Bastien J W
Soc Sci Med. 1982;16(7):795-803. doi: 10.1016/0277-9536(82)90232-5.
Western medicine has not been functionally incorporated into Andean economic, cultural, and social systems. Evaluation studies show that even though accessibility to Western medicine has increased considerably for rural Andeans, they still rely on traditional medicine. Western medicine has not been able to articulate with Andean ethnomedicine because of different structural relations within each system. Western medicine assumes a mechanistic ideology, chemical-based cures and technology which function efficiently within an urban-industrial framework; whereas Andean medicine assumes a synchronistic ideology, natural-based cures and personal skills which function efficiently within a mountainous rural area with structural components of verticality, specialization and reciprocity. Verticality implies that Andeans specialize in extracting resources from a limited number of zones and then exchange their resources for those produced by people on other zones. Andean ethnomedicine follows principles of verticality in that certain communities specialize in various aspects of Andean medicines, according to the resources available to that community. These medical practitioners travel to other communities providing their services in exchange for services or goods. The author illustrates this from his research among the Qollahuaya Andeans. The community of Kaata specializes in curing by divination and ritual. These diviners are important for community health of Andeans. The communities of Curva and Chajaya specialize in herbal curing: these herbalists are important for treating physical causes. However, the diviners and herbalists complement each other in providing for the total health of Andeans. The final section deals with concrete suggestions of how certain features of Western medicine can functionally fit Andean economic and social structure.
西医尚未在功能上融入安第斯的经济、文化和社会体系。评估研究表明，尽管安第斯山区农村居民获得西医的机会大幅增加，但他们仍然依赖传统医学。由于每个体系内部结构关系不同，西医未能与安第斯民族医学相结合。西医秉持机械论思想、以化学为基础的治疗方法和技术，在城市工业框架内高效发挥作用；而安第斯医学秉持同步论思想、以天然为基础的治疗方法和个人技能，在具有垂直性、专业化和互惠性结构要素的山区农村地区高效发挥作用。垂直性意味着安第斯人专门从有限的区域提取资源，然后用他们的资源交换其他区域的人生产的东西。安第斯民族医学遵循垂直性原则，即某些社区根据该社区可获得的资源，专门从事安第斯医学的各个方面。这些行医者前往其他社区提供服务，以换取服务或物品。作者通过他对科亚瓦亚安第斯人的研究对此进行了说明。卡塔社区专门通过占卜和仪式治病。这些占卜者对安第斯人的社区健康很重要。库尔瓦和查贾亚社区专门从事草药治疗：这些草药医生对治疗身体疾病很重要。然而，占卜者和草药医生在保障安第斯人的整体健康方面相互补充。最后一部分讨论了关于西医的某些特征如何在功能上适应安第斯经济和社会结构的具体建议。
