Me’ Winik: Discovery of the Biomedical Equivalence for a Maya Ethnomedical

Syndrome by Berlin and Jara

A)Introduction

1)This paper documents biliary disease for the first

time among the Tzeltal and the Tzotzil.

2)The authors elucidate the interface between the

ethnomedical illness model and the biomedical

disease complex.

3)They look at me’winik.

Market San Juan Chamula Mexico (Tzotzil, Maya)

• Ethnoepidemiological surveys show that

women have a relative risk of 6.6 to 1.

• Me’ winik is literally “mother-man”, is

described as an organ located in the

abdomen, below the sternum.

A) Explanatory Model

1) the Me’winik: a golf ball to tennis ball sized organ.

2) Vigorous exercise, carrying a heavy load, and suffering

a fall can lead to me’winik.

3) The me’winik may move around the mid abdomen.

4) When the pulsing organ rises too high, there is pain

and the outcome is likely to be fatal.

5) The organ may press on or twist on the uterus and

result in reversible sterility.

6) Both males and females are massaged by a midwife.

1) The anatomy, physiology, and pathology of this

folk syndrome do not correlate well with

biomedical descriptions of biliary disease.

2) In the past, it was presumed to be

gastroenteritis.

Medical Studies

The authors identified 8 cases of me’winik,

• 7 were confirmed as biliary disease by clinical

exam, and

• 5 were verified by follow-up X-ray exam.

Of the six patients in a second sample,

• 4 had a diagnosis of chronic cholecysitis or

inflammation of the gallbladder.

• In 2 cases there was gallstone formation.

1) The predominance of women with this condition is

not surprising.

2) Although both males and females suffer biliary

disease, the prevalence is higher in women than in

men worldwide.

• Interestingly, biliary disease does not appear

on the public health department’s

epidemiological statistics reports for this

region.

• Me’winik is probably either simply treated as a

gastrointestinal problem such as parasite

infection or inflamed colon, or as a

gynecological problem.

The successful correlation of the folk syndrome

me’winik with the biomedical diagnosis of biliary

disease, points out the need toward earlier entry

of anthropologists into health programs.