Traditional or transitional medical systems? Pharmacotherapy as a case for analysis

Questions have been raised about the validity of labels such as 'western', 'alternative', and 'traditional' as applied to medical systems. This study shows that the rubric 'traditional' may be validly applied to clusters of medical systems sharing common elements that distinguish them from 'western' systems. At the same time, pluralism in diagnostic and therapeutic procedures must be recognized even within each system. The discussion in this paper analyzes explanatory models, drawing mainly from Asian examples and focussing on pharmaceuticals. A purely cognitive approach may however be insufficient in understanding the different medical systems. A review of socio-historical factors that influence medical systems highlights important processes such as cultural reinterpretation and indigenization that characterize what could be more appropriately described as transitional medical systems. Changes in cultural forms, such as the acceptance of western pharmaceuticals, may still rely on traditional cognitive frames of reference, suggesting eclecticism amid conservatism. Issues of theoretical and practical concern are outlined at the end of the article.