aguarunaan actively produced hybrid medicine.21 Yankush's shamanic appropriation of biomedicine is itself the process by which he asserts his shamanic ethnic social agency and affects cultural and medical change among his community. Because of his appropriation of biomedicine Yankush was "highly regarded" among colonists, but Brown adds that "his fame among colonists seemed to raise rather than lower his standing among the Aguaruna" (1988:104-105). Yankush's ability to renegotiate actively the constitution of his knowledge and practice is not a corrosive effect but precisely what is needed to assure its "cultural survival/' Indigenous cultural survival is too often espoused in implicit rescue terms, the constant rediscovery oi yet another slightly different version oi the untouched, primordial, pristineand

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therefore staticindigenous identity: what I call the ante-self. Indigenous culture, ethnomedicine included, must be understood "in a truly dynamic and agential way" (Jackson 1994:304). This cannot be achieved except by positing indigenous peoples as essential contributors to such change. It strikes me that it is only through a simultaneous critique of Western mythic ideological misconceptions of ethnomedicine and highlighting of ethnomedical practitioners who contradict it in local practice that medical development can be rethought and further exploitation thwarted. Ethnomedical practitioners, too, are agents of change. An attempt to redevelop the West's understanding of ethnomedicine must come from examining the ways indigenous peoples develop these medicines themselves. It is such an examination that allows a reflexive demystification of the political, social, and medical asymmetries that Western development of the Third World, with its colonial legacy, engenders. Until such attempts are the rule and not the exception, one must approach the topic as warily as the local shaman, divining who exactly it issorcerer or scientistwielding the suspicious power of the needle.

notes
Acknowledgments. I am grateful to the Tinker Foundation for a travel grant that supported part of this research. The article benefited greatly from the (ever) insightful input of Kathleen Lowrey. Special thanks should also go to Terence Turner who supported the article's original production and to Michael F. Brown whose work makes the article possible in the first place and whose comments I considered essential before submission. I am grateful to the editors ofMedicalAnthropology Quarterly for permission to use the extended quote from Michael Brown's (1988) article. I would like to further thank Jean Comaroff, T. M. S. Evens, Jean Jackson, and Janet Morford for their time spent giving extremely thoughtful and useful comments and criticisms, and Michael Herzfeld for his editorial counsel. Le agredezco al Dr. Marcos Cueto del Instituto de Estudios Peruanos por todo sus comentarios y especialmente su advertencia que la idea de "colaboracion" ya no existe solamente como un problema entre la biomedicina y la etnomedicina sino tambien como un problema entre los acadeYnicos norteamericanos y los academicos latinomericanos. Edward Hammond of Rural Advancement Foundation International provided helpful information about the ICBGPeru project. I remain grateful for all these contributions but of course I am fully accountable for the ideas presented here. 1. The ordinances pertaining to the construction of reducciones include mandates for the construction of European-style hospitals (Crouch etal. 1982:15; ordinance 121). For a more detailed examination of the policies regarding reducciones and their implications in colonialism, see Fraser 1990:40-45, 75-81. 2. Representative examples of this kind of earlier "medical anthropology" are Ackerknecht 1942, Evans-Pritchard 1937, Rivers 1924, and Turner 1967. 3. There is in fact at least one example where ethnomedicines are referred to explicitly as nonmedicine, as when Press refers to "urban curandero" practices as "non-medical" services (1971:749). 4. For examples of the use of "medical pluralism" as an analytical trope see Bastien 1992a, Cosminsky 1983, Crandon 1986, Crandon-Malamud 1991, Frankenberg 1980, and Leslie 1980. 5. Neuman and Lauro (1982) describe expanding ethnopharmaceutical research on indigenous plant knowledge as a primary benefit of linking biomedicine and ethnomedicine. They do not mention intellectual property rights or compensation for indigenous peoples. 6. The Aguaruna are a group of lowland Indians of the Jivaro linguistic group. The Jivaro region stretches across the southern fringe of the Ecuadorian and north-central Peruvian lowlands. Harner's ethnography (1972) gives an adequate introduction to Jfvaroan cultural life. 7. The author holds a copy of the Consejo's protest letter to NIH and the principal investigator of Washington University's research team. It is dated March 10, 1995 and contains a detailed account of the Consejo's claims against the Washington University team, as well as a demand that the research team leave Aguaruna-Huambisa territory. Portions of the letter have been translated and reprinted publicly by RAFI (1995). 8. I see clear connections between this Western conception of cultural stasis and cultural progress with the Western conception of history and myth which Turner (1988) criticizes. His argument systematically refutes the idea that indigenous Amazonian societies operate solely under a mythic (as opposed to a historical) social consciousness, delineating the ways in which myth and history coexist and cooperate in Kayapo discourse. In doing so, he also refutes the ubiquitous Western idea that before contact with Europeans indigenous peoples had no sense of history. The opposition that Turner discusses between history and myth is conflated with these similar oppositions of stasis and progress (or change), tradition and science, and, I would argue, ethnomedicine and biomedicine. Similarly, these oppositions, when correlated with the opposition between Western culture and indigenous culture, serve as a justification of further Western

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imposition under the illusion of bringing or giving indigenous peoples history, change, progress, and development, of which they are ostensibly incapable by themselves. 9. We would do well to remember the imaginative name of the California-based ethnopharmaceutical research firm, "Shaman Pharmaceuticals," which demonstrates such an interest in shamanic plant knowledge. According to King (1994), Shaman Pharmaceuticals has a great interest in promoting indigenous property rights and compensation for indigenous plant knowledge. Yet, the very appropriation of the word shaman for use in ethnopharmacological research indicates to me that this sort of scientifically fragmented understanding of and interest in shamanism is rampant. 10. For laments of the disappearance of the shaman, see Reichel-Dolmatoff 1975 and Perrin 1987. 11. This sort of contrast between "modern" biomedicine, with its technological-scientific basis, and shamanism, represented as the primordial healing practice, functions similarly in Achterberg's (1985: ch. 1, 3) discussion of "The Shaman and the Scientist." 12. Given that I do not have space for an expanded description of shamanism in lowland South America, some general knowledge about shamanism must be taken for granted. For a more extensive introduction to Jfvaro shamanism, see Harner 1972: ch. 4, 1973, and Brown 1986:60-65, 1988. Another text that gives a fuller picture of shamanic practices in the lowland region of South America is the edited volume by Langdon and Baer (1992). 13. Brown (1988:103,117, n. 2) notes that Jivaro shaman ism is an almost exclusively male-gendered venture. 14. This session was originally presented and analyzed by Brown (1988). For Brown's background about the session, see 1988:105-106. The transcript is on pages 106-111. It is important to note that the text of this transcript is quoted directly and precisely. The line numbering has changed due to the different journal formats. I present the second and third registers (that is, the sung/chanted verse) of Yankush's shamanic discourse in italics in order to make them distinguishable from the first (spoken) register. In Brown's original the second and third registers are presented in boldface; I replace this with italics due to format restraints. All text within brackets is Brown's narration or explanation. In the original some of the narrative or explanatory text was also in parentheses; in this article this text is enclosed in brackets for consistency. I reproduce the transcript for my own publication with permission from the author and Medical Anthropology Quarterly. 15. Lest it be a concern that Yankush is a rare exception in his incorporation of Western medical elements into his practice, there is evidence of this kind of appropriation from many other sources, some as early as 1974 (see Bastien 1992a:161; Kensinger 1974:287; Langdon 1988:53; Ramfrez dejara and Pinzon Castano 1992:294). There is also evidence of this appropriation in other folk medical practices in South America (see Langdon 1988:49; Taussig 1987: ch.16), as well as all over the world (see Reeler 1990). 16. This hallucinogen is used in much shamanic practice in South America and is typically referred to as either yaji (or yage) or ayahuasca. 17. The most popular conception of the ethnic category of mestizo is a person of mixed race (that is, a mix of European and Indian). However, mestizo is also sometimes applied to other groups who are not necessarily of mixed race but speak Spanish and have converted to Christianity (with varying degrees of actual participation in Christian services, some may only be nominally Christian). The categories of "Christian," "white," and "mestizo" are often used interchangably by Aguaruna, at least to the extent of signifying someone who is non-Aguaruna. 18. Whether or not this singing is intelligible to the onlookers remains to be seen given that Brown does not (or perhaps cannot) distinguish between the second and third registers. 19. South American Indians believe that fat is extracted in order to be sold ultimately to the elite class, to tourists, and to North Americans. It is thought to be used for generating electricity for North America. For a fuller explanation of pishtaco beliefs see Ansion 1989 and Crandon-Malamud 1991. 20. And within South America the lowland Amazonian region has become the particular locus of "authentic" shamanism as Taussig (1987), Salomon (1983), and Rogers (1994) all discuss. 21. What should also become clear in my reading of Yankush is that the tendency to overemphasize the individualized uniqueness of the shaman only further obscures the importance of the social relations in which shamans are inextricably involved and on which they inevitably have strong impact. This attempt to move toward a better social understanding of shamans is also discussed by Atkinson (1992) and touched on by Overing Kaplan (1984).

references cited
Achterberg, Jeanne 1985 Imagery in Healing: Shamanism and Modern Medicine. Boston: New Science Library. Ackerknecht, Erwin H. 1942 Problems of Primitive Medicine. Bulletin of the History of Medicine xi:503-521. Akerele, Olayiwola 1987 The Best of Both Worlds: Bringing Traditional Medicine Up to Date. Social Science and Medicine 24(2):177-181. Ansion, Juan, ed. 1989 Pishtacos: De Verdugos a Sacaojos. Lima: Tarea.

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Atkinson, Jane 1992 Shamanisms Today. Annual Review of Anthropology 21:3O7-33O. Bastien, Joseph 1982 Exchange between Andean and Western Medicine. Social Science and Medicine 16:795-803. 1992a Drum and Stethoscope. Salt Lake City: University of Utah Press. 1992b Shaman versus Nurse in an Aymara Village: Traditional and Modern Medicine in Conflict. In Andean Cosmologies through Time. Robert Dover, Katharine Seibold, and John McDowell, eds. Pp. 137-165. Bloomington: Indiana University Press. Brown, E. Richard 1978 Public Health in Imperialism: Early Rockefeller Programs at Home and Abroad. In The Cultural Crisis of Modern Medicine. John Ehrenreich, ed. Pp. 252-270. New York: Monthly Review Press. Brown, Michael F. 1986 Tsewa's Gift. Washington, DC: Smithsonian Institution Press. 1988 Shamanism and Its Discontents. Medical Anthropology Quarterly 2:102-120. 1989 Dark Side of the Shaman. Natural History, November:8-10. Bryant, John H. 1980 WHO's Program of Health for all by the Year 2000: A Macrosystem for Health Policy MakingA Challenge to Social Science Research. Social Science and Medicine 14a:381-386. Comaroff, Jean 1981 Healing and Cultural Transformation: The Tswana of Southern Africa. Social Science and Medicine 15b:367-378. 1982 Medicine: Symbol and Ideology. In The Problem of Medical Knowledge. Peter Wright and Andrew Treacher, eds. Pp. 49-68. Edinburgh: Edinburgh University Press. Comaroff, John, and Jean Comaroff 1992 Medicine, Colonialism, and the Black Body. In Ethnography and the Historical Imagination. Pp. 21 5-233. Boulder, CO: Westview Press. Cosminsky, Sheila 1983 Medical Pluralism in MesoAmerica. In Heritage of Conquest: Thirty Years Later. Carl Kendall, John Hawkins, and Laurel Bossen, eds. Pp. 159-173. Albuquerque: University of New Mexico Press. Cox, Paul, and Michael Balick 1994 The Ethnobotanical Approach to Drug Discovery. Scientific American, June. Crandon, Libbet 1986 Medical Dialogue and the Political Economy of Medical Pluralism: A Case from Rural Highland Bolivia. American Ethnologist 13:463-476. Crandon-Malamud, Libbet 1991 From the Fat of Our Souls. Berkeley: University of California Press. Crouch, Dora, Daniel Garr, and Axel Mundigo. 1982 Spanish City Planning in North America. Cambridge: Massachusetts Institute of Technology Press. Cueto, Marcos 1994 Visions of Science and Development. In Missionaries of Science. Marcos Cueto, ed. Pp. 1-22. Bloomington: Indiana University Press. Eliade, Mircea 1964 Shamanism: Archaic Techniques of Ecstasy. Willard Trask, trans. Princeton, NJ: Princeton University Press. El I ing, Ray 1981a Introduction: Relations between Traditional and Modern Medical Systems. Social Science and Medicine 15a:87-88. 1981 b Political Economy, Cultural Hegemony, and Mixes of Traditional and Modern Medicine. Social Science and Medicine 15a:89-99. Escobar, Arturo 1995 Encountering Development. Princeton, NJ: Princeton University Press. Evans-Pritchard, E. E. 1937 Witchcraft, Oracles, and Magic among the Azande. Oxford: Clarendon Press. Fabian, Johannes 1983 Time and the Other. New York: Columbia University Press. Fanon, Frantz 1978 Medicine and Colonialism. In The Cultural Crisis of Modern Medicine. John Ehrenreich, ed. Pp. 229-251. New York: Monthly Review Press. Farquhar, Judith 1994 Knowing Practice: The Clinical Encounter of Chinese Medicine. Boulder, CO: Westview Press. Flaherty, Gloria 1992 Shamanism and the Eighteenth Century. Princeton, NJ: Princeton University Press. Foster, George M., and Barbara G. Anderson 1978 Medical Anthropology. New York: John Wiley and Sons. Frankenberg, Ronald 1980 Medical Anthropology and Development: A Theoretical Perspective. Social Science and Medicine 14b:197-207.

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Fraser, Valerie 1990 The Architecture of Conquest. Cambridge: Cambridge University Press. Coleman, Daniel 1991 Shamans and their Lore May Vanish with the Forest. New York Times, June 11: C1, C6-C7. Greaves, Thomas, ed. 1994 Intellectual Property Rights for Indigenous Peoples: A Source Book. Oklahoma City, OK: Society for Applied Anthropology. Harner, Michael 1972 The jivaro: People of the Sacred Waterfalls. Garden City, NY: Anchor Books. 1990 Preface to the Third Edition. In The Way of the Shaman 1980. Pp. xi-xv. San Francisco: Harper. Jackson, jean E. 1995 Preserving Indian Culture: Shaman Schools and Ethno-Education in the Vaupes, Colombia. Cultural Anthropology 10(2):302-329. 1994 Becoming Indians: The Politics of Tukanoan Ethnicity. In Amazonian Indians: From Prehistory to the Present. Anna Roosevelt, ed. Tucson: University of Arizona Press. Kalweit, Holger 1992 Shamans, Healers, and Medfcine Men. Michael Kohn, trans. Boston: Shambhala. Kay, Margarita 1987 Lay Theory of Healing in Northwestern New Spain. Social Science and Medicine 24(12):1051-1060. Kensinger, Kenneth 1974 Cashinahua Medicine and Medicine Men. In Native South Americans. Patricia J. Lyon, ed. Pp. 283-288. Boston: Little, Brown. King, Steven 1994 Establishing Reciprocity: Biodiversity, Conservation and New Models for Cooperation between Forest-Dwelling Peoples and the Pharmaceutical Industry. In Intellectual Property Rights for Indigenous Peoples: A Source Book. Thomas Greaves, ed. Oklahoma City: Society for Applied Anthropology. Kreimer, Elizabeth 1988 An Andean View of History and a Strategy of Cultural Survival, in Otra America en Construccion. Carlos Pinzon and Rosa Suarez, eds. Pp. 22-43. Amsterdam: University of Amsterdam. Krippner, Stanley 1988 Shamans: The First Healers. In Shaman's Path. Gary Doore, ed. Pp. 101-114. Boston: Shambhala. Langdon, E. Jean 1988 Interethnic Processes Affecting the Survival of Shamans: A Comparative Analysis. In Otra America en Construccion. Carlos Pinz6n and Rosa Suarez, eds. Pp. 44-65. Amsterdam: University of Amsterdam. 1992 Dau: Shamanic Power in Siona Religion and Medicine. In Portals of Power. E. Jean Langdon and Gerhard Baer, eds. Pp. 41-62. Albuquerque: University of New Mexico Press. Langdon, E. Jean, and Gerhard Baer, eds. 1992 Portals of Power. Albuquerque: University of New Mexico Press. Langdon, E. Jean, and Robert MacLennan 1979 Western Biomedical and Sibundoy Diagnosis: An Interdisciplinary Comparison. Social Science and Medicine 13b:211 -220. Latour, Bruno 1988 The Pasteurization of France. Alan Sheridan and John Law, trans. Cambridge, MA: Harvard University Press. Leslie, Charles 1980 Medical Pluralism in World Perspective. Social Science and Medicine 14b:191-195. Lewis, Walter H., and Memory P. Lewis 1994 Basic, Quantitative, and Experimental Research Phases of Future Ethnobotany with Reference to the Medicinal Plants of South America. In Ethnobotany and the Search for New Drugs. Ghillean T. Prance, Derek Chadwick, Joan Marsh, eds. Pp. 60-76. New York: John Wiley and Sons. Macleod, Roy, and Milton Lewis, eds. 1988 Disease, Medicine, and Empire. London: Routledge. McDonald, Catherine 1981 Political-Economic StructuresApproaches to Traditional and Modern Medical Systems. Social Science and Medicine 15a:101-108. Mehl, Lewis E. 1988 Modern Shamanism: Integration of Biomedicine with Traditional World Views. In Shaman's Path. Gary Doore, ed. Pp. 127-138. Boston: Shambhala. Nandy, Ashis, and Shiv Visvanathan 1990 Modern Medicine and Its Non-Modern Critics: A Study in Discourse. In Dominating Knowledge. Frederique Apffel Marglin and Stephen Marglin, eds. Pp. 143-184. Oxford: Clarendon Press. Neumann, A. K., and P. Lauro 1982 Ethnomedicine and Biomedicine Linking. Social Science and Medicine 16:1817-1824.

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Overing Kaplan, Joanna 1984 Shamanism in Lowland South American Societies: A Problem of Definition. In Past and Present in the Americas. John Lynch, ed. Pp. 167-171. Manchester, UK: Manchester University Press. Paul, James A. 1978 Medicine and Imperialism. In The Cultural Crisis of Modern Medicine. John Ehrenreich, ed. Pp. 271-286. New York: Monthly Review Press. Perrin, Michel 1987 The Way of the Dead Indians. Michael Fineberg, trans. Austin: University of Texas Press. Posey, Darrell 1990 Intellectual Property Rights: What Is the Position of Ethnobiology? Journal of Ethnobiology 10:93-98. Prance, Gnillean T., Derek Chadwick, and }oan Marsh 1994 Ethnobotany and the Search for New Drugs. New York: John Wiley and Sons. Press, Irwin 1971 The Urban Curandero. American Anthropologist 73:741-756. RAFI (Rural Advancement Foundation International) 1995 RAFI Communique. Sep/Oct 1995. Electronic document at http;//www.charrn.net/~rafi/19955.html, Ramirez de Jara, Maria C , and Carlos E. Pinzon Castafio 1992 Sibundoy Shamanism and Popular Culture in Columbia. In Portals of Power. E Jean. Langdon and Gerhard Baer, eds. Pp. 287-304. Albuquerque: University of New Mexico Press. Reeler, Anne V. 1990 Injections: A Fatal Attraction? Social Science and Medicine 31:11191125. Reichel-Dolmatoff, Gerardo 1975 The Shaman and the Jaguar. Philadelphia: Temple University Press. Rivers, W. H. R. 1924 Medicine, Magic, and Religion. New York: Harcourt Brace. Rogers, Mark 1 994 Images of Power and the Power of Images: Identity and Place in Ecuadorian Shamanism. Ph.D. dissertation, University of Chicago. Rosenthal, Joshua 1996 Equitable Sharing of Biodiversity Benefits: Agreements on Genetic Resources. Paper presented at OECD International Conference on Biodiversity Incentive Measures. Cairns, Australia: March 25-28. Salomon, Frank 1983 Shamanism and Politics in Late-Colonial Ecuador. American Ethnologist 10:413-428. Sherzer, Joel 1983 Kuna Ways of Speaking. Austin: University of Texas Press. Taussig, Michael 1980 Reification and the Consciousness of the Patient. Social Science and Medicine 14b:3-13. 1987 Shamanism, Colonialism, and the Wild Man: A Study in Terror and Healing. Chicago: University of Chicago Press. 1992 Homesickness and Dada. In The Nervous System. Pp. 149-182. New York: Routledge. Taylor, Anne-Christine 1981 God-Wealth: The Achuar and the Missions. In Cultural Transformations and Ethnicity in Modern Ecuador. Norman E. Whitten jr., ed. Urbana: University of Illinois Press. Trachtman, Paul 1994 NIH Looks at the Implausible and the Inexplicable. Smithsonian, September:110-123. Turner, Terence 1988 History, Myth, and Social Consciousness among the Kayapo of Central Brazil. In Rethinking History and Myth. Jonathan Hill, ed. Pp. 195-213. Urbana: University of Illinois Press. Turner, Victor 1967 The Forest of Symbols. Ithaca, NY: Cornell University Press. Wright, Robin, and Jonathan Hill 1992 Venancio Kamiko: Wakue"nai Shaman and Messiah. In Portals of Power. E. Jean Langdon and Gerhard Baer, eds. Pp. 257-286. Albuquerque: University of New Mexico Press. Young, Allan 1981 The Creation of Medical Knowledge: Some Problems in Interpretation. Social Science and Medicine. 15b:379-386. 1982 The Anthropologies of Illness and Sickness. Annual Review of Anthropology 11:257-285.

submitted September 30, 1996 accepted May 27, 1997

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