Ethnomedicine of the Thakurs By Niklas Wagner Caesarstr.31 50968 Koeln Germany Email : niklas.wagner@koeln.de Ethnomedicine of the Thakurs 1. Introduction 1.1 Ethnomedicine 1.2 Indian Ethnobotany 1.3 Anthropology 2. Ill health Concept 2.1 Social 2.2 Supernatural 2.3 Natural 3. Nature and Role of Medicinal Practitioner 4. Therapies 5. Health Seeking Behavior 6. Case studies 7. Conclusions 1. Introduction This Paper deals mostly with the Book "Medicinal World of the Tribals - Explorations in Illness Ideology, Body Symbolism and Ritual Healing" by Robin D. Tribhuwan. I will focus on the concepts of Ill Health and the Ethnomedicinal Pathway, which Tribhuwan develops to describe the disease etiology and the health seeking behavior of the Thakur community. I will use the Ethnomedicinal Pathway on some illness episodes I collected myself. But first let me define the field of Ethnomedicine and its position in Anthropology. 1.1Ethnomedicine The Oxford dictionary defines medicine as, “An art of restoring and reserving Health”. Every human society has developed ways and means to cope up with diseases, thereby creating a system of medicine. (Hughes: 88) Tribhuwan follows Hughes Definition of Ethnomedicine as, "Beliefs and Practices relating to disease which are the products of indigenous cultural development and are not explicitly derived from the conceptual framework of modern medicine." (Hughes: 88) 1.2 Indian Ethnobotany Ethnobotany deals with the relationship between humans and plants. Ethnobotany includes study of foods, fibers, dyes, tans, other useful and harmful plant, taboos avoidances and even magico-religious beliefs about plants. (Pandy 489) In India scientific work on the local medicinal traditions is mainly done by scientists with taxonomic botany background. Their main interest is in listing the local and scientific plant name with their uses. They are mostly concerned with the concrete relationship between plants and humans such as food, medicine, house building, agricultural operations and other domestic uses. Thus most data on medicinal systems of India and their treatment are listings of medicine and technology used connected with the disease for what they are used as treatment and statements about the objective effect. (Tribhuwan 251) 1.3 Anthropology But there is also an Anthropological perspective on medicine. It includes what Pandy calls the abstract relationship between humans and plants, which includes faith in the good and bad powers of plants, taboos avoidances, sacred plants, worship and folklore. (Pandy 489) According to Tribhuwan: "Medicinal Anthropology encompasses the study of medicinal phenomena as they are influenced by social and cultural phenomena and social and cultural phenomena as they are illuminated by their medical aspects" (Lieban 1034, 1073) For Tribhuwan the job of an Anthropologist is to document and understand ethnomedical phenomena as defined and understood by the natives from an emic perspective. For in-depth analysis of medical culture more is needed than mere listing of medicinal plants and description of therapeutic practices from an emic perspective. One should look for the deeper meanings and symbolic beliefs regarding health and disease. In his book The Medicinal World of the Tribals Robin Tribhuwan describes the Ethnomedicine of the Thakur tribe in Maharashtra. In the 1981 census they numbered 323191 in Maharashtra. They are divided into two endogamous sections the Ma and the Ka Thakurs, which are both scheduled Tribes. Tribhuwan made his field studies in three villages of Karjat, Tehsil and in Raigarh district. Their villages are located outside of those of Hindu castes. They cultivate rice, nagli and vari and work as laborers in the field, forests or road construction. They are patrilineal and virilocal or neolocal where married brothers do not live together. The main objective of Tribhuwan is to show with his book, that through the view of a symbolic medicinal anthropology, one can get a deep view in not only the medical symbols but in turn the symbolical system of the whole culture as medicine is interwoven with all other aspects of culture. Any domain of social life is build in implicit frame work of meanings and that these meanings are not confined to a single area of social sphere but cross cut different institutional structures and provide the whole social system. (Tribhuwan22, 23) I think that the state of sickness lets oneself reflect on what normally seems given and so not focus of everyday attention, so medicinal Anthropology is a good way to understand the worldview of the studied people, Young writes. "Serious sickness interrupts everyday routine and the more or less uncritical acceptance of life. It turns people into metaphysicians and philosophers." Young 276 But Tribhuwan wants also to illuminate the whole medicinal system of the Thakurs. Following the theoretical Base of (Lieban 1042) who defines the areas of Ethnomedicine as disease classifications, etiology, nature and role of ethnomedical specialists, ethnomedical therapy, he divides his study exactly in this manner. His sound knowledge of the Thakur culture is illuminated through these different aspects. I shall first describe 1. Disease classifications 2. Etiology (thoughts regarding the cause of Disease) and 3. Body symbolism (bodily images as perceived by the natives in different social contexts) of the Thakurs, under the concept of Ill-health. Then I shall describe the Ethnomedical specialists in the Thakur culture and later explain their therapy forms. 2. Ill health Concept The WHO defines it as "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Lieban 1055 So there is physical mental and social health. The modern Biomedicine is mainly concerned with the micro organic agents as a cause for sickness. Mental health is the domain of psychology and finally the social part of health is that with what the anthropologists are concerned with. Lieban 1031 Tribhuwan puts together all the findings of his study and mainly of his literature review in the concept of ill-health. The state of ill-health is not merely a malfunctioning of biological and psychological processes, but a symbolic and meaningful expression of human conflicts, social indifferences, grudge, jealousy, deviance, hatred, cultural disorder etc. that exist at a social level. State of ill-health occurs due to Disruption and Disharmony of Man’s relationship with The State Of Ill-health: A Conceptual Model MAN Family members & relatives other clan members with members of KA with MA Thakurs OTHER SOCIAL GROUPS With other tribes With other caste groups With political groups DEITIES Clan Gods and Goddesses Village Gods and Goddesses Deities of other social groups EVIL SPIRITS Male and female spirits of same tribe Spirits of other tribes and castes Spirits of birds and animals Male ancestral spirits ANCESTRAL SPIRITS Female ancestral spirits COSMIC FORCES AND BEINGS Sun Moon Earth Wind Lightening Fire Light Planetary spirits Sky NATURAL ENVIRONMENT Heat Cold Diet Dryness / Moisture Others (insects, snakes etc.) Or other way around, “It is a condition, which signals the disruption of culturally ordered harmonious relationship of a man with his family, clan members, members of other social groups, with spiritual, supernatural, ancestral, natural and cosmological forces and beings”. In other words a state of ill-health depicts man's disrupted natural and socio-cultural order. (Tribhuwan, 1998: 297) In the following I describe each part of the diagram more closely: 2.1 Social Ill health can communicate a disrupted relationship in social order, consisting of relatives, members of clans of same or different tribe or caste. The body becomes a victim of disease, because of conflict itself or through the use of good evil means. Tribhuwan connects here Thakur ideology of social relationship, hierarchy and interaction to the field of ill-health. Disruption of Thakur Relationship with Other Tribes and Caste Groups Thakurs categorize all social groups they interact with into Dev and Davan jatis (castes). Dev from Sanskrit Deva-God and Davan-Daemon. This is done on basis of social hierarchy, dietary habits, occupational and regional functions, rules of social interaction, economic and social status and language. They consider themselves as of the lower Davan jatis, and are dependent on the Dev jatis economically and in religious rites. Dev jatis are seen as incarnations of the ten planetary spirits (Baya’s), which are described later in this paper. Each Baya is connected to and named after one of the ten Dev jatis. Davan jatis are seen as the origin of evil spirits, evil eye, witches and sorcerers. Healing of illnesses caused by the social realm is done symbolically through rituals addressing the supernatural beings symbolically connected with the group of people seen as cause. (Tribhuwan 75 - 76) Evil eye The evil eye is power that emanates from the eye of someone who is jealous of, or hating someone else and strikes victims objects or the victim himself. It is important to acknowledge, that the person casting an evil eye may not be consciously doing it. Thakurs believe that anybody can cast evil eye. But there are some groups who are especially suspected. For example, barren woman are believed to cast evil eye on fertile woman and newborn out of jealousy. Hence, they are excluded from many rituals and are stigmatized. Davan Jatis are thought of being experts in it. Thakurs think of the other Davan jatis as source of evil eye. From the view of the Dev jatis as Thakurs are also Davan jatis they are seen as a source. Other persons suspicious are Bhutalas and Bhutalis translated by Tribhuwan as Sorcerers and Witches. (Tribhuwan 65 - 69) Witchcraft and Sorcery A Witch in Evans Prichard's definition is someone male or female who harms others by mere spiritual force, intentionally or unintentionally. However, a sorcerer needs to perform rituals, cast spells or give bad medicine to harm people. So evil eye would fall under the category of witchcraft. For Tribhuwan the difference between Sorcerers and Witches is the one of sex. He uses these two different words to translate male and female form of one Word Bhutala/i. Butalas and Bhutalis after Evans Prichard’s definition, practice witchcraft as well as sorcery, because they also use rituals using any bodily substance of the victim to cast a spell, tasteless powders to be sipped into the food of the victim, chanting of evil mantras or charmed objects, like a lemon as symbol for the victims soul which is pierced with thorns. (Tribhuwan 69 - 71) Menstruating woman Menstrual blood according to the Thakurs is dark, evil, hot and corrosive with reference to the penis and is thus impure and polluting. A man having sex with a menstruation woman or people who consume food made by one are believed to get leprosy. During this period women are social outcasts, they do not interact with their family or the members of the tribe. They do not work at all and get food in separate dishes. (Tribhuwan 64) Breach of social pollution taboos. Tribhuwan refers here to the taboos of menstruating and barren woman. See therefore the Subsections evil eye and menstruating woman. But he gives an other example. As kathkaris another tribe is viewed to be inferior and unclean because of their dietary habits. Food cooked by them causes stomach upset for the Thakurs. (Tribhuwan 79 - 80) 2.2 Supernatural Disruption of man's relationship with deities (Failure to perform divine duty) Thakurs live in fear of their deities. They pray to them mainly to avoid harm rather than in expectation of something good. Illness can come as result of not performing worship and other rituals as duty towards the divine, but also as punishment for wrong doing. Sometimes Illness is seen as visitation of a deity. The hierarchical classification of their Gods is as following (Tribhuwan 76): 1. 2. 3. 4. 5. 6. 7. Sun as most supreme Mother Earth: Goddess of fortune and fertility Moon and Water (Brothers of Sun), the Sisters of Earth: 9 Bayas, Lightning and Fire. Village Gods Other deities Clan Gods Ancestral Spirits Disruption of human relationship with cosmic entities and forces. Thakurs believe in 10 planetary spirits, which are Mother Earth and her 9 sisters called Bayas. The Bayas are unmarried or barren as opposed to mother earth, who has the Sun God as her husband. Thakurs believe that they enter the body of a human which failed to perform a religious duty or made a general moral fault. They come to warn the Thakurs and bring them back on the right way. In form of heat they enter through one of the ten openings. 1. Eyes 2. Nose 3. Ears 4. Mouth 5. Soul (atma) 6. Wrist pulse 7. Naval 8. Urethral or Vaginal 9. Pulse of the feet 10. Anus. Every opening is symbolically connected with one of the 10 planets. The blood becomes hot and erupts in small pox, chicken pox, boils, body sores etc. When someone is possessed by a baya his body gets a divine status. The whole village sings songs to praise the baya and asking her to forgive their wrong doings and depart from the body for seven to fourteen days. (Tribhuwan 72) Besides the Bayas there are other cosmic deities which also need to be worshiped. Sun, Moon and Water are to be seen as Godly brothers, while Lightening and Fire are sisters. They are supreme powers, if not worshipped they can cause disease. Evil forces in the cosmos are the giants, that reside in south, these bring illness and death. Thus south is considered in contrast to the other directions as an evil direction. (Tribhuwan 75) Deviance from cultural set norms in order of house construction and design A traditional Thakur house resembles the cosmos, a house hat is not build in the traditional way is evil and invites sickness, misfortune and troubles. (Tribhuwan 77) Evil Spirits Thakurs believe that bachelors and spinsters who die become evil spirits staying on earth because of unfulfilled sexual desires. Bachelors become either Munjas, white spirits, or Khais, black spirits. Spinsters become Hadelis hairy spirits wearing a green sari. They Trouble the humans in two ways: Possession of evil spirit Headache, fever, shivering and abnormal behavior are believed to be symptoms of a possession of an evil spirit. In treatment the Bhagat asks ritually to the spirit why he has possessed the patient and than fulfills his demands so that the spirit leaves the persons body. (Tribhuwan 58) ` Sexual intercourse with spirits Sexual intercourse of a woman with a Munja leads to an albino child. Sex with a Khais leads to a congenitally deformed child. Both are killed as they are believed to be evil and harmful for the mother and the Thakur society. (Tribhuwan 60) Good Ancestral Spirits Failure to perform ritual duties and worship to the ancestral spirits may result in possession and illness. The treatment resembles that of evil spirits. (Tribhuwan 72) 2.3 Natural Loss of Basic bodily equilibrium due to entry of excessive heat or cold The Thakurs believe in a hot colt dichotomy. The health of the body depends on equilibrium of these two. Factors that interrupt this equilibrium are: A. Consumption of too hot or too cold diet. Too hot temperate food is bad for the stomach. Too spicy food leads to diarrhea or dysentery. Too cold temperate food causes cold, cough and pneumonia. This can also affect the child through the breast milk of his mother. All food and medicinal herbs are classified in hot or cold not depending on temperature but as intrinsic quality. Conditions caused by hotness are treated with cold herbs or cold water; respective conditions caused by coldness are treated with hot herbs or water. B. Exposure of the body to cold or hot environment As Working and walking in the hot sun, exposing oneself to too hot environment, entry of hot breeze in the body through the nostrils or getting caught in the rain. (Tribhuwan 78 - 79) Wrong combination of diet Thakurs believe that taking fish together with curd causes Leucoderma. Other combinations of food are avoided because of their classification in the hot-cold system. So after eating banana (cold) one needs to eat something hot like bread before one can drink water (cold). (Tribhuwan 81 - 82) Disruption of human relationship with flora and fauna Certain animals such as Tiger, Snake and Peacock are worshiped as gods by the Thakurs. The same as for the other deities counts for them. Wrath falls on the Thakur if they are not worshipped. For example then the Tiger eats their cattle. Octimum sanctum and Calotropies gigantia are symbols of fertility and Mother Earth, if they are worshipped upon in a ritual context the cause sterility. Bauhinia racimosa symbolizes sun on Dasera festival day, if it is not worshipped than it also can cause illness. Ficus religiosa and benyamina are seen as abodes of evil spirits; disturbing them leads to possession and illness. (Tribhuwan 80 - 81) 3. Nature and Role of Medicinal Practitioner There are certain ethnomedical specialists in the Thakur culture. They are well respected by other members of society and play a dual role. Not just as medicinal practitioner but also as farmers. The Definition of a Shaman after Michael Harner as, “Man or woman who has direct contact with the spiritual world through a trance state and has one or more spirits at his/her command to carry out his/her bidding for good or to cure persons affected by other spirits or by own violations.” Tribhuwan uses the word Shaman for the local healers called Bhagat and Bhagatin. While the female Bhagatin falls in trance, the male Bhagat uses a ritual. He spins a metal pot filled with water, while chanting a Mantra which lists all possible 24 supernatural pathogenic agents. When the pot stops the pathogenic agent mentioned is the one responsible. The Thakur "Had Vaidu" Tribhuwan calls Bonesetter, is someone who provides treatment for mechanical injuries such as sprains, broken bones as massaging and branding. He has sound knowledge about positions of bones and blood vessels. "Vaidu" is a Herbalist, someone who uses different parts of Plants and Animals for preparation of internal and external applied medicine. A "Mantrik" is a Herbalist who is specialized on snake bites and scorpion stings. A "Sunie" - Midwive is always female. She gives advice and medical aid to expectant mothers, assist deliveries, treats illnesses of new mother and child and also gives advice for their nutrition. Her assistant is called Potdhari. (Tribhuwan 279) 4. Therapies Therapy in Ethnomedicine ranges from home remedies to herbal, mechanical and magicreligious provided by medicinal specialists (Lieban 1044) As examples of mechanical therapy found in indigenous societies Tribhuwan gives Trephining, bone setting, removal of ovaries, cesarean section, laprotomy Unlectomy. (Tribhuwan 251) The Plants used in chemical Treatment are abundant the Foundation of Revitalization of Local Health Tradition talks about 8000 Plants that are used for medical purpose by the different traditional systems of medicine of India alone. (www.frlht.org) Tribhuwan states that depending on the division of the causes of illness into natural, social and supernatural/spiritual, the therapy is chosen. If the cause is a natural, therapy will be a nonmagical herbal treatment. If the causes lie in the social, supernatural or spiritual realms the therapy has to be magico-religious. After Glick Tribhuwan says that many times when mechanical or chemical therapies are employed, magico-religious treatment may also be an essential part of the treatment, or it is seen as incomplete. (Tribhuwan 285) Ritual Healing Tribhuwan names the entire process of healing in ethnomedicinal context as ritual healing. He defines a ritual as, “Rituals are a set of stylized bodily actions (which may include iconic symbols such as acts, objects, words, gestures, prayers, songs, chants and other things) performed in a culturally defined place, situation or context by certain actor/s only, encompassing basic rules to accomplish given tasks or goals in any social sphere with a given cultural frame of reference.” (Tribhuwan 253) The process of ritual healing here is defined as culturally prescribed normative actions or ritualized forms of behavior of medical practitioners, patients and other participants historically designed in order to compromise with the pathogenic agents (social, natural, spiritual, ancestral, cosmological, supernatural) so as to reconcile the disrupted cultural order in order to restore the health of the patient. (Tribhuwan 300) 5. Health Seeking Behavior Tribhuwan reduces the health seeking behavior of the Thakur into a flow diagram. By comparing illness episodes of Thakurs with other Tribals of Maharashtra the Kathkaris Warlis and Bhils, he comes to a generalized pathway that claims to be applicable for every other culture also. The Ethnomedicinal Pathway describes the various phases a Patient Passes to get cured. The actors besides the patient are family heads, village elders, relatives and medical specialists. (Tribhuwan 274) ETHNOMEDICAL PATHWAY: A CONCEPTUAL MODEL Initial Diagnosis and Presenting Illness Natural Causes of Illness Village elders and friends Cultural Family elders and relatives Decision to choose a therapy Allopathy, Homeopathy or Ayurveda Ethnomedical Specialist Home Remedies If not cured Payment in Cash Shamans, Priests, Herbalists, Midwives and Bonesetters Shift in therapy Diagnosis and Interpretation of the cause of illness If not cured Ethnomedical Therapy Shift in therapy Kind Herbal, Mechanical and Magico-Religious If not cured Thanksgiving Rituals and Ceremonies Cash The first step in the ethnomedicinal pathway is the process of initial diagnosis which tries to clarify the origin and cause of the illness. Here mainly the patient and his family are the actors of searching the meanings and symbolic elements involved in the etiology of illness. On times relatives and village elders are involved. Physical symptoms and suspected social situations and contexts are looked upon when suggestions on the cause of illness are made by the actors. (Tribhuwan 276) Tribhuwan categorizes the causes of illnesses into natural and cultural causes and a combination of both. As natural causes he lists environmental factors as they are perceived in context of an indigenous system of knowledge given here the example of hot/cold dichotomy. Cultural causes are defined as perceived or attributed to the intervention of culturally recognized supernatural, spiritual and magical pathogenic agents, as well as social conflicts. (Tribhuwan 277) An Ill Person can ignore the disease or decide between many different forms of therapy. The therapies recognized by his culture range from home remedies to herbal mechanical and magico-religious specialists. Besides this there are homeopathic, allopathic and ayurvedic therapies available. After the classification of the cause of illness the decision makers choose a therapy considering following questions: What type of disease is it? What are the pathogenic agents associated with it? What were the situations and contexts in which the disease occurred? How serious is the disease? What are the symptoms associated with it? When the Illness is believed to have natural causes it will be treated with non magical therapy for example within the system of hot/cold dichotomy or by herbalists. Illness which cause is linked to supernatural or magical interventions treated has to be treated in this manner, ritualistic by a Bhagat or Bhagatin. Social causes are also treated through ritualistic means with supernatural symbolism. Tribhuwan cites Glick that many times both therapy forms are employed, because the treatment is otherwise seen incomplete. (Tribhuwan 279) The next phase is again one of diagnosis, this time through a medical specialist. Methods of Diagnose differ from culture to culture and can be even seen by the members of one group as a ethnical boundary marker, as I found out in an Interview with a Warli boy. Tribhuwan highlights this by listing of the methods of medicinal practitioners of 4 different tribal groups in Maharashtra. For example a Shaman confirms the actual cause of the illness through consulting divine entities by performing diagnostic rituals and/or by getting into trance. A Bhagat (Shaman/Priest of the Thakur) uses a metal pot filled with water and a little ash that he turns while he is reciting a mantra listing the 24 possible pathologic agents which could be responsible for the illness. When the metal pot stops turning the just mentioned pathogenic agent is responsible. A female Shaman of either the Thakur, Warlis, Bhils or Kathkaris goes into trance to get this information. Whereas the Herbalists of this tribes use checking of pulse and other aspects of the body and ask the patient about the etiology of his illness, to diagnose the illness. (Tribhuwan 279- 285) Once the Healer has found the cause he applies the Therapy, which is the next step in the Ethnomedicinal Pathway. Therapy was described above. One of the main thoughts of the Ethnomedical Pathway is the mechanism called Shift of Therapy: When one form of therapy does not lead to the expected outcome the patient may change the form of therapy and choose an other form of therapy or an altogether different medicinal system. This can continue until the outcome is acceptable. Tribhuwan mentions four following factors which promote the shifting: (Tribhuwan 286) 1. Prolonged duration of the disease. 2. Serve pain caused by the disease or health program. 3. Cultural events, situations, actions, circumstances, places etc. in which the disease may have occurred. 4. Suggestions and advice by others regarding the origin and cause of the illness. Lieban 1057 When the Patient returns to normal health again the healer is paid or there may be a thanks giving ritual, directed towards the pathogenic agent or the curer. Mostly in case in which the medicinal practitioner is not supposed to earn anything with his healing activity, through this ritual he is gifted something. For example a bottle of liquor, a coconut or even a feast. (Tribhuwan 289) 6. Case studies While we visited Warlis in Thane District near Dahanu in the Village Patilpada and on occasion of a Tribal Exhibition in Pune Dr. Tribhuwan and me collected some Illness episodes to see if his model is applicable on them. I quote three of them here. Muru Torad of Thakur Tribe 38 years old, married, has two Sons and two Daughters and lives in the village Nagewadi in the Taluka Karjat Jila Raigad. His occupation is bamboo craftsman and cultivator. His Daughter Gautan 5 years old not jet going to school had fever. On the first four days the illness was ignored. On the fifth day she started crying a lot so he took her to a Bhagat. He diagnosed through the metal pot technique that an ancestral male spirit was responsible for the severe fever, because Muru had forgotten to worship him. He smeared holy ash on the forehead of the child and told to take it orally on the 6th and 7th day. On the 7th day a Chicken was sacrificed to the ancestral spirit. The blood was thought for the spirit the meat became a meal for the Bhagat. Because she was still not better on the 8th day Muru took her to a private allopathic doctor in Karjat 24 km away. He gave her injections and Medicine. On the 9th day she was much better. This illness episode shows clearly how a prolonged illness, and serve pain, which is expressed trough the steady heavy crying of Gautan, leads to shift in therapy. The pleasing ritual for the ancestral spirit has also an good outcome for the Bhagat a chicken as income for his efforts. Avind Arjun Lakhan of Warli Tribe 17 years old comes form the village Kahandolpada near Dahanu Thane and has one Brother and two Sisters. His Father is for half of the year cultivator and the other half daily wage laborer. He had stomach ache on the first day so his mother gave him a crushed root mixed with water. As it was not getting better he went on the third day to a Bhagat. He diagnosed through a divination technique using a rice pan and rice that there was no supernatural cause. So he gave him a decoction of a Root. Avind took it for four days, once a day and was cured. For thanking the Bhagat the Family gave him a Coconut. Here the principle is getting clear what comes naturally is treated naturally. Also on shift from home remedies to a medicinal specialist is seen. Arun Devajikove of Gond Tribe (unmarried, age 26, education 3rd Standard) Suffered from what my translator translated with schizophrenia. For this Interview the translator was not Dr. Tribhuwan but Dr. Tush, an ayurvedic practitioner who comes form a family of herbalists of the Thakur tribe, which should not be confused with the Thakur tribe. At the first day Arun got afraid of people that were not members of his family and saw snakes everywhere, which other people did not see. On same Day he went to the Hospital. There in the night he dreamed, that a former friend with whom he had now a serve conflict, told him that he put something in his drinking water to harm him. At the next day. The Doctor in the hospital told him that they can not help him and relatives suggested he should see a Vaidu. Arun said, the Vaidu did not need to diagnose, because he is in direct connection with the supreme and so knows everything, The Vaidu gave him a herbal pack, that he had to wear around his neck as a talisman and told him to not leave his home for 21 days. On the 3rd day he was feeling already better, but he completed his 21 days staying at home. The Vaidu did not expect any specific amount of money, he told him to give as much as he would like. He gave him 250 Rs. Here the shift in therapy occurred because of the failure of the selected therapy to help the patient and the suggestion of relatives. The cause of the disease revealed itself delayed in vision or dream of the patient himself, this possibility is not mentioned by Tribhuwan. This cause also attributed to the shift of therapy as the cause was of black magic type and when known initially would have led the decision to search for supernatural help of a Vaidu, who in Gond culture has a direct connection with the supernatural. 7. Conclusions Ill health concept shows the Thakur culture in difference to bio medicine which recognizes only the physical causes. Causes of illness are seen in the relationship an individual has, with his different levels of his social surroundings. Through following the hints that came up in the research towards the Ill-health concept Tribhuwan investigated the cultural parts of religion, moral and social world of the Thakurs. Tribhuwan concludes with saying: This study has made an attempt to unravel the symbolic and meaningful aspects of ethnomedicine of the Thakurs as a symbolic system not in its own right, but as a representation of the cultural whole. An attempt has been made in this study to show how medical symbols (acts, words, objects, ideas, relationships, colors, songs, chants etc.) stand for, suggest and reveal cultural realities other than themselves. That the Domain of ethnomedicine is not confined to a single area of social life but represents not only the Thakur culture but also is part of the greater Hindu Caste system. (Tribhuwan, 1998, 291) The symbolism of cultural parts is interconnected into a greater whole underlying the whole culture. So the meanings forms a continuum. In Indigenous cultures man is frequently thought of as continuous with both the social and nonsocial aspects of his environment Hughes 88 The division of the causes of illness in social, natural, Spiritual, ancestral, cosmological, supernatural and natural vs. cultural are etic categories. After describing the emic perspective on Thakurs ethnomedicine throughout the book, Tribhuwan takes again the etic Perspective in forming the concepts of Ill-health and Ethnomedicinal Pathway. The Ethnomedicinal Pathway was fitting on the Illness episodes investigated trough my own interviews. A category of finding the cause of the illness, which was not described in the Model, namely through a dream of the ill person, was found. Literature: Young, Allan 1982 The Anthropology of Illness and Sickness in Annual Reviews of Anthropology, No 11, 257- 285 Tribhuwan, Robin D. 1998 Medicinal World of the Tribals - Explorations in Illness Ideology, Body Symbolism and Ritual Healing, Discovery Publishing House, New Delhi Lieban, Richard 1973 Medical Anthropology in Honigman, JJ ed Handbook of Social and Cultural Athropology Rand Mcnally and Company, Chicago Hughes, Charles C. 1968 Medicinal Care: Ethnomedicine in Sills, David L. International Encyclopedia of the Social Sciences The Macmillan Company & The Free Press 87 - 93 Glick, Leonad B., 1967, Medicine as an Ethnographic Category: The Gini of the New Guinea Highlands in Ethnology, Nr. 6, S. 31 - 56, Evans-Pritchard, E. E. 1037 Witchcraft, Oracles and magic among the Azande. Oxford: Clarendon Press Pandey, B.P. 1978 Economic Botany S. Chand & company LTD. New Delhi