Visualizing the Medical Institution of a Society

For purposes of illustration, one can describe the medical Institution of a society as consisting of five concentric circles (see fig. 1). As will be elaborated presently, the contents of any one of these circles depend on and build on the contents of those included within it. To this space of the medical are connected various nonmedical institutions or "stations" of the society that affect and are affected by what happens in the medical sector.

The three inner circles constitute the basic core of the medical and can be equated with individuals, average persons of a society. The kinds of diseases and injuries that a particular member of a society is prone to experience or undergo is one way of interpreting the material content of these three inner circles. Were one to visualize a very large pool of these "individuals," they would in effect describe the ecologically based and historically contingent epidemiological load of the population of a particular society. This way of conceptualizing the medical Institution will not be given attention in this chapter. It should be understood, however, that distinctive pictures of disease and injury realize the medical sphere of any particular type of society, as discussed in chapters 3 and 4.

Figure 1.
Institutional Structures of Society

The three concentric inner circles are used to provide a descriptive picture of concepts used in previous chapters. The two inner circles describe the information, genetic and cultural, respectively, the products of which determine how disease and injury are configured and played out as sickness and healing in an individual of any particular society. The product of circles one and two is what is found in circle three, the SH response or behavioral output—a social construction or eventuality of sickness and healing.

Circles four and five describe not an average individual but an average society. These circles are thus equated with groupwide aspects of the medical Institution. Circle four is set aside for the society's parameters of sickness and healing. The overall style and cultural rationale inherent in the products of medical memes and institutions make up circle four. Circle five is set aside for the social groups, organizations, agencies, and material products of the medical Institution, all of which enable and in some respects govern the way sickness and

healing are configured and played out in a society. Each of these components of the medical Institution is taken up separately in what follows.