Conclusion and Summary

General expectations in social relationships of the multiplex sort provide a connection between the elaborate sets of understandings shared among experts and the health needs of the majority of the community among whom the experts' understandings are not shared. There are a variety of types of medical care available to the Swahili. Galenic medicine, viewed by some as "traditional" Swahili medicine, and Western medicine are the most common and popular.

The experts' understandings in the Galenic approach hold that a balance among the body's four elements is essential to health, and this is strikingly similar to the balance in social relationships called for by Swahili ideals. This common element organization, or pattern, involving two different domains may serve to promote the acceptability of the balance understanding as a guide to behavior for those who share the balance understandings in both domains. Most community members do share the understandings about social behavior, but they do not share those concerning the body and illness. Nevertheless, the pattern may affect them through making it more likely that Galenic medicine will be recommended to them and through its having an intrinsically appealing structure.

When community members understand themselves to be ill, and these understandings are made on very similar grounds by almost everyone, they consult—or are given advice by—people they trust and of whom they generally expect help. These advisers as often as not direct the patients to practitioners on the basis of earlier advice they have themselves received. The schemata that lead patients to take advantage of the understandings shared by the medical practitioners are organized around the advice that has been given rather than around intrinsic relationships among the understandings concerning illness and medical care. Since the advice is accepted on the basis of the general expectations of help and concern that are part of the statuses of the advisers (most of whom are parents, spouses, kin, and neighbors), statuses are seen as playing a key part in the relations among understandings as well as among people.

In chapter 10, the part of social structure in culture's operation will be examined further. It will be shown that statuses affect the relations among understandings in ways quite different from constructing schemata through being vehicles for "importing" them.