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SO( Sci, M,d VollSB, pp 10710 114, 1981Prinled in Great Britain
All righls reserved
0160-7987;81;020107-08102.00;0Copyright e 1981 Per8amon Press
Ltd
REMEDIOS CASEROS: MEXICAN AMERICAN HOMEREMEDIES AND COMMUNITY
HEALTH PROBLEMS
ROBERT T. TROTTER II
Department of Behavioral Sciences, Pan American University,
Edinburg, TX 78539, U.S.A
Abstract-A sample of 1235 case examples of remedios caseros
(home remedies) was analyzed to deter-mine the morbidity patterns
for "home treated" ailments in Mexican American communities in
SouthTexas. A group of seventy most commonly encountered ailments
was discovered, as described in thepaper. An analysis was made of
the variations within the morbidity patterns of these ailments in
relationto the age and sex of the informant. Parallels are drawn
between the research findings and the results ofconventional
morbidity research efforts.
Investigations of the patterns of community healthproblems in
the United States are of relatively recentadvent. and are normally
pursued within the contextof a demographic analysis of morbidity.
While mor-bidity has been defined by Tomlinson [1, p. 138] as"the
study of illness", the more commonly accepteddefinition is that of
the United States National HealthInterview Survey, which defines
morbidity as:
basically a departure from a state of physical or
mentalwell-being, resulting from disease or injury, of which
theindividual afflicted is aware. Awareness connotes a degreeof
measurable impact on the individual or his family interms of the
restrictions and disabilities caused by the mor-bidity [2, p.
42].
Most morbidity research divides illness into chro-nic or acute
states and attempts to measure either theincidence, t prevalence~
or both of biological and ofpsychological ailments. The protocols
for theNational Health Interview Survey state:
A condition is considered to be chronic if (I) it is describedin
terms of one of the chronic diseases on the "Checklist ofChronic
Conditions" or in terms of one of the impairmentson the "Checklist
for Impairments"... or (2) the conditionis described by the
respondents as having been first noticedmore than 3 months before
the week of the interview.
An acute condition is defined as a condition which haslasted
less than 3 months and which has involved eithermedical attention
or restricted activity [2, p. 45].
The most common foci of morbidity research areeither household
surveys or institutionally basedstudies that attempt to look at
morbidity in relationto hospitals, doctors' offices, clinics, etc.
Theseresearch efforts normally attempt to measure theoccurrence of
disease states that are recognized by themedical system, using
instruments developed for that
.As an example, national attention to morbidity datacollection
did not occur to any significant extent until theadvent of the
National Health Interview Survey (NHS) in1956. Even now, formal
demographic texts often pay scantattention to the subject.
t The incidence rate is equal to the number of new casesduring a
specified period of time per unit of the midpointpopulation [5, p.
236].
t The prevalence rate is equal to the number of personsdiagnosed
as having a condition on any given day per unitof the total
population [5, p. 236].
107
purpose [~e 2, 3]. Unfortunately, the weaknesses of.these
studies are relatively numerous. Central to theseweaknesses is the
condition that morbidity is far moredifficult to identify than the
other major demographicmeasure of health, mortality. Death is a
reasonablyclear-cut event, and its cause can usually be traced
toone or more of the entities listed in the
InternationalClassification of Diseases. On the other hand,
asPeterson [5] clearly demonstrates, the recognition ofan illness
or ailment is an event that is based on thesubjective
interpretation of symptoms by patients ortheir families. To
overcome this problem, some mor-bidity studies have turned away
from clinicalmeasures of health status and have developed anumber
of instruments designed to categorize andquantify the informant's
life condition, including suchnebulous states of well-being as
happiness [see 6-7].Unfortunately, as Mechanic points out, the
indirectmeasure of "health status is so involved with subjec-tive
perceptions, social expectations, role demands,and value
judgments... (that these measurementsoften become)... only poor
approximations of theconcepts the investigators wish to study" [9,
p. 183].And as Peterson [5, p. 239] indicates, a comparison
ofmorbidity patterns across cultural boundariesbecomes particularly
perilous. This is partially due tothe condition that the rank
ordering of the impor-tance of diseases to a community is normally
basedon quantitative evaluations of the reported incidence,or
prevalence, of previously defined illnesses. This is apractice
which is generally acceptable for a dominantcultural group, such as
Anglo Americans in theUnited States, since the categories of
illnesses beingmeasured are relatively well agreed upon by both
theinformants and the evaluators. However, this agree-ment is not
necessarily pertinent for ethnic groups ormembers of other cultures
who recognize and beha-viorally react to disease entities not
recognized by thedominant group, and who may fail to recognize
dis-eases that are a part of the medical model [5, pp.235-244].
This paper presents an alternative method forexploring community
morbidity patterns for groupswhere more conventional approaches
either have notbeen undertaken, or cannot be conducted at
present.The method utilizes an anthropological approach forthe
derivation of a typology of ailments, combinedwith quantification
to allow the rank ordering of ail-
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108 ROBERT T. TROTTER II
ments in relation to their "prominence". in the com-munity.
Developing a community based classificationof ailments avoids the
cultural bias of the methodspreviously mentioned, however, it
produces its ownweakness in that it does not generate incidence
andprevalence rates comparable to other studies. Thisweakness can
be considered minor, in light of the factthat the illness typology
produced by this method cansubsequently be used to generate surveys
of mor-bidity, using more conventional methodologies, whentime and
financial resources (or interest) permit.
RESEARCH AREA AND POPULATION
The data for this paper were collected in the LowerRio Grande
Valley of Texas, commonly called theValley by local residents. The
Valley is composed offour Texas counties (Starr, Hidalgo, Willacy
andCameron) adjacent to the United States-Mexicoborder at the mouth
of the Rio Grande River. It con-tains numerous small and
medium-sized towns, thelargest of which are Brownsville, Harlingen,
andMcAllen. The estimated half-million people in theValley live in
a nearly continuous "population strip"following the river and the
railroad up and down theValley in an approximately east-west
direction.
Agriculture is the primary Valley industry,although assembly
plants, maquiladoras, and U.S.-Mexico "sister" plants are being
introduced into thelocal economy. This condition, along with the
demo-graphic spread of the population, has produced anarea that is
neither rural nor urban, but some inex-tricable combination of the
two.
With the exception of the immediately adjacentborder towns of
Reynosa and Matamoros (Tamau-lipas) Mexico, the Valley is somewhat
isolated. Thenearest towns of any significant size are
CorpusChristi and San Antonio, 130 and 250 miles awayrespectively.
This relative isolation, along with theextreme ease of movement
between the United Statesand Mexico causes the Mexican border towns
to haveboth a strong cultural, as well as economic impact onthe
Valley. Part of the impact comes from the nearlyone million people
on the Mexican side of the riverwho account for between 40 and
60"10 of the retailtrade in the Valley, while they also provide a
largelabor pool that reduces upward wage pressures andmakes both
seasonal and permanent underemploy-ment a chronic problem for
Valley residents. Theresult is that the Valley contains the two
poorestStandard Metropolitan Statistical Areas surveyed inthe 1970
Census of Population. At that time the percapita income in Hidalgo
County was 11777 perannum, with over half of the population falling
belowfederal poverty guidelines. There is no indication thatthe
1980 Census will significantly revise the economicprofile of the
area.
The demographic chara
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Remedios caseros: home remedies in Mexican America 109
unduly clustering in anyone area, age group, or socialgroup.
Therefore, the results are reasonably represen-tative of the
ethnopharmacological knowledge andpractices of the region.
yerberos, who know literally hundreds of remedies[see 10].
The sample contains 1235 cases collected from 378informants
ranging in age from 15 to 86(mean = 50.5; median = 50; mode = 50).
All of theinformants in the sample identified themselves asMexican
American; 58.6% of the cases were providedby individuals born.in
the United States, while 41.4%of the cases were provided by
individuals born inMexico. A later report will measure whether or
notthere are significant differences in the remedios andailments
reported by these two groups. Women pre-dominate in the sample;
85.4% of the cases (1050),where sex is identified, were collected
from women,while 14.6% (179) were collected from males (6 had nosex
identifier). This is generally representative of thestudy
population, in that ethnographic data collectedin the Valley
indicates that women are normally theprimary informants about
remedios caseros. There-fore, the sample can be considered
representative ofthe general knowledge about remedios caseros in
thearea.
The sample should probably be considered a con-venience sample,
since no effort was made to assurethat the data collected for the
ethnopharmacologicalarchive would be amassed in a way that made it
rep-resentative of any specific geographical or sociocul-tural
characteristics of the Valley. Nevertheless, aninspection of the
data indicates that it is consistentwith the results of
ethnographic research conductedby the author and others, and that
the informantscover the demographics of the Valley area without
THE DATA
One assumption was made about the case data thatis central to
the results of this paper. It was assumedthat when people were
asked in a nondirective man-ner to recall remedios caseros, the
ones they recountedwould be either the ones they most commonly used
orthe ones that treated ailments that had been signifi-cant events
in either their own lives or the life ofsomeone important to them.
In either situation, themost frequently repeated case examples are
assumedto be the ones that represent a combination of com-mon and
key ailments in the community. Those lessfrequently presented are
assumed to represent un-usual or less frequently encountered
community ail-ments. A total of 510 remedios caseros (both
botanicaland non-botanical items) treating 198 discrete ill-nesses
were discovered in the sample. Within thisfield, there was clearly
a core group of remedios thatconstituted the bulk of those
presented in the samplecases. The 25 most frequently encountered
remedios(4.9% of all remedios discovered) constitute 40.9% ofthe
total cases in the sample.. Since each remedio islinked to one or
more ailments it is obvious that thereis also a core group of
ailments which informants feelare amenable to home treatment.
Although, it mightbe more accurate to state that each ailment is
linkedto one or more remedio, since new remedios wereencountered
and coded throughout the coding pro-cess at approximately the same
frequency, while theailments began to repeat very rapidly and
almost nonew ailments were added to the informant's ailmenttypology
from the point when about half of the totalsample was coded. The
core group of ailments ispresented in Table 1.
The sample produced a core group of 70 most fre-quently
encountered ailments that are treated byremedios caseros. These
remedies (representing 35.9%of the tota1198 ailments) constitute
84.0% of all of thecases. t
This group of ailments is assumed to be an ethno-typology of
health problems within MexicanAmerican communities, especially
those ailments thatinformants feel can or should be given home
treat-ment as opposed to medical attention. The labels ofthe
ailments (or conditions) were taken directly fromthe collection
form, without modification. Those ail-ments that could be
translated (or had been by theinformants) are rendered in the table
in English. Carewas taken to assure that the exact English
equivalentof a Spanish term was used and where there is noEnglish
equivalent, the Spanish was retained. In mostcases, the informants
provided the translation, butwhere they did not do so, matches were
sought withsimilar cases, or other informants in the communitywere
utilized to provide the translations. Some of theoriginal list of
ailments produced by this method werecombined in the table (e.g.
IJpset stomach and indiges-tion; or body aches and aches and pains)
into a singleailment category, since informants tended to fail to
beable to differentiate amongst the labels and used them
* The 25 most common remedios caseros are: manzanilla(cammomile)
Matricaria chamomilla L.; savile (aloe vera)Aloe barbadensis Mill.;
ruda (rue) Ruta graveolens L.; yerbaaniz (anise) Pimpinella anisum
L.; yerba buena (mint) Men-tha spicata L., estafiate (worm wood)
Artemisia mexicanaWilld.; hojas de naranjo (orange leaves) Citrus
aurantium L.,albacar (sweet basil) Ocimum basilicum L.; oregano
(ore-gano) Monarda methaefolia Graham; ajo (garlic) Alliumsativum
L.; pelos de elote (corn silks) Zea mays L.; canela(cinnamon)
Pulchea orodata (L) Cass; romero (rosemary)Rosmarinus officinalis
L.; borraja (borrage) Borajo offici-nalis L.;cenizo (purple sage)
Leucophyllum texanum Benth.;nopal (prickly pear cactus) Opuntia
sp.; Rosa de Castillo(rose) Rosa centifolia sp.; salvia (sage)
Salvia leucanthaCav.; hojas de mesquite (mesquite leaves) Prosopis
glandu-losa Torr.; marijuana (marijuana) Cannabis sativa L.;
nogal(pecan) Carya illonoensis Koch; comino (cumin)
Arracaciaatropurpurea Benth. et. Hook; golondrina
(swallow-wort)Euphorbia prost rata Ait.; sacate de limon (lemon
grass) un-identified local plant; el azajar (orange blossoms)
Citrusaurantium L.
t Table 1 was limited to those ailments which wererepeated in
the sample at least four times. Including ail-ments that
represented approximately 0.2% of the cases(the other multiple
example cases) would have increasedthe core group by the addition
of 35 ailments, but wouldonly have increased the cumulative
percentage of cases by7.0";';, too large an increase for too small
an addition towarrant their inclusion. The final 93 ailments were
singleexample cases from the sample. Since they were notrepeated,
they were considered to be inappropriate for in-clusion in the core
group. In fact, the core group couldeasily be restricted to the top
forty or fifty most commonlyencountered ailments and still
represent the bulk of the keymorbidity problems found within the
Mexican Americancommunities of South Texas.
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110 ROBERT T. TROTTER II
Table I. Most common ailments treated by remedios caseros
No. ofcases
No. of Cumulativecases % %
Cumulative% %Ailment Ailment
765546454338363636292727
6.24.53.73.73.53.12.92.92.92.72.22.2
6.210.714.418.121.624.727.630.533.436.138.340.5
0.70.70.70.60.60.60.60.60.60.50.50.50.50.50.50.40.40.40.40.40.40.40.4
69.370.070.771.371.9n.573.173.774.374.875.375.876.376.877.377.778.178.578.979.379.780.180.5
I. Stomach ache2. Cough3. Nervios4. Colic5. Fever6. Earache7.
Diarrhea8. Susto9. Upset stomach
10. Constipation11. Eye irritation12. Painful joints.
arthritis13. Insomnia 2314. Sores (granos) 2315. Bladder
infection 2016. Burns 2017. Kidney infection 2018. Diabetes 1919.
Intestinal parasites 1720. Sore throats 1721. Colds 1622. Boils
(tacotes) 1523. Bleeding 1424. Heart problems 1425. Insect bites
1426. Headaches 1327. Menstrual cramps 1328. Congestion 1129.
Empacho 1130. Gases 1131. Acre 1032. Anemia 1033. Balding 1034.
Cuts 1035. Late menstruation 1036. Bronchitis 9
Total cases = 1235
1.91.91.61.61.61.51.41.41.31.21.11.11.11.01.00.90.90.90.80.80.80.80.80.7
42.444.345.947.549.150.652.053.454.755.957.058.159.260.261.262.163.063.964.765.566.367.167.968.6
0.40.40.30.30.3
80.981.381.681.982.2
0.30.30.30.30.3
82.582.883.183.483.7
37. Stomach cramps 938. Toothache 939. Ulcers 940. Asthma 841.
Body aches and pains 842. Infected wounds 843. Feeling rundown 744.
High blood pressure 745. Tired blood 746. Mental disorders 647.
Mild rashes 648. Mouth infections 649. Obesity 650. Pneumonia 651.
Tuberculosis 652. Hemorrhage 553. Hemorrhoids 554. Hiccups 555.
Liver 556. Mal de ojo 557. Mumps 558. Pain 559. To keep away evil
5
spirits60. To sterilize wounds 561. Warts 562. Cancer 463.
Infertile womb 464. Insufficient milk 4
for nursing65. Stomach infection 466. Sun stroke fevers 467. To
induce labor 468. Tonic for blood 469. Urinary tract 4
infection70. Whooping cough 4
Total ailments = 1980.3 84.0
interchangeably. The resulting list is assumed to con-tain only
conditions that are considered by the infor-mants to be mutually
exclusive categories. If there isany error in the categories, it is
probably in the direc-tion of lumping together categories that
should haveremained separate rather than from retaining cate-gories
that duplicated or overlapped one another.
MORBIDITY PAlTERNS
The core ailments can be assembled into groups ofrelated
illnesses which are useful for an analysis ofsome of the trends in
morbidity derived from thedata. Although these groupings do not
represent afolk taxonomy of ailments, several interesting
attri-butes of the morbidity patterns in Mexican
Americancommunities are apparent from an inspection ofTable 1. The
first is the inclusion of ailments thathave no English equivalents
and are basically of amagical or supernatural nature. These
ailments aresusto, empacho, keeping evil spirits away, mal de
ojo,and caida de mol/era (one case, not listed in the coregroup).
They are the so-called Mexican American folkillnesses that have
received such prominent attentionin the anthropological literature,
since the folk medi-cal system makes this basic distinction
between
natural and magical ailments [see 11-16]. The pres-ence of these
ailments, in and of themselves, guaran-tees that the morbidity
patterns of MexicanAmericans are different from those of
AngloAmericans. However, caution should be maintainedto avoid
overemphasizing the prominence and impor-tance of these ailments
within the ethnomedicine ofMexican Americans. To ignore them
because they donot fit the medical model would be a serious
mistake,one which would distort the actual morbidity patternsin
Mexican American communities, since these ill-nesses are "a
departure from a state of. ..well-beingof which the individual
afflicted is aware" [2]. At thesame time, these ailments represent
only 2.5% of thetotal group of ailments in the sample and
constituteonly 4.7% of the total sample of cases. So the
under-emphasis of the treatment of other ailments, as hasbeen done
in the past, is equally inappropriate andproduces an even more
serious distortion of com-munity health patterns in places such as
the LowerRio Grande Valley.
In addition to the folk illnesses, there are severalother groups
of ailments that provide insight into thehome treatment of health
care problems in MexicanAmerican communities. These include
digestive sys-
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Remedio.~ caseros: home remedies in Mexican America III
equal to 22.3% of the total sample of cases. The ail-ments in
this group are very similar to the group of"other acute ailments"
reported for the United Statesas a whole. Cole states the
following:
Among the category of "other acute ailments" for females,about
one-fifth were reported as genitourinary problemsand one-eighth as
deliveries and disorders of pregnancyand puerperium. Among males,
over one-fourth of thisresidual category was reported as diseases
of the ear, one-sixth as diseases of the skin, and about one-tenth
as head-aches. These conditions were also prominent amongfemales
[17, p. 35].
tem problems, upper respiratory ailments, infectiousand
parasitic diseases, injuries and environmentallyproduced ailments,
other acute conditions, mentalproblems, and chronic ailments. These
categories cor-respond, at least partially, with the groupings of
ill-ness most frequently presented in morbidity tablesand articles.
Since some of the ailments listed in TableI could potentially be
placed in more than one ofthese categories, the list of ailments
assigned to eachis presented within the context of the discussion
ofthat grouping.
The digestive system problems listed in the coreailment group
include stomach aches, colic, diarrhea,upset stomach, constipation,
gases, stomach crampsand ulcers. These ailments account for 20.7%
of thetotal cases in the sample, which makes them the singlemost
prominent group of closely related ailments inthe community. This
finding is consistent with othermorbidity studies, since, as Cole
[17, p. 36] indicates,problems with the digestive system are
reported muchmore frequently amongst low income families
thanamongst families of moderate or high income.
The core group of upper respiratory infections in-cludes coughs,
sore throats, colds, congestion, bron-chitis, pneumonia, and
whooping cough. These ail-ments account for a total of 9.6% of the
total cases inthe sample. In most morbidity studies, upper
respirat-ory infections constitute the largest single group
ofailments [17, p. 34] with the common cold being theprinciple
contributor to incidence rates. Colds rank21st on the core group
list, however, when the cate-gory "colds" is combined with two cold
symptoms(coughs and congestion) the group cases equal 6.7% ofthe
total sample and would rank first on the core list.
Infectious and parasitic diseases listed in the coreailment
group include intestinal parasites, tubercu-losis, and mumps, which
account for 2.3% of thesample of cases. Public heath morbidity
reports fromthe Lower Rio Grande Valley all indicate that therates
for nearly all infectious diseases are significantlyhigher than
elsewhere in the United States. Twofactors, the poverty of the area
and the proximity andease of access to Mexico, are blamed for this
con-dition. Yet, this condition does not appear to be re-flected in
the core ailment group. One explanation forthis is that the
majority of infectious diseases are nowviewed as being best treated
by medical intervention,and they are, therefore, no longer a part
of the hometreatment or ethnopharmacological system.
The category injuries and environmentally pro-duced ailments
includes eye irritation, sores, burns,bleeding, insect bites, cuts,
wounds (2 categories), mildrashes, and sun stroke. These ailments
represent 8.5%of the cases analyzed for this paper. These
ailmentsare primarily first aid problems and are not
easilycomparable to the accident category that is presentedin most
morbidity studies [17, p. 35].
The final grouping of acute illnesses, "other acuteillnesses",
includes fevers, earaches, bladder infections,kidney infections,
boils, headaches, menstrual cramps,acne, anemia, late menstruation,
toothaches, achesand pains, feeling rundown, tired blood, mouth
infec-tions, hemorrhage, hemorrhoids, hiccups, liver prob-lems,
pain, warts, infertile womb, insufficient milk,stomach infection,
inducing labor and urinary tractinfection. The sum of all the cases
in this group is
An inspection of the list of ailments in this categoryshows that
these are also prominent ailments treatedby home remedies. The
comparison of ailments by sexis presented below.
Chronic ailments are normally separated out fromacute ones for
special emphasis in morbidity studies,and have even formed the
topic of interest for specificstudies. The chronic ailments found
in the core groupare arthritis, diabetes, heart problems,
balding,asthma, high blood pressure, obesity, and cancer,which
constitute 5.4% of all of the cases analyzed.Approximately one-half
of the civilian non-insti-tutional population of the United States
commonlyreports having more chronic conditions [17, p. 38],however,
only 1.2% of the females and 3.0010 of themales were considered
disabled to the extent theycould not work or do whatever they were
doing priorto the disability [17, p. 40]. Listed in the
conditionsreported nationwide as most commonly restricting
ac-tivity were arthritis, visual impairments, hearing im-pairments,
high blood pressure, heart conditions,digestive conditions, and
orthopedic impairments [17,pp. 40-42]. Obesity is generally not
labeled as anillness in medically based surveys, while asthma
anddiabetes are not amongst the prominent problemslisted by Cole
for the United States as a whole. Thismakes a comparison of the
ethnographic and demo-graphic data difficult, however, it is
interesting to notethat both studies listed four ailments as
prominentproblems: arthritis, digestive conditions, heart
prob-lems, and high blood pressure. Equally germane is thegrowing
concern in the Valley over the evidence thatthere is a higher
incidence of diabetes amongst Mexi-can Americans than the country
as a whole [18, p.44]. Cancer was placed in the chronic illness
categoryby the author, since its duration is often more thanthree
months, but a similar treatment was not foundin Cole [17], Peterson
[5], Tomlinson [19] or Mech-anic [9]. The other illness in this
category, balding,represents a community health concern that
wouldnot be considered a high priority condition by themedical
establishment, but is of concern within thecommunity. It is
discussed in more detail below.
The final category of illnesses derived from group-ing the core
ailments is the category of "mental prob-lems". These include the
categories nervios, insomnia,and mental disorders. N ervios is a
broad conditionthat includes anxiety, irritability, and insomnia
buthas no exact English equivalent, either as a folk illnessor as a
medical condition. The category "mental dis-orders" includes
depression, sadness, the relief of gen-eral mental disorders, and
the restoration of sanity.The broadness and inexactness of
definition of these
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ROBERT T. TROTTER II112
Table 2. Sex specific comparisons of frequencies of ailment case
examples
Females Males
Cumulative%
No. ofcases
Cumulative% %Ailment Ailment
No. ofcases
I. Arthritis 9 5.02. Fever 9 5.03. Stomach ache 9 5.04. Upset
stomach 9 5.05. Constipation 8 4.56. Diarrhea 7 3.97. Sore throats
6 3.48. Intestinal parasites 5 2.89. Nervios 5 2.8
10. Boils 4 2.2II. Cough 4 2.212. Eye irritation 4 2.213. Insect
bites 4 2.214. Kidney infection 4 2.2IS. Backache 3 1.716. Bladder
infection 3 1.717. Feeling rundown 3 1.718. High blood pressure 3
1.719. Heart problems 3 1.720. Insomnia 3 1.721. Sores 3 1.7
Total cases, male informants = 179
5.010.015.020.024.528.431.834.637.439.641.844.046.248.450.151.853.555.256.958.660.3
6.411.215.419.322.826.129.332.134.336.538.540.342.344.045.747.348.950.451.752.954.0
1. Stomach ache 67 6.42. Cough 50 4.83. Colic 44 4.24. Nervios
41 3.95. Earache 37 3.56. Susto 35 3.37. Fever 34 3.28. Diarrhea 29
2.89. Eye irritation 23 2.210. Upset stomach 23 2.2II. Constipation
21 2.012. Insomnia 20 1.913. Sores 20 1.914. Arthritis 18 1.715.
Burns 18 1.716. Bladder infection 17 1.617. Diabetes 17 1.618.
Kidney infection 16 1.519. Colds 14 1.320. Headaches 13 1.221.
Intestinal parasites 12 1.1
Total cases, female informants = 1050
ailments makes a comparison of these problems withclinical
mental health categories impossible untilenough further research
has been done to more pre-cisely define them and their treatment
within an eth-nographic context. This category represents 6.1%
ofthe total sample of cases.
AGE AND SEX COMPARISONS
Most morbidity studies include a comparativeanalysis of
morbidity patterns by sex and by ageranked groups within the gender
categories. The datacollected for this paper were sufficient to
allow a par-tial analysis of the sex and age related differences
inhome treated morbidity problems in the Valley. How-ever, a
certain amount of caution should be main-tained in applying this
data elsewhere, due to the rela-tively small number of case
examples collected frommale informants. Thus, this must be
considered anexploratory, rather than a final analysis of sex and
agespecific morbidity problems.
Table 2 presents the 21 most commonly recordedailments for all
males and for all females, along withthe frequency of reporting of
each ailment within therespective group, but not for the total
sample of cases.
Even a casual inspection of the rankings for the twosexes
indicates a considerable divergence between thetwo groups, which is
confirmed by computing a chi-squared statistic for the table that
indicates that thereis less than one chance in a thousand that the
differ-ences between the group was produced by chancealone (x2 =
621.3, 27 df, P < 0.001). Thus, there areage specific
differences in the reporting of remedioscaseros by males and
females which are probablylinked to differences in their morbidity
patterns (seeTomlinson [19], Cole [17], Mechanic [9] and Peter-son
[5] for discussions of the causes for these differ-ences).
There were 10 ailments from Table I, the core ail-ment group,
that were collected only from femaleinformants. These included
colic (44 cases), headaches(13 cases), balding (10 cases), tired
blood (6 cases),hemorrhoids (5 cases), keeping away evil spirits
(5cases), mumps (5 cases), infertile womb (4 cases), uri-nary tract
infection (4 cases), and whooping cough (4cases). Other multiple
example ailments presented byfemales, but not by males, include
dolor del aire, chills,babies' diarrhea, bad luck, deformaties, bed
wetting,nose bleeds, sprained joints, ringworms, dandruff,pano
(dark spots on the skin), dry irritated skin,measles, loss of
appetite, to gain weight, anxiety, faceproblems (spots, rough
skin), help close navel on new-borns, and to clean the uterus.
There were ~even con-ditions presented by males alone (restoring
eyesight,clean out stomach, poison oak, keep teeth and gumshealthy,
stay awake, abscesses, and intestinal flu), butsince they are all
single example cases, it is impossibleto assess their importance
until the sample of casesfrom male informants is increased
significantly.
Some patterns are suggested by the above data. Anumber of the
ailments collected solely from womenare childhood diseases, such as
colic, mumps, andwhooping cough, which suggests a much greater
roleof females in the treatment of these illnesses than formales.
Others are "female problems," such as infertilewomb (along with
morning sickness, vaginal douches,yeast infections, which were not
in the core group).The fact that no males reported keeping away
evilspirits as a problem may be due to the greater rolewomen in the
community play in participating in re-ligious activities. However,
as yet there is no explana-tion, and not even a decent speculation,
as to whyonly women reported balding as a community healthproblem,
especially given that balding is in the tophalf of the core ailment
group.
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Remedios caseros: home remedies in Mexican America 113
Table 3. Age and sex specific comparisons of frequencies of
ailment case examples, ages: 17-44
Females Males
No. ofcases
Cumulative%
No. of Cumulativecases % %Ailment%Ailment
2115121212II101088777
Total=311
6.84.83.93.93.93.53.23.22.62.62.32.32.3
6.811.615.519.423.326.830.033.235.838.440.743.045.3
655433332222
8.57.17.15.74.34.34.34.32.92.92.92.9
8.515.622.728.432.737.041.345.648.551.454.357.2
I. Upset stomache2. Constipation3. Intestinal parasites4.
Painful joints5. Diarrhea6. Fever7. Sore throats8. Stomach ache9.
Boils (tacotes)10. ColdsII. Gas12. Nervios
I. Stomach ache2. N ervios3. Colic4. Cough5. Diarrhea6.
Earache7. Constipation8. Susto9. Fever10. Upset stomachII. Eye
irritation12. Kidney infection13. Sores (granos)
Total = 70
The comparisons presented in Table 2 are furtherrefined in
Tables 3 and 4, which present the agespecific comparisons of the
most commonly reportedailments of males and females from the sample
cases.
Age specific comparisons are commonly reportedfor the age ranks
of 0-6, 7-16, 17-44 and 45 and over[17, p. 34]. However, there were
only eight cases inthe sample that were collected from males under
theage of seventeen years old, so only the two compari-sons of age
ranks in Table 3 and Table 4 arepresented. The reason for the
difference in the size ofthe lists of ailments is that the lists
were restricted tomultiple example ailments reported for the males,
and
the length of the female rankings was conformed tothat of the
male list of multiple examples.
Dividing the data into these groupings allows athree-way
comparison of the listing of the ailments:between males and females
in each of the two ageranks, and between the same sex informants in
thetwo different age ranks. The differences between theailments
presented by the males and females withineach rank is far greater
than it would have been ifproduced by chance alone
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114 ROBERT T. TROTTER II
will decide to use both systems either simultaneouslyor
sequentially, as discussed in Trotter and Chavira[10].
Future research, both in Mexican American com-munities and
within other cultural groups, which fol-lows or extends the format
set out in this papershould produce valuable results in at least
two areas.One is a delineation of the parameters of the systemof
choice that is operating; the factors which deter-mine the course
of treatment of an ailment pursuedby a patient, both at given
points in time and througha course of treatment. The second is in
determiningthe nature and scope of the whole field of homehealth
care and self help patterns, since these are notnormally known nor
are they commonly capable ofbeing established by other
methodologies, yeat theyappear to have a major impact on the health
status ofcommunities or regions where they are found.
variables playa part in differentially shaping the mor-bidity
patterns of home treated ailments in ways thatare probably similar
to those reported by Cole [17]and others for national and regional
morbiditystudies. Similarly, the differences between the two
ageranks for informants of the same sex were significant.for
females, the probability that the differences withinthe two lists
of the top ten ailments for the 17-44group and the 45 + group were
due to chance alonewere less than one in a thousand (xl = 95.5, 12
df,P < 0.001), and the probability that the differences inthe
top 10 ailments in each of the two male lists werealso less than
one in a thousand (xl = 44.16, 15 df,P < 0.001). These findings
are consistent with othertypes of morbidity studies, which have
shown thatsuch differentials are due, at least in part, to
thechanging social environment for the individual atvarious ages
and, in part, to the changing physiologi-cal characteristics of
individuals of varying ages.Thus, all three comparisons produce
results that arecomparable with conventional morbidity studies.
SUMMARY AND CONCLUSIONS
The data presented within this paper indicate thatan analysis of
appropriate samples of remedios caseroscan provide a considerable
amount of insight into thecommon ailments treated in the home with
ethno-pharmacological resources. Further, the morbiditypatterns
discovered by the analysis of this type of dataparallel those from
more conventional mortalityresearch efforts, especially in that the
patterns of thehealth problems collected from informants vary
sig-nificantly in relation to the age and sex of the individ-ual
providing the information.
The ailments and groupings of ailments describedin this paper
are interesting not only for the patternswithin the ailments that
are included in the sample,but also for the patterns of ailments
and groups thatare not found in the sample. Since the majority
ofMexican Americans in the Valley now have access tomedical
treatment, it can be assumed that remedioscaseros are currently
being utilized within the contextof a total field of health
resources that necessitatesomeone choosing between home treatment
andmedical treatment. Some ailments appear to betreated only in the
home and others treated only bythe medical establishment. Thus, the
core ailmentgroup was inspected for regularities that might
sug-gest a rationale behind the choices that are made. Theresult is
that the core ailments were subdivided intothree groups: ailments
having no medical treatment(e.g. susto, mal de ojo, etc.); ailments
that do not nor-mally require medical treatment (e.g. cuts,
minorrashes, burns, stomachaches, diarrhea); and ailmentsthat the
patient perceives the medical system hasfailed to cure or eliminate
(e.g. terminal cancer, dia-betes, balding, or arthritis). The
rationale for choosingfolk remedies, then, may be a process of
evaluatingthe symptoms an ailment presents, classifying it as
aparticular ailment, and pursuing treatment. If it isfurther
assessed or categorized as being outside thescope of medical
treatment, or if medical treatmenthas "failed", then, obviously,
many people will opt forself help forms of treatment, rather than
giving uphope. Naturally, some health problems are
extremelyambiguous in their presenting symptoms, and patients
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