CHAPTER TWO LITERATURE REVIEW
2.2 African Traditional Medicine (ATM)
2.3.4 Diagnosis in Yoruba Traditional Medicine
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distinctions made by Lambo (1979) between astral, spiritual and esoteric causes appear to be very slim and there also appears to be considerable overlap‖ (p. 38).
Given these different classifications and the observation of Sofowora (2008), one can say that there are three basic disease causations in Yoruba traditional medicine. These distinctions align with the classifications of Forster and Anderson, (1978:103) in their postulation of three basic disease causations (naturalistic, emotionalistic and personalistic) in non-Western societies. This alignment becomes visible in either the overlap found in the categorisations of Lambo (1979) or in the mere change of syntax as found in the cases of Odejide, (1978) and Jegede, A. (2010).
However, despite the lack of scientific validation of the usefulness of the spiritual component in ethno-medicine, some institutions in the USA are incorporating it into their services (O‘Connor, 1995). They claim that ethno-medicine is effective. Similarly, spiritistic practitioners working in the Puerto Rican and Balican hospitals have indicated positive results, based on the fact that patients spent reduced time in these institutions (Krippner & Welch, 1992; and Thong, Carpenter, & Krippner, 1993).
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Scholars such as Buckley (1997) identified methods of diagnosing common diseases or diseases with naturalistic causations. The patient is first observed in order to diagnosis his/her condition, and this involves watching the patients‘ attitude and gestures. If this does not give enough lead, then the process may extend to the family members of the patient, in order to find out whether the disease being observed runs in the patient‘s family. Jegede, A. (2010) noted this and added a new disease causation called
―hereditary‖ to the existing categories (p. 41).
Diagnosis in Yoruba traditional medicine affirms the nature of a condition by naming or describing what is observed. Once a healthcare practitioner observes a condition, the next thing he/she does is to name the condition. Scholars agree that naming of diseases helps to describe the condition of the patient, thereby diagnosing the disease. Maclean (1976) and Buckley (1997) noted that ―each disease has its name … but there is a loose subdivision of diseases into two groups, the germs (kòkòrò) and the worm (aràn)‖
(Buckley, 1997:26).
This division helps to name and diagnose common diseases. For the Yoruba, the name of any disease already diagnosis what the disease is, either in its appearance (Ibà pọ njú pọ ntọ - fever that makes the eyes and the urine red, otherwise known as yellow fever) or in the effect (àtọ gb - that which makes one urinate as well as lose weight, otherwise known as diabetes) (Simpson, 1994:29).
Oyebola, (1982) expressed the power of naming diseases when he advocated the Western medical equivalents of the local names of diseases, symptoms and signs. He noted that, ―since these healers have a very firm grasp of the local dialect, usually they have no problem in identifying diseases when they are called by their local names by patients consulting them‖ (p. 32).
Simpson (1994) re-emphasised the naming of diseases or symptoms as a means of diagnosis, by observing that, names already indicate diagnosis of the symptoms in the patient. For example, ẹ jẹ ríru literally means boiling blood. This describes and names high blood pressure or hypertension. So does,
ọ
dẹ orí describe mental illness.ọ
dẹ orí literally means the hunter of the head. This describes the head as having something influencing or hunting it.The name of a disease or condition helps in diagnosis. It is clear that an oníșègùn will unmistakably diagnose ọdẹ orí if the patient says he/she feels that something is walking around inside his/her head;
crawling around his/her body; hears sound in his/her head and in his/her ears, etc. (Simpson, 1994:90).
Jegede, O. (2010) joined the discourse on diagnosis when he noted that beyond observation and naming symptoms, Yoruba traditional healthcare system uses phyto diagnosis. This is the use of natural means or
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plants to diagnose diseases. The oníșègùn is equipped to read the reaction on the skin of a patient when there is a contact with some particular leaves. This reaction helps to diagnose the presence or absence of a particular disease. For example, Jegede, O. (2010) noted that Ewé-ìjòyún (Pergularia daemia) can be used to diagnose Ibà jẹ dọ jẹ dọ (typhoid fever) from Ibà (malaria). This diagnosis is made ―if, after rubbing it on a patient‘s forehead, the forehead swells a bit, it implies that the client has typhoid. Otherwise, malaria is diagnosed‖ (Jegede, O. 2010:39).
Going beyond the methods of diagnosing naturally caused diseases, Jegede, O. (2010) talked about the use of divination as a diagnostic tool for personalistic caused diseases in Yoruba traditional medicine.
Since diseases have been found to have both natural and supernatural causes, diagnosis in Yoruba traditional medicine is embarked upon on two levels, either on the natural level, by using ordinary diagnostic tools, or on the supernatural level by using supernatural diagnostic tools. There may be occasions when the practitioner may resort to using the two types (natural and supernatural) diagnostic tools.
The methods of diagnosis used in YTM are determined by the practitioner‘s area of specialisation and the nature of the disease.
the basic concept of Western medicine centres around the results of experiment, and the disease is regarded as caused by physiopathological agents (including micro-organisms and noxious substances in food and the environment). Traditional medicine, however, considers man as an integral somatic and extra-material entity and many developing countries will accept the fact that disease can be due to supernatural causes arising from the displeasure of ancestral gods, evil spirits, effect of witchcraft, the effect of spirit possession, or the intrusion of an object into the body (Sofowora, 2008:37).
Yoruba people believe in ―the spiritual psychic attack, the effects of repercussions and occasional harmful encounters with the invisible lower elements (spirits)‖ (Esho, 2005:34).
This does not change the view of Buckley (1997), that in Yoruba traditional medicine, every disease is first presumed to have a natural cause. In Yoruba traditional medicine, when a situation or disease defiles natural diagnosis, it is believed that one has to turn to divination. This happens because Yoruba people believe that a disease can have more than one cause. That is, a disease can start as a natural one after which some other forces can take charge of the condition, giving it a supernatural dimension. ―If a naturalistic or empirical remedy proves to be ineffective, a patient or his family may then try other procedures, especially offerings to the witches or sacrifices to an òrìșà‖ (Simpson, 1994:109).
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Actions such as these are attributed to the belief in supernatural causation that gives credence to the methods of diagnosis that the șawo/șè‟șègùn (diviner and healer) employ in their practice of Yoruba traditional medicine. The șawo/șè‟șègùn occupy the highest level in the practice of Yoruba traditional medicine because of their involvement in a wider disease spectrum. Osunwole (1989:29), observed that șawo/șè‟șègùn combine divination with other traditional healing methods. They are vast in both physical and spiritual aspects of Yoruba traditional medicine.
At this level, the diviners have a range of divining tools to choose from. These divining tools help to diagnose the conditions of patients before the prescription of relevant medicine. At the level of divination, the healthcare providers partner with the divine. This partnership earns them the name șawo/șè‟șègùn (diviner and healer). The divining tools they use include obì (kola nut), ẹẹ rin (four cowries), ẹẹ rìndínlógún (sixteen cowries), ọ pẹ lẹ (cowry chain), agbigba (looks like the ọ pẹ lẹ , but bigger than the ọ pẹ lẹ ), ikin (sixteen palm-nuts),
ọ
sanyìn, etc. (Simpson, 1994:94). In the case of the babaláwo, ikin and ọ pẹ lẹ are the tools used for the diagnosis of diseases that have personalistic causations.Jegede, O. (2010) noted that obì àbàtà is used in diagnosing pregnancy (p. 39). In addition to these, Ajayi, (1996) noted ―omi-wíwò (water gazing), àtẹ lẹ -ọwọ wíwò (palmistry), owó-wíwò (gazing on money), atipa or abókùú sọ rọ (necromancy) and wíwo ojú (gazing on the eyes)‖ (p. 1) as diagnostic methods. Bascom, (1969) and Awolalu, (1979) among others, have noted that the most outstanding of all the diagnostic tools employed in YTM is Ifá divination.
Signatures of the sixteen major Odù - Ojú Odù mérèrìndínlógún
Ogbè Òyèkú Ìwòrì Òdí
I II II I
I II I II
I II I II
I II II I
Ìrosùn Òwónrín Òbàrà Òkànràn
I II I II
I II II II
II I II II
II I II I
Ògúndá Òsá Ìká Òtúúrúpòn
I II II II
I I I II
I I II I
II I II II
Òtúá Ìretè Òsé Òfún
I I I II
II I II I
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I II I II
I I II I
(Abimbola, 1976:29). The author made adjustment in Òsá and Òtúúrúpòn respectively.
The babaláwo (the diviners) are the ones entrusted with these (ikin and ọ pẹ lẹ ) diagnostic tools. Different scholars have referred to the babaláwo as the ―fathers of secret‖ (Bascom, 1969:81). Babaláwo are both oníșègùn and bàbá awo (father of secrets). They are diviners and healers who are the custodians of the Ifá corpus. For the Yoruba people, Ifá literary corpus contains all that there is to be known, it is consulted at every stage in life. As Osunwole (1989) noted, ―Ifá priests were the chief medical consultants in crisis time‖ (p. 225).
Anika (2010) noted that spiritual causes are to be considered as possibilities when the determining factor of an illness has left a medical practitioner with a mystery that is unexplainable. This is because, both the psychological and the allopathic medical fields have completely disregarded spiritual aspects of a patient due to the fact that it cannot be scientifically proven. This requires that more attention be given to spiritual causes of diseases, because spiritual causes require spiritual diagnosis and cure.
The use of these methods of diagnosis requires the experience and expertise of the healthcare provider.
Experience plays a big role in Anamnesis. This is the recollection of a previous existence of a patient. ―The practice delves deeply into the patient‘s past and often ramifies into the patient‘s entire family and/or social setting‖ (Tella, 1977). It is believed that ―an offence committed in the past existence of a patient can cause his disease after reincarnation‖ (Sofowora, 2008:41).
Hence, diagnosis and treatment of diseases are carried out using physical and divinatory means. What is used is determined by the patient‘s condition. In Ifá divination, sickness or misfortune results from a breach of the equilibrium between humans and the spirit world, or a dysfunctional relationship between the gods and their mortal followers. To restore this equilibrium, a babaláwo employs the holistic diagnostic methods, combining leaves, roots, bark, latex, incantations, rituals and divination (Voek, 1997:115).
This view is shared by Jegede, O. (2010), who observed that ―a babaláwo uses physical and non-physical diagnostic methods. The babaláwo physically examines the body of the client, including the blood, urine, faeces, etc., to ascertain the nature of the disease… the metaphysical methods of diagnosis include the use of Ikin-Ifá (Ifá palm kernels) and
ọ
pẹ lẹ (Ifá divination chain)‖ (p. 36). The use of Ikin-Ifá andọ
pẹ lẹ ispossible because ―the collective wisdom of the Yoruba people as contained in the Ifá verses (Odù) includes a huge reservoir of traditional curative and therapeutic material‖ (Jegede, O. 2010:1).