For further reading of some of the methods of infertility alleviation were nineteenth century, London New York: Methuen, 1984 Fox, R. Kinship and Thus, Lord Denning: We shall have a man whose se 5. G.D. Mitchell &R Snowden, The social implications of riage, C UP,new be used to procreate children long after he himself is d artificial insemination by donor, Report to ESRC on Grant edition, 1983. may procreate dozens and dozens of children by 00/23/0031,1982. and a women. There could be dozens of children walking about the 6. The Committee tends to use this principle when it app Good. Research Practices streets with the same fair features as the father but no one will of a particular practice, but not when it does not in the study of kinship. know who is the father(House of lords Weekly Hansard, Vol. 7. It should also be remembered that state agencies regularly Academic press, 1984 456, No 1265, col 544 ) In the House of Commons, Mrs Jill take children into care for their best interests. Knight said 'It seems such a calculating business to flush 8. Perhaps this needs a little further explanation. Take the of the ingredients in a test tube before shoving it into the deep whom is widely known about and the other no-one knows about freeze. It is a bit like a housewife buying a packet -mix from The husband will be the pater of the child, and the first lover supermarket store, cooking it all up and then popping it in may be publicly regarded as the genitor whereas, in fact, it the freezer to save time at the weekend(House of Commons the second lover who is actually responsible for the pregnancy Weekly Hansard, vol 68, No. 1326, col. 566) and is thus the genetic father 3. A much-quoted MORI poll commissioned by the Inter- 9. In fact, there are four possible roles here, because just denominational Order of Christian Unity published in with men the genitor and the genetic father may be a different September 1984 showed that 57%o of those polled were against person so the genetrix may be different from the geneticmother. human embryos. The results of a survey carried out by doctors occur and the wrong egg to be fertilia ble for a mix-up to surrogate motherhood and 51%o against experimentation in Edinburgh and reported in The Times(1 May, 1985)indicated 10. Ghost-marriage is the marriage of a woman to a dead that of the 1,000 women interviewed nearly three-quarters man, so that her offspring, regardless of whom the genitor against laws being passed to forbid all embryo research re those of the deceased. The levirate is the marriage of a oman to her deceased husband's brother but any children she 4. See Angus McLaren, Reproductive rituals: the percep may bear to him are regarded as belonging to the dead man of fertility in England from the sixteenth century to the 11. Oxford: Clarendon Press, 1982. Anthropology and clinical Practice CECIL HELMAN Cecil Helman is a lecturer This article arises from my own dual perspective- as crises of relevance. within the medical world, the last both medical doctor and anthropologist. It covers some 50 years have seen a gradual shift in its centre of gravity Middlesex Hospital of the areas where the concepts, skills, and research from the isolated family physician embedded in a Medical School, and is a ndings of social anthropology have been useful to those community(and in its local culture) towards the new Research Fellow in ivolved in clinical or preventive medicine. My own view, temples of medical science- the hospital, the medical University College London. clinically applied anthropology will be one of the few in the types of data that medicine considers valid: from He is also the founder of branches of anthropology that will expand in the next the subjective interpretation of symptoms and signs the british medical Anthropology societ decade or so towards the notionally objective'(and quantifiable) 1976 indings of diagnostic technology. But the growth of higl Medicine and social anthropology technology medicine has been paralleled by a growing dissatisfaction with medical care, and with its neglect Anthropology and clinical medicine have had a long of the social and psychological dimensions of ill-health association over the years, but one marked- until quite This backlash against'scientific' medicine has led to an cently. by mutual incomprehension. Doctors have increase in litigation, to the growth of alternative long seen anthropologists as merely the collectors of therapies, and to a new interest (now offically approved medical exotica from the non-Western world -of by WHO) in the role of traditional healers in the Third ' primitive' practices and beliefs, which can be World. It has also allowed anthropology to play a larger comfortably juxtaposed against the triumphs of the role in understanding those socio-cultural aspects of brave new world of medical science. A more thoughtful, illness and health ignored by modern medicine, and thus but less common approach, has been to scour the help design more appropriate forms of health care in indigenous pharmacopoeias that anthropologists have the future. For example, anthropology can contribute brought back from the field, searching for drugs that to the understanding of how cultural metaphors that are could be useful in a Western setting(a project now linked to certain serious diseases(such as AIDS), may supported by the world health Organization). In this adversely affect their detection, spread, or even way, studies of ethnobotany have brought to light curare treatment rom South America, anti-malarial plants from the Hausa of Northern Nigeria, and ammi visnaga from Preventive medicine traditional Egyptian medicine- found to be useful for treating whooping cough, angina pectoris, and other In a growing number of studies, anthropology has conditions.A third, even less common approach, has been an important part of multi-disciplinary research cen the use of ethnographies to understand how certain into the origin and spread of certain types of ill-health diseases can be related to the ways a particular human especially those where cultural factors are important group has adapted to its own environmental niche. In some cases, anthropologists have worked on projects In the past few years, for different reasons, both together with clinicians, epidemiologists, nutritionists medicine and anthropology have suffered their own and geneticists. One famous example, from the