The caul and its relation to drowning, lawyers and sorcerers.

The caul is a fragment of amniotic membrane that is occasionally observed adherent to the head and face of a newborn child. A dried caul has been in The University of Adelaide Pathology Archive for a number of years. Beliefs in the supernatural powers of these detached membranes are found in the historical traditions of a wide variety of cultures, resulting in cauls being regularly dried out and sold as talismans. It was thought that lawyers could sway opinions in court more readily if they possessed a caul, and that such a token could either be used to facilitate black magic rituals or alternatively to thwart the machinations of sorcerers and witches. A pervasive belief was that a caul would guarantee that the owner would never drown resulting in cauls being sold for between £10 to £30 in the seventeenth century at a time when considerable naval warfare and maritime exploration were occurring. Thus, rather than illuminating pathophysiological processes occasional specimens in pathology archives may remind us of folk traditions and superstitions that have long since been forgotten in modern times.

Knowledge, attitude and traditional practices towards epilepsy among relatives of PWE (patients with epilepsy) in Marrakesh, Morocco.

Epilepsy remains one of the most common neurological diseases in the world but seems to be widely misunderstood, especially in low-income countries. Patients with epilepsy (PWE) can face considerable stigma in society, and there have been various studies that evaluate the knowledge and attitude of the population towards epilepsy. However, there was no study of this kind in Morocco. PURPOSE: Our aim was thus to assess knowledge, attitudes, and traditional practices specifically among relatives and caregivers of PWE in our community, in order to better evaluate their educational needs. METHODS: This cross-sectional and descriptive study was carried out over a year long period in the outpatient neurology clinic of the Mohammed 6 University Hospital, a tertiary referral center in Marrakesh, Morocco. The respondents were relatives of PWE (usually parents and siblings) or spouses who attended the outpatient clinic alongside them. The interviews were carried out by the same investigator at the outpatient clinic during patient's visits, face-to-face using Moroccan Arabic or Darija, with an 18-item questionnaire. RESULTS: Responses of 100 participants were analyzed. The mean age was 40 years old and 5 months. Sixty-six percent of the respondents were women, 50% of rural origin and 76 % lived in an urban area. Forty-one percent were illiterate, and 74% were of low income. Only 65% of the participants knew the Arabic term for epilepsy. For 48%, epilepsy was linked with witchcraft or demonic possession. Seventy-five percent of the respondents had at least one prior consultation to a traditional healer. Only 5% in our study knew the first-aid basics to apply in case of a seizure. CONCLUSION: Despite having a relative with epilepsy, our participants' knowledge was very poor. The level of education and income seem to be the two major contributing factors. Cultural beliefs and superstition are very pervasive, and the majority of our sample had already used traditional healing and alternative medicine. Our study highlights the need for a more global intervention in Morocco encompassing healthcare policies, awareness campaigns, and educational reforms.

The experiences of Iranian patients with epilepsy from their disease: A content analysis.

This qualitative study investigated experiences of patients with epilepsy in Iran regarding stigma. Twenty-two participants were chosen by purposive sampling method. After getting informed consent, we conducted and recorded interviews and then transcribed them verbatim. After that, all the researchers read the texts thoroughly, and the data were analyzed using conventional content analysis method. Seven categories emerged from the analysis including need for support, defense mechanisms, superstitious beliefs, negative feelings, negative reactions of others, imposed deprivations, and spirituality. These results will increase healthcare professionals' knowledge about the problems of Iranian patients with epilepsy and improve the design of healthcare models that can promote successful coping strategies for them.

Death and Survival of Patients with Hansen's Disease in Colonial Korea / 의사학

The purpose of this research is to describe how Hansen's disease patients experienced the modern system of control of Hansen's disease introduced by Japan, and the inimical attitude of society against them in colonial Korea. The study also seeks to reveal the development of the system to eliminate Hansen's disease patients from their home and community to larger society and leprosarium in this era. Sorokdo Charity hospital (SCH), a hospital for Hansen's disease patients, was built in 1916, and vagrant Hansen's disease patients began to be isolated in this hospital beginning in 1917 by the Japanese Government-General of Korea (JGGK). Once the police detained and sent vagrant Hansen's disease patients to SCH, stigma and discrimination against them strengthened in Korean society. Because of strong stigma and discrimination in Korean society, Hansen's disease patients suffered from daily threats of death. First, their family members were not only afraid of the contagiousness of Hansen's disease but also the stigma and discrimination against themselves by community members. If a family had a Hansen's disease patient, the rest of community members would discriminate against the entire family. Furthermore, because Hansen's disease patients were excluded from any economic livelihood such as getting a job, the existence of the patients was a big burden for their families. Therefore, many patients left their homes and began their vagrancy. The patients who could not leave their homes committed suicide or were killed by their family members. The victims of such deaths were usually women, who were at the lower position in the family hierarchy. In the strong Confucian society in Korea, more female patients were killed by themselves than male patients. Moreover, all of patients victims in the murder were women. This shows that the stigma and discrimination against Hansen's disease patients within their families were stronger against women than men. Strong stigma and discrimination made the patients rely on superstition such as cannibalism. Patients believed that there were not any effective medicine. There were a few reports of patients who were cured, and many were treated with chaulmoogra oil in the modern Hansen's disease hospitals. Eating human flesh was known as a folk remedy for Hansen's disease. As such, patients began to kill healthy people, usually children, to eat their flesh. Increased stigma led to increased victims. Hansen's disease patients who left their homes faced many threats during their vagrancy. For survival, they established their own organizations in the late 1920's. The patients who were rejected to be hospitalized in the Western Hansen's disease hospital at Busan, Daegu, and Yeosu organized self-help organizations. The purpose of these organizations was first to secure the medicine supply of chaulmoogra oil. However, as stigma and discrimination strengthened, these organizations formed by Hansen's disease patients demanded the Japanese Government-General of Korea to send and segregate them on Sorok island. They did not know the situation of the inside of this island because news media described it as a haven for patients, and very few patients were discharged from this island to tell the truth. On this island, several hundreds of patients were killed by compulsory heavy labor, starvation, and violence. They were not treated as patients, but as something to be eliminated. Under strong suppression on this island, the patients resisted first by escaping this island. However, in 1937, some patients tried to kill a Korean staff but failed. Attempted murderers were all put in the jail, also located on this island. In 1941, a patient murdered another patient who had harassed other patients, and in 1942, Chunsang Lee, a patient, killed the director of Sorok island. These instances show that there was a system to eliminate Hansen's disease patients in colonial Korea.

[Brua and psychiatry: A pilot study among Dutch-Antillean patients in the Netherlands]. / Brua en psychiatrie: een pilotstudie onder patiënten in Nederland afkomstig van de voormalige Nederlandse Antillen.

BACKGROUND: Individuals native to Aruba, Bonaire, and Curaçao, the abc islands of the former Netherlands Antilles, often attribute their complaints to brua, although they seldom discuss this with health professionals. This may have a negative influence on the therapeutic relationship and diagnostic processes.
AIM: To explore the role of brua in the illness perception of psychiatric patients in the Netherlands who were originally from the abc islands.
METHOD: A random sample of patients under treatment at Parnassia Psychiatric Institute in The Hague were interviewed with the aid of a semi-structured questionnaire.
RESULTS: Of the 18 psychiatric patients interviewed, 10 (56%) believed in brua, and 3 (17%) considered it the cause of their disease. Although none of the interviewees admitted to an active involvement in brua, 8 (44%) had been in touch with a traditional healer and 9 (50%) possessed artifacts meant to provide protection against evil. Regarding the usefulness of discussing brua with health professionals, opinions were divided.
CONCLUSION: Psychiatric patients in the Netherlands native to the abc islands are all knowledgeable of brua, with more than half of them believing in it. Despite the fear and shame that people often experience, making brua fit for discussion in clinical practice would improve the relationship between health professional and patient, yielding further opportunities for diagnosis and treatment.

Ritualistic child sexual abuse in post-conflict Eastern DRC: Factors associated with the phenomenon and implications for social work.

Ritualistic child sexual abuse (RCSA) is a critical and under-recognised form of child maltreatment prevailing in developing countries. In the Democratic Republic of Congo (DRC), children from specific communities suffer complex forms of RCSA perpetrated with extreme brutality by various individuals and groups of conspirators. Although the DRC has achieved significant milestones towards combatting war-related sexual abuse of women and children, disturbing forms of RCSA, notably child kidnapping, rape, child defilement for fetish and superstitious beliefs, child sexual exploitation, and cult-based child marriage persist and affect many victims. This study examines the factors associated with the resurgence of RCSA in post-conflict eastern DRC. The article also discusses the implications of such forms of abuse for social work practice and education in a post-war context.

Enjoying your cultural cheesecake: Why believers are sincere and shamans are not charlatans.

Cultural evolution explains not just when people tend to develop superstitions, but also what forms these beliefs take. Beliefs that are more resilient in the face of apparent refutations and more susceptible to occasional confirmation stand a greater chance of cultural success. This argument helps to dispel the impression that shamans are mere charlatans and believers are "faking it."

When people with dementia are perceived as witches. Consequences for patients and nurse education in South Africa.

AIMS AND OBJECTIVES: To explore and describe the link between culture and dementia care with the focus on the influence of the belief in dementia as witchcraft and people with dementia as witches. BACKGROUND: In South Africa, especially in townships and rural areas, dementia is often perceived as connected to witchcraft rather than to disease. Persons labelled as witches-mostly older women-may be bullied, ostracised, beaten, stoned, burned, even killed. METHOD: One strand of findings from a larger international study is presented with in-depth qualitative interviews of one close family member and seven nurses caring for patients with severe dementia in nursing homes in Tshwane in South Africa. A hermeneutic analytic approach was used. RESULTS: Two main themes are found, namely "Belief in witchcraft causing fear of persons with dementia" and "Need of knowledge and education." Fear of and violence towards people with dementia are based on the belief that they are witches. Some of the nurses had also held this belief until they started working with patients with dementia. There is a great need for education both among healthcare workers and the populace. DISCUSSION: The "witch" belief prevents seeking professional help. As nursing homes tend to be private and expensive, professional dementia care is virtually unattainable for the poor. Dementia needs a more prominent place in nursing curricula. Nurses as educators need to know the local culture and language to be accepted in the various communities. They need to visit families affected by dementia, give awareness talks in churches, schools and clinics and facilitate support groups for carers of people with dementia in the local language. CONCLUSION: Improved nurses' education in gerontology and geriatric care is needed. Trained specialist nurses may work as mediators and help eradicate the witchcraft beliefs connected to severe dementia.

Magical thinking decreases across adulthood.

Magical thinking, or illogical causal reasoning such as superstitions, decreases across childhood, but almost no data speak to whether this developmental trajectory continues across the life span. In four experiments, magical thinking decreased across adulthood. This pattern replicated across two judgment domains and could not be explained by age-related differences in tolerance of ambiguity, domain-specific knowledge, or search for meaning. These data complement and extend findings that experience, accumulated over decades, guides older adults' judgments so that they match, or even exceed, young adults' performance. They also counter participants' expectations, and cultural sayings (e.g., "old wives' tales"), that suggest that older adults are especially superstitious. (PsycINFO Database Record

A profile of child branding cases in Kashmir valley.

The article deals with child branding cases that were researched over a period of two years. Child branding practice is a common occurrence in the rural areas of the Kashmir valley where it is often practiced by faith healers [quacks] having no knowledge of underlying disease processes or the possible differentials of the same; leaving treatment protocols a distant possibility for the same. These illiterate so called healers possibly relieve the initial stigmata of the disease process that is pain by many procedures including burning the affected population with hot coals; embers; and various other pain inducing processes. In this way cutting a painful condition by stimulating another painful condition by possible intervention of body's "pain gating mechanisms" bring a somewhat temporary relief to the sufferer. This undiagnosed and mistreated underlying disease condition meanwhile continues to linger on with increasing severity often causing morbid relapses and ultimately resulting in a highly mortal course when the patient is actually brought for tertiary hospitalization. The present study aims to establish a pattern between child branding and its medical; social and economic correlations .Among these correlations the study will focus on disease related morbidity and mortality; role of community based faith healers ["quacks"]; poverty and illiteracy. The study will also reveal how bits and pieces of scientific information have been used to misdiagnose and mistreat a significant population belonging to pediatric age group. It will further try to evaluate the role of "pain gating" mechanisms as a means of pain relief and the partial success in motivating a significant population by these healers to be part of such practices. A positive outcome of this study is educating a significant part of affected population to shun such practices and follow proper treatment regimens.

Religion, Spirituality and Folk Medicine/Superstition in a Neonatal Unit.

Beliefs and practices surrounding religion and spirituality (RS) feature in neonatal units, although healthcare professionals and families hold different views on their role in neonatal care. Descriptive study performed at the Neonatology Unit of Santa Lucía University Hospital, Cartagena. Separate forms concerning spirituality, religion and folk medicine were administered to professionals ascribed to the unit (n = 70) and parents (n = 93). 70% of professionals and 60.2% of parents perceive RS as playing a relevant role in neonatal care; however, 45% of professionals prefer that parents do not express their RS beliefs. Actual use of prayer by parents while in the unit was 55.9%, compared to the staff's estimation of 20.8% (p < 0.001); parents believe that RS affects outcomes indirectly, mediating through caregivers, contrary to the staff perception that parents turn to RS for a direct effect on outcomes (p < 0.001); professionals, unlike parents, found RS to be of little benefit to children (p < 0.001) or in reducing parental anxiety (p < 0.001). Amulets were found alongside 26.6% of children. Up to 40% of parents believe in magic concepts such as evil eye. Many families express RS while a member is hospitalized and, while staff recognize its importance, they often fail to respond correctly. The use of amulets and ritual objects is still common and can express the need for emotional and psychological support. Caregivers need to be aware of the medical, psychological and emotional implications of these practices.

Pestilence, riots, lynchings and desecration of corpses. The sleep of reason produces monsters.

Vampirism has been a component of Central European and Balkan folklore since the Middle Ages and was often believed to be responsible for the transmission of serious infectious diseases such as plague and tuberculosis/consumption. Vampirism was believed to be spread within the same family or village and if the rite of the so-called second burial after death was not performed. The practice of "second burial" entailed exhumation of the body and the removal of the shroud from the mouth of the corpse, and a search for evidence if the corpse had chewed the cloth. If the shroud was chewed, a handful of earth or a brick was put into the body's mouth so that the vampire could no longer harm others. In some cases, the corpse was decapitated and an awl, made of ash, was thrust into its chest. Furthermore, the limbs were nailed down to prevent its movements. Remarkably, these beliefs were not restricted to the popular classes, but were also debated by theologians, political scientists at the height of the eighteenth century (Enlightenment). In the Habsburg Empire, this question attained such important political, social as well as health connotations as to force the Empress Maria Theresa to entrust an ad hoc study to her personal physician Gerard van Swieten with a view to determining what was true about the apparitions of vampires that occurred throughout central Europe and in the Balkans. The result of this investigation led to a ban on the "second burial" rites. Despite this prohibition, the practice of necrophilia on the bodies of suspected people continued, and both a cultured and popular literature on vampirism continued to flourish well into the nineteenth century.

La anatomía y las prácticas adivinatorias en las antiguas civilizaciones / Anatomy and divination practices inancient civilizations

Se describe la relación de la anatomía con la aruspicina, también conocida como hieroscopia y extispicina. Se trata del método de adivinar, examinado las vísceras de un animal sacrificado e interpretando detalles de esta anatomía macroscópica con el fin de predecir el futuro, siempre ligado a una voluntad divina. Eran las antiguas civilizaciones las que practicaban este arte supersticioso de adivinar basados en la conformación anatómica que presentaban dichas vísceras. Por estas razones, es muy probable que estos individuos hayan desarrollado un notable conocimiento de la anatomía y que hayan utilizado una terminología anatómica propia que hoy desconocemos por falta de documentación.

The relation between anatomy with haruspicina (also called hieroscopia and extispicina) is described. This is the method to guess, examined the entrails of a slaughtered animal and interpreting details of this gross anatomy in order to predict the future, always linked to a divine will. Ancient civilizations were those who practiced this art to guess superstitious based on anatomical conformation presenting these viscera. For these reasons, it is likely that these individuals have developed considerable knowledge of anatomy and have their own anatomical terminology used today unknown for lack of documentation.

Branding in children: a barbaric practice still exists in India.

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era.

Believing what we do not believe: Acquiescence to superstitious beliefs and other powerful intuitions.

Traditionally, research on superstition and magical thinking has focused on people's cognitive shortcomings, but superstitions are not limited to individuals with mental deficits. Even smart, educated, emotionally stable adults have superstitions that are not rational. Dual process models--such as the corrective model advocated by Kahneman and Frederick (2002, 2005), which suggests that System 1 generates intuitive answers that may or may not be corrected by System 2--are useful for illustrating why superstitious thinking is widespread, why particular beliefs arise, and why they are maintained even though they are not true. However, to understand why superstitious beliefs are maintained even when people know they are not true requires that the model be refined. It must allow for the possibility that people can recognize--in the moment--that their belief does not make sense, but act on it nevertheless. People can detect an error, but choose not to correct it, a process I refer to as acquiescence. The first part of the article will use a dual process model to understand the psychology underlying magical thinking, highlighting features of System 1 that generate magical intuitions and features of the person or situation that prompt System 2 to correct them. The second part of the article will suggest that we can improve the model by decoupling the detection of errors from their correction and recognizing acquiescence as a possible System 2 response. I suggest that refining the theory will prove useful for understanding phenomena outside of the context of magical thinking.