Soc Sci Med. 1988 ; 26(8): 793-802.

Pluralistic etiological systems in their social context: a Brazilian case study. In memory of James S. Coleman.

Ngokwey N.

UNICEF, C/o PNUD, Praia, Cape Verde Islands, West Africa.

The main thesis of this paper is that multifactorial explanations of illness in medically pluralistic settings arise in distinctive interactional contexts. The first part is an overview of the anthropological literature on illness etiologies, specifically on the functions and nature of these etiological notions. The second part is a description of local notions of illness causation in Feira de Santana (Brazil) using an analytical model based upon a holistic view of culture which includes four closely interrelated domains: natural, socio-economic, psychological and religious. This multifactorial nature of the etiological system is examined in light of: (a) the various sources that constitute the popular stock of etiological knowledge; (b) the different aspects of causality that can function as hierarchical levels in causal chains; (c) the process of the social production of etiological knowledge. The third part, an analysis of one informant's account of his illness, serves to illustrate the point developed in the first 2 parts.