Group differences in the structure of illness.

The paper reports an attempt to study in a naturalistic and quantitative fasion the features of illness episodes. Such episodes, as perceived and reported by lay persons, constitute a basic datum in ethnomedicine. Yet, they have rarely been the object of systematic research for theoretical and methodological reasons. The paper discusses ways in which illness episodes have significance in ethnomedicine and in health services research generally, and describes a method which can be used in field situations to study them. The content, internal structure and organization which illness episodes have are given attention by analysing and measuring the components of illness in a panel of adult females who reside in the highland state of Chiapas in Southeastern Mexico. Comparisons are undertaken in the two most dissimilar subgroupings of the region. Some commonalities and group differences in the duration of symptoms and in the way symptoms interrelate are described. An interpretation of these differences is offered, with principal emphasis given to the social circumstances and to the (cultural) meanings of illness in the two groups. The procedure employed, which is consistent with the way in which vital signs are recorded in the hospital, lends itself to field studies of the way symptoms and signs of disease unfold in the individual across time. The idea of a language of illness, which is introduced and developed in the paper, is used to draw emphasis to the communicative and symbolic features of illness.