patient, and confirming the patient in a sick role. there are still few ethnographies done in the U. K though nthropological studies have also provided a useful this gap is gradually being filled. Much of the data corrective to those doctors who still believe that primary available now comes from sociologists, but care is what the phrase implies. They have shown that, anthropologists have contributed studies of ethnic in Britain and America, only a minority of abnormal minorities, of concepts of illness among working class ymptoms(about one-quarter to one-third) are dealt with women in Aberdeen, Glasgow and Cardiff, of menstru by the official medical system. In both countries, the beliefs in South Wales, of folk models of 'fevers,'colds' real site of primary health care is within the family, with and 'chills'in a London suburb, and of health beliefs mothers and grandmothers being the main health care in an East End community. Littlewood and lipsedge providers. Other sources of health advice are doctors' in their Aliens and alienists, have also examined the receptionists, pharmacists, womens magazines, radio relationship of British psychiatry to ethnic minority rogrammes, as well as local folk healers(both sacred patients, and the problems of cross-cultural labelling of nd secular) such as astrologers, psychic healers, Tarot mental illness. Other studies in this area are under way card readers, and herbalists. Self-help groups (some and should illustrate further the value of looking at ill equivalent to what Turner calls communities of health in the community from an emic perspective suffering )also provide much of the health care, especially of stigmatized conditions or lifestyles. Medicine as a professional subculture Traditional healers from among ethnic minorities such Recently, following the advice of their colleagues to as Hindu vaids, Muslim hakims, Chinese herbalists and study up,' in the social scale, anthropologists have turned acupuncturists, and Caribbea their attention to studies of the medical profession in part of the spectrum of healers available outside the different Western countries. They have pointed out the medical profession. Kleinman, in his Patients and culture-bound nature of Western medicine, and the Healers in the Context of Culture, suggests that healers variations in the content and distribution of certain in each culture be subdivided into three overlapping diagnostic categories(such as schizophrenia), the type "sectors of health care the professional, or legitimated of treatments used (such as the rate of certain surgical representatives of Western medicine, the folk, both sacred operations ) and the number and types of drugs and secular folk healers, and the popular sector of lay self-diagnosis and treatment. In non-Western societies, attempts have been made to relate these variations to health care, and this takes place within familiar social certain core cultural values of each society. A recent and cultural contexts book, Physicians of Western Medicine, edited by two anthropologists, included thirteen ethnographies of Several medical anthropologists have pointed out American, Canadian and English doctors. It covers, for intrinsic differences between medical and lay perspectives example, the world-views of American internists and on ill-health, and this has formed the basis for their psychiatrists, surgical decision-making, medical models critique of Western medicine. The medical or disease of the menopause, and the complex interrelationships perspective employs a reductionist world-view, between patient and practitioner explanatory models in emphasizing physiological data as being intrinsically an English suburb. Other studies, published elsewhere, more'realthan social or psychological factors. It is also have described the rituals of purity and pollution in characterized by a mind-body dualism, and by a view surgical operating theatres, and the use of folk concepts f disease as an abstract, recurrent'thing, which has and language by general practitioners. It is instructive the same content whenever it appears, irrespective of to compare these studies, with the more common studies local cultural conditions. By contrast, the illness or lay of both Western and non-Western folk healers perspective is a broader concept, including the subjective illustrate how these different systems of healing cover response of the patient to being unwell; how he, and those different, though overlapping, parts of the spectrum of around him, view the origin and significance of this misfortune. Other medical ethnographies have been event; how it affects his behaviour or relationships with useful in understanding the role of the medical subculture others(Frankenberg uses the term sickness to apply to in exercising social control, or in'medicalizing'dissent this social aspect); and the steps he takes to remedy the non-conformity, or the normal phases of the female life- situation. It includes not only his experience of ill-health, cycle. Similarly, they help one to understand the spread but also the meanings he gives to that experience. Illness, of medical metaphors into everyday life (an epidemic herefore, is clearly patterned by culture, and learning of muggings, the virus of soccer hooliganism), about it should be an important part of all health care. especially where they are associated with dangerous In linking a group,s culture to that of the individual diseases of uncertain origin- such as cancer or AlDS. patient, Kleinman suggests that clinicians discover their patients' explanatory models.notions about the Anthropologists in clinical settings origin, timing, physiology, severity, and appropriate In Britain, anthropologists working in me treatment of their condition Part of these models ften find themselves in marginal, ill-defi emic perspectives on the causation of ill-health, and often they are viewed as outsiders, other misfortunes. A large number of ethnographic consultants brought in to find a specific studies have been done on beliefs about the origin of specific clinical problem. Why do one category of ill-health in the individual's behaviour, or in his natural, patients refuse vaccination, while another welcome social, or supernatural environments. Many famous them? Why do patients in one ethnic group classify onographs in this area are reprinted in Landy's comprehensive book Culture, Disease, and healing. penicillin as symbolically 'hot, and therefore refuse to cept it for fevers? Why do some patients cling to food To make such medical ethnographies meaningful to taboos, even in the presence of obvious malnutrition? health professionals, it has become increasingly Why do about 90 of patients use self-treatment, or important to move away from purely non-Western lay health advice, before arriving at the GP's surgery naterial. Studies of shamanism in Siberia, or To many anthropologists, used to a more open-ended ethnomedicine in Zaire, have not been met with a brief, this applied aspect of their work may bring with receptive ear by most Western doctors. Unfortunately, it the danger of a new reductionism- the clinical