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September 18, 2011 / B.J.D.Armas

Hot-Cold Theory of Illness

  • He says that at the end of every doctor—patient interaction patients would ask him what to eat during therapy. At first, the physician said that it really
    didn’t matter, that they should eat healthy food. People were
    not satisfied with such a silly answer. After learning about
    the basic categorization of hot. and cold illnesses and foods;
    he was able to answer patients’ questions in culturally acceptable
    ways. Consequently, his patients were much happier.
    When he left the village after a year, people told him
    that when he first came, they didn’t think he knew anything,
    but then he became a good doctor.
  • Illness, on the other hand, is believed
    to result from a humoral imbalance which causes the
    body to become excessively dry, cold, hot, wet, or a
    combination of these states. Food, herbs, arid other
    medications, which are also classified as wet, or dry,
    hot or cold, are used therapeutically to restore the
    body to its supposed natural balance. Thus, according
    to the system, a “cold” disease, such as arthritis, is
    cured by administering “hot” foods or medications.
  • Sinularly an upset stomach may be attributed to
    eating too many cold-classed foods which are believed
    to chill the stomach, a condition known as frialdad del
    estómago (orfrto en el estómago)
  • pasmo refers to tonic spasm of any voluntary
    muscle. This condition is usually attributed to a chill
    [.àrising from exposure to cold air when the body is in
    än overheated state. In its other use, pasmo refers to a
    cough, stomach pain, or other cold-classified symptom
    hich has become chronic. Many people attribute such
    lingering symptoms to a chill or the eating of cold-
    :classffied foods.
  • The data which will be discussed were derived
    from three sources: (1) from observations in 64 Puerto
    Rican households, made over a period of one yEar
    as part of an ethnographic study of mediCal beliefs and
    practices within the target area of the Dr. Martin Luther
    King, Jr., Neighborhood Health Center in the south
    Bronx; (2) ±’esponses to a questionnaire concerning postpartum practices and infant care, which was administered
    to all Latin American women living
    in the Martin Luther King Health Center area who
    had given birth in November and December, 1967
    (questionnaire was administered as a focused intenview
    three months after the women had given birth
    [number mnterviewed—27D; and (3) anecdotal reports
    from medical personnel at the Martin Luther King, Jr.
    Neighborhood Health Center.
  • As a result,
    when the patient contracts a common cold or other
    cold-classified illness, he will stop eating these potassium
    sources because they are contraindicated for
    his immediate conditioit Women particularly run into
    difficulty with this type of regimen, since many of
    them are careful to avoid both cold foods and acidic
    cool fruits during their menses. This practice therefore
    eliminates all potassium souxces usually suggested to
    them. A way out of this dilemma might be for the
    physician to prescribe potassium in solution as a “vitamin”
    (and therefore hot) to be taken during menstruation
    or whenever the patient has a cold or tà suggest
    hot foods rich in potassium (like coffee, cocoa, peas,
    etc), in addition to the usual cold foods, so that patients
    have enough options to make choices within the
    hot-cold system themselves.
  • the use of pemcilhn for treatmeat
    of rheumatic fever fits the logic of the system In
    addition, bland diets recommended for ulcer patients
    prohibit most of the foods which are considered hot
    Iand would therefore be avoided as a matter of course
    within the folk system Sinularly, the use of aspirin for
    relief of colds or arthritic pam accords with both therapeuUc
    systems. Indeed, although the hot-cold -and
    modern therapeutic systems differ in their basic
    ‘2remises, the behavior they imply is probably more
    similar than antipathetic One may even conjecture
    that the viability of the hot-cold system is founded to
    some extent on this fundamental agreement in the
    health behavior imphed by the two systems
  • the formula base usually recommended
    to mothers on leavmg the hospital, is consulered
    hot, and whole milk is considered cool Smce
    i if ants tend to develop rashes, and rashes are believed
    come from hot foods, mothers prefer to feed their
    pifants cool foods instead of the hot evaporated milk
  • As might be expected, measles, chickenpox, and other
    childhood diseases involving rashes are classified as
    hot in this nosology
  • Thus, a “weak” womb (matriz dc’bil) is believed
    to “jump” about in the body cavity in search of something
    hot to fortify it. Rue1 mixed with black coffee,
    rum, or cocoa, is taken as a remedy for this condition.
  • cthnmunicatioi
    with Spanish-speaking patients most frequently oc
    curs in one of three contexts: (1) the physician speak
    ing (usually in English) directly to his patient or, in;
    family practice, to various members of the family a
    well, (2) the hysiciari speaking through a translato
    or health worker from the Hispanic community wh
    ifiters the communication through his own set of med
    ical standards or accommodations between the profeE
    sional and folk therapeutic systems, and (3) healt
    professionals informing the Spanish-speaking publi
    through mass media or printed brochures. Each
    these contexts obviously offers different opportun
    ties for sharing information and for mutual accoir
    modation between communicators.
  • For optimum therapeutic success, there are clearly
    two important pieces of information which must be
    interchanged between patient and physician in order
    to deal with any divergent views which may exist between
    them concerning the illness or treatment regimen:
    (1) the physician must determine if the patient’s
    views undermine the treatment regimen, and (2) if
    so, a modus operandi must be reached whereby patient
    and physician agree on an appropriate treatment
  • The elderly and recent adult migrants who
    never completed high school are most likely to esi
    pouse the hot-cold system openly and consciously to
    weigh therapeutic decisions within its framework.
    jf Among 64 Puerto Rican families in the ethnographic
    ? study, 23 (36%) had adults who fell into this category
  • Yeople who have been born in the States, on the other
    hand, or who have received most of their primary and
    secondary education here are not likely to express
    agreement with the hot-cold system openly. They may,
    1however, defend those parts of it which agree with
    standard medical practice (eg, the association between
    ? ulcers and hot foods) and almost certainly follow at
    least some of the practices entailed by the system at
    home. Even among the second generation American-
    Morn, the culture pattern may sti II survive in attenuated
    form. Remedies which stem from the hot-cold
    theory are remembered from childhood and may occasionally
    be used, even though an awareness of the underlying
    hot-cold system is completely lost.
  • the process of acculturation through the
    generations creates subtle variations in the way hotcold
    beliefs manifest themselves in the behavior of
    Puerto Rican patients. If the physician suspects that
    hot-cold theories have a bearing on the treatment regimen
    he is prescribing, it is therefore in the interests of
    good therapy to probe his patients’ commitment to
    these beliefs. This is best done by indicating to the pa-
    .tient an awareness of the belief system but without im-
    Plying judgment of it.
  • Respect for the patient’s tradition and an abffity
    to work with the therapeutic choices inherent in it allows
    for development of a treatment regimen with the
    patient which does not contravene his deeply held
    ideas about illness and will therefore stand a much
    better chance of success.



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