INDIGENOUS medicine

I’ve been presented with opportunities during the course of my life, and I’d like to think I learned from them. I have touched the earth and learned from Her, touched the people and learned from them and, having been touched, I touch those helping spirits who have guided and supported me since I’ve had memory. I have sat in synagogue with my Jewish elders, teachers of my spiritual lineage, praying in the ancient tongue of the Tribe of Israel; I have sat in the zendo with my Roshi, balanced stillness at my center, chanting phrases from sacred Buddhist texts; I have sat in countless teaching circles, wise men and women drumming guardrails for my world-walks to remembered realities; I have sat in sweat lodge with my tiospaye, offering up timeless prayer songs in the eternal language of the Lakota; I have sat at the side of beloved teachers of Mayan, Mexihka and Huna traditions, to whom I was led, whispering voiceless gratitude as times past and present merged; and I have sat in the ceremonial circle with my community as a and spiritual teacher, speaking sacred words in the tradition of my Indo-European Indigenous ancestors.

Not an academic undertaking by any means or experience from afar— the “joy of the journey” often became “where the rubber meets the road”— and each experience has led me deeper into my heart, deeper into relationship with that Something Greater and deeper into the Truth.

Through the act of embracing the spiritual traditions of my genetic, historical and soul’s lineage, I have gained a deep understanding of the empowerment and healing that can come from acknowledging and connecting with one’s cellular memory, tribal ancestry and cultural history—and keeping it alive.

The profound gift given me moves far beyond personal self-discovery; scattered puzzle pieces have rejoined, time and space have solidified and I find myself rooted in knowing that from the wisdom of our ancestors, will come the wisdom of our children.

Some of you reading this are keenly aware from whence you’ve come, others are not. Regardless, what is important to realize, I believe, is the fact that—whether we know it or not—ultimately, somewhere on our familial timelines, we all have an Indigenous tradition, a tribal heritage, as its source. Embracing this premise offers new eyes to old landscapes and suddenly, the topic of “Indigenous Medicine” becomes not about “them” or “other;” it is about each of us.

For whether it is the case that your DNA holds traditions of the red road, the green road, the black, yellow or brown road, we are all standing at the crossroads. And as the past helps to guide the future, I think it’s a good thing these days to hold them both in our vision.

That statement seems particularly true in light of what I discovered while preparing this piece. What began as a simple expose on Indigenous and , the intention of which was to provide deeper insight into the variety and wealth of accumulated healing wisdom available, suddenly exploded. In writing, I became aware of the complex series of events--and vast amounts of research--that have been, and continue to be, taking place in regard to the utilization and protection of Traditional medicine worldwide. It is no longer merely a search of the past-it is about a living present as well.

Perhaps you have greater familiarity with the situation than I had previously, perhaps not; regardless, I look forward to sharing this medicine journey across time. I believe it to be both meaningful and timely.

To begin, let’s define some terms: Indigenous medicine is a term often used synonymously in literature with “Traditional medicine,” “Folk medicine,” “Earth-based traditions” and “Ethnomedicine,” although some sources differentiate between Indigenous/Traditional medicine and Folk medicine. They state that Folk medicine is less formalized and structured, consisting of healing practices and ideas of body physiology and health preservation known to some in that particular culture; it is merely general knowledge passed along informally and practiced or applied by anyone in the culture that has some prior experience, and they then share it among families or communities. (https://en.wikipedia.org/wiki/Traditional_medicine)

“Ethnomedicine” draws on approaches and methods from the social sciences, and is the formal study or comparison of Traditional medicine practiced by various ethnic groups and especially by Indigenous peoples. It is concerned with the cultural interpretations of health, disease and illness and the nature of local healing systems, but also addresses the health care seeking process and specific healing practices; it is sometimes also used as a synonym for Traditional medicine. (JEthnobiol Ethnomed. 2005:1:1)

The terms “Indigenous medicine (IM)” and “Traditional medicine (TM)” are often used synonymously or even together, being abbreviated as ITM. These terms generally refer to a comprehensive group of ancient health care practices, modalities or healing systems, existing before the application of modern science to health and refined over hundreds or even thousands of years, that are specific to, deeply rooted in and in keeping with, the country, societal and cultural heritage and/or ethnic population out of which they were created. (https://www.wipo.int/export/sites/www/tk/en/resources/pdf/medical_tk.pdf)

Developed to some degree by all cultures, Indigenous/Traditional medical systems vary widely, cover a wide scope and have historically been practiced outside of, and separately from, the more recent Western Biomedical/Allopathic medical model. As the WHO defines it, Traditional medicine is “the sum total of knowledge, skills, approaches, practices and products based on the theories, beliefs and experiences indigenous to a culture, whether explicable or not, that incorporate plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination, in the maintenance of health and well-being, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses.” World Health Organization [WHO], “Fact Sheet No. 134: Traditional Medicine,” (May 2003), available at http://www.who.int/mediacentre/factsheets/2003/fs134/en/; WHO, “Traditional Medicine: Definitions”, WHO/EDM/TRM/2000.1, 2000, available at http://www.who.int/medicines/areas/traditional/definitions/en/.

“Biomedicine” is a nonspecific term which refers to a broad field of study and category of medical practice. Based on the principles of the natural sciences, it borrows elements from the history of human and veterinary medicine, anatomy, physiology, genetics, pathology, zoology, botanical sciences, chemistry, biochemistry, biology and microbiology, applying them to the understanding, treatment and prevention of disease; it is also referred to as “Conventional,” “Western,” “Clinical,” “Scientific,” “Modern,” “Mainstream” and” “High Technology” medicine. While Traditional medicine is concerned with the direct application of medical knowledge, Biomedicine looks at its history and involves itself in new research to push the limits of what medicine is able to accomplish. (Segen's Medical Dictionary.2012, Farlex, Inc)

“Allopathic Medicine”-synonymous with Biomedicine, is a term commonly used to identify the modern, mainstream system of medical practice in Western countries. It targets disease with remedies that treat or suppress symptoms or the condition itself and tends to produce effects different from those produced by the disease under treatment. (https://www.scidev.net/global/medicine/feature/traditional-medicine-modern-times-facts-figures.html)

“Complementary/” (CAM) are terms that refer to the healthcare practices that are not part of a country’s own tradition and are not integrated into the dominant healthcare system. Specifically, CAM describes a group of health care systems, practices and products not presently considered to be part of Allopathic medicine; it includes Traditional medicine, as well as modern practices developed outside of Indigenous communities. Sometimes the two terms are used synonymously, or TM may be referred to as CAM when it is adopted outside of its traditional culture.http://www.who.int/medicines/areas/traditional/congress/beijing_declaration/en/index.html

If a non-mainstream practice is used together with conventional medicine, it is considered “complementary;” if a non-mainstream practice is used in place of conventional medicine, it is considered “alternative.” (https://nccih.nih.gov/health/integrative-health)

“Integrative Medicine” is a term that refers to the blending of conventional and natural/complementary medicines and/or therapies along with lifestyle interventions in a holistic approach, taking into account the physical, psychological, social and spiritual wellbeing of the person. (https://www.scidev.net/global/indigenous/feature/integrating-modern-and-traditional-medicine-facts-and-figures.html) Integrative health care often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system. It aims for well-coordinated care between different providers and institutions. (https://nccih.nih.gov/health/integrative-health)

“Herbal Medicine/Herbalism” is a designation that includes , herbal materials, preparations and products that contain plant materials or combinations of plants as active ingredients. Herbalism is the practice of making or prescribing plant-based herbal remedies for medical conditions and is considered a form of alternative medicine. (https://www.scidev.net/global/indigenous/feature/integrating-modern-and-traditional- medicine-facts-and-figures.html)

The World Health Organization (WHO) began work over two decades ago to develop a national policy on Traditional medicine. One of their earliest meetings was in Beijing (November 1999), where representatives of WHO met and issued a document to clarify their work entitled, “A Report of the Consultation Meeting on Traditional and Modern Medicine: Harmonizing the Two Approaches.” Although they concurred that each Traditional medical system was as unique as its country of origin, they also recognized common characteristics and perspectives that most shared. The report states:

•”Traditional medicine is based on a belief that health is a state of balance between several opposing aspects in the human body. Illness occurs when an individual falls out of balance, physically or mentally. The “causes” of imbalance could be change of weather; intake of certain food; external factors, such as magical or powers; mental stimulation and societal reasons. Traditional medicine tries to restore the balance using different therapies.

• Traditional medicine is based on the needs of individuals. Different people may receive different treatments even if they suffer from the same disease. Traditional medicine is based on a belief that each individual has his or her own constitution and social circumstances which result in different reactions to “causes of disease” and treatment.

• Traditional medicine applies a holistic approach. It considers a person in his or her totality within an ecological context and usually will not only look after the sick part of the body. Besides giving treatment, traditional practitioners usually provide advice on lifestyles and healthy behavior.” Western Pacific Region: 22-26 November 1999, Beijing, China © World Health Organization, 2000. https://iris.wpro.who.int/bitstream/handle/10665.1/5573/19991126_CHN_eng.pdf

These healing modalities, then, are understood to be complex holistic health care systems, whose foundation stems from the common understanding of the earth as a source of life directly and intricately related to human health. It is based on a world view of the body as part of nature, interacting with forces both internal and external to it, and emphasizes the need for balance between the body, mind, spirit and the natural world. In this system, health reflects a balance of these internal and external influences; illness, on the other hand, is a manifestation of imbalance and observation remains key to assessing the nature of the imbalance and providing the appropriate corresponding intervention.

Herein lies the fundamental difference between the Biomedical model and an Indigenous cosmological paradigm; the conventional medical model, young in its evolution yet popularly embraced, is characteristically biologically based. It views the human system much like an automobile, its anatomical parts fueled by chemical interaction. Physiologically mechanistic and independent of its local environment and greater world in which it exists, it runs regardless of the nature of the roadways, amount of traffic or the quality/quantity of interactions with other vehicles. A well-running vehicle is homeostatic, possessing mechanisms that help regulate its system, enabling it to constantly be in a steady state. If it should break down, it simply gets fixed, and when it gets too old, past the point of repair, extra additives are put in the tank to keep it going until it gets junked.

The frame of reference for those living within an Indigenous culture or raised with Traditional medicine ways, however, is in stark contrast. For them, illness, healing and health are not isolated events; humans are not merely blood and bone nor are they separate from the totality of life. Life mirrors nature—it is cyclic; whether it be daily, monthly, yearly or a lifetime, physiologically, psychologically or emotionally—the body/mind/spirit of an individual waxes and wanes, ebbs and flows with changes that take place both within the individual as well as in the heavens, on the earth, and in relation to those with whom life is shared. Rather than homeostatic, this way of being is homeodynamic; life is continual movement, constant flux— a powerful yet recognizable dance that was, and still is for many, honored in ceremony and with ritual as a way to connect the within and the without.

It is commonly believed that, throughout history, some form of medicine was practiced by all cultures on the planet and it was not an isolated methodology. Rather, the promotion of health and the healing and cure of illness and disease was part of a larger system-a working and living portion of a culture’s entire cosmological system that interwove spiritual beliefs, an explanation of the universe, the norms and values of the society of which it was a part, and even tasks of daily living. Historically, with the advent of modern scientific thought, a dichotomy developed between the spiritual world and the physical, the “sacred and the profane” and, in the non-traditional world, spiritual belief, and medicine became individual entities without overlap; for most Indigenous cultures, however, they were, and continue to be, intimately intertwined.

(For a more detailed explanation, I invite you to download a copy of my “Energetic Medicine” article on this website’s homepage)

Cosmological views, such as those held by Indigenous cultures, were often associated with the first form of religion known as Animism. Animism as a religion is based on the belief that all things—living and nonliving—are alive and have a vital essence or a spirit that can be contacted. It is the view that there is more than just the physical self; an individual is part of a giant cosmic web in which all aspects are interconnected and the universe consists of a complex network of forms, energies, and vibrations. This animistic worldview was neither contained to any one part of the world, nor limited to any specific Indigenous culture. Each cosmological system acknowledged and called this vital essence, life force or universal energy by a different name, including ruach for the ancient Hebrews, chi/ki in the Orient, mana in Hawaii, prana in India, reiki in Japanese, huaca in Peru, nwyfre for the and wakonda and manitou among some of the Native American tribes of North America. (White, J/ Krippner, S, Eds., Future Science, Anchor Books, New York, 1977)

The concept of life force energy became a distinctive element separating Indigenous medicine and Biomedicine; prior to research findings in modern physics, the study of Bio-electromagnetics (BEM) and field theory, early Biomedical practice refused to consider it a reality, whereas in the Indigenous medical world, acknowledgement of the existence of bio-electromagnetic “energy” was/is a matter of fact and the impact it has in healing and on life itself was/is never in question. Not merely a belief handed down generationally, in Indigenous/Traditional cultures the world over, it was/is a vital component of, and the foundational basis for, one’s relationship with all that there is, both in the seen and the unseen world.

Historically, the practice of Traditional/Indigenous medicine varied widely, relative to the societal and cultural heritage of different countries, with some developing and documenting highly complex and structured methodologies. A partial list of sophisticated traditional medical models include those created and utilized by the Indigenous peoples of China, Korea, Irani, India, Africa, Native American, Greek, Inca and Latina America/Mexico (Curanderismo). Oriental medicine, including acupuncture and adjunct modalities, is one example of Indigenous medicine from Asian cultures, while Ayurveda is the Indigenous medical system of India, both of which are thousands of years old.

It is believed that these practices developed out of the specific needs and characteristics of the culture, history, philosophy and availability of resources. But research has shown, in many cases, similarities existing between methodologies found around the world. Finding multiple cultures using similar modalities to cure a given health issue provides a strong indication that a particular methodology is particularly effective, having stood the test of time and having been corroborated across multiple civilizations. Acupuncture is a good example of this as there has been found to be not only a Chinese system, but also a Korean system, a Japanese system, an Egyptian version and even a Neanderthal version that predates all the others. Each of these cultures found ways to make the same concept work at different times in different manners without any interaction with each other.

The same circumstances can be found when comparing the Traditional medicine ways of the Indigenous tribes of North America. Native American medicine refers to the combined health practices of over 500 distinct nations that inhabited the Americas prior to European arrival in the 1500’s. Specific practices varied among tribes but, to a large degree, the similarities far outweighed the differences. Native American Indigenous medicine, as a whole, is based on the understanding that human beings are part of nature and health is a matter of balance. The natural world thrives when its complex web of interrelationships is honored, nurtured and kept in harmony.

Native American cosmology recognizes aspects of the natural world that cannot be seen by normal vision but which can be experienced directly and intuitively. One had to learn how to negotiate the dynamic interplay between internal influences and the external influences of the community and especially, those of the natural world, where unseen forces must be addressed and integrated, in order for balance—and therefore health— to be achieved and maintained on all levels.

The finding of cosmological and practice similarities in disassociated parts of the world is not surprising, and I am sure theories have been postulated. I believe the answer, however, lies not in the efficacy of a particular methodology but, rather, from a deeper attunement with the collective.

Dr. Michael Harner, an anthropologist, expanded on the work of Mircea Eliade, a pioneer in the study of and author of, among others, “Shamanism: Archaic Techniques of Ecstasy”(1951). After years spent researching in the Amazon and elsewhere, Dr. Harner established the Foundation for Shamanic Studies (FSS) in 1979 and soon after published “The Way of the Shaman” in 1982. A leading authority in the field of shamanic research until the time of his death in 2018, he and the Foundation gained an international reputation for their commitment to supporting, preserving and teaching shamanism worldwide. (https://www.shamanism.org/)

(Personal note: Michael introduced me to shamanism when I walked into his basic class in San Francisco in 1990 and, for over a decade, I had the honor of training with, and learning from, this man. The depth of his wisdom and the height of his humor knew no bounds-dhp)

Michael and his colleagues researched Indigenous/Traditional cultures throughout the world and, over time, found that great commonalities existed amongst them in regard to worldview, belief systems, perspectives on illness and health, healing methodologies and tools; but of even greater interest were the similarities found with those individuals whose task was to travel into unseen worlds for assistance with healing.

This individual was called by many different names, each specific to the culture. The word that is most well-known in this century, however, is “shaman,” the origin of which comes from the Tungus people of northern Asia. They may be called other things within their own particular culture, such as “Sangoma” among the Zulu, “Babalawo” among the Yoruba, and “Kahuna” in Hawaii. Manifestations of shamanism may also differ from one ethnic group to another. (http://shamanismconference.org/shamanism/)

As Dr. Harner and his colleagues have defined it, “a shaman is a man or a woman who, at will, enters an altered state of consciousness (which Dr. Harner calls "the shamanic state of consciousness" or "SSC") in order to make journeys in what are technically called "the lower, middle, and upper worlds." World-wide, this state is achieved most commonly, but not exclusively, with the aid of “sonic driving; this entails the systematic use of drumming, rattling, singing or other instruments to create specific auditory stimulation that alters consciousness and helps maintain this altered state. These other worlds, accessible to the shaman in the SSC, exist outside of space and time and are regarded as an alternate reality; the shaman's purpose in journeying to it in the SSC is to interact consciously with certain guardian powers or spirits there, which are usually perceived as "power animals" or "allies" or "helping spirits." The shaman solicits the friendship and aid of such power animals in order to help other people in various ways, and he or she may also have spiritual teachers in this hidden reality who give advice, instruction and other forms of assistance. In summary, the shaman is a "walker between the worlds," able to see and enter realms intentionally that most people encounter only in dreams and myth, and from these realms the shaman brings back vital information for the healing of individuals, the community at large, or the earth itself.” (Harner, Michael, The Way of The Shaman: A Guide To Power and Healing, Harper and Row, 1980.)

The signature of a shaman, then, is the ability to find extra-ordinary solutions to ordinary problems and to alleviate physical pain and suffering through the intervention of transpersonal spiritual powers. In this way, a shaman is distinguished from other kinds of healers and medicine people who also serve their community. What designates a shaman is not the activities they perform, but his/her use of this specific state of consciousness which, in its use, provides the opportunity to derive the knowledge and power to perform those activities. For example, a shaman can be an herbal healer or an interpreter of dreams, but others who interpret dreams and heal with herbs may not be shamans; or, in another instance, unlike an herbal healer who might know from study of tribal lore which plant to use if someone is sick, the shaman will, on the other hand, go ask the spirits for assistance or they will go speak directly with the spirit of the plant to make sure it is the right medicine or they might go and confront the spirit of the dis-ease and talk to it directly (often accompanied by his/her guiding spirits).

In summation, the shaman journeys into alternate realities utilizing learned techniques, and these journeys are made at will and taken with conscious control. He or she is aware that there must be a specific intended mission while in that shamanic state of consciousness; it is not entered into for play but for serious purposes. They have work to do in the SSC and they must know the basic methods for accomplishing that work; they know how to get there, and they have a relationship with those helping spirits with whom they interact while there.

Spirits are defined in shamanism simply as those things or beings which are normally not seen by people in an ordinary state of consciousness. But shaman do not “believe” in spirits—they talk with them, they interact with them—they no more believe in the existence of spirits than they believe they have a house and a family; it is not a belief system, rather, it is a system of knowledge based on firsthand experience.

Also, as Non-ordinary reality (NOR) exists outside of time and space, it enables the shaman to move between worlds or between past, present and future. They do not journey haphazardly; having learned how to travel, they have gained information about the cosmic geography of NOR, so that one may know where to journey to find the appropriate animal, plant, answers, or other powers. This otherworld does have a structure and substance—just different than the one we normally know and live in. These are not imaginal realities; some of Dr. Harner’s research around the globe involved gathering detailed information on different shaman’s journeys, from which he actually mapped out the worlds. The results showed a remarkable consistency that exists among tribal cultures the world over as to the structure of a non-ordinary reality and he found, in many cases that it was often represented as a world tree.

Although not every shaman performs the same services, the methods they all employ that set them apart from other healers or leaders in the tribe is that of working with the spirits. Dr. Harner has found in his research that there are three primary areas in which the shaman alone can work on behalf of his community.

1. - Defined as any method for discovering information about ordinary reality issues or problems through non-ordinary methods; examples of these are tarot cards, runes, pendulum or, in shamanic work, by asking the spirits directly for information. In this case, the shaman would journey into non-ordinary reality to find lost objects or seek answers to questions; often these questions were about such matters as location of food resources for the tribe, career or location changes or about a particular health problem. Once in NOR, he/she would receive information from the spirits and bring back an answer.

2. Psychopomp- This term literally means, "to conduct or to lead souls." A standard service in many cultures, here the shaman acts as a guide to lead or conduct the soul of a dying person into the next world; it is helping people to die, moving the soul from life into death, to make that choice and take that journey to the “other side of the veil.” They also work at the other end of the spectrum, assisting before or at births to help a new soul make a safe entrance into this life. In addition, they also work with those souls who are already dead who may be in need of assistance to move on. For one reason or another, Souls can get trapped between this world and the next, get caught or stuck between lives, and need help too.

3. Shamanic Healing-Here, healing is looked at from a spiritual perspective. From the point of view of core shamanism, disease is caused by one or a combination of several things. The shaman may do a diagnostic journey prior to meeting to ascertain what work is necessary or they may be informed in the course of journeying into NOR as they’re working with an individual. Three main categories were found across traditions; these are power loss, soul loss, and extraction of spiritual intrusions. a. Power Loss- Power loss can be defined from the point of view of core shamanism which teaches that we all have spirits in particular animal forms- known as power animals-who are around us and who protect us and keep us healthy. Loss of this helping spirit is considered loss of one’s spiritual power which could lead to chronic problems such as depression, illness, or misfortune. In this case, a power animal retrieval is performed; here the shaman journeys into NOR, finds it and assists in its return, bringing back a helping spirit manifesting in animal form whose characteristics and qualities are such as to help the suffering individual. Often specific messages are given from this helping spirit to the person to better assist them with ways to maintain power.

b. Soul Loss-Soul loss is based on the concept that our soul is like a hologram and we can lose parts of it and still operate in the world; losing all of the parts would constitute death. It occurs when we lose part of our spiritual vital essence; this can occur with trauma, at times of great confusion in our lives, even something as simple as being jolted awake by an alarm clock. It is important to know that not all trauma necessitates soul loss and soul loss is not always caused by trauma-it is different for every person.

Soul loss is not a negative event, per se; it is a survival technique, a way for our body and psyche to survive an experience—it is the healthy part that leaves to get through the event. However, problems can develop when the soul part that split off does not, or cannot, come back on its own and needs assistance to return. This can manifest for an individual as feelings of disassociation, periods of memory loss, addictions, and even chronic illness and depression; a person can get a sense of it for themselves if, after an accident, surgery/medical procedures, death of loved one or powerful life event. They may not feel fully present, have one or more “blank areas” in their life or feel a vague sense of emptiness. It is also possible to have “collective” soul loss, in cases where whole communities-or countries-experience traumatic events; animals and land can also experience soul loss.

In this case, the shaman will perform a ‘soul retrieval”—a journey into NOR— and, working with their helping spirits, will ask if there are parts out there ready to come home. Being led to those part(s), they will assist in their return; it may also be the case where the shaman’s helping spirits provide a healing on the part prior to return and may also return with messages for the individual. c. Extraction of Spiritual (Power) Intrusions—This occurrence, found in shamanic traditions worldwide, is based on the concept that every illness, both physical or emotional, has a spiritual form and “intrusions” can enter and create problems. Illness due to an intrusion usually manifests as localized pain or discomfort, often accompanied by an increase in temperature which, from a shamanic point of view, is connected with the energy from the intrusion.

In these cases, once the cause is established, the shaman will move into a shamanic state of consciousness (SCC) and, with the assistance of helping spirits, look inside the person, “see” the intrusion, and extract it from the body. Although this aspect of illness is commonly recognized among Indigenous cultures, there are a variety of ways in which a shaman may divine the places where the intrusions exist, “power up” or prepare prior to performing the extraction, to extract the intrusion and how and where to release it.

It is important to understand that spiritual intrusions and their extractions are not the same as a possession and an exorcism. These intrusions are not evil; they just do not belong in the person’s body. An intrusion is easily recognizable to someone performing an extraction, taking a form that clearly does not belong in the body. When removed, it does not necessarily need to be destroyed; in many cases, it is merely returned to its natural home or is either placed in a container of water next to the patient or thrown towards the closest large body of water, where it is “seen” going into its depths, thereby being neutralized.

In addition, it should also be noted that, in cases where physical symptoms manifest simultaneously, conventional medical care might also be necessary; based upon the degree of severity, both may be appropriate as shamanic healing, while working with the non-ordinary aspects of an illness, is not a substitute. While it is the case that spiritual healing can, indeed, lead to physical healing, specifically in the case of a spiritual intrusion, where physical repercussions could appear in a fashion similar to the western concept of infection, the resultant ordinary aspects may need to also be addressed.

Spiritual/Power intrusions, like communicable diseases, seem to occur most frequently in urban areas where human populations are densest. From a shamanic perspective, this is because many people, without knowing it, possess the potentiality for harming others with eruptions of their personal power when they enter a state of emotional disequilibrium; this is especially possible when the emotion stems from reaction to an external source, when common responses such as anger, resentment, jealousy and hatred are exhibited.

People not with shamanic principles and/or the existence of energy fields, do not have a guardian spirit or a power animal to shield them, nor do they know how to work with their own energies to maintain boundaries so as to avoid reception of others’ energies. In turn, most have no knowledge that they, too, may be harming others unintentionally with their own emotional states. Shamans believe when people are unaware that their hostile energies can penetrate others, the potential for unconsciously causing detriment to their fellow human beings is great. To become conscious of one’s spiritual/energetic behavior, and understanding the ramifications that could exist, can be beneficial for all.

While it is the case the majority of spiritual power intrusions are unconsciously sent, it is also a reality that intention has an effect; an individual can send, or be the recipient of, these potentially harmful energies if intentionally utilized. For an individual who chooses to intentionally “throw medicine” or send these harmful energies, repercussions are usually swift. It is good to be aware that there are specific spiritual principles regarding this situation, as well as a variety of available methods that can be considered and/or implemented; however, that discussion lies beyond the scope of this current conversation.

(Personal Note: As this topic is one with which I am familiar and have experience, you are welcome to contact me for more information-dhp)

When someone feels a need for healing work of this sort, with either a traditional shaman or a person trained and experienced in these practices, they may encounter a gamut of possible variations. As individual differences often exist in regard to procedures/requests and etiquette before, during and after (usually based on tribal tradition or spirit “suggestions”), it is always advantageous to respectfully ask questions to promote greater understanding, ease and trust; this is strong work for everyone involved so having a sense of things can be helpful. Generally, the shaman/practitioner will listen to the individual, determine, with spirit's help, what the person needs and then, based on what's been heard, rebalance the system, either by taking out that which does not belong or replacing that which is missing. Sometimes the above methods are utilized either alone or possibly in conjunction with other spirit medicine (plant, animal, stone) and, in some instances, the spirits could relay through their intermediary if there are specific tasks or behaviors for the patient to assist them in regaining that balance.

In Indigenous/Traditional medicine, it is understood the physical body can only heal up to the point that nature can be reversed; however, even if the physical system is past the point of reversing itself, this work can still assist in creating wholeness of the spirit, help to empower, and provide peace and comfort, regardless of what is happening to the physical body. This approach is about healing versus curing and ultimately, it is not only possible, but appropriate, to facilitate healing the spirit into death, allowing a person to die healthy.

Unlike most of the Western culture which thrives on individualism and independence, Indigenous cultures are based on cooperative sharing within a community that is interdependent—with each other, the land and Divine Source, Creator, the “That Which is Greater.” This is true of their approach to medicine as well. In shamanic work, the power of healing comes from another person being willing to intervene in the spiritual realms on someone’s behalf. Far from being intellectually based, these ancient practices, founded on centuries of previous experience, require considerable focus, intent, trust and respect. It is serious, but extremely loving, work; the intention of it, in all cases, is a return to wholeness, a re-empowering of self, a healing of the spirit. And the spirit world is more than cooperative, more than willing to support our growth into fullness as human beings, which is our right. For it is not merely the individual who benefits; as we become whole, our wholeness moves out onto the rest of the planet, and the more whole and full the planet becomes….which is as it should be.

SPIRITS OF NATURE/POWER OF PLACE

Most Indigenous cultures, even those that have been significantly acculturated into surrounding “mainstream” societal structures, continue to maintain their animistic- based world view, values, principles and practices; these spiritual traditions are considered “earth-based” traditions. Though historically and geographically diverse, as seen earlier with shamanic practice, similarities exist. One common belief held world-wide and for centuries, is regarding the relationship of human to nature. In these traditions, because all aspects of the natural world are invested with spiritual life-have a spirit that can be contacted—they are able to reach out to “2-leggeds” (humans), just as “2-leggeds” are able to do the same; in both cases, it is often the shaman, the “walker between the worlds” that is able to both contact and hear them. It is clearly NOT —rather, it is an interdependent, respectful, collaborative two-way relationship, established often for healing or for divinatory purposes; in the latter case, this often takes place in order to ensure the health and safety of the community. The spirits of nature are able to be contacted (or heard), and, entering into relationship, human and the natural world work in cooperation for the benefit of all.

In these traditions, the whole earth is considered sacred but historically, in each culture’s home-land, it is often the case particular places have been found that were felt to hold powerful earth energy. It was not always the “spirit-talkers” only who could perceive this energy. Indigenous traditions not only taught that the land was alive, they were shown; for the people, the land on which they stood in all directions and the sky above them was part of the community—extensions of each other, the entirety of their world was family. To honor the land was to honor both the ancestors, the ancient ones who went before and who still stood watching, and honor those coming after, the next generation to whom the traditions and the land would pass. In this way, continuity was not merely a philosophical or scholarly concept; it was a daily life activity.

Raised with sensitivity as a result of this understanding, individuals could find themselves drawn to these places to attune themselves with the energy. They did so in a variety of ways, including vision quests, pilgrimages, the walking of ancient trackways and walkabouts, or in moments of quiet ceremony or meditation on what they felt to be sacred sites. In this way, a person was able to open themselves up to the teaching, inspiration and healing that came with communing with the spirits of that place or with nature….and, as with any relationship, they were respectful in their interactions, always knowing afterwards to say thank you. The person usually did so by offering a gift considered sacred within their culture such as blue corn, tobacco or seeds (something that was biodegradable) expressing gratitude for the gift of this union.

In addition to those places of powerful earth energy, often discovered to have underground water running or strong electro-magnetic pull, there were—and are—points on the earth felt to be especially connected to certain aspects of Divine power. Natural places are the most basic sacred places:stones, springs, mountains, islands, and trees were. and are, locations where the anima loci or ‘place soul’ can best be felt and approached. These particular places then come to be considered sacred places when humans recognize and acknowledge them. In many traditions, those with shamanic training were either especially sensitive to these spirit-filled places and were drawn to them, found them by means of divination techniques or by speaking with their guiding spirits. Once found, these places were utilized. It was for this reason special spots were honored with circles of stone, groves of trees, sacred wells, monuments and with ritual. The landscape was seen as a living temple, and worship occurred, not in houses built by man, but on the sacred earth and before an open sky. Those sacred places or holy sites were known to heal the body, nourish and replenish the soul, and open a door to the Divine through communion with the spirits of nature. Different places had different spiritual qualities and an individual could have a personal spiritual relationship with these qualities.

AN INDIGENOUS TRIBAL TRADITION EXPLORED: THE WORLD OF THE CELTS AND

For most people, the words “Indigenous culture” and “Traditional medicine” tend to conjure up image of Natives—perhaps in the Americas, Amazonian regions, Australian outback, cold lands to the north or islands in the sea—regardless of where, images typically flow to those settled for centuries, living on the land of their ancestors, repeating ceremonies or creating medicines as taught by the elders or given as gifts on the wind. While in many cases, it is true that Traditional/Indigenous medicine has been confined to cultures in specific locations over time, there have been exceptions. One of these is the Traditional/Indigenous Medicine and culture of the Celts.

Attempting to trace the history of a specific tribal culture is complex and the Celts are no exception; much debate exists and volumes have been written on the topic. However, it is an important endeavor, as most people of European descent today can count on having some “Celtic” ancestry. It is also necessary to clarify that I use the term “Celt” as a general one, not distinguishing them further from Britons, Gauls, Picts, Scots, Sythians, Irish or Gallations. The Jutes, Anglo-Saxons, Vikings and Normans were also tribes whose presence influenced the history and culture of the great portions of Europe and the Isles; indeed, resources are available that clarify and distinguish Norse (Viking) and Anglo-Saxon medicine as having separate characteristics, typically being related to their home countries.

This vast array of influences account for the extreme lack of knowledge about the Celts before their contact with the classical civilizations of Greece and Rome. Prior to that time, most of the knowledge about their culture comes from archeological finds and speculation derived from folklore, legends and questionable historical accounts. This finding is not inconsistent with other Indigenous tribal cultures evolving within the same timeframe; in most cases, there would be little or no recorded history for an undetermined period. The Celts however, due to their mobile life style, actually had increased opportunities for interaction which, in all likelihood, provided earlier access to a recorded history.

Be assured there is more than enough information available to share with you regarding Celtic cosmology, spiritual tradition and evolution of their unique Indigenous medical/healing practices. I have intentionally combined these topics, for it is the case, as with other Indigenous/Traditional cultures, the world of spirit and the physical world were inseparable; together they created guidelines for living which then flowed into a corresponding social structure. The Pre-Christian Indigenous Celtic spiritual and social structure was complex, with much of it involving the relationships they had with both the natural and the unseen world. However, as this culture typifies the majority of Indo-European cosmology, it offers an excellent example of the belief system that surrounded the maintenance of health, both for the individual and for the community as a whole. ************************************************************* On a Personal Note: I am pleased to be able to share this portion of my website with you. My primary intention for doing so is because I feel it vital, especially in our current world, to offer an expanded vision of what constitutes a “tribe.” Almost 30 years ago, I studied with the Order of Bards, Ovates and . After finishing my training, I ended up teaching Druidry and Celtic Shamanism, Cross-Cultural Shamanic technique, and holding seasonal ceremony for 20+ years, as well as spending a few years as an Ovate Tutor for the Order. I cannot tell you the number of individuals, with whom I shared teachings and sacred space, who told me of their angst and frustration; they were feeling so deeply the need to reconnect with the earth, the sacredness of all life and Divine Source, yet that hunger was not being satiated—that emptiness filled—by their current spiritual path. Feeling they had no place to turn, some attempted to follow the way of the Eastern traditions, others to walk the “red road,” often discovering that neither of those was right for them. Over the weeks, months (and years for some!) we spent together, I saw—and heard—them integrate the teachings of the Celtic spiritual tradition into their own lives, seeing it as a key to understanding their Indigenous ancestry and a way in which to view the world rather than a formal religion; as a result, many of these individuals took portions of this ancient wisdom that “spoke to them” and, incorporating it into their established religious practices, felt a greater level of fulfillment and connection then they had previously.

The Celts were once the largest Indo-European tribe in the world, as well as possibly being the most documented; therefore, it is a strong likelihood most individuals of European descent have a lineage related in some way to this tribal tradition or another closely connected with similar cosmological views. I was told by the stones, while at Stonehenge years ago, to offer a way “home” for those who felt they had lost their tribe, by introducing them to what I have come to call “The Green Road.” Being able to create opportunities for others to explore their heritage and cellular memory in a deep way has been powerful. As I said in the introduction to this portion of my website, we are standing at the crossroads between our past and our future….and knowing where we’ve been helps us to know where we’re going.

Thank you for hearing my words and allowing me to share this; I have extreme gratitude for those who spent time with me in pursuit of deeper understanding. We learned much together. dhp /|\

****************************************************************** In general, it is believed by historians that the tribal people who would later be called the Celts originated from a common Indo-European homeland in Eastern Europe, specifically areas that are now part of Germany, Austria, Slovakia, the Czech Republic and Hungary; some archeologists have even identified the Beaker people of Central Europe or Iberia and the Battle-Axe people of southern Russia as “proto” or “original/primitive” Celts. The first indication of their presence was, in fact, established through artifacts found in what is now Austria. Like many tribal cultures, they did not have a written language and, for the most part, transmitted their history orally. What is clear, however, is that the Celts were not just one race or ethnic group. They were a unified group of tribes having, for the most part, similar languages, cultures and traditions. https://www.history.com/topics/ancient-history/celts

The name “Celt” was one given to them. First documented during the seventh or eighth centuries B.C. when encountered by the Roman Empire, which ruled much of southern Europe at that time, the Romans identified them as “Galli” and the Greeks, “Keltoi,” both of which meant “barbarians.”

Historical evidence indicates that, from the sixth millennium B.C. onwards, the Celts expanded from their homelands both east and westward, through France (or Gael), Switzerland, Spain, Italy, Rome, Greece and Turkey eventually reaching Britain and Ireland in the west and India in the east. In addition, there is some evidence that points to their presence in Egypt and a parallel seems to exist between the northeastern tribes of North America and the Celts as well; archaeological research in New England indicate a European settlement existed as far back as 800 BC which, based on findings, strongly suggests the people who inhabited that settlement were Celtic. https://www.livescience.com/44666-history-of-the-celts.html

At their peak, during the fourth and fifth centuries B.C., practically the whole of Europe was of Indo-European origin and, in the majority, Celtic. Tribes were migrating across Western Europe and Celtic settlements became a constantly changing collection of variant Indigenous nations; evidence indicates that, through utilization of trade routes and adoption of local customs in colonized areas, Celtic culture experienced much change and innovation during this period.

From what is known, this appears to have been true spiritually as well. Tribes from areas now known as the Caucasus region in southern Russia, Turkey or perhaps even India, moved into the region, bringing with them their particular knowledge base and social/religious customs. Simultaneously, aspects of Druidry, the future spiritual tradition of the Indigenous Celts, though not yet formalized or called such, evolved over years and were believed to have been the held spiritual perspective by the Celts of that time. It has been surmised, by those studying this time in history, that the intermingling of these spiritual traditions-all animistically- based, impacted the evolution of Druidry as a structured belief system.

In this regard, it is interesting to note studies in comparative mythology show that Sanskrit literature documents ancient Indian rituals very similar to those traceable in Celtic Ireland, and there are certain striking parallels which can be drawn between some Hindu deities and Celtic gods, as well as other similarities in their religious traditions and prayers; whether this influence was due to the influx of these other migratory tribes or the Celts own migration through lands home to the earliest versions of the Hindu and Jain , is not known. (What Do Druids Believe? Philip Carr-Gomm, Granta, 2006)

The Celts arrived in Britain by, or possibly just prior to, the fourth or fifth century B.C. and Ireland by the second or third century B.C. Beginning with the reign of Julius Caesar in the first century B.C., the Romans launched a military campaign against the Celts, killing them by the thousands and destroying their culture in much of mainland Europe. Caesar’s Roman armies attempted an invasion of Britain at this time, but were unsuccessful, and thus the Celtic people that had migrated earlier established a homeland there. https://www.history.com/topics/ancient-history/celts

Archeological findings suggest that, upon arrival to their new homeland, the Celts found they were not alone; that there were others inhabiting the area. Again, amidst much debate, it appears that the British Isles may have been visited by humans as early as the retreat of the ice age, and was home to an Indigenous Neolithic (new Stone Age) culture. Scholars suggest, then, that the Druids, as they are known to us in the classical texts, evolved as a result of the merging of this local Neolithic culture with the incoming Celts, who came in from the east with their own spiritual traditions; of course, what is unknown is the degree of overlap that existed between these two spiritual traditions and how much one might have influenced the other.

Side Note: “Although the Druids have always been associated in the popular imagination with stone circles such as Stonehenge, academics until recently dismissed this idea. Historians used to say that the Druids couldn’t have used Stonehenge and all the other stone circles in Britain, because the Druids were the priests of the Celts, and the Celts only arrived in Britain in 500 BCE. Since no stone monuments were built after 1400 BCE, they pointed to the gap of nine hundred years separating the last of the stone circles from the arrival of the Druids. But in the sixties many historians changed their minds. They realized that the origin of the so-called Celtic tribes was far more complex than originally presumed, and suggested instead that early or Proto-Celts were probably in Britain as early as 2000 BCE - when the great stone monuments were still being built - and that they could well have been involved in their use or construction.

Forty years later academic opinion is still divided. Some experts emphasize the lack of continuity between religious structures and practices in the second and first millennia BCE. But others point to the new sense of continuity in the genetics and culture of the British, with the rejection of the idea of a Celtic ‘invasion’. This second school of thought makes it possible to again see the Druids as the priests and priestesses of the stone circles, a tendency reinforced by the increasing recognition of the importance of ritual astronomy in the construction of these monuments”. (https://www.druidry.org/druiway/what-druidry/brief-history-druidry/longer-history-druidry)

The early Celtic social structure in Britain was a mix of religious cosmology, animism, and democratic idealism, with each tribe holding its own territory consisting of agricultural, forest, and wilderness lands. Other lands were worked in common for the chieftain, priests, the sick, and the poor. They were a fearless people; both men and women were trained as warriors. The various Celtic clans or tribes of the Isles were unified by their common belief system and its priesthood, the Druids.

The word “Druid” has been given various interpretations; what appears to be the most linguistically sound translation, however is shown below:

“PLINY thought that the name "Druid" was a Greek appellation derived from the Druidic cult of the oak (δρυς).(1) The word, however, is purely Celtic, and its meaning probably implies that, like the sorcerer and medicine-man everywhere, the Druid was regarded as "the knowing one." It is composed of two parts--dru-, regarded by M. D'Arbois as an intensive, and vids, from vid, "to know," or "see."(2) Hence the Druid was "the very knowing or wise one." It is possible, however, that dru- is connected with the root which gives the word "oak" in Celtic. speech-- Gaulish deruo, Irish dair, Welsh derw--and that the oak, occupying a place in the cult, was thus brought into relation with the name of the priesthood. The Gaulish form of the name was probably druis, the Old Irish was drai. The modern forms in Irish and Scots Gaelic, drui and draoi, mean "sorcerer." (1) Pliny, HN xvi. 249. (2) D'Arbois, Les Druides, 85, following Thurneysen. (http://www.sacred-texts.com/neu/celt/rac/rac23.htm)

The first historical record of Druidry (also called Druidism) comes from the classical Greek and Roman writers of the third century B.C. onward; it is clear that, at the time of their writings, the Druidic tradition had already been firmly established both in mainland Europe and the British isles, with Druid schools and colleges in existence on both the British isles and the mainland, primarily Gaul (France). Julius Caesar and Diodorus Siculus wrote about the Druids, painting a picture of them as scholars and religious leaders who function in a similar way to the priestly caste of the Hindu Brahmins, assuming the role of officiant, philosopher, and teacher, conveying an oral tradition which required students to learn many verses by heart. The Druids were clearly understood by the Romans, then, at the time of their emergence on the scene, to not merely be simple barbaric priests or priestesses (men and women held equal rank). For not only were they the professional custodians of Celtic spirituality, overseeing religious functions, they also formed a societal class of their own—an intellectual class, that incorporated all of the learned professions and covered a wide variety of spiritual and communal responsibilities. They were involved at all levels of daily life; Druids held special status and were exempt from military service and taxation requirements. Assumed leader of the people, it was the Druid who really ruled, for his or her word was law. (https://www.druidry.org/druiway/what-druidry/brief-history-druidry/longer-history-druidry)

Although Julius Caesar classified what he called the Celtic intellectual elite as one category, the Druids organized themselves into three distinct groupings, with each group having specific training, functions and tasks to perform. They were the Bard, the Vate or Ovate, and the Druid.

BARD The first group was that of the Bard. Our modern understanding of the word poet or Bard is severely limited, for they were much more. They were the keepers of tradition, of the memory of the tribe-they were the custodians of the sacredness of the word. Although they represented the first level of training for an apprentice Druid, do not think for a moment that a Bard was somehow in a lowly or inferior position. There were many levels of accomplishment, but the most skilled of Bards was held in high esteem and took part in many of the functions of the other two groups.

The training of a Bard was intense and lasted for many years-there were variations in the curriculum between Scotland, Ireland, and England, but it is recorded that, in Ireland, training lasted 12 very rigorous years. They became masters of both record and inspiration. Working in this way meant working with heritage, lineage, and the mythology of the tribe. It meant opening the doors to creativity. They were entrusted with the task of coming to knowledge of the sacred power of the word, and it manifested as the ability to become inspired and to inspire others.

To carry the records of the tribe as keepers of its tradition and memory, they needed to know the stories and the poems which preserved the lineage; but to be masters of Inspiration they needed to compose their own poems and stories as well. Much of this occurred in solitude and using sensory deprivation methods, often spending long periods of time alone in caves, not only in order to commit to memory the vast number of stories required of them, but also to seek the attainment of poetic inspiration, which was an important spiritual practice.

VATE/OVATE The next group was that of the “Vate” or Ovate. It was this group, to the greatest degree, that was responsible for understanding the mysteries of life and death and rebirth, for transcending time, for divining the future, for conversing with the ancestors and travelling beyond the grave to provide insight and counsel to those still living on earth. Like Bardic training, the Ovate curriculum was vast as well and is assumed to have taken years of training (though no details are found in the writings).

If the Bards opened otherworldly doors with the power of the word, then the Ovate opened the doors of time. In this way, Ovates were masters of prophecy and divination- able to move between past and future and to travel to the realm of the ancestors, using it both as a repository of tribal wisdom, as well as a place to which the Ovate could turn for guidance and inspiration on behalf of the tribe. It was also the Ovate's responsibility to find the wisdom of the spirit, plant, and animal world and bring it back for the benefit of all. To achieve this many techniques and rituals had to be performed that would assist the Ovate to move into the proper state of consciousness to receive this information. In short, the Ovate was a spiritual detective.

Divination from nature has always been at the root of native spirituality, and the early Celts saw all places in nature as being sacred residences of the spirits.The Ovate used nature as a means of communing with spirits and could divine through any part of the natural world by their understanding of the earth, plants, animals, and their inter- relationship with all life-forms.

Based on this connection, it seems logical that the Ovate’s specific study was tree-lore, herbalism, and healing. In a broad sense, they used the plant world as a great teacher of the laws of death, rebirth, and transformation, of sacrifice and transmutation. They worked with the balance of nature as a mirror to balance human body and psyche--for they knew if the heart, mind or body was out of tune with nature, one would suffer; in this way, they also acted as a psychotherapist. Trained in the art of healing, they studied the application of natural remedies in relation to the elements, the seasons, and with solar, lunar, and stellar power and in so doing, they assisted in the opening up of channels of communication for an individual not just with self and others, but also with the Divine.

DRUID Given the extensive training of both the Bard and the Ovate, it can be ascertained that it took over 20 years of training before an individual could be initiated as a Druid. The Bards and the Ovates were then, in turn, instructed and trained by respected Druid elders.

These Druid priests, men and women, preserved religion, law, scholarship, and science and had paramount influence over all with their sacred authority. They managed the higher legal system and courts, administering justice and judgments, officiated over the worship of the gods and the spirits, including sacrifices. As their training encompassed that of the Bard and Ovate, the Druid was able to move and work in otherworldly realms as well as in the ordinary world; because of these abilities, Druids were priests and ceremonial officiants, but were also considered magicians, poets, counselors, healers, world-walkers and philosophers.

Literature shows that the Druids possessed not only ancestral and otherworldly knowledge; they were also very much involved in the sciences, being skilled astronomers, engineers, mathematicians and chemists. The Greek and Roman commentators on ancient Druidry (where much of our information on early Druidry is derived, albeit somewhat colored) frequently remarked in the literature that the Druids were concerned with spiritual astrology, with discovering the will of the gods, with learning about the metaphysics of the soul. In this way, we can see why the observation of the elements, weather, and the stars played an important part in ancient Druidic teachings, for these observations revealed the nature of the universe, bringing the Druid into harmony with all life. (www.druidry.org)

The ancient teachings of the Druids represent one of the wellsprings of inspiration in the Western spiritual tradition. Everything a Druid learned was memorized, passed by word of mouth from one Druid to another through the ages, spending decades learning their profession. A prime directive in Druidry was to observe nature, human behavior and events, observing life as it was happening and orally pass along the history of the Celtic people (oral only, as their doctrine forbid any Druidic practice to be in written form). This included all medicines, as well as any and all medical, ritual and/or ceremonial practices.

The main emphasis of Celtic food production was herding and crop cultivation. Community ritual focused on ensuring good weather and other favorable circumstances. These needs required clergy who specialized in leading ritual. Also, some became specialists in law and other ancestral lore while others specialized in learning and recounting myth. Working alongside these specialists in ritual and lore were seers—called “fáthi” in Irish—who probably contacted Otherworldly forces to obtain knowledge and overcome unfriendly spirits.

Each Druid was a walking terminal of knowledge and, although individual Druids were sometimes attached to training schools, most were highly accessible, serving in their appropriate capacity within the community. What each Druid did share however, was access to a common wisdom-pool; not only of historical and ancestral knowledge, but of natural history, geography, story, verse, and memory.

The Druid was at heart, a philosopher, and their concern was with the meaning and purpose of life on earth. In addition to natural philosophy, they also studied moral philosophy. Their morals and ethics were characterized by a great interest in, and respect for, justice, honor, and fair play, emphasizing that each person was responsible for their own conduct. (www.druidry.org) A Druid was expected to use his/her divinatory skills and sight of otherworldly things for many essential and pragmatic purposes, such as advising the tribe chief/king as they made policy, settling disputes and legal claims, and announcing the beginning of agricultural seasons/activities such as planting, harvesting and hunting. Druids were involved in, and typically officiated, both individual and community ritual and ceremony, including stage-of-life rituals such as childbirth, maturity, marriage and death.

They also used their divinatory skills, in addition to their wisdom, to glean information and advise Chieftains and Clan leaders on any number of issues. In times of war, a Druid’s skills were utilized to learn about the enemy’s movements and plans, and to call elemental powers to the aid of the tribe, if needed. Alternatively, the Druids could put an end to an unjust war; among other skills, they had a reputation for pacifying armies about to fight.

All of their roles involved decision-making, direction, and the imparting of knowledge and their skills belonged to the tribe and not to themselves alone. In both spiritual and practical matters, the Druid was an inseparable part of Celtic tribal life and necessary for the tribes continued survival and welfare.

Understanding the Druid's place in the culture, then, it is clear to see why the Romans saw them as a threat to their empire. They had dealt with them before, on the mainland; this time, however, they were determined to eradicate them. For the Druids represented not just a religious hierarchy, but real political and administrative authority among the Celts. https://www.britainexpress.com/History/Roman_invasion.htm

In an attempt to abolish them, the Druids were first excluded from Roman citizenship, with Roman citizens being forbidden by law to practice Druidic rites. Then they were banned by a decree of the Roman senate in approximately 54 AD, and the Druid colleges throughout the land were destroyed. Ireland and Scotland did not suffer to the same degree, as they remained beyond the reach of the legions.

The Druids held out for years on their sacred isle of Iona, directing the resistance until the Romans finally attacked the island itself and destroyed the Druid stronghold there, thus breaking the chain of Druid leadership in Celtic Britain.

It was during this time of Roman suppression that also arrived in the islands, in approximately 200 CE and, by the end of the seventh century, Christianity was firmly established throughout the British Isles. https://www.historylearningsite.co.uk/ancient-rome/the-romans-and-the-druids/ From the fifth until the eighteenth century almost nothing is found in the literature regarding the practice of Druidry, but the tradition did not die and its wisdom was not completely lost—it merely changed and evolved.

The Bardic tradition continued; the Bard's ability enabled them to carry the Druidic tradition through those times when others had to go into hiding, as they often were able to masquerade as mere minstrels, story-tellers, or poets. They were allowed into the royal courts and homes of nobles where, under the guise of story- telling, they kept alive the history, myths, and ideals of Druidry.

At the same time, when Druidry was forced underground, the Ovates blended into the background, keeping the traditions alive through their healing and divinatory work as fortune-tellers, herbalists and midwives.(www.druidry.org)

Historically, it appears that Druidry in some form also survived through practices of those people who either never aligned themselves, or who became disillusioned, with the church. Customs and practices survived in this way as “folk tradition,” with people meeting secretly to avoid persecution; these people were labeled by the Romans and Christians as Pagans.* There are individuals even today who claim that their families have preserved the Druid traditions, and there are other stories and discoveries through the years that indicate that Druidry was far from extinguished. (*NOTE: the word “pagan” is meant pejoratively and the Merriam Webster Dictionary has included in its definitions “heathen,” “irreligious,” “hedonist,” “follower of polytheism,” and “one who has little or no religion and who delights in sensual pleasures and material goods.” However, the truth is it comes from the Latin “paganus” translated loosely as “country” or “countryside dweller” or “rustic;” thus it was initially a word describing a person of locality rather than a religion.)

After the destruction of formal Druidic foundations in Britain by the Romans, the historical picture became confused and fragmented. But Irish literature indicates, even after the inception of Christianity and the waning of the Druidic influence as a political and social force, the Druidic teachings flowed directly into the Irish Bardic schools where poets were taught. In fact, this period saw great amounts of literature coming out of the Bardic colleges, producing the poetry of many of the Celtic legendary figures. At the same time, Celtic scholars, especially those of Ireland and , also produced many texts containing a good deal of information about Druids and Druidry. These Bardic schools continued to function in Ireland, Scotland and Wales, up until the seventeenth century, finally closing during political turmoil.

By the sixth century, all of Europe was Christian, and overt pagan practice had ceased to exist, having gone underground. Ironically, although Christianity was antagonistic to other faiths, it ended up also being built out of many elements of Druidry. As Christianity was being established in the Isles, many Celtic spiritual sites and popular rituals were adapted to Christian usage and what evolved was a unique and beautiful blend of Christianity and Druidry, known as the Celtic church. One of the elements it maintained was the connection with nature and with nature’s mysteries and there are stories of Celtic saints speaking with animals and plants, as the old Druids used to do. It has been surmised that this could have been due to the presence of surviving Druids who took shelter in the monastic sanctuary of the church, becoming monks and nuns and, as they were no longer forbidden to write, used the opportunity to infuse some aspects of Druidry onto the written page. Of particular fame is the “Carmina Gadelica,” the most complete anthology of Celtic oral tradition assembled; it is a compendium of prayers, hymns, charms, , blessings, literary-folkloric poems and songs, proverbs, lexical items, historical anecdotes, natural history observations and miscellaneous lore gathered in the Gaelic-speaking regions of Scotland between 1860 and 1909. In one portion, it actually refers to “, my Druid” and in another replaces with Christ. (www.druidry.org)

The Celtic church was less centralized and more monastic than the Roman church and was distinct from other forms of Christianity at that time. Although in many cases, these groups decided to join with the Roman church, Celtic Christianity, with its Druidic threads, was strong enough to have expanded into Europe.

What is especially interesting and pertinent is the fact that the influx of Celtic monks from the renowned Celtic monastic centers of Ireland, Scotland, and Wales influenced the new occidental Christian Church to such an extent that it ended up adopting a certain number of Celtic traditions that have filtered down to us, such as the concepts of the trinity (however, in Druidry, it is G-d the father, nature the mother and earth the daughter), resurrection and redemption, as well as ritual processions of clergy and parishioners, pilgrimages to sacred sites and even festivals of certain Celtic divinities such as , , and Dana, which were literally rehashed as festivals of St. Michael, St. Cornelius, and St. Ann; other Celtic goddesses became holy virgins, and the great queen of the Celts became the grandmother of Jesus.

Even the solstices and equinoxes were Christianized; however, the Church could not totally efface the indigenous social calendar because it was linked to important agricultural practices, with human (and other worldly) activities and spiritual processes following cycles of both vegetative and animal growth. Instead, festivals of sowing and harvesting the fruits of the earth, and the honoring of internal and external cycles, were reassigned to church festivals, and various saints became the focus of the rituals. This resulted in a solar-based Christian holiday calendar directly influenced by the Celtic festivals of the already established lunar-based Druidic calendar. The names-and the meaning behind the festivals were, however, molded to fit the Church, and they are still observed today.

Some brief examples are: Samhuin (Oct31-Nov2; Celtic New Year): = All Hallows; All Saints; All Souls Winter Solstice (Dec 21): Re/Birth of the Sun= Christmas (Birth of the Son) (Feb 2): Candlemass; Feast of St.Blaise; St Brigit’s Day Spring Equinox (March 21)=Easter Beltaine (May1):=Mayday; Roodmas Summer Solstice=St Johns Day; Lughnasadgh (Aug 1)= Lammas; St. Catherine’s Day Autumnal Equinox (Sept 21)=Harvest Day; Michaelmas

Each Celtic festival held, and still holds, a great deal of significance and beauty, both sacred and mundane, and is accompanied by detailed ritual; for more information, please see the OBOD website. (www.druidry.org)

(https://celticlife.com/)

CELTIC INDIGENOUS MEDICINE

(portions of the following have utilized and paraphrased information from the most amazing website, entitled, “Land Sky Sea” (http://homepage.eircom.net/~shae/contents.htm) which contains within it some of the most detailed information on Celtic cosmology that I have seen in all the years I’ve been teaching. Although other sources have been utilized as well, I would like to extend my gratitude for their extraordinary compendium)

In many cases, although some customs survived in a Christian framework, Celtic rituals and customs did not change to suit a Christian worldview. Remnants of ancient practices and rituals remained, especially in rural areas, as folk tradition; with this information, often handed down through generations and coupled with Classical and Bardic/Druid writings, it becomes possible to reconstruct concepts and rituals that reflect the pre-Christian Celtic belief system and worldview.

“It has long been recognised that the herbal knowledge of Indigenous people has some basis in scientific fact, and these days researchers are more ready to admit than many other folk that healing practices have some effect on the particular illnesses and injuries that beset all human groups. Indeed, such medicine is now dignified with the name ‘ethnomedicine’ and there are many studies of surviving Indigenous healing methods in Africa, the Americas, Asia and parts of Europe. The healing practices of the ancient Celts, and the approaches handed down and utilized even now, especially in the areas of modern Wales, Cornwall, Scotland and Ireland, are similarly worthy of study and consideration.” (http://homepage.eircom.net/~shae/contents.htm)

Celtic Indigenous medicine is, indeed, considered a form of ethnomedicine. The Celts were prevalent across Europe and, in spite of other tribal influences, they developed a well-defined, complex medical system specific to their spiritual and cosmological beliefs. Many of their healing practices came directly from the beliefs they held, evolving from their relationship with the land upon which they lived and how they viewed the world around them.

Once settled in their new land, the Celts developed a deep spiritual and physical connection to the land. They became primarily an agriculturally-based community and much of early pre-Christian Celtic spirituality was a response to the natural world in which they lived and worked.

The Celts devised a lunar calendar; the year was split into 2 halves--the dark time, which ran from Samhuin to Beltaine and the light time, which ran from Beltaine to Samhuin, with their days beginning the night before. There were 8 Seasonal festivals-4 solar, which corresponded to the solstices and equinoxes and 4 lunar, which fell midway between the solar, based primarily on cycles of growing and herding. Each of these festivals were accompanied by specific ceremonies to honor these shifts, generally intertwined with the use of the four elements, directions, and the circle as well as other objects relative to the ceremony and powers were invoked and evoked based on the intention.

Keenly aware of their dependence on, and interdependence with, the natural forces around them, the Celts did not pray to a power that existed outside their world in some far-off heaven. For them, power was present in this world. The elemental forces could wield their power to drastically affect human lives. In turn, the deities knew how to control the power of the elements, to balance rain and sun as needed for a good harvest, to hold back rivers from flooding and to bring together all the forces that could bring prosperity to an agricultural people.

Because there was never a separation between external shifts and those occurring internally, the interdependence and intimate relationship of “as above, so below, as within, so without” was a vital component during not only ceremonial times, but on a daily basis as well; as a result, ritual became an integral part of daily life.(http://homepage.eircom.net/~shae/contents.htm)

As it was commonly believed that humans needed to learn to live in balance with natural forces instead of trying to control them, everyone in the society had some knowledge of how to live in balance with the forces who shared their world. To demonstrate their dedication and to assist in these interactions, the people had an almost endless assortment of daily routines, charms prayers and rituals, as well as those held monthly, seasonal and yearly, all performed at certain times and days and accompanied by the right ritual actions or words that sought the protection and help of the deities, ancestors or otherworldly beings or forces.

Balance, then, was fundamental to the natural order and had to be maintained by ritual, work and the law. In the performance of individual ritual, deep, interdependent connections were built between the individual and the world of nature and spirit. Assembling together and participating in ritual and ceremony, under the guidance of a Druid as their religious leader, the community as a whole achieved balance in itself and with the universe. What the participants did in a ritual had significance for themselves, for their community, and for the world around them.

Celtic approaches to healing were, as with the entirety of their cosmological beliefs, animistic in nature. Because it was believed that everything in the natural world had a spiritual energy or essence that could be contacted, they did not pray to the natural world for good health; instead, in their interactions with the world around them, they learned to work in collaboration, understanding that a respectful relationship with the natural environment, the elements and those from the Otherworld, was required for the avoidance of illness and maintenance of good health. (http://homepage.eircom.net/~shae/contents.htm)

Celtic medicine was based upon an awareness of this relationship and the need for coherency and balance, not only for the community as a whole, but for each individual existing within it. Sickness, disease and death were often seen to arise as a result of disorder and imbalance; legends tell of many who met their death as a result of violating their “geis,” a prohibition or taboo placed upon them which, when broken, disturbed the order of things. Sickness was seen as coming from one of several events: as a result of actions that went against natural laws, a state of disruption in the balance of the regular world with the Otherworld, caused by certain inadvertent or disrespectful interactions with its inhabitants, or from malign influences such as the evil eye used by witches, faery or malevolent persons who had been offended. In fact, there is a consistency in the belief that offending any Otherworldly beings can result in sickness. (http://homepage.eircom.net/~shae/contents.htm)

At its foundation, Celtic views of the world stemmed from the recognition that they shared the land and its resources with other human beings, worldly creatures including animals, birds, plants, and trees and a host of beings whose presence was not always easily detected. Some seemed to travel between worlds, while others were more permanently attached to specific geographic features or parts of the visible world. The unseen beings could be friendly, indifferent, or even hostile, depending on who they were, what they wanted and how the individual behaved.

There were several categories of unseen beings with specific characteristics and, often, specific places they called home.

1. There were those spirits that were linked to the natural forces and spirits associated with landmarks and the weather, including the elements (sun, moon, wind, storm, dew, rain); they were part of the visible world and their purposes might run counter to those of human beings.

2. There were powerful beings depicted with some anthropomorphic characteristics but who were still distinctly "other." They had the power and skill to control the weather and other natural forces. Humans could become their clients and enlist their aid. As the Christian era progressed, these figures were perceived as fallen angels or demons, but were commonly called by the Celts the Sidhe or faery. (http://homepage.eircom.net/~shae/contents.htm)

Much has be written and sources describe a variety of different types and relatives; it begins, however, with the Tuatha de Danaan, the people of the Goddess ( in Irish) who is the Celtic land or Mother goddess. They were considered supernatural angelic-like beings who came to Ireland and, after several battles, decided to go underground and live in barrows and cairns; this new habitat led to another name for them and they became known as the Sidhe. The more common, widely-known name of "fairy" came from the unwillingness of the people to call the Sidhe or Danaan folk by their name, for that was considered bad luck. Euphemisms such as "hill folk," "the gentry," "wee folk," "good folk," "blessed folk," "good neighbors," or "fair folk" abounded, and "fair folk" was shortened to "fairies;” they have also been called "faery," “fey,” or the “Ancient Ones.” http://www.csun.edu/~hceng029/yeats/funaro.html

Some sources describe a variety of different types and locations of their home; some say the faery or Sidhe come from TirnanOg-Land of Ever Young, while others say they either live underground in fairy mounds, across the western sea or in an invisible world that coexists with the world of humans, like a parallel universe. I personally have come to know them as the Sidhe, the Shining Ones of the Hollow Hills(http://homepage.eircom.net/~shae/contents.htm)

All the Sidhe (or Si, in modern Irish) were associated with many supernatural abilities. Believed to live side by side with the human world, both beneficial and harmful interactions would take place. Fairies were feared to be interested in stealing people, especially babies of new mothers, and if someone took ill, they could be accused of being a "changeling," left by the Sidhe in place of the original healthy individual. The dreaded "Slua Sidhe" of fairies was an evening cavalcade, out to do some mischief or harm. The Sidhe, however, were also welcomed when they helped the poor, did chores, left money for people or endowed them with great talent, so they weren't always considered devilish. All faery/Sidhe, no matter where they are, or what kind they are, are both good natured and bad natured, They can use their magicks, glamour and ability to heal or to hurt, and often they are said to be rather selfish. If you should disrespect them or impede their activities, you will likely encounter some type of revenge or will be required to make “payment” to rebalance things. http://celticsociety.freeservers.com/sidhe.html;l http://grovesofannwyn.tripod.com/TypesOf.html ; http://homepage.eircom.net/~shae/contents.html

The Celts were very aware of the variety of unseen beings with whom they were in relationship, and they were also aware of the two other environments over which they had no control but which were intimately linked to daily life. These were the Underworld and the Otherworld. “The Underworld was inhabited by the dead and the Otherworld by the deities. Although both worlds are separate, the distinction between them could be blurred. The myths show that living people occasionally visited both worlds, but traffic was more common in the other direction. The deities seem to have been able to enter the physical world at any time but the dead had to wait for liminal times when thresholds could be crossed. These coincided with a change from one state to another such as at dusk, when the new day began and, most especially, at the Celtic festival (Samhain in modern Irish) that marked the end of the old year and the start of the new. Overall, there is a somber, dark heavy energy here. However, based upon the situation, it was appropriate to attempt to contact the spirits of Ancestors or particular spirits of the dead who could be called on to lend help to living humans.

By contrast, the Otherworld was bright and cheerful with abundant food and drink. Time passed at a rate different to that of the ordinary world. Its inhabitants were ageless. Existing parallel to our world, the Otherworld was the principal home of the ancient Celtic deities. The Underworld is closely related to the Otherworld and sometimes equated with it. Both represent dimensions where mysterious beings and creatures lived.”

Although they emanated from the Otherworld, the deities were thought to be both like and unlike humans. The pre-Christian Celts did not see their deities as abstract, universal archetypes or indifferent, uninvolved powers. They were thought of as personal, conscious, unique, and specific beings who were interested in the affairs of this world and acted to directly influence the course of events. Deities could be powerful allies if you maintained a good relationship with them. Humans who were willing to dedicate the time and energy necessary to cultivate a relationship with deities could count on their help in times of need. However, it was believed that disaster might ensue if the relationship were neglected.

Healing magic might also involve invoking a deity of health and healing such as Airmid (Irish), Diancecht (Irish), Laeg (Irish), Meg the Healer (Scottish), Miach (Irish), Ariadne (Welsh/Cornish/Breton), or Clota (Scottish). Airmid was the daughter of the God of Medicine, Diancecht. She was a magician and herbalist adept in all the healing arts.” (http://homepage.eircom.net/~shae/contents.htm)

An additional environment that impacted the health and well-being of both individuals and the community was that of the “Betwixt and Between.”

There was power inherent in the times and places between the fullness of times and places. In fact, between these states of being exist shades of gray, the intervals of dawn and dusk, the moments as one year ends and the next begins, the space between land and water, flatland and forest. Liminality is the quality of these threshold states that can refer to time of day or year, sexual identity, physical location, state of mind, being, weather, or social role.

Liminal people included poets, seers, and musicians because it was believed they could contact the Otherworld. Seers and poets who crossed to the Otherworld were expected to bring back direction and guidance that might involve change or return health and they were often asked to do so on behalf of another or the community. Liminal places included forests, seashores, crossroads, territorial boundaries, caves, river fords, wells, bridges, and burial grounds. Such places held inherent power and were likely sites to encounter deities, the dead, and other non-human entities from whom information could potentially be obtained. (http://homepage.eircom.net/~shae/contents.htm)

OTHER SOURCES OF POWER AND SIGNIFICANCE FOR HEALING

THE HEALING POWER OF HERBS The ancient Celts were close to the land, so they knew about the healing plants of their world and used the plants around them. Celtic herbalism was born.

Herbalism-Celtic Ethnomedicine-categories were well established and have been the source of Western herbal medical study. Use of herbs by Druids and Scottish Highlanders are found in manuscripts from the 8th c and even before for variations of illnesses and healing; they offer valuable medical information that has been and is still being used, although much of the healing lore has been lost.

Some specific herbs that were utilized are described here: “IN CELTIC TRADITION, HERBS WERE PLANTS USED FOR AROMATIC, SAVORY OR MEDICINAL PURPOSES AND OFTEN HAD ASSOCIATIONS WITH SPECIFIC CELTIC DEITIES. DRUIDS WERE ESPECIALLY SKILLED IN BOTANY AND THE USE OF HERBS AND POISONS. DOSAGE FORMS INCLUDED TEAS, TINCTURES, FOMENTATIONS, SYRUPS, AND SALVES, COMMONLY USED HERBS INCLUDE: ANISE, BLACKTHORN, CARAWAY, CHAMOMILE, DANDELION DILL, ELDER, EYEBRIGHT, FOXGLOVE, WILD , WILD GARLIC, GINGER, HAWTHORN, HORSE RADISH, IVY, JUNIPER (THE BERRIES WERE BELIEVED TO HAVE PROTECTIVE PROPERTIES AND WERE BURNED IN THE SCOTTISH HIGHLANDS FOR PURIFICATION), LAVENDER, MINT, (FAVORED BY THE DRUIDS, AND OAKS SPORTING MISTLETOE, WERE MOST SACRED. THIS WAS ALSO SEEN AS A SIGN FROM THE OTHERWORLD), PLANTAIN, ROSEMARY, ROWAN (BELIEVED TO AVERT THE EVIL EYE AND VERY PROTECTIVE.), SKULLCAP, SORREL, ST. JOHN’S WORT, VALERIAN, AND YARROW (A SACRED HERB USED AS A LOVE CHARM AND ONE OF THE FAMOUS HERBS OF THE “LANCASHIRE WITCHES)” (https://www.selfgrowth.com/experts/jonathan_klemens.html)

HERBS USED AS PREVENTION Since sickness was often thought to have its origin in the Otherworld and prevention being better than a cure, plants and trees were also widely used for protective magic and had an important role to play in the maintenance of health.

RITUALS CONNECTED WITH THE PICKING OF HERBS Not surprisingly, herbs had to be gathered in the right way; that is, with the appropriate actions, charms and invocations. NOTE: there is practical and sensible advice about the drying of the parts of this plant, interwoven with the rituals. The time of gathering according to the heavens, the propitiation of the earth or earth spirits, the use of the circle drawn with iron, were as much part of their science, their systematic and formulated knowledge, as the method of drying the plant. (http://homepage.eircom.net/~shae/contents.htm)

A Statement of Intent would have been an important part of the ritual gathering of the plant as well, since the spoken or breathed word was thought to be magically potent. However, there are other components in this healing ritual which re- occur throughout Celtic healing folklore, including the use of water, especially from wells, and use of medicinal plants and herbs, repeated a certain number of times. THE POWER OF THE ELEMENTS (Earth, Air, Fire, Water)

Fire & Water were particularly Important Elements in Celtic Thought & Belief

** Both were used to traditionally cleanse the circle to create sacred space prior to Druid ceremony. **The Druids believed that a person’s soul and the universe were indestructible although fire and water could, at times, prevail over them. **Fire and Water used together in incantations protect against an ill-omened bird **Both Fire and Water can be destructive and life giving. **Both Fire (as the Sun) and Water have an important role in healing.

FIRE gives warmth and light, symbolized with sun; possesses the power of transformation and when harnessed is helpful for cooking; ritual burning of an object was thought to destroy it in this world but send it transformed into the Otherworld. As the Sun, it is a source of great healing energy; sunrise considered an especially potent time and good for enhancing the effect of healing rituals. Walking 3 times around a fire or sacred place was a potent ritual action as it imitated the circling of the sun (always walk diesel) to draw down its beneficial powers prior to any undertaking.

FIRE was venerated as a most sacred and holy thing, bringing blessings or divine favor and could strengthen and protect. It was unlucky to carry fire out of a house where a person was ill for to do so was to take away the blessing from the house and possibly the sick person’s spark of life. Fire was also used during some of the seasonal festivals: during Samhuin, cattle coming in from the fields for the winter would be walked between 2 fires to clear any vermin and people could throw things they were ready to let go of into the fire also at Samhuin to start a new year; at Beltaine, people would jump over the fire and the bonfires symbolized a new summer.

WATER mediated between the other realms, traveling from the sky as rain and returning as evaporating dew after making the land fertile. Water also connected humans with the Otherworld. According to Irish stories, at least some rivers were thought to originate in wells in the Otherworld and then flow into this world. Such rivers, and wells and springs, were thought to carry the power and knowledge of the Otherworld to this one. Sacred to the Celts, many offerings of weapons and ornaments were thrown into lakes, streams and rivers. As with Fire, sending them into the water may have been thought to send them to the Otherworld. Water was also associated with Wisdom and is associated with regeneration and rebirth.

WATER was considered a cleanser and a vehicle or medium for carrying things, seen and unseen. Its medicinal qualities alone were highly regarded, especially if it came from a particular river or well; some lakes and rivers were thought to have healing properties and the power to cure ailments. It had the power to cure ailments. It was believed that circling a spring well sunwise (deasil) and leaving an offering might cure disease. Used in folk healing, WATER was used as a medium for making up herbal potions, used to absorb and take on the healing and beneficial qualities of other objects; it had the ability to absorb or carry the magical and curative effect of prayers and incantations. Plant, animal and magical cures were commonly combined with water, often administered three times. OTHER FORMS OF WATER USED FOR HEALING -As a form of water, Spittle was widely used as a healing and protective agent. It was often thought to be even more effective for healing if it was mixed with the soil or dust from a sacred well or site. Lady Wilde records that fasting spittle, especially if mixed with clay from a healing well, was especially efficacious.

-The Water of Life –‘uisge beatha’in Gaelic, usquebaugh in Scots and Whisky in English, it considered to be almost a panacea, given for a variety of ailments but believed to be specific for smallpox. Clearly confidence in the medicinal value of whisky endured in Scotland long after the Middle Ages. (https://celticlife.com/)

SWEAT HOUSE Sweat houses were an essential folk-medical site in rural upland areas. Looking a little like stone igloos covered by grass and earth, the interiors were heated with turf, and patients entered and spent time in the closed settings and sweated out their fevers. An account from Rathlin Island on the north coast of Antrim noted: “…that previous to the bath, a fire was kindled inside, and when it was sufficiently heated, the ashes were swept out. The people came to be cured of the pianta fuar, as she called the rheumatism, the Irish name meaning literally ‘cold pains.” (Mulcahy 1903, 589).

While one of the concerns of formal medicine was the lack of regulation they associated with folk medicine, there was evidence of some good regulatory practice at sweat houses. Used to cure flu, arthritis and rheumatism, they were sometimes regulated by itinerant bath masters who would check potential users as to their ability to withstand the rigors of the sweating cure. More importantly, sweat houses were privately or communally owned, providing a service to extended families and small communities in remote locations especially in the northern half of the country. This was especially important in locations where any form of conventional primary health care service did not meaningfully emerge until the end of the 19th century when a network of dispensaries, as part of a new ‘medico-administrative’ apparatus of power, introduced a more regulated set of public health spaces into the Irish countryside. But up to this time, sweat houses, similar in form to Scandinavian sauna or Mexican temazcalli, developed epigenetically and provided a form of local empowerment and ownership over a set of necessary healing practices. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352604/figure/ )

STONES QUARTZ/ROCK CRYSTAL: The ones that sparkle in the sun and give a pale glow In moonlight were highly prized; seen frequently at ritual sites in Celtic countries. Properties could be harnessed medicinally by placing them in a bowl of water, the water then being drunk or applied to a part of the body in need of healing.

OTHER STONES: The same was done with certain stones, especially white ones, and metal objects which were thought to have special powers - especially gold, silver and iron. Although rubbing the affected part with them could access their powers, they were also placed in water which was then used medicinally. Sometimes small stones which resembled a part of the body had to be rubbed on the appropriate part.

DIET AND CARE OF THE SICK Manuscripts have been found that place emphasis on diet, exercise and care of the sick (eg. keeping them away from nose and disturbances); sleep and music were also used to help in caring for the sick.

THE POWER OF THE SPOKEN WORD-ORAL TRADITION

The SPOKEN WORD was seen as possessing magical and creative power. It was used FOR HEALING through use of which was defined as a particular format of spell-work in which the words are chanted or sung, it is built up by the repetition of words, phrases, sounds and cadences to produce a hypnotic effect. The GOAL was to create an altered state of consciousness both for person reciting and for listener(s), making them more receptive to suggestion.

HEALING CANTATION COMBINED WITH RITUAL ACTION -Simulates ridding the sufferer of disease, -Also use when drinking or applying healing herbs or objects; reinforces the intention -INCANTATION must have a powerful and positive effect. -USE NAMES OF POWER-Deities and the Ancestors -often used in incantations and were thought to actively summon up the powers of the deity or being so named.

The lulling and hypnotic effect of the incantation or charm often made ritual actions more effective. Being in the presence of a healer, a person known to have special powers also had an invigorating effect on the psyche and immune system of the patient. (http://homepage.eircom.net/~shae/contents.htm)

RITUAL ACTIONS Symbolic/highly dramatic, were also a feature of folk healing -Other ritual components found in Celtic healing folklore -USE of water, especially from wells -USE OF medicinal plants or herbs, repeated a number of times

USE OF “RIDDANCE” OR “TRANSFERENCE” Used with charms and incantations, idea here that the illness overwhelms the person, but by transferring it to other beings and elements it not only leaves the person but is redistributed so that it loses its power to do harm and a better balance is achieved. Another charm sends a part of the malady onto ‘the great surging sea’ for ‘She herself has the best means to carry’ and we see here again the role of water as transporter and cleanser.

STORY-TELLING An important part of Celtic society, its uses and benefits went far beyond that of mere entertainment and social cohesion. In the process of the telling the ancestors were brought to life and their supernatural powers affirmed. The people of the tribe or community were brought into contact with the myths that affirmed the values and truths that were believed to underpin the mundane world. Folk traditions were abundant, using stories as their means of sharing the information. TREES AND GROVES Many trees were hallowed including the rowan, hazel, oak, and yew. The veneration or worship of the oak tree or oak-god was commonplace in Celtic and non-Celtic Europe; it could be used as food (acorns ground for flour) and to build shelter. Gatherings and festivals were often held in sacred oak groves.

In popular writing, the oak is most closely associated with the Celts, and there is little doubt of its importance. Pliny writes that oak trees had especial significance for Druids, and that they conducted their most sacred rituals in oak groves. However, geographical location seems to have dictated the variety of tree held sacred by each tribe.

Each tree, shrub and bush was valued for the benefit it provided, irrespective of its place in the hierarchy. Although some oaks were especially sacred to the Celts, the tree's main importance was for provision of acorns on which domesticated pigs could feed during the winter. Hazelnuts were a valuable source of protein and other nutrients for humans during the lean winter months. Other trees and shrubs were used to dye cloth, tan leather or for medicinal purposes. Apart from their more mundane uses as sources of food, medicine, dye-stuffs and building materials, trees were also associated with fertility of the land.

Respect for their land and environment is very evident in the mythology of the Celts. Many deities are associated with natural features such as mountains and rivers, and with trees and animals. Some scholars suggest that deities "dwelled in the landscape and presided over all human undertakings." Such capricious forces might manifest themselves in almost any form and therefor merited respect.

CIRCLES To move in a circle like the sun was a way of putting oneself in alignment with the movement of the Heavens and was appropriate and beneficial; And, by putting oneself in harmony with the order of things it was thought to be a health benefit; to walk COR DEISEIL (in a sunwise motion) is the natural way of things asserting the power of truth and order. Circling Deiseil around a location or a person not only showed respect, it was also a means of protection.

Also, as the Sun was considered a source of great healing energy, sunrise was an especially potent time and good for enhancing the effect of a healing ritual.

When performing ceremony or when walking around a fire or at a sacred site, it was taught that one should always walk sunwise or deiseil, usually a certain number of times; three is usual, but it could be seven or nine. Walking in this way was considered a potent ritual action because it imitated the circling of the sun and would draw down its beneficent power on any undertaking.

In contrast, moving WIDDERSHINS or COR TUATHAL against the sun, was usually reserved for cursing and rituals of harmful intent.

However, in some instances it is appropriate to move WIDDEDRSHINS and can be used as an unwinding or a banishing of something as well as a way of getting rid of the disease.

It is said that one way of bringing about a cure was by passing the afflicted person or animal through a circle, believed by folklorists to symbolize regeneration, a new birth. The circle could be made of a variety of materials, from woodbine, to yarn, to a cleft in a tree or a hole in a stone. (http://homepage.eircom.net/~shae/contents.htm)

Personally when performing ceremony or creating sacred space, I will open the circle by moving deiseil and when I am unwinding it and closing it down, I will walk widdershins.

BIRDS Birds, including the raven, swan, goose, owl, eagle, ouzel, and crane were considered sacred in the Celtic culture. Birds had special significance for the early Celts. Their ability to fly was akin to freeing the soul in death, symbolism often found in Celtic Christian iconography. Mythology contains many instances of birds as Otherworld beings or as messengers from the Otherworld. Waterfowl were especially revered because they were associated with air, land and water, often regarded as thresholds between this world and the Otherworld (especially the crane).

ANIMALS Other divine animals included the dog, cat, wolf, bull, boar, stag, horse, bear, salmon, ram, serpent, and butterfly. These animals are often depicted in intricate knotted patterns. Animals were mythically important to the Celts too. Boar, deer and other animals have already been mentioned in connection with the hunt and farming.

Even more importantly, the deities could transform themselves into animals, and the Celts often identified deities or their powers with animals. They never knew if the animal they hunted was a deity or not. Although deities could assume the shape of animals, the Celts also believed that animals, or at least representations of animals, had special powers of their own or through their association with deities. A number of myths and stories depict animals as helpers and guides, especially in liminal areas such as the forest or sea or the entrance to the Otherworld.

Creatures, too, might not be what they seemed and many animals were thought to have inherent magical power or wisdom. One Scottish prayer invokes the power of the raven. Some cranes were thought to be able to speak with humans. Seals, if they cast off their skins, might mate with humans and from such encounters would come a dark-eyed family that told each And sometimes animals and birds could be the shifted forms of deities.

DOCTORS, HEALERS, PRACTITIONERS IN THE CELTIC WORLD

I. CLASSICAL ACCOUNTS-EARLY HEALERS Not a great deal was written during this time as Druidic training was an oral tradition; however, based on what is known of their training, it would seem apparent that some form of healing was known to them, especially in the case of the Ovate. The Classical writer Pliny the Elder (23-79 AD) did call them healers; Strabo described the Ovates and Druids as “natural philosophers;” and Julius Caesar described them as being “skilled in the workings of nature,” these latter two comments allude to them having some knowledge of herbs and other natural medicines and healing. (http://homepage.eircom.net/~shae/contents.htm)

Additionally, for the Celts, as much illness was attributed to Otherworldly influences, it was to be dealt with in the same manner; to that end, many of the healing practices and tools already listed, were most probably utilized, perhaps with the assistance of a folk healer as well as potentially having Otherworldly intervention perhaps by a faery doctor, a seer physician or a Druid or Ovate.

II. SEER PHYSICIANS/FAIRY DOCTORS Celtic Seers and Diviners were often utilized to seek knowledge of what other’s should do; in this case, they would be called upon to do so to aid in the healing of another, with their own supernatural knowledge and powers as well as enlisting Otherworldly aid. Also, according to one medieval account of medicine in Ireland, it was expected of the greatest physicians that they should be able to diagnose each illness of the various members of the family from the smoke rising from the hearth, giving another demonstration of the connection between divination and healing. (http://homepage.eircom.net/~shae/contents.htm)

Fairy doctors, found in Celtic folk traditions, obtained their knowledge and healing abilities from the Otherworld. They were able to converse with the fairies and other spirits in order to find out what the cause of a person’s illness was and how it might be cured. There is a consistency in this belief, namely that offending Otherworldly Beings results in sickness. The fairy doctors and traditional healers of the Celts were able to restore right relations with the Otherworld and bring about healing.

III. PROFESSIONAL PHYSICIANS/HEREDITARY PHYSICIANS As the name implies, there were men during medieval times that, without the aid of supernatural skills, used medicine and healing methods to successfully treat. Often, they were army physicians, belonging to troops; they treated the injured by putting plants and herbs into their wounds and, in some cases, possibly performing types of surgical procedures.

By the Middle Ages, Celtic social life was primarily organized on the clan system of lineage-based groups owning and occupying a particular territory. Clansmen were usually kinsmen of their chief, but a clan would also include unrelated families drawn in for protection or other benefits and in time assuming the clan name

It was characteristic of Celtic society in Ireland, Scotland and Wales to have learned and professional classes who adhered to a strong hereditary principle, had rights and status in law and were bound to clan leaders and princes. It was also commonly thought traditionally that these families of physicians were descended from someone who has been given access to Otherworld knowledge; a tradition arose that their healing skills had come from a fairy. (http://homepage.eircom.net/~shae/contents.htm)

The health of a Highland chief and his immediate kinsmen would be safeguarded by his hereditary physician according to strict legal requirements. For example, any man who injured a friend or neighbor physically was obliged by law to provide for the care of his victim until recovery was confirmed by the physician. The care of the common people was another matter, for illness and injury would be treated within the family, with the advice of a wise woman or healer versed in the herbal remedies and healing charms handed down through many generations. . (https://celticlife.com/)

With the arrival of the Christian religion to replace the old Druidic rituals, Irish scholarship flourished, spread to other Celtic lands and no doubt brought with it some skills in tending the sick. As the clan system developed in both Ireland and Scotland, the chiefs began to surround themselves with personal entourages of learned men, including physicians, and the link with the Church progressively diminished, though the hereditary nature of medical practice continued.

In Celtic Ireland, the early physicians appointed to noble Irish clan families were highly educated men, with connections to the great European medical schools such as Louvain and Padua, while some other hereditary physicians established medical schools of their own in Ireland.

In Celtic Scotland there were comparable medical families; one of whom and perhaps the most famous in Scotland, the Beatons, provided medical service not only to noble clan families, but also to the Royal House of Scotland, serving the Scottish kings from the 14th to the 18 Century.

The attachment to clans of hereditary learned men began to decline in the 17th Century and died out in the succeeding one. In the early period of the clan system, bards and breves were ranked higher than leeches in the chief's hierarchy of attendants but physicians gradually rose in status and in the end were the last of the learned men to be attached to the chiefs' retinues.

As late as 1784, descendants of the hereditary medical dynasties were still established as physicians to some of the great families in the Western Isles, though generally clan affiliations had ceased. Many members of the medical families continued to practice medicine but in the Lowland Scottish tradition based on university medical schools and apprenticeships, rather than in the traditional Celtic way. (https://www.rcpe.ac.uk/heritage/hereditary-physicians-celtic-medicine)

It was in the Middle Ages, then, that there began to clearly emerge two streams of health care in Celtic society – the first was medicine as practiced first by Ovate/Druid, then by the Christian clergy and army physicians, following soon after by the Clan Chiefs’ professional /Hereditary physicians and the second was through transmission of a great body of folklore/folk/ and Traditional medicine passed down, primarily through an oral tradition and practiced by both countryside folk as well as by those Ovates and Druids who survived but went into hiding.

The later clan physicians would have known about the nostrums and charms of folklore and ignored or disparaged them in public. Nevertheless, with their inability to cure prevalent diseases such as smallpox, they probably tacitly condoned the herbal and other remedies of wise women, though their written manuscripts did not record such Indigenous treatment and were based almost entirely on classical sources. They translated into Gaelic the great medical texts originally written in Greek, Latin or Arabic, adding glosses of their own, and in so doing extended medical knowledge and made it more widely accessible throughout the Celtic world. (https://celticlife.com/)

In regard to the evolution of Celtic medicine in Wales, it seems that some of the Welsh medical manuscripts show more native influences than those of Ireland. There are not many charms, but many of the recipes are fairly simple, unlike the more complicated remedies of the learned European tradition. They are of two types, lists of remedies for specific diseases and recipes. The prose is of a more native kind similar to that found in the works relating to bards and lawyers. It is characterized by numerical groupings, including triads, which made them easier to learn; it is interesting to note that this format was one utilized by the Bards, Ovates and Druids as they were required to commit vast amounts of information to memory--they also grouped information in triads as three was a sacred number.

IV. WOMEN HEALERS Although the physicians in the Irish laws and legends are commonly referred to as ‘he’, there is evidence that women were also physicians and healers throughout Celtic lands. An ancient Irish manuscript states "It is worthy of remark that in our legendary history female physicians are often mentioned: and so we see that in ancient Ireland the idea was abroad which is so extensively coming into practice in our own day." What training these women had and how they fitted into the system of medical care in ancient Ireland is unknown. It seems likely that their knowledge was passed down orally and that they treated the common people of the territory for everyday ailments and wounds rather than battle-field injuries or those that were the subject of compensation claims. An alternative possibility is that they received training previously either from or as a Druid. As it is the case that men and women held equal status and both men and women could study and attain Druid status, it would follow that training might have occurred and, during the times of hiding, they utilized their knowledge as a folk-healer, a faery doctor, a midwife and/or an herbalist. (http://homepage.eircom.net/~shae/contents.htm) V. FOLK MEDICINE/FOLK HEALERS In the early Celtic world, there was general belief in the supernatural – fairies, demons and the threat of the evil eye (‘droch-shuil’) and there were certain people who were believed to have occult powers while others were able to exorcise evil spirits. These beliefs were complemented by a deep knowledge of the therapeutic properties of plants, animal products and other materials, even water. The wise women and other gifted individuals would use these medicinal substances in combination with charms and incantations in the treatment of disease.

In medieval Ireland there were healers who ministered to the needs of the people of the túath and were distinct from the official, qualified doctors who helped to administer the sick rule of law and tend to the victims of violence and injury. As in most societies, these men and women and their counterparts in Wales and the Highland and Islands of Scotland, continued to heal the sick, wounded and mentally ill in their communities up to the present time. Many of these native physicians healed in a way that reflects that of the seer-physician of the Táin and earlier Celtic tradition. They were ‘knowledgeable’ men and women who had healing abilities and who, in an almost shamanic way, were able to converse with supernatural powers in order to cure illnesses, find lost things, remove spells and predict the future. Some of these healers gained their knowledge from learning and books, some purely from the fairies or other supernatural beings, some from a combination of both. In Irish folk tradition the various ups and downs of life that people had no control over were generally put down to the activities of Otherworld beings. The fairy doctors were able to restore the balance with the fairy world and so bring about healing. (http://homepage.eircom.net/~shae/contents.htm)

VI. SURGEONS AND BONE SETTERS Surgery was practiced from the earliest times - there is evidence, for instance, of trepanation (the making of holes in the skull) being carried out in the Bronze Age in Scotland, from a skull found on the Isle of Bute. It also appears that there were British surgeons in existence in the 50s CE s as a grave was discovered in Southern England containing medical instruments. The 13 instruments found would have enabled the surgeon to carry out a range of procedures, such as cutting, excising, retracting, extracting and dissecting. The Irish law tracts, while silent on the techniques and range of the surgeons’ activities, confirm that surgical procedures were carried out in Ireland.The Bretha Crólige shows that the physician was allowed to cause bleeding during his treatment but he had to pay a fine and meet the cost of the patient’s sick-maintenance if he cut a joint or sinew.

It should be noted that, whereas in other parts of the British Isles surgeons developed from barbers and until comparatively recently were of inferior status to physicians, the Celtic physicians combined medical and surgical skills, and were expert in such procedures as trephining, venesection and cutting for the stone.

Bone-Setters have certainly existed in Wales, Scotland and Ireland since the medieval period and probably longer. Like the charmers and other folk healers, bone setting was something that ran in the blood and bone setters were gifted with ‘the touch’. They practiced their skill alongside their normal occupations. Their particular skill was in healing sprains and dislocations and, although there were certainly some who missed tubercular joints and failed to detect fractures, there were many who were very competent in what they did and enjoyed a good reputation. Massage, binding of the affected part of the limb and the faith the patients had in the bone-setter were all part of the practice. There were also several versions of a charm which was widely used for sprains and dislocations.

Indeed, as an empirical example of authentic practice, the bone-setter was and remains an important folk practitioner across cultures and has strong links to contemporary authenticated forms of CAM like osteopathy and chiropractic.

In Ireland, the bone-setter was a valued folk medical practitioner across the province of Ulster. While they often carried out an itinerant practice, moving from place to place as needed, they also operated from known locations to which they drew in turn a handsome clientele. Almost always male, they drew on a wealth of often hereditary experience, as well as what they learned from their fathers and grand-fathers; as far as their patients were concerned, this gave them as much authenticity and ownership of practice as any professional physician which allowed them to continue to heal. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352604/)

VIIA. SEERS (summarized & taken primarily from this wonderful site; http://homepage.eircom.net/~shae/contents.htm)

Tales of the Celts, whether historical accounts, medieval myths, or more modern folktales, are filled with references to the ability of some to see and know what is hidden from most. This ability has given the Celts as a whole the reputation of being mystical dreamers, when in fact, though the belief in such abilities is widespread, it has always been believed that only a few receive what in English is called the "sight."

Those with the sight obtain knowledge either by a sudden knowing or through a vision. Such visions are often symbolic and easily misinterpreted. Sometimes, they may be startlingly real, like watching a video in one's mind, but frustratingly incomplete. A seer may see an accident occurring but have no idea when or where the event is supposed to take place. Other times, the seer simply knows the answer; suddenly the knowledge is simply there in one's mind. It may even come as a feeling that the knowledge is passed into one's body like an electric charge so that the experience may be more a bodily knowing than an intellectual one. There is also evidence that some Celtic seers spoke from a state that might be likened to trance, in which the seers did not actually realize what they were saying and might have no memory of what they had said once they recovered from the trance-like state. Sometimes, the experience combines several of these elements so that, for example, the seer sees the events in a vision and knows when and where they will occur.

It is thought the art of Celtic seership may have reached its height in the pre-Christian period when such skills were valued. In those days, gifted children and young adults were probably guided and trained by elders with experience and skill. Remnants of these traditions can be found in descriptions left by poets of medieval Ireland. Although some of the seer's skills were banned by the Christian establishment, others were permitted.

Every culture has its own words for talking about what visionaries and seers do. Like many, the Celtic traditions use words and images relating to sight and vision to talk about the ineffable experiences of shamanic-type practitioners and others who journey to the Otherworld. For example, the Irish term imbas (modern iomas) means "vision that illumines." As such, it refers to the ability to see what is not visible to most. Imbas also means the experience of having that vision. Combined with forosnai, the term also refers to a method of inducing vision. The Welsh awen has similar meaning and use, and awenyddion refers to the insight that comes from receiving awen. Awenyddion also refers to practitioners who went into trance and made ecstatic utterances.

All these concepts were the opposite of sous, the Irish term for the knowledge obtained by study and scientific or rational investigation. The Irish term fios refers to knowledge obtained through inspiration, contact with the Otherworld, or mantic insight. In modern Irish, fios or fios feasa can be used to refer to what is sometimes called second sight. The person who has this ability is called fer (man) feasa or bean (woman) feasa. If their gift includes the ability to heal, then the practitioner is likely to be called fairy doctor or herb doctor in English.

In Scottish Gaelic, this ability is more likely to be called da shealladh-"two sight" or "double sight." The phrase refers to the ability to see two worlds-this world and the Otherworld-at once. The vision itself is known as taibhs (the same word is used for ghost or wraith). The visionary person is called a taibhsear and the process taibhsearachd. The sight includes the ability to see the dead and the non-human. It may also include the ability to know what is happening at a distance or what will happen. Sometimes the knowledge comes because it is sought, or it may come unbidden; this can be quite upsetting, especially if it concerns bad news.

The second-sight is a singular faculty of seeing an otherwise invisible object, without any previous means used by the person that sees it for that end; the vision makes such a lively impression upon the seers, that they neither see nor think of anything else, except the vision, as long as it continues: and then they appear pensive or jovial, according to the object which was represented to them. At the sight of a vision, the eye-lids of the person are erected, and the eyes continue staring until the object vanishes.

The sight was also thought to include knowledge of how to cure illness, especially illness resulting from curse or "fairy" attack. Since seers often knew a great deal about herbal treatments, they could combine this knowledge as well. Visions may come as literal views of what is or will happen-like watching a video-or they may be symbolic. For example, among Scottish seers, a common symbol was to see an impending death as a body with a shroud upon it. The position of the shroud indicated when the death would occur. If the shroud completely covered the body, death was imminent, a matter of hours. If the shroud came up to the waist only, then death might be delayed by several months. Sometimes the seer might misinterpret symbols or other parts of a vision.

Earliest Images of Celtic Seers The earliest evidence of religious belief in Celtic culture comes from the objects found in graves or at religious sites. Since the ancient Celts did not record their beliefs, we can only guess at the significance of these objects. Some information regarding their cosmology and spiritual tradition has been handed down through an oral tradition, as well as by Celtic church documents.

In the Classical period, non-Celtic writers generally agreed that there were three primary types of religious specialists among the Celts of Continental Europe. While the titles and occupations vary somewhat, they were generally seen as the Druides, /Ovates (also often labeled as Seers), and the Bardoi or Singing Poets.

Types of Seers In the medieval period, traces of five types of seers were found in both Ireland and Wales. (i) Druí: Irish sources depict Druids as priests, seers, astrologers (in the ancient sense), teachers of lore, and witnesses of oaths. However, by the time of the earliest law texts (7th-8th centuries), Druids have been reduced to the status of sorcerer (in a pejorative sense) and their status became mixed. (ii) Fáith: a seer, although the sight was also one of the functions of the poet. (iii) Fili, éces: a poet could be a powerful figure in early Irish society. The poet's main function was to satirize and honor through verse. Thus, the poet controlled the distribution of honor, an extremely important commodity in all Celtic societies. Conversely those who satirized without cause were subject to harsh penalties. In myths, fili and other poets are depicted as acquiring their skills from the Otherworld, though it is clear from the laws and texts on the poet's art that they also spent long years learning the complex rhyming schemes and other metric rules that were required of poetic artists among the Celts. (iv) Fénnidi: historically, the fénnidi were young, usually landless, warriors who left their family groups to live in marginal areas such as the forest. They lived in a warband-type group called a Fian led by the Righfénnid. They survived mostly on what they gathered or hunted in the forest. Literature suggests that they were required to find the animals, appease the protectors of the animals, and ward off hostile forces; to accomplish these acts, they may have utilized their “sight” which could have been considered a sort of hunter shamanism.

(v) Awenyddion: in the 12th Century, Gerald of Wales wrote about his travels in which he described the activities of some poets, stating:

“Among the Welsh there are certain individuals called aweyddion who behave as if they are possessed by devils. You will not find them anywhere else. When you consult them about some problem, they immediately go into a trance and lose control of their senses as if they are possessed. They do not answer the question put to them in a logical way. Words stream from their mouths, incoherently and apparently meaningless and lacking any sense at all, but all the same well expressed: and if you listen carefully to what they say you will receive the solution to your problem. When it is all over, they will recover from their trance, as if they were ordinary people waking from a heavy sleep, but you have to give them a good shake before they regain control of themselves and when they do return to their senses they can remember nothing of what they have said in the interval. If by chance they are questioned a second or third time on the same matter, they give completely different answers. It is possible that they are speaking through demons which possess them, spirits which are ignorant and yet in some way inspired. They seem to receive this gift of divination through visions which they see in their dreams. Some of them have the impression that honey or sugary milk is being smeared on their mouths; others say that a sheet of paper with words written on it is pressed against their lips. As soon as they are roused from their trance and have come round again after their prophesying, that is what they say has happened.”

In later Celtic writings and in collections of folklore, evidence has been found describing some of the methods used by seers, indicating that these techniques did survive over time. (http://homepage.eircom.net/~shae/contents.htm)

NOTE: Much discussion surrounds the question of the accuracy of calling the bard, ovate, druid or seer--or actually any one of these healers who possessed “supernatural” or “extra-ordinary abilities --a shaman. while it is clear that some of them possess shaman-like abilities or work in a similar fashion, “spirit-workers” are found in most, if not all, animistic- based Indigenous cultures, but not all fit the description of a true “shaman.” it is important to be aware that the word “shaman” is not indigenous to most cultures and each tradition defines these special folk in ways unique to their own cosmological framework. if you are interested or would like further clarification, I found two very good discussions specifically on this topic. https://www.druidry.org/library/members-articles/shamanism-celtic-world Celtic Tradition: The Sight http://homepage.eircom.net/~shae/contents.htm

VIIB. CUNNING-FOLK In Wales, the Dyn Hysbys or ‘Cunning’ man or “the wise” was a similar character - although by definition he was always male, there were also ‘cunning’ women, the Gwraig Hysbys. The dyn hysbys, like his Irish counterpart, also had the sight and could find lost things, lift evil spells and cure. He was able to call the spirits, the ‘tylwyth teg’, the fair people, (fairies), to enlist their help. Unlike similar healers in Ireland however, the Welsh dyn hysbys often used charms, spells and magical rites derived from a magical tradition that was based on esoteric material from countries like Persia and Egypt that had flooded into Europe after the first crusade. The group called "cunning-folk" or "the wise" seem to correspond to the Irish "fairy-doctors." To them is attributed the ability to see and/or interact with the inhabitants of the Otherworld, to diagnose ills caused by fairy actions, and to find out how to correct the ill through interaction with the Otherworld. (http://homepage.eircom.net/~shae/contents.htm)

VIIC. CHARMER There was also a type of folk healer in Ireland, Scotland and Wales known as a Charmer or “Swynwr.” Charmers usually possessed no other magical powers and treated only ailments that were thought to have a "natural" cause. This included injuries from accidents (bleeding, burns, snake-bites, and pricks) and diseases such as ringworm, toothache, scrofula, and warts. Charmers did not interact with the Otherworld or treat ailments that were attributed to the actions of the "fairies." Charmers usually inherited the job along with the charm or charmed object and the knowledge of how to use it.

The Charmer was able to heal by virtue of a charm passed down to him, the fairy doctors by their contact with the Otherworld, but there were also people who were able to heal because they were the seventh son of a seventh son or because of contact with various creatures. We have already seen that in Wales shingles could be cured by someone who had eaten eagle flesh, or whose ancestor had. In Ireland, putting a worm into the hand of a child before he was baptized, and leaving it there until the worm died, gave that child the power to heal all childish diseases in later life. In the South and West of Ireland, a person who had licked or had physical contact with a lizard was given immunity from burns himself and able to heal them in others. As recently as the late 1980s in Ireland a man who had the power to heal burns because he had licked a lizard as a child had patients referred to him by two local doctors. (http://homepage.eircom.net/~shae/contents.htm)

VIID. CONJURER In Wales the swynwr was seen as distinct from the Consurwr-- Conjurer or Dyn Hysbys; he did not claim supernatural powers but only to have secret knowledge which enabled him to heal. This knowledge was passed down the generations and its efficacy depended on it being kept secret. The charmers were somewhat more acceptable to the Christian folk than the dyn hysbys who got their powers from spirits. It was said he was able to stop hemorrhaging by reciting a charm, to heal burns and to ‘break’ the illness known as clefyd y galon, “the disease of the woolen threads” which appears to have been a deep melancholy affecting the heart. As in parts of Ireland and Scotland, the tradition is alive and still very much resorted to by local people, although there is evidence that it is changing to incorporate some of the different healing methods brought to Wales by incomers. Additional notes are shown below to clarify the separation of folk medicine vs modern “Biomedicine” in some of the Celtic countries:

TH FOLK MEDICINE IN IRELAND VS MODERN IN 18-20 C. Paraphrased & Summarized from: Indigenous Narratives of Health: (Re)Placing Folk-Medicine within Irish Health Histories Ronan Foley (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352604/)

NOTES: In considering those more profound histories, it may be valuable to recast folk-medicine as representative of a set of traditional public health practices to be set alongside the necessary development of formal health care services. Central to this were ‘informal practitioners and practices’ placed somewhere between professional and lay health/medical knowledges. In addition, there were long histories in a number of Celtic countries around the complex relationships between charms, nature cures and the power of hereditary healing families, members of which had a control over the practice of medicine in locations like Ireland and the Highlands of Scotland .

When considering folk medicine in Ireland across the 18th to 20th centuries, power was a central theme, especially in terms of its position within the wider practice of formal medicine and healing. Linked to power, regulation played a significant role, in different forms, in the management of that power. Foucault noted that there was a quite blurred history within what he termed, noso-politics, in how formal medical structures took hold and older folk practices were subsumed or incorporated to a wider public health from the 18th century on (Foucault 1980). Hierarchies were evident in the expression of power between both informal and formal practitioners in place and also around patient/practitioner interactions. From the 18th to well into the 20th century, there was a contrast between local, often free healers, and the slowly developing professional for-profit medicine. In rural Ulster, the hierarchies were subverted somewhat in rural areas because of a preference for local folk healers and a deep distrust of the ‘collar and tie men’ of the medical profession. At the other end of the scale, the professional bodies responsible for scientific medicine created an identifiable group of trained professionals for whom the practices of folk medicine seemed anathema. Yet such a positionality of inclusion and exclusion was never clear- cut in terms of the experience of health care provision and utilization across the country, evident in the different spaces of practice and the overlapping bodies of practitioners. In considering the relationship between power and sites of medical practice, it was expressed in a geography that was hierarchical and relatively rigid. Spatially, power needs to be concentrated to be visible, hence the symbolic importance of the hospital or workhouse in Irish research. Yet the more fluid practices of folk-medicine were expressed in mobile sites and settings, certainly in terms of some of the belief-based practices; conditional, relational, even sometimes invisible in that knowledge of their existence or location only existed via word-of-mouth. Such settings included country fairs, people’s homes, the healers’ own homes as well as other communal settings, but all were places associated with a reputational form of healing power and energy.

While one of the concerns of formal medicine was the lack of regulation they associated with folk medicine, a persistent associated theme in discussions of medical regulation and power was that of training and healing expertise. In the development of a hierarchical structure of formal medical power, training was crucial. Metaphors exist of the folk practitioner as representing the ignorant/untrained/low/unapproved and the medic as representing the knowledgeable/trained/high/approved. HISTORICAL ASPECTS OF FOLK-MEDICINE AND MODERN MEDICINE IN 18TH C SCOTLAND Paraphrased & Summarized from https://burnsmuseum.wordpress.com/2017/09/11/18th-century-scottish-folk-medicine/

The 18th century was a time of great change in Scotland – its major cities were full of learning and progress in areas such as architecture, philosophy, science, religion and – importantly – it marked the beginning of the change from medieval to modern medicine. Modern medicine is, essentially, just folk medicine that worked. A huge proportion of modern western medicine is derived from plants that had been used for centuries. A well-known example being willow bark used to treat pain; a derivative from this was eventually used in Aspirin

However, for every tincture, potion, ointment and salve that worked; many more had no more power to heal a wound or illness than the Primary School method of putting a wet paper towel on it. It was a belief that if there was an illness – God provided a cure. Unfortunately, unlike diseases like scurvy, which was cured by something as simple as Vitamin C from Kale or Citrus fruits, a large number of diseases had many treatments, but no cures. Smallpox remained the scourge of the 18th Century, responsible for as much as 10% of all deaths worldwide.

Throughout the 18th Century, the people of rural Scotland were dependant on their home remedies for treating illness; home remedies that were often medieval in their origins. The issue was that although trained Doctors did exist at this time; they were expensive to hire, rare and travel was difficult from city to isolated village. So communities made do with what they could. Home remedies were often passed down from word of mouth, stories, songs, letters and kitchen cookbooks – meaning they changed very little over the years – much opposed to orthodox medicine, which underwent a huge shift in the 18th century. There were many books on home medicine – including Buchan’s Guide to Domestic Medicine, however, a large proportion of the rural population could not afford the books and illiteracy was still very high. Most diagnoses and medicines were administered by a local healer, wise-woman (or man), apothecary or family members – as most housewives would have grown herbs for medicinal use or at least have known where to look for them; making potions and ointments to be stored away for later use. Local healers would often be members of a family known for practicing medicine, or even a landowner who owned some of the ‘do-it-yourself’ medicine books. Burns famously wrote of ‘Dr Hornbook’, a teacher who practiced as a healer, albeit not successfully if the Grim Reaper was to be believed. A famous book of ‘do-it-yourself’ medicine was William Buchan’s succinctly titled ‘Domestic Medicine: or, a Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines’. The list of local plants and herbs that could be used in treatments in the book is exhausting; Eventually, due to the increasing professionalization of medicine over the 18th Century, the gulf between local healers and trained, professional Doctors widened – the latter saw the former as superstitious and looked down upon traditional forms of medicine quite vehemently. This led to many folk medicines being abandoned in favor of more modern, clinical and chemical cures. However, even today we still sometimes use folk medicine in its original from, for example: the Dock Leaf, which grows around nettle patches, crushed and is used to cure their stings, is an ancient cure passed down generation to generation. DRUIDRY: POST-CHRISTIANITY TO PRESENT

Paraphrasing the words of Philip Carr-Gomm, current Chief of the OBOD, from the OBOD website; a summation is provided for educational purposes ( https://www.druidry.org/druid-way/what-druidry/brief-history- druidry/longer-history-druidry)

THE HISTORY OF DRUIDRY IS COMPLEX, DEBATABLE AND, AS A SPIRITUAL TRADITION, HAS WAXED AND WANED THROUGHOUT TIME; IT HAS OFTEN GOING UNDERGROUND, BUT IT WAS NEVER TOTALLY ELIMINATED.

Sixteenth Century- THE REVIVAL BEGINS Scholars in Europe ‘rediscovered’ the Druids, and then began to reclaim their Celtic heritage. The Church had taught that the Celts were savages until the arrival of Christianity. But with the translation and printing of the classical texts on the Druids, Europeans discovered that their ancestors were far from being savages. At the same time, reports were coming back regarding Indigenous Native American tribes who, like their own Celtic ancestors, had maintained their autonomy and traditional ways in spite of Christianity’s attempts to convert them. These events stimulated philosophical changes and a period known as “The Druid Revival” began. Individuals formed groups and societies in order to study Druidry and Celticism. Ancient cultural and seasonal Druidic festivals were revived, Celtic language and traditions were celebrated and this revival began to grow and flourish in Wales, Cornwall and Brittany.

Seventeenth Century- THE REVIVAL CONTINUES TO GROW In the seventeenth century a few scholars began to take interest in the mysterious monuments – the artificial mounds, stone circles, dolmens and standing stones – that filled the countryside around them, and suggestions were made that it was the Druids who built them. Early archeological attempts stimulated further interest from others who started to look for traces of Druidism within Christianity. The thought that their pre- Christian ancestors were not brutish and ignorant but were, instead, wise philosophers was inspiring, stimulating much research and writing; the Freemasons became interested, resulting in a merging of Revival Druidic thought and the world of Masonry via such organizations as the Ancient and Archaeological Order of Druids, which was later joined by Winston Churchill.

Eighteenth & Nineteenth Centuries-DRUIDRY BLOSSOMS During this time, the Druid revival continued expanding, with several Druid orders being established, some of which still continue to exist. Concurrently, there was a dramatic increase in interest in the Celts, subsequently resulting in further literary output, as well as growing interest in Druidry. Diverse organizations associated themselves with the Druids, including the Freemasons, who chose, however, to have Christianity as their foundation. It is thought some small groups may have begun to quietly evolve independent of any other established religious tradition, thus placing Druidry in the world as a distinct path with spirituall practices uniquely its own. Twentieth Century-DRUIDRY COMES ALIVE Druidry began to be promoted as its own unique spiritual path and the Ancient Druid Order became a source of unification for followers of varied religious and philosophical outlooks; conveyed teachings were based on Theosophy and the Western Mystery schools, but drew inspiration from the ancient Druids and the work of Druid Revivalists.

Interest in Druidry has continued to grow since that time, with many divisions and splits, resulting in several different Druid Orders. Additionally, there has been an intermeshing of Druidry with other mystical traditions such as the Rosecrucians, Freemasons and the Culdee Church.

It was a complicated “Tower of Babel” spiritual and political free-for-all of sorts during that time. This began to change in the 1940’s and 50’s as interest in pagan traditions grew. The Ancient Druid Order was joined by several individuals, one of whom began to promote () while another enhanced and developed Druidry extensively, by focusing it more on Pre-Christian Celtic tradition and mythology. The result of this union was the elaboration of an “eightfold cycle of observances” --the 8 seasonal festivals-- which are the foundation of both Wiccan and Druid practice.

As is the case with many Indigenous traditions, cultural and religious influences and assimilation took its toll on the Celt’s cosmological belief system and it is impossible to return to the source-the original spiritual truth of the Celtic/Druidic tradition. However, far from being “dead,” adaptations have occurred based on the needs of the followers and new traditions sprout from the old. Emerging from a Western European tribal-based Celtic “pre-Druid” culture 2500 years ago, modern Druidry has evolved, based on Roman and Greek classical accounts, archeological findings of earlier “proto-Druids,” Bardic stories, monastic Christian-tinged Druidic literature, records of Celtic myths and legends from Wales and Ireland, and a veritable storehouse of literature produced during the 17th and 18th centuries by the Druid Revivalists. As Philip states, “far from Druidism being introduced to the world just once, a long time ago, it is continually being introduced – by a variety of people, in different countries, and in a number of different forms.” (https://www.druidry.org/druid-way/what-druidry/brief-history-druidry/longer-history-druidry)

One of the more well-known modern Druid Orders, The Order of Bards, Ovates, and Druids (OBOD), traces its origins back to the early 1700s and is dedicated to preserving the Druid tradition-its teaching program is based upon a love and understanding of the natural world and offers a way of working with the self and nature. There are three levels, the Bardic Grade, the Ovate grade and the Druid grade. All three levels, and especially the Druid, teach how, through the ancient Celtic heritage and belief system, to unite our natural, earthly selves with our spiritual selves, becoming clear as to our purpose and direction in life, and then encouraging us, as ready, to make a commitment to the future growth and care of the planet and all that reside upon it. Its teachings reinforce the concept of the interconnectedness of all of life--it is a way of seeing and being in the world that truly creates an attitude of responsibility towards one self and the world. (Philip Carr-Gomm, Elements of the Druid Tradition, p64)

From my personal perspective and experience, I believe there is much more available to us of the ancient Celtic and Druidic spiritual tradition than we may think. Just as Michael Harner and his associates found, while spending years facilitating a “re-memberment” of other earth-based traditional cultures, oral traditions do not get lost as do those on paper--the secrets and the truths are still held in memories and hearts. Stories relayed by many in rural areas of Scotland, Wales and Ireland have, and continue to, shed light on some of the traditions of their ancestors--the retelling of history--“my cousin’s cousin’s Uncle said” and “my grandmother told me once that her grandmother told her” are treasures that have, and will once again, come to light. In addition--and perhaps to an even greater degree--the land remembers, the sea remembers, the sky remembers-- and those in the Other World, with whom relationships were formed, never forget; following the old ways of divination and “seeing” have also provided details to assist in unearthing hidden truths of this ancient tribal tradition. In the “betwixt and between” the ways of the ancient Druids still live.

Rather than being stuck in past ancient beliefs, Druidry is still both applicable and relevant to us. Although intellectual controversy can continue to exist between political and religious ideologies, Druidry can be seen as far more than a religion- it is a way of seeing and walking in the world, and as such, can be considered by anyone, no matter what their culture or religion.

Today, Druidry has become a dynamic nature-based spiritual path that is being practiced all over the world. Each group is unique in its focus and attracts a different type of person. However, most if not all, have in common the basic practices and ceremonies that are part of the Druidic world view and tradition. Perhaps the best way to share its perspective and values is to share the “Seven Gifts of Druidry” written by Philip Carr-Gomm, head Chief of the OBOD.

“IT NOW SEEMS THAT THE OLD WAYS, REINTERPRETED FOR OUR TIMES, CAN OFFER US THE KIND OF SPIRITUALITY THAT WE NEED TO HEAL THE SEPARATION THAT HAS OCCURRED BETWEEN OURSELVES AND OUR ENVIRONMENT. DRUIDRY IS ONE SUCH WAY AND, ALTHOUGH AT FIRST SIGHT, IT MIGHT APPEAR TO BE JUST AN OLD CURIOSITY, A QUAINT MEMORY FROM THE DISTANT PAST, IF WE TAKE THE TIME TO LOOK AT IT MORE CLOSELY, WE WILL DISCOVER A TREASURE-CHEST JUST WAITING TO BE OPENED.” AND IN THIS CHEST WE CAN FIND AT LEAST SEVEN GIFTS DRUIDRY BRINGS TO OUR MODERN WORLD: THE FIRST GIFT IS A PHILOSOPHY WHICH EMPHASIZES THE SACREDNESS OF ALL LIFE, AND OUR PART IN THE GREAT WEB OF CREATION. IT CARES PASSIONATELY ABOUT THE PRESERVATION AND PROTECTION OF THE ENVIRONMENT, AND OFFERS A WORLDVIEW, WHICH IS ECOLOGICAL, GEOCENTRIC, PRAGMATIC, IDEALISTIC, SPIRITUAL AND ROMANTIC. IT DOES NOT SEPARATE SPIRIT AND MATTER - IT OFFERS A SENSUOUS SPIRITUALITY THAT CELEBRATES PHYSICAL LIFE.

THE SECOND GIFT PUTS US BACK IN TOUCH WITH NATURE: WITH A SET OF PRACTICES THAT HELP US FEEL AT ONE AGAIN WITH NATURE, OUR ANCESTORS, OUR OWN BODIES, AND OUR SENSE OF SPIRIT, BY WORKING WITH PLANTS, TREES, ANIMALS, STONES, AND ANCESTRAL STORIES. EIGHT SEASONAL CELEBRATIONS HELP US ATTUNE TO THE NATURAL CYCLE, AND HELP US TO STRUCTURE OUR LIVES THROUGH THE YEAR, AND TO DEVELOP A SENSE OF COMMUNITY WITH ALL LIVING BEINGS.

THE THIRD GIFT BRINGS HEALING: WITH PRACTICES THAT PROMOTE HEALING AND REJUVENATION, USING SPIRITUAL AND PHYSICAL METHODS IN A HOLISTIC WAY TO PROMOTE HEALTH AND LONGEVITY.

THE FOURTH GIFT AFFIRMS OUR LIFE AS A JOURNEY: WITH RITES OF PASSAGE: FOR THE BLESSING AND NAMING OF CHILDREN, FOR MARRIAGE, FOR DEATH, AND FOR OTHER TIMES OF , WHEN IT IS HELPFUL TO RITUALLY AND SYMBOLICALLY MARK OUR PASSAGE FROM ONE STATE TO ANOTHER.

THE FIFTH GIFT OPENS US TO OTHER REALITIES: WITH TECHNIQUES FOR EXPLORING OTHER STATES OF CONSCIOUSNESS, OTHER REALITIES, THE OTHERWORLD. SOME OF THESE ARE ALSO USED BY OTHER SPIRITUAL TRADITIONS, AND INCLUDE MEDITATION, VISUALIZATION, SHAMANIC JOURNEYING, AND THE USE OF CEREMONY, MUSIC SWEATHOUSES, BUT THEY ARE ALL GROUNDED IN SPECIFICALLY CELTIC AND DRUIDIC IMAGERY AND TRADITION.

THE SIXTH GIFT DEVELOPS OUR POTENTIAL: DRUIDRY AS IT IS PRACTICED TODAY OFFERS A PATH OF SELF- DEVELOPMENT THAT ENCOURAGES OUR CREATIVE POTENTIAL, OUR PSYCHIC AND INTUITIVE ABILITIES, AND FOSTERS OUR INTELLECTUAL AND SPIRITUAL GROWTH.

THE SEVENTH GIFT OF DRUIDRY IS THE GIFT OF MAGIC: IT TEACHES THE ART OF HOW WE CAN OPEN TO THE MAGIC OF BEING ALIVE, THE ART OF HOW WE CAN BRING IDEAS INTO MANIFESTATION, AND THE ART OF JOURNEYING IN QUEST OF WISDOM, HEALING AND INSPIRATION. (Adapted from Druid Mysteries by Philip Carr-Gomm; OBOD website: www.druidry.org)

Dawn in Stonehenge, 40 members of the Order of Bards, Ovates & Druids, in ceremony, in prayer, welcoming & being welcomed by the Ancients… grateful as photo was snapped--even moreso when I saw--t’was not the sun casting rays…rather, I think, one of my dearly loved Sidhe come for a kiss! RESOURCES FOR INDIGENOUS MEDICINE SHAMANISM & DRUIDRY

SOUL LEADING YOU FORWARD TO LEARN MORE AND/OR LOOK INTO TRAINING?

I am happy to share with you individuals from whom I have personally learned, places I have studied & other people, books & sites that have touched me in a good way. There are many other wonderful choices out there. Perhaps these can be a stepping stone…Listen with your Heart, See with your Heart, Trust your Heart….and you will end up exactly where you need to be!

ORDER OF BARDS, OVATES AND DRUIDS (OBOD): https://www.druidry.org/

BRITISH DRUID ORDER (BDO): https://www.druidry.co.uk/

PHILIP CARR-GOMM (druidry): https://www.philipcarr-gomm.com/

TOM COWAN (shamanism/Celtic): http://wp.riverdrum.com/?page_id=6

CAITLÍN & JOHN MATTHEWS (shamanism/Celtic): http://www.hallowquest.org.uk/

FOUNDATION FOR SHAMANIC STUDIES (FSS-Harner): www.shamanism.org/

SANDRA INGERMAN:(shamanism) www.sandraingerman.com/

JOSE/LENA STEVENS (shm) https://thepowerpath.com/ https://shamaniceducation.org/

TZENWAXOLOKWAUHTLI TZATZOEHETZIN, Aztec Carrier of the Medicine System Tetzkatlipoka: The Aztec Tradition of Consciousness, Energy and Healing http://www.shamanportal.org/display_details.php?id=1098&country=&category=&sub_category=

MARTINE PRECHTEL (Mayan) https://www.floweringmountain.com/

SERGE KAHILI KING/Aloha http://www.huna.net/ https://www.huna.org/html/alohaint.html

SOCIETY FOR SHAMANIC PRACTITIONERS www.shamanicsociety.org

SHAMAN PORTAL(resource for all things shamanic) http://www.shamanportal.org/index.php

LAND/SEA/SKY(++Celtic med info;chp17) http://homepage.eircom.net/~shae/contents.htm

CELTIC LIFE (++Celtic medicine info) https://celticlife.com/the-story-of-celtic-medicine/

CELTIC MED: https://www.selfgrowth.com/articles/Ancient_Celtic_Myth_Magic_and_Medicine.html

LAKOTA AUTHORS TO CHECK OUT: JOSEPH MARSHALL III HOWARD BAD HAND

FOOL’S CROW KENT NERBURN BLACK ELK

CIRCLING BACK TO OUR FUTURE—THE STATUS OF INDIGENOUS/TRADITIONAL MEDICINE IN THE 21ST CENTURY…

For millennia, people around the world have maintained their health by working collaboratively with their natural environment and healed the sick with herbal or animal- derived medicinals and rituals, handed down through generations; medicine was almost entirely confined to traditional remedies and practices tailored specifically to local cultures utilizing natural resources. But, as seen with Celtic Indigenous medicine and so many other forms of "Traditional/Indigenous medicine,” when the “modern” world enters, the “old ways” are often, for the most part, cast aside; in the case of the Celts and Druids, it was not a mere case of a shift in power, they were also subject to an intentional attempt at total cultural and religious eradication as well as a devaluation of their Traditional medicine and lifestyle; unfortunately, throughout history, they have not been the only recipients of this process.

This situation has clearly been exemplified in the modern world as well, when colonists and missionaries arrived in Asia, Africa and America, bringing with them not only a new religion but modern scientific techniques and medicine. As biomedicine became the norm and its popularity and use spread throughout the world with the building of hospitals and medical clinics, this form of medicine—and its proponents—established superiority; subsequently, ancient medicines and practices, as well as the practitioners, were at best, marginalized. More often, however, they and their practices were ostracized and demeaned. For example, in many African countries, herbalists and Traditional medicine people were not forbidden to practice but they were largely considered inferior, their traditional knowledge ignored, and some holistic and energetic/spiritually-based healing methods were outlawed. (https://www.scidev.net/global/systems/editorials/the-imperatives-for-traditional-medicine.html)

But the ways that worked for centuries were not forgotten. Currently, despite the huge advances in modern medicine, it has become clear that many people in the developing world still turned to their traditional knowledge to treat illness and disease, relying on their Indigenous forms of medicine, attempting to coexist within a modern medical setting. According to the World Health Organization, whose position is to create and maintain a healthy world populace, Traditional and Indigenous forms of medicine are still being used widely throughout the world, but especially in developing countries. Based on collected data, within the last decade:

--In India 70% of the population and in Ethiopia more than 90% of the population depends on TM for primary health care. --It is reported that more than 70% of the population in Chile and 40% of the population in Colombia have used traditional medicine. --In China, Traditional medicine accounts for approximately 40% of all health care delivered. --In Africa, Asia, Latin America and the Middle East, 70-95% of the population still use Traditional medicine (TM) for primary healthcare. Promoting Access to Medical Technologies and Innovation, 2012 World Health Organization, World Intellectual Property Organization and World Trade Organization https://www.who.int/phi/PAMTI_WHO-WIPO-WTO.pdf However, despite the age-old tradition of acceptance and continued use by many, Traditional/Indigenous medicine has concurrently had decreasing official support in most countries in proportion to the rise of modern western medicine. (https://www.scidev.net/global/indigenous/feature/integrating-modern-and-traditional-medicine-facts-and-figures.html)

This is not surprising. Biomedicine and Traditional medicine are two fundamentally different arenas, with vastly different belief systems being held between western biologically-based practitioners and their Traditional Indigenous healer counterparts in regards to illness, health and healing. The concept of illness as an imbalance of self with the environment or the cosmos and any connection between spirits and illness has generally been dismissed as superstition with the efficacy of treatment clinically unconfirmed and, therefore, inconsequential and unnecessary. In addition, determination of use, freedom of availability, verifiability of a particular medicine or practice outcome, standardization of dosage and/or treatment, and medical qualifications appear diametrically opposed. The literature shows few instances where either could see the relevance of the other. In the event that the “official policy” promotes the use of biomedical standards, as has been the case, it would logically follow that Traditional forms of medicine are not being advocated, to any large degree, within the typical hospital/clinic setting. Western Pacific Region: 22-26 November 1999, Beijing, China © World Health Organization, 2000. https://iris.wpro.who.int/bitstream/handle/10665.1/5573/19991126_CHN_eng.pdf

BUT THE SITUATION HAS BEEN, AND IS, CONTINUALLY SHIFTING…and I learned things about the current status of Traditional medicine of which I had no idea. While perusing the documents I came across from various regulatory agencies, I found myself going through a myriad of emotions. And I admit, between my professional degrees, training and experiences as both a physician and lecturer of Indigenous /Traditional medicine and CAM modalities since the mid-1970’s, I initially had a bias—towards the Indigenous medicine people and those that carry, and utilize, Traditional Knowledge (TK) and against the Biomedically-based physicians, researchers, organizational regulators and proponents. Truly, my first assumption was that, even with the voiced support from regulatory agencies like the WHO, the WIPO and the WTO, the Indigenous healers and Traditional medicine people were going to get squeezed out of their work, their medicines and possibly their lives due to the lack of Western medical training and understanding of clinical studies, protocol, and standardization. I figured I would hear of more medicine people who were cajoled and placated into getting brushed aside while they got pennies on the dollar or lost their medicines to biopiracy.

But I’m beginning to think, hopefully, that I’m mistaken. First I realized, the more I read, what a complex and challenging issue this is worldwide. As I dove deeper, I began to see the gift and the opportunity…and I heard the words of committed people-not only in their attempt to provide an avenue for bringing Traditional medicines to clinicians as potential new medications, some of which are desperately needed, but also to maintaining the integrity of ancient traditions, to preserving the environment’s balanced biodiversity and to resolving that compensation will be fair and traditional experience honored. And, with the eyes of an Indigenous/traditional/complementary/integrative/holistic physician and practitioner of almost 45 years, I see the potential for ripples…but I will let you decide for yourself. There was so much material that I came across, what I’ve included for you is some interesting data, several documents I thought important and informative—including the wonderful August 2015 opening remarks made by Dr. Margaret Chan. Director- General of the World Health Organization in her address at the International Forum on Traditional Medicine—and some excellent resources and references, in the event you are sparked to further explore. Perhaps it is due to my own personal and professional background, or because I have been spiritually aligned with Indigenous communities or simply because the future of our healthcare matters—regardless, I was moved and felt a need to share.

It is clear from my reading that it has been, and will most likely, continue to be a task that is both interesting and formidable- coordinating an attempt to bring variant forms of worldview and medicine together, not to mention the diversity of all others involved (and there are many!); to develop appropriate protocols, create and maintain clinically approved biomedical testing methods, meet the myriad of required regulatory standards while honoring and respecting cultural heritage and Indigenous rights, support the independent decisions of each involved country while attempting to promote international conformity— while simultaneously having what appear to be nonstop meetings and, of course, creating availability and accessibility and providing optimal healthcare for all.

It is important to remember, of course, that the world is not stagnant-it is homeodynamic-ever-changing—and that information, politics, budgets and potential possibilities, dead ends and breakthroughs are constantly occurring. Like the seasons and the cycles of nature, things keep moving; to stand still is to stagnate. It will be interesting to see the progression of events and what it will mean to the people. But at least someone is stirring the pot. Unlike Celtic Indigenous medicine with the Druids as medicine keepers, unlike many of the Native American tribes and their shaman, unlike other traditions, who were banned from their spiritual practices and their medicine, placed in situations, voiceless and lacking support, there appear to be advocates and visionaries these days who are, it seems, looking both backward to the ancients and forward to the people’s traditional continuity, working toward integration and cooperative collaboration for the health and wellbeing of our world community—in spite of potential adversities. It does not seem an easy road, by any means, nor are there any perfect solutions. But there is movement toward unity…and the intention of global respect and positive benefit. And that, in and of itself, is worthy of gratitude and support. It is worth working toward.

From a 2009 press release by the UN Economic & Social Council: “We cannot ignore the potential of Traditional medicine” in the race to achieve the Millennium Development Goals and renew primary health care for those who lacked access to it, Council President Sylvie Lucas stressed today as she launched the 54-member body’s first panel discussion on “The contribution of Traditional medicine to the realization of international development objectives related to global public health,” in connection with its upcoming 2009 Annual Ministerial Review. Ms. Lucas went on to say “Traditional medicine was a field in which the knowledge and know-how of developing countries was “enormous”-– and that it was a source of hope for improving the world’s health-care situation.” https://www.un.org/press/en/2009/ecosoc6385.doc.htm THE WORLD HEALTH ORGANIZATION The last two decades have witnessed globally renewed interest in the use of Traditional, Complementary and Integrative medicine.

The World Health Organization (WHO) began work over two decades ago to develop a national policy on Traditional medicine. One of their earliest meetings was in Beijing (November 1999), where representatives of WHO met and issued a document to clarify their work entitled, “A Report of the Consultation Meeting on Traditional & Modern Medicine: Harmonizing the Two Approaches.” Although they concurred that each Traditional medical system was as unique as its country of origin, they also recognized common characteristics and perspectives were formulated and concerns and issues clarified. Some key events occurred during the last several years of the 20th century and into the 21st that assisted in forward movement. Then began a flurry of policy development, resulting in the papers below:

• TRADITIONAL AND MODERN MEDICINE: HARMONIZING THE TWO APPROACHES, WESTERN PACIFIC REGION 2000; BEIJING, CHINA; WHO (NOV 22-26 1999) https://iris.wpro.who.int/bitstream/handle/10665.1/5573/19991126_CHN_eng.pdf

• GENERAL GUIDELINES FOR METHODOLOGIES ON RESEARCH AND EVALUATION OF TRADITIONAL MEDICINE; WHO (2000). http://apps.who.int/medicinedocs/pdf/whozip42e/whozip42e.pdf

• THE WORLD HEALTH REPORT 2000 HEALTH SYSTEMS:IMPROVING PERFORMANCE; WHO (2000). https://www.who.int/whr/2000/en/whr00_en.pdf?ua=1

• WHO MEDICINES STRATEGY: FRAMEWORK FOR ACTION IN ESSENTIAL DRUGS AND MEDICINE POLICY 2000–2003; WHO (2000) http://www.healthpolicy.cn/rdfx/jbywzd/gjjy2/who/yjwx/201002/P020100311039158727474.pdf

• WHO MEDICINES STRATEGY: COUNTRIES AT THE CORE 2004-2007; WHO (2004) https://apps.who.int/iris/bitstream/handle/10665/84307/WHO_EDM_2004.5_eng.pdf?sequence=1

• WHO FACTSHEET ON TRADITIONAL MEDICINE. WHO (2008) https://www.who.int/mediacentre/factsheets/fs134/en/

• WHO CONGRESS ON TRADITIONAL MEDICINE, (NOV. 8, 2008); WHO (2009). https://www.who.int/traditional-complementary-integrative-medicine/about/beijing- congress/en/index4.html

• THE WORLD MEDICINES SITUATION 2011, TRADITIONAL MEDICINES: GLOBAL SITUATION, ISSUES AND CHALLENGE. WHO (2011) http://digicollection.org/hss/documents/s18063en/s18063en.pdf

• PROMOTING ACCESS TO MEDICAL TECHNOLOGIES AND INNOVATION INTERSECTIONS BETWEEN PUBLIC HEALTH, INTELLECTUAL PROPERTY AND TRADE (WHO) 2012. https://www.who.int/phi/PAMTI_WHO-WIPO-WTO.pdf

• WHO TRADITIONAL MEDICINE STRATEGY 2014-2023 (WHO) 2013 https://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/

From: Documenting Traditional Medical Knowledge Prepared by Ryan Abbott, M.D., J.D., M.T.O.M. March 2014 https://www.wipo.int/export/sites/www/tk/en/resources/pdf/medical_tk.pdf

Because traditional medicines may form a vital part of individual or community identity, human rights issues are intimately bound with TMK. Historically, colonialism and cultural imperialism have marginalized traditional practitioners and medicine, and misappropriation of TMK has had disastrous effects on community livelihood and cultural identity. On the other hand, so have the human rights violations imposed upon them.

UNITED NATIONS DECLARATION ON THE RIGHTS OF INDIGENOUS PEOPLES

Within this diverse global community, a movement began almost 50 years ago, advocating for self-determination with the right to regain and retain traditional indigenous cultural practices and has resulted in some successes worldwide. However, in 2007, in a landmark moment following more than two decades of negotiation, 143 member states adopted the UNITED NATIONS DECLARATION ON THE RIGHTS OF INDIGENOUS PEOPLES (UNDRIP) reflecting widespread recognition by the international community to the individual and collective rights of indigenous peoples. UNDRIP Article 24 specifically affirms the fundamental rights of Indigenous peoples to their Traditional medicines and health practices, and to all social and health services. Although not a legally binding instrument, UNDRIP represents an important step forward in developing a framework of internationally agreed upon norms and principles specifically reaffirming the unique human right to health for Indigenous peoples. Though the UNDRIP was designed to promote a set of international standards and obligations to be adopted by member states and potentially translated into national policy making, there is a general lack of research examining its effectiveness and influence in the context of health policy.

United Nations General Assembly. United Nations Declaration on the Rights of Indigenous Peoples: resolution adopted by the General Assembly, 2 October 2007. Internationational Work Group for Indigenous Affairs (IWGIA) The Indigenous World 2014. . Edited by Mikkelsen C. New Jersey: Transaction Publishers; 2014:93–100. https://www.un.org/development/desa/indigenouspeoples/wpcontent/uploads/sites/ 19/2018/11/UNDRIP_E_web.pdf UNITED NATIONS GENERAL ASSEMBLY. UNITED NATIONS DECLARATION ON THE RIGHTS OF INDIGENOUS PEOPLES: Resolution /Adopted by the General Assembly, 2 October 2007

Principles of human rights should be applied to all aspects of Traditional healing. In September 2007, the U.N. General Assembly adopted the United Nations Declaration on the Rights of Indigenous Peoples. This Declaration was the product of more than twenty years of discussion within the U.N. system, and Indigenous representatives played a key role in the development of this declaration. Today, there are over 370 million Indigenous people in 90 countries worldwide. Excerpts from the United Nations Declaration on the Rights of Indigenous People, Article 24 1: Indigenous peoples have the right to their Traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals. Indigenous individuals also have the right to access, without any discrimination, to all social and health services. 2. Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right. Article 31 1. Indigenous peoples have the right to maintain, control, protect and develop their cultural heritage, Traditional knowledge and Traditional cultural expressions, as well as the manifestations of their sciences, technologies and cultures, including human and genetic resources, seeds, medicines, knowledge of the properties of fauna and flora, oral traditions, literatures, designs, sports and traditional games and visual and performing arts. They also have the right to maintain, control, protect and develop their intellectual property over such cultural heritage, Traditional knowledge, and Traditional cultural expressions. 2. In conjunction with Indigenous peoples, states shall take effective measures to recognize and protect the exercise of these rights.

72 71 United Nations permanent forum on Indigenous issues [UNFPII], about UNFPII and a brief history of Indigenous peoples and the international system, 72 United Nations Declaration on the Rights of Indigenous Peoples. Adopted by G.A. Res. 61/295 (sept. 13, 2007), available at http://www.un.org/esa/socdev/unpfii/documents/drips_en.pdf. [http://www.un.org/esa/socdev/unpfii/documents/drips_en.pdf]. http://www.un.org/esa/socdev/unpfii/en/history.ht STATEMENT FROM WHO RECOGNIZING THE EFFICACY OF TRADITIONAL MEDICINE BIG STEP!

Documenting Traditional Medical Knowledge Prepared by Ryan Abbott, M.D., J.D., M.T.O.M. M © World Intellectual Property Organization, March 2014 https://www.wipo.int/export/sites/www/tk/en/resources/pdf/medical_tk.pdf

Dr. Ryan Abbott of the World Intellectual Property Organization has prepared a document in which he summarizes and clarifies the current situation of Traditional medicine (TM) and Traditional Medicine Knowledge (TMK) and the challenges accompanying it.

EXCERPTS FROM PAPER: He summarizes: “Traditional medicine is not only a vital source of health care, but also an important source of income for many communities. Traditional medicine may even form an integral part of a community’s identity. Pre-industrial communities have been responsible for the discovery of most of the medicinal plants in use today, and many communities are still involved in the wild collection, domestication, cultivation and management of medicinal plant resources. This economic activity supports many indigenous peoples and local communities, a benefit that in turn provides incentives for the conservation of TM.

Indigenous peoples and local communities may possess knowledge related to harvesting and preparing herbs, as well as knowledge on medicinal use. This information can be invaluable, not only to the indigenous peoples and local communities who have historically used herbal medicines, but also for any attempt to export and use medicine outside of its traditional environment.

TMK may also contribute to a community’s way of life and spiritual beliefs. For example, traditional African medicine is characterized by a holistic world-view that embraces people, animals, plants, and inanimate objects in an inseparable whole from which all beings derive their life force.19 Traditional African medicine may involve spiritual healing, a process thought to be mediated through spiritual or divine powers. The majority of people in Africa living with HIV/AIDS depend on traditional healers and herbal treatments for psychosocial counseling and health care. While general knowledge of the healing properties of medicinal plants may be widespread, only a select group of trained practitioners knows exactly how herbs are used in the traditional system.”

Dr. Abbott states: “The World Health Organization (WHO) has acknowledged that “traditional, complementary, or alternative medicine has many positive features, and that traditional medicine and its practitioners play an important role in treating chronic illnesses, and improving the quality of life of those suffering from minor illness or from certain incurable disease.

He also references potential safety issues with use of Traditional Medicine: “The use of Traditional medicine presents unique public health challenges. WHO notes that ‘inappropriate use of traditional medicines or practices can have negative or dangerous effects’ and that ‘further research is needed to ascertain the efficacy and safety’ of many traditional medical practices. Traditional medicines are not necessarily safe simply because they are “natural” and have a long history of use. The use of traditional medicines may delay the use of effective allopathic treatments, and it can directly cause adverse effects. Health risks may be posed by drug-herb interactions and problems related to quality control.” The WHO's Beijing Declaration in 2008 marked a milestone in acknowledging te need to integrate Traditional medicine into national health systems. Below is a portion:

NATIONAL AND INTERNATIONAL POLICIES ON TRADITIONAL MEDICINE BEIJING DECLARATION

In Beijing in November 2008, government officials representing Member States of WHO adopted a declaration that provides an endorsement of traditional medicine. The WHO Congress on Traditional Medicine was the first time that WHO Member State representatives came together solely to discuss traditional medicine and to prepare an advocacy document. In the Beijing Declaration, they recognized the role of Traditional medicine in the improvement of public health and supported its integration into national health systems where appropriate. The declaration encourages governments to create or improve national policies on Traditional medicine. It also promotes improved education, research and clinical inquiry into traditional medicine, as well as improved communication between health care providers. In May, 2009, the World Health Assembly (WHA), the governing body of WHO, noted the adoption of the Beijing Declaration and urged Member States to implement its policies. The WHA further directed WHO to provide support to Member States in implementing the Beijing Declaration.

EXCERPTS FROM THE BEIJING DECLARATION I. The knowledge of Traditional medicine, treatments and practices should be respected, preserved, promoted and communicated widely and appropriately based on the circumstances in each country.

II. Governments have a responsibility for the health of their people and should formulate national policies, regulations, and standards as part of comprehensive national health systems to ensure appropriate, safe and effective use of Traditional medicine.

III. Recognizing the progress of many governments to date in integrating traditional medicine into their national health systems, we call on those who have not yet done so to take action.

IV. Traditional medicine should be further developed based on research and innovation in line with the "Global strategy and plan of action on public health, innovation and intellectual property" adopted at the Sixty-first World Health Assembly in resolution WHA61.21 in 2008. Governments, international organizations and other stakeholders should collaborate in implementing the global strategy and plan of action.

V. Governments should establish systems for the qualification, accreditation or licensing of Traditional medicine practitioners. Traditional medicine practitioners should upgrade their knowledge and skills based on national requirements.

VI. The communication between conventional and traditional medicine providers should be strengthened and appropriate training programmes be established for health professionals, medical students and relevant researchers.

CTSD-Bridges March 2009. 63 The Beijing Declaration, Adopted by the WHO Congress on Traditional Medicine, (Nov. 8, 2008), http://www.who.int/medicines/areas/traditional/TRM_BeijingDeclarationEN.pdf TRADITIONAL MEDICINE WORLDWIDE

Much of the current literature states that Traditional medicine is “gaining appeal and interest all over the globe” and that “it’s making a comeback.” Well, according to the World Health Organization Traditional medicines, including herbal medicines, have been, and continue to be, used in every country around the world in some capacity and in much of the developing world, 70–95% of the population rely on these Traditional medicines for primary care. For much of the Indigenous world—and for many of us—it never left. In fact, nearly a quarter of all modern medicines come from natural products, many of which were first used in traditional remedies. And of 121 prescription drugs used worldwide against cancer, 90 are derived from plants.

Meanwhile, modern medicine is desperately short of new treatments. Drugs take years to get through the research and development pipeline, at enormous cost. And rising drug resistance, partly caused by misuse of medicines, has rendered several antibiotics and other life-saving drugs ineffective. So scientists and pharmaceutical companies are increasingly searching TM for new drug sources. Across the globe, researchers, policymakers, pharmaceutical companies and traditional healers are joining forces to bring TM into the twenty first century, believing “if both developed and developing countries joined research capacities in equitable collaborations, new scientific techniques could spark a revival in global health research and development.” Prasad, S. & Tyagi, A.K. Traditional medicine: the goldmine for modern drugs (Advanced Techniques in Biology and Medicine, 2015.

A key first step, according to the WHO, is to acknowledge the role TM already plays in people’s healthcare, identifying which forms are most popular, and whether people rely on TM on their own or seek advice from health professionals; below you will see what they have been finding. Stats taken from: The World Medicines Situation 2011 (WHO) http://digicollection.org/hss/documents/s18063en/s18063en.pdf

** In many developed countries, estimates suggest up to 80% of the population has used some form of TM (such as acupuncture or homeopathy), with Herbal treatments standing out as the most popular form.

** In U.S. a 2007 study of TM (aka CAM) reported almost four out of 10 adults had used some form within the past year.

** Some 100 million people are believed to use Traditional, Complementary or Herbal medicine in the European Union (EU) alone—and as high as 90% of the population in some countries.

** Canada, France, Germany and Italy report that between 70% and 90% of their populations have used Traditional medicines under the titles “Complementary,” “Alternative,” or “Nonconventional.”

**As of 2007, 62 countries had established National Institutes for Traditional Medicine; this was increased substantially from 12 in 1970. UN Economic & Social Council (2009); https://www.un.org/press/en/2009/ecosoc6385.doc.htm

**A survey conducted in 2010 found that 74% of U.S. medical students believed that Western medicine would benefit by integrating Traditional or “Alternative” therapies and practices. https://www.researchgate.net/journal/1741-4288_Evidence Abbott, RB. et al. Evidence-based Complementary and Alternative Medicine (2010) IN THE U.S. A HUGE CHANGE HAS RECENTLY TAKEN PLACE!

Brief History: 1930-National Institute of Health (NIH) was born with $750K 1991-Congress passed legislation, providing funding to establish the Office of Alternative Medicine (OAM) at the NIH; formally opening in 1992 within the Office of the Director, NIH 1998- Congress elevated status=OAM became National Center for Complementary and Alternative Medicine; began operations with a budget of $50 million. 2009- With growing interest in CAM & perhaps involvement by UN and WHO, NCCAM operating budget in 2009=$125.5 million. 2014- In a measure signed by President Obama, Congress NCCAM’s name changed to the NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH), to more accurately reflect the Center’s research commitment to studying promising health approaches already in use by the American public. https://nccih.nih.gov/health/integrative-health 2019-THE BUDGET FOR NCCIH, FY2019=$ $146.5 million!

Personal Note: Having been in this field since the mid-70’s, and involved in the movement toward greater acceptance of medicines called now Traditional, Indigenous, Holistic, Complementary and Integrative, I am thrilled to see the word “Alternative” taken out and have it replaced with “Integrative.” It is a clear message that supports the international call for the unification of seemingly diverse methods of healthcare—to utilize them in an integrated fashion—the goal of which is provide greater accessibility and availability with increased options and, ultimately, more well-rounded high quality healthcare for all patients—and includes, of course, expanded hospital privileges and insurance coverage.

*********************************************************************** AND THE INDUSTRY IS WORTH BIG MONEY! WHO Traditional medicine strategy 2014-2023. (WHO, 2013)

--In 2005, Traditional medicines worth US$14 billion were sold in China. --In 2012, global sales of Chinese herbal medicine reached US$83 billion.

--It was estimated that Americans spent $33.9 billion out-of-pocket on CAM products and services during2006-2007, accounting for 11.2% of total out-of-pocket health care expenditures.

-- In 2007, Brazil saw revenues of US$160 million from traditional therapies; part of a global market of more than US$60 billion.

--The global market for all herbal supplements and remedies could reach US$115 billion by 2020, with Europe the largest and the Asia-Pacific the fastest growing markets. The demand is driven by women as the main consumers of dietary supplements, by growing emphasis on healthy living and concerns over the side-effects of mainstream drugs. SUMMARY: THE WORLD MEDICINES SITUATION 2011, TRADITIONAL MEDICINES: GLOBAL SITUATION, ISSUES AND CHALLENGE (WHO) 2011 http://digicollection.org/hss/documents/s18063en/s18063en.pdf. https://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/

>>Regulatory status and the associated terminology varies widely. Traditional medicines are use as prescription or over-the-counter (OTC) medications, as self-medication or self-care, as home remedies, or as dietary supplements, health foods, functional foods, phytoprotectants, and under any of many other titles in different jurisdictions, with only minimal consistency between the definitions of these terms from country to country and significant communication issues as a result. Regulation of traditional medicines is a complicated and challenging issue as it is highly dependent upon experience with use of these products. Model countries such as China, India, and South Africa present usable templates, as do the guidelines on regulation and registration of traditional or herbal medicines produced in the WHO African, Eastern Mediterranean, and South-East Asian regions and in the European Union. Efforts to make traditional medicines mainstream also have to cope with varying regulation; every country has a national drug authority of sorts, but with different rules. In response, the WHO has been working to develop international guidelines and technical standards to help countries formulate policy and regulations to control traditional medicines.

>>To control quality and to ensure safety and efficacy in production of traditional medicines is difficult. WHO, in cooperation with the WHO Regional Offices and Member States, has produced a series of technical documents in this field, including publications on Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP), along with other technical support, to assist with standardization and creation of high quality products. Evaluation of quality, safety and efficacy based on research is needed to improve approaches to assessment of traditional medicines, a situation made difficult to remedy in light of historically inadequate public and private funding to address this growing concern. Challenges between Biomedicine & Traditional medicine, beside those having to do with standards, regulation, safety & efficacy include knowledge sharing & protection, testing, dosage, consultation, training, procedure & record keeping; the potential for ethical issues & culture clashes also exists.

>>World Health Assembly resolution 62.13, passed in May 2009 by the WHO Member States urges national governments to respect, preserve and widely communicate traditional medicine knowledge while formulating national policies and regulations to promote appropriate, safe, and effective use; to further develop traditional medicine based on research and innovation, and to consider the inclusion of traditional medicine into their national health systems. WHA 62.13 also urges Member States to cooperate with each other and to share knowledge while working to strengthen communication between conventional and traditional practitioners.

THE WHO HAS RECORDED A STEADY AND MARKED INCREASE IN COUNTRIES WITH NATIONAL POLICIES ON TRADITIONAL & COMPLEMENTARY MEDICINE, OR NATIONAL REGULATIONS ON HERBAL, MEDICINES OVER THE PAST 15 YEARS.

ALSO: Approximately half the countries that responded to a global survey in 2012 reported regulating Traditional and Complementary medicine practitioners

**THIS SUMMAR IS ONLY A PORTION OF DR. ABBOTT’S DOCUMENT, BUT PROVIDES AN EXCELLENT OVERVIEW OF THE SITUATION**

DOCUMENTING TRADITIONAL MEDICAL KNOWLEDGE Prepared by Ryan Abbott, M.D., J.D., M.T.O.M. March 2014 © World Intellectual Property Organization, 2014. https://www.wipo.int/export/sites/www/tk/en/resources/pdf/medical_tk.pdf

(from the “Executive Summary”)

“Traditional medical knowledge is experiencing increased attention worldwide in light of global health care demand and the significant role of traditional medicine in meeting the public health needs of developing countries. Traditional medicines already comprise a multibillion dollar, international industry, and the biomedical sector is increasingly investigating the potential of genetic resources and traditional knowledge. Documenting and protecting these medicines is becoming a greater priority.

Traditional knowledge has historically been at odds with modern intellectual property systems designed to protect innovations such as new pharmaceutical drugs. However, as the financial value of many forms of Traditional medicine becomes recognized, Traditional knowledge holders and nations rich in genetic resources are arguing for greater protection through non-conventional systems of intellectual property protection. Traditional knowledge holders are increasingly demanding fair and equitable distribution of benefits from the commercialization of Traditional medicine, as well as the prior informed consent of Indigenous peoples to prevent misappropriation.

Many problems associated with the protection of Traditional medical knowledge lack clear solutions. In attempting to protect Traditional medicine, Traditional knowledge holders are confronted by a confusing and diverse group of national and international policies, regulatory systems designed primarily to accommodate pharmaceutical medicines, safety and efficacy concerns, and challenges to ownership.

This text is designed to assist Traditional medical knowledge holders, government representatives and third-party collaborators to think about issues of intellectual property law specifically related to Traditional medical knowledge. It is not intended to provide legal advice, but rather to help stimulate thinking about traditional knowledge and to provide illustrative case studies.

There is no generic way to protect Traditional medical knowledge. Traditional knowledge holders should carefully consider identified community goals for the use of Traditional medicine and the risks and benefits of documentation. Whether Traditional medical knowledge is documented can have far reaching consequences on intellectual property protection, commercialization and promotion of Traditional medicine, regulatory submissions and interactions with collaborators. It is important that Traditional knowledge holders be adequately informed to safeguard their reputations and interests when interacting with third parties.

**THIS 2015 LETTER FROM THE WHO DIRECTOR EXPLAINS VERY SUCCINCTLY THE CHALLENGES AND OPPORTUNITIES ASSOCIATED WITH COORDINATING USAGE OF BOTH MODERN & TRADITIONAL MEDICINE AS A MEANS OF INCREASING ACCESSIBILITY OF HEALTHCARE WORLDWIDE**

WHO DIRECTOR-GENERAL ADDRESSES TRADITIONAL MEDICINE FORUM

Dr Margaret Chan, Director-General of the World Health Organization Opening remarks at the International Forum on Traditional Medicine China, Macao SAR.a ; 19 August 2015

“Excellencies, honourable ministers, distinguished experts, ladies and gentlemen, I welcome this opportunity to address the International forum on traditional medicine, especially as we inaugurate the WHO collaborating centre on traditional medicine in Macao.

Modern medicine and traditional medicine make unique contributions to health, but both also have their limits and shortcomings. Countries, especially in the developing world, are wise to use the best of these two approaches in a carefully integrated and regulated way.

Traditional medicine has much to offer, especially as a contribution to primary health care and universal coverage, and most especially at a time when chronic noncommunicable diseases have overtaken infectious diseases as the world’s biggest killer. For many millions of people, often living in rural areas of developing countries, herbal medicines, traditional treatments, and traditional practitioners are the main, sometimes the only, source of healthcare. This is care that is close to homes, accessible, and affordable. In some systems of traditional medicine, such as traditional Chinese medicine and the Ayurveda system historically rooted in India, traditional practices are supported by wisdom and experience acquired over centuries. In these contexts where traditional medicine has strong historical and cultural roots, practitioners are usually well- known members of the community who command respect and are supported by public confidence in their abilities and remedies.

This form of care unquestionably soothes, treats many common ailments, reduces suffering, and relieves pain. It also keeps people with minor complaints and illnesses from flooding clinics and emergency wards. However, these well-known advantages contribute to one of several criticisms of traditional medicine. The belief that traditional healers are the first and best line of defence against illness and disease can lead to potentially life-threatening medical emergencies, especially when this belief blocks or delays access to mainstream medicine. In reality, this criticism does not align well with the situation on the ground. Many poor people with severe disease do not visit clinics or emergency wards precisely because none are available or accessible. Traditional medicine is the default, not the first choice. It is the only option available.

The danger comes not from the practice of traditional medicine per se, but from the failure of so many developing countries to provide universal access to essential health services. Surveys undertaken by WHO show that essential medicines for the treatment of acute diseases are available in only slightly more than half of all public health facilities. For privately run facilities, the figure rises to 68%. This means that large numbers of people who manage to reach health facilities are leaving them empty-handed.

In other cases, traditional medicine is the default option simply because Western medicine has nothing to offer. We witnessed this situation most vividly during the Ebola outbreak in West Africa. For the thousands of people infected and their doctors, modern medicine had nothing to offer, no vaccines and no treatments beyond supportive care. Patients and their families understandably preferred care in homes or by traditional healers to isolation in treatments centres where few left alive. Other criticisms centre on the weak institutional frameworks for regulating the quality and safety of traditional medicine. This weakness is likewise pervasive throughout the developing world, for all medical products. For medicines, only around 20% of WHO Member States have a well-functioning regulatory authority. Around 50% have variable regulatory capacity. And 30% have no or only very limited regulatory capacity.

Ladies and gentlemen, Modern medicine also has some shortcomings, both real and perceived. Paradoxically, these shortcomings have created a situation where traditional medicine meets a perceived need, yet earns a bad name at the same time.

In wealthy countries, the public often reacts in a negative way to health care that is seen as over-medicalized and over-specialized, with the patient treated like a collection of specialized body-parts, and not as a whole person. People want more control over what is done to their bodies. They want to self-regulate their own health. As seen in the movement of vaccination refusal, science is often mistrusted, sometimes even vilified. Rumours spread via social media can carry more weight that hundreds of well-designed peer-reviewed research reports. People are suspicious that powerful new drugs may have side effects that have either not yet been detected or were never honestly disclosed. People may also mistrust their doctors. They want second and third opinions. They look for an expert with more expertise. These expectations were well illustrated by the practice of doctor shopping and hospital hopping that contributed to the rapid spread of MERS in the Republic of Korea. Some analysts attribute this dissatisfaction and mistrust to the system, the infrastructure, the training, the incentives, and the orientation of modern medical care. In many countries, this system dictates that a doctor spend no more than around 20 minutes with each patient. During these few minutes, the doctor is expected to act, not talk, to order. Moreover, the number of doctors practicing family medicine continues to shirk dramatically in favour of more specialists and sub-specialists. Family physicians are a vanishing profession right at the time when the rise of NCDs makes their skills essential for prevention and the continuity of care.

On the R&D front, the miracles of modern medicine, which have had such a stunning impact on life expectancy, are slowing down. The discovery of truly novel molecular compounds is becoming rare. Unlike antibiotics, many drugs for the treatment of chronic diseases and conditions, like high blood pressure, need to be taken long-term, if not life-long, raising concerns about cumulative toxic effects. Some newer drugs for treating cancer and diabetes have shown severe, sometimes life-threatening side effects. A drug for treating dementia or managing obesity has yet to be discovered. Many expensive drugs for treating cancer prolong life for only a few months, and the quality of that added life is often miserable.

The phenomenal rise of the alternative medicine industry responds to some of these shortcomings in what modern medicine has to offer. In several North American and European countries, the production and sale of herbal medicines, dietary supplements, and other so-called “natural” products have become a huge and profitable industry. In the USA alone, this industry is a $32 billion a year business.

The industry fiercely defends its territory, its claims, and its profits. Aggressive marketing that makes unsubstantiated claims has antagonized many in the medical establishment. As medical professionals argue, most alternative medicines are introduced onto the market, via over-the- counter sales or the Internet, without any regulatory oversight. In their view, the public risks self-medication with products that are potentially ineffective or toxic, or both. In this case, industry has hijacked traditional medicine, but without the skills of experienced practitioners. The resulting hostility and indignation are readily apparent in the titles of recent books that expose and condemn the industry’s behaviours, like “Trick or treatment”, “Snake oil science”, or “Death, lies, and politics in the vitamin and herbal supplement industry.” All of these publications share one fundamental conclusion: the efficacy of most traditional medicines and practices has not been confirmed in conventional clinical trials.

I would like to gently challenge that conclusion. The scientific method was not designed to accurately evaluate the full human experience that occurs when traditional medicine is delivered by skilled, experienced, and trusted practitioners in its cultural and historical home. Controlled clinical trials can evaluate the intervention or the herbal product, but not the full experience. Moreover, complaints of pain, anxiety, and stress nearly always have a subjective dimension. The placebo effect is a well-documented scientific phenomenon. As Nobel laureate Elizabeth Blackburn reminds both sides in the debate: “We tend to forget how powerful an organ the brain is in human biology.” Scientific research on the physiological effects of stress confirms the validity of that reminder.

Most medical infrastructures in wealthy countries were designed to manage infectious agents and did that job very well. They have done far less well with the prevention and treatment of NCDs, which rarely have a discrete cause like a single bacterium, virus, or parasite. Evidence is mounting that diet, exercise, and stress reduction can do a better job of preventing or delaying the onset of heart disease than most drugs and surgical procedures.Here, traditional medicine excels. Traditional medicine pioneered interventions like healthy diet, exercise, herbal remedies, and ways to reduce everyday stress.

Ladies and gentlemen, The view that traditional medicine should be given a more legitimate place within the structure of formal health care systems continues to provoke considerable debate.

Countries aiming to integrate the best from traditional and modern medicine would do well to look not at the many differences between the two approaches. Instead, they should look at those areas where both converge to help tackle the unique health challenge of the 21st century.”

Thank you.

This 257-page document was created through the collaboration between the Secretariats of the World Health Organization (WHO), World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO) and their colleagues. It, like all of the other documents I read from these organizations, was mind-boggling in its scope and innovation. I, for one, never hear much about them through the general media, but the work they are doing to regulate, protect, promote and assist is simply amazing. Below you will find some excerpts I found especially interesting and en-lightening and even somewhat reassuring.

Promoting Access to Medical Technologies and Innovation: Intersections Between Public Health, Intellectual Property and Trade

2012 World Health Organization, World Intellectual Property Organization and World Trade Organization. Reprinted with index, 2013. Web site: www.who.int/phi/en/ https://www.who.int/phi/PAMTI_WHO-WIPO-WTO.pdf

EXCERPTS TAKEN FROM “TRADITIONAL MEDICINE” CHAPTER:

• Traditional medicine has long been used as a mainstay of health care for many populations; many countries increasingly seek to preserve and promote traditional medicine systems.

• Traditional health practitioners develop their expertise through observation, building on empirical understanding about the use of traditional formulations.

• Traditional medicine contributes significantly to the health status of many communities, and is increasingly used within certain communities in developed countries. Appropriate recognition of traditional medicine is an important element of national health policies. Traditional medicines are increasingly being used outside the confines of traditional cultures and far beyond traditional geographical areas without proper knowledge of their use and the underlying principles. Herbal products which are categorized as something other than medicines and foods are becoming increasingly popular, and there is potential for adverse reactions due to lack of regulation, weaker quality control systems and loose distribution channels. They are also being used in different doses, extracted in different ways and used for non-traditional indications, including mail order and Internet sales. (WHO, 2004a).

• As with other medicines for human use, traditional medicines should be covered by regulatory frameworks to ensure that they conform to required standards of safety, quality and efficacy, according to the status and position of traditional medicine in the country’s national health policy and health system.

• The regulation of traditional medicines takes many different forms around the world. Depending on the national legislative and regulatory framework, they can be sold as prescription or nonprescription medicines, dietary supplements, health foods or functional foods. Additionally, the regulatory status of a particular product may differ in different countries. The same herbal product can be considered differently if it is traded between two countries which have different regulatory approaches and requirements.

• As developing countries increasingly look to their indigenous TK as the basis for new products with significant export potential, this creates a need for the regulation of quality, safety and efficacy of such products, thus posing challenges for regulators and producers.

• Many existing modern medicines are originally based on herbal products. Traditional medicines also contribute to the development of pharmaceutical treatments; as much as one-third to one-half of pharmaceutical drugs was originally derived from plants. Research efforts are being made to scientifically and clinically validate traditional medicines for use as future pharmaceuticals. • The high prevalence of traditional medicines being used throughout the world, coupled with efforts to integrate traditional medicines in modern national health systems, has increased the demand for information on the safety, efficacy and quality of these medicines. • The growth in the trade of health products based on traditional knowledge (TK), coupled with growth in the use of TK as a lead for biomedical research, treatment and product development, have caused concern and have provoked a policy debate about the misappropriation of TK and the development of, and compliance with, appropriate protocols for access to, and use of, TK, especially traditional medical knowledge. • Research is continuing on traditional medicines and traditional medical knowledge in various different areas, each generating a multitude of policy issues.

Many of the issues concern genetic materials used as the basis for medical research, and traditional medical knowledge that is either used directly to produce new products or is used as a lead in researching new treatments. The principal shift in focus has been to recognize that: 1. The custodians and practitioners of traditional medical knowledge may have legitimate rights 2. Their knowledge cannot be assumed to be in the public domain, free for anyone to use 3. As financial and non-financial benefits from R&D are shared along the product development pipeline, an equitable portion should also be provided to the origin or source of the material

The cultural, scientific, environmental and economic importance of TK has led to calls for it to be preserved (safeguarded against loss or dissipation) and protected (safeguarded against inappropriate or unauthorized use by others), and there are many programs under way at national, regional and international levels to preserve, promote and protect different aspects of TK. Such measures include: 1. Preserving the living cultural and social context of TK, and maintaining the customary framework for developing, passing on and governing access to TK 2. Preserving TK in a fixed form, such as when it is documented or recorded.

A. WHY PROTECT TRADITIONAL KNOWLEDGE? The IGC (Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore) has considered the policy objectives for international protection, including to: ** Recognize the holistic nature of TK and its intrinsic value ** Promote respect ** Meet the actual needs of TK holders and empower TK holders ** Promote conservation and preservation of TK ƒƒ ** Support customary practices and community cooperation ** Contribute to safeguarding TK ** Repress unfair and inequitable uses and preclude unauthorized IPRS (intellectual property rights) ** Promote innovation and creativity, community development and legitimate trading activities ** Ensure that PIC and exchanges are based on mutually agreed terms, and promote EBS.

B. WHAT IS TO BE PROTECTED, AND FOR WHOSE BENEFIT? There is as yet no accepted definition of TK at the international level. In principle, TK refers to knowledge as such, in particular knowledge resulting from intellectual activity in a traditional context, and includes knowhow, practices, skills and innovations. It is generally accepted that protection should principally benefit TK holders themselves, including indigenous peoples and local communities. However, there is no agreement on whether families, nations, individuals and others (such as the state itself) could be beneficiaries. While TK is generally regarded as collectively generated, preserved and transmitted, so that any rights and interests should vest in Indigenous peoples and local communities, in some instances beneficiaries may also include recognized individuals within communities, such as certain traditional health practitioners (with a specific reference to traditional medical knowledge). Some countries do not use the term Indigenous peoples or local communities and consider that individuals or families maintain TK.

C. WHAT IS IT TO BE PROTECTED FROM? One problem confronting TK holders is the commercial exploitation of their knowledge by others, which raises questions of legal protection of TK against unauthorized use, the role of PIC ( prior informed consent) and the need for EBS (equitable benefit- sharing). TK holders also report lack of respect and appreciation for such knowledge. For example, when a traditional healer provides a mixture of herbs to cure a sickness, the healer may not isolate and describe certain chemical compounds and describe their effect on the body in the terms of modern biochemistry, but the healer has, in effect, based this medical treatment on generations of clinical experiments undertaken by healers in the past, and on a solid understanding of the interaction between the mixture and human physiology.

D. HOW TO PROTECT TRADITIONAL KNOWLEDGE? The diversity of TK means that no “one-size-fits-all” solution could suit all countries and communities. It is also a significant challenge to establish how protection under a national system could be enforced regionally and internationally. Further work is being done in this area; research and policy determinations are ongoing.

E. DOCUMENTATION Documentation is especially important because it is often the means by which people beyond the traditional circle get access to TK. It does not ensure legal protection for TK, which means that it does not prevent third parties from using TK.

OTHER INVOLVEMENT BY WHO

>>In 2006, the International Regulatory Cooperation for Herbal Medicines (IRCH) a global network of regulatory authorities responsible for the regulation of herbal medicines which operates in conjunction with the WHO, was established. Its mission is to protect and promote public health and safety through improved regulation of herbal medicines.

>>Currently, over 120 WHO member states regulate herbal medicines. To support the efforts of member states in establishing and implementing effective regulation of herbal medicines, the WHO has published key global technical guidelines, in terms of their quality, safety and efficacy and sustainable use. Several other sets of guidelines are in development, including guidelines on the assessment of herbal medicines, the methodology for research and evaluation of traditional medicine, good manufacturing practices (GMPS) for herbal medicines as well as conservation and sustainable use of medicinal plants, such as good agricultural and collection practices (GACP) for medicinal plants.

>>The WHO has developed a series of volumes of WHO monographs on selected medicinal plants, which aim to provide scientific information on the safety, efficacy and quality control of widely used medicinal plants.

>>The WHO provides models to assist member states in developing their own monographs or formularies for these and other herbal medicines, and it also facilitates information exchange among member states.

=>>The WHO, in cooperation with its member states, promotes the rational use of traditional medicine for health care.

>>The WHO monitors the status of traditional medicine around the world and has published a worldwide review on how traditional medicines and CAM are recognized and regulated at a national level. This work aims to facilitate the development of legal frameworks and the sharing of experiences between countries (WHO, 2001b).

>>National regulatory systems on traditional medicine vary considerably worldwide. These range from an absence of regulation to highly structured regulation similar to that applied to pharmaceuticals. WHO notes that an appropriate legal and regulatory infrastructure for TM is vital in “promoting and maintaining good practice; assuring authenticity, safety and efficacy of traditional and complementary/alternative therapies; and providing equitable access to health care resources and information about those resources.”

>>The WHO has also published a report on a WHO global survey on national policy on traditional medicine and regulate Promoting Access to Medical Technologies and Innovation. The WHO is currently updating its traditional medicine strategy and, for this purpose, is undertaking a second global survey.

World Health Assembly, 67. (2014). Traditional medicine. SIXTY-SEVENTH WORLD HEALTH ASSEMBLY WHA67.18 Agenda item 15.1 24 May 2014 Traditional medicine NOTES FROM THE WORLD HEALTH ASSEMBLY: REPORT ON TRADITIONAL MEDICINE

The Sixty-seventh World Health Assembly, Having considered the report on traditional medicine,1 Recalling resolutions WHA22.54, WHA29.72, WHA30.49, WHA31.33, WHA40.33, WHA41.19, WHA42.43, WHA44.34, WHA54.11, WHA56.31, WHA61.21, and in particular WHA62.13 on traditional medicine, which requested the Director-General, inter alia, to update the WHO traditional medicine strategy 2002–2005, based on countries’ progress and current new challenges in the field of traditional medicine; Affirming the growing importance and value of traditional medicine in the provision of health care nationally and globally, and that such medicines are no longer limited exclusively to any particular regions or communities; Noting the heightened level of interest in aspects of traditional and complementary medicine practices and in their practitioners, and related demand from consumers and governments that consideration be given to integration of those elements into health service delivery with the aim of supporting healthy living; Noting alsthat the major challenges to the area of traditional and complementary medicine include deficiencies in: knowledge-based management and policy, appropriate regulation of practices and practitioners; monitoring and implementation of regulation on products; and appropriate integration of traditional and complementary medicine services into health care service delivery and self-health care,

1. TAKES NOTE of the WHO traditional medicine strategy: 2014–2023, its three objectives, and the relevant strategic directions and strategic actions that guide the traditional medicine sector in its further development and the importance of key performance indicators in guiding the evaluation of the implementation of the strategy over the next decade;

2. URGES Member States, in accordance with national capacities, priorities, relevant legislation and circumstances: (1) to adapt, adopt and implement, where appropriate, the WHO traditional medicine strategy: 2014–2023 as a basis for national traditional and complementary medicine programmes or work plans; 1 Document A67/26. WHA67.18 2 (2) to develop and implement, as appropriate, working plans to integrate traditional medicine into health services particularly primary health care services; (3) to report to WHO, as appropriate, on progress in implementing the WHO traditional medicine strategy 2014–2023;

3. REQUESTS the Director-General: (1) to facilitate, upon request, Member States’ implementation of the WHO traditional medicine strategy: 2014–2023, supporting their formulation of related knowledge-based national policies, standards and regulations, and strengthening national capacity-building accordingly through information sharing, networks and training workshops; (2) to continue to provide policy guidance to Member States on how to integrate traditional and complementary medicine services within their national and/or subnational health care system(s), as well as the technical guidance that would ensure the safety, quality and effectiveness of such traditional and complementary medicine services with emphasis on quality assurance; (3) to continue to promote international cooperation and collaboration in the area of traditional and complementary medicine in order to share evidence-based information, taking into account the traditions and customs of indigenous peoples and communities; (4) to monitor and allocate appropriate funds in accordance with the WHO programme budget towards the implementation of the WHO traditional medicine strategy: 2014–2023; (5) to report to the World Health Assembly periodically, as appropriate, on progress made in implementing this resolution. Ninth plenary meeting, 24 May 2014 A67/VR/9 The WHO Traditional Medicine Strategy 2014–2023 Developed and launched in response to the World Health Assembly resolution on traditional medicine (WHA62.13). The strategy aims to support Member States in developing proactive policies and implementing action plans that will strengthen the role traditional medicine plays in keeping populations healthy.

Addressing the challenges, responding to the needs identified by Member States and building on the work done under the WHO traditional medicine strategy: 2002–2005, the updated strategy for the period 2014–2023 devotes more attention than its predecessor to prioritizing health services and systems, including traditional and complementary medicine products, practices and practitioners.

Traditional, Complementary and Integrative Medicine

https://www.who.int/traditional-complementary-integrative- medicine/publications/trm_strategy14_23/en/

Downloads Publication details • Arabic (File size: 1.13 MB) Number of pages: 76 • Chinese (File size: 3.65 MB) Publication date: December • English (File size: 2.79 MB) • French (File size: 2.88 MB) 2013 • Italian (File size: 1.85 MB) Languages: Arabic, Chinese, • Russian (File size: 2.83 MB) English, French, Russian, • Spanish (File size: 2.91 MB) Spanish ISBN: 978 92 4 150609 0 WHO Traditional Medicine Strategy: 2014-2023

Networks and Collaborations

• International Regulatory Cooperation for Herbal Medicines (IRCH) • WHO Collaborating Centres for Traditional Medicine • Expert Advisory Panel for Traditional, Complementary and Integrative Medicine • Non-State actors in official relations

Vision and Strategy

• WHO Traditional Medicine Strategy: 2014-2023 The strategic objectives are: - To build the knowledge base for active management of T&CM through appropriate national policies. - To strengthen the quality assurance, safety, proper use and effectiveness of T&CM by regulating products, practice and practitioners. - To promote universal health coverage by integrating T&CM services into health care service delivery and self-health care. Publications and Databases

• Information portal to Traditional and Complementary Medicine publications • Traditional, complementary and integrative medicine • Publications and databases

ADDITIONAL REFERENCES & RESOURCES

THESE FIRST THREE ARE EXCELLENT! The Imperatives For Traditional Medicine By: Sian Lewis and David Dickson 30/06/10 https://www.scidev.net/global/systems/editorials/the-imperatives-for-traditional-medicine.html

Integrating Modern and Traditional Medicine: Facts and Figures By: Priya Shetty 30/06/10 Copyright: Flickr/UNAMID https://www.scidev.net/global/indigenous/feature/integrating-modern-and-traditional-medicine- facts-and-figures.html

Wedel J. Bridging the Gap between western and indigenous medicine in eastern Nicaragua. Anthropological Notebooks. 2009;15:49–64.Integrating traditional indigenous medicine and western biomedicine into health systems: a review of Nicaraguan health policies and miskitu health services

SPECTRUM OF ISSUES

**A background article outlines the differences in how modern and traditional medicine are practised, evaluated and managed, and explores where and how these clash (see Integrating modern and traditional medicine: Facts and figures). https://www.scidev.net/global/indigenous/feature/integrating-modern-and-traditional-medicine- facts-and-figures.html

**The practical hurdles to developing traditional medicines into modern pharmaceutical products, in particular, can be significant. Science journalist Yojana Sharma describes how they are being tackled to gain global regulatory acceptance (see Taking traditional medicines mainstream). https://www.scidev.net/global/health/feature/taking-traditional-medicines-mainstream.html

**In Africa, according to South African drug development expert, Kelly Chibale, the first step must be to create a database and physical collection of natural products from traditional medicine. Modern methods of screening, assessment and preclinical pharmacology can then be applied to develop commercial products (see Discovering Africa's drug potential). https://www.scidev.net/global/indigenous/opinion/discovering-africa-s-drug-potential.html

**If modern science can be used to explore traditional medicines, so too can it be used to reinforce the knowledge systems that support them. Antony Taubman, head of intellectual property at the World Trade Organization, argues that the latest information technologies are well suited to characterising the local and cultural context of traditional medical knowledge and of preserving and transmitting it for use in modern practice (see Recognising traditional health systems). https://www.scidev.net/global/health/opinion/recognising-traditional-health-systems.html

**But integrating modern and traditional medicine extends beyond simply applying modern methods to ancient knowledge. Traditional medicine experts, Bhushan Patwardhan and colleagues, call for an integrative knowledge system that recognises the epistemological differences between traditional medicine and modern science and establishes norms for cross-cultural interactions (see Ending medical dominance over the developing world). https://www.scidev.net/global/health/opinion/ending-medical-dominance-over-the-developing- world.html

**It can be done. Oswaldo Salaverry, director of the National Centre for Intercultural Health in Peru, describes the progress in his country in embedding traditional medical practices, such as vertical birth, into the national healthcare infrastructure for the benefit of public health (see Modernising traditional medicine must work for locals). https://www.scidev.net/global/health/opinion/modernising-traditional-medicine-must-work-for- locals.html

Abbott, R. B. et al. Medical student attitudes toward complementary, alternative and integrative medicine Evidence-based Complementary and Alternative Medicine (2010)

WHO factsheet on traditional medicine. WHO (2008)

WHO Country Cooperation Strategy 2006–2011, India: Supplement on traditional medicine WHO Country Office for India, New Delhi (2007)

Ghalib, H. The hunt for the next Artemisinin TDR News (2007)

National policy on traditional medicine and regulation of herbal medicines: report of a global WHO survey WHO (2005)

Deadly counterfeit diabetes drug found outside China's Xinjiang Xinhua News (2009)

Tilburt, J.C. and Kaptchuk, T.J. Herbal medicine research and global health: an ethical analysis Bulletin of the World Health Organization 86 577–656 (2008).

Ernst, E. Homeopathy: what does the "best" evidence tell us? The Medical Journal of Australia 192 458–60 (2010).

Maslove, D.M. et al. Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies BMC International Health and Human Rights 9 26 (2009)

Patwardhan, B. Drug discovery and development: Traditional medcine and ethnopharmacology perspectives SciTopics (2009)

Potential of traditional medicine should be fostered, Economic and Social Council President tells panel on attaining Millennium Development Goals in public health. UN Economic and Social Council (2009)

Robinson, Molly Meri and Xiaorui Zhang The world medicines situation 2011 (WHO, 2011)

WHO traditional medicine strategy 2014-2023. (WHO, 2013)

Talkmore Ngarivhume and others Medicinal plants used by traditional healers for the treatment of malaria in the Chipinge district in Zimbabwe (Journal of Ethnopharmacology, 2015)

Bertrand Graz and others To what extent can traditional medicine contribute a complementary or alternative solution to malaria control programmes? (Malaria Journal, 2011)

Sahdeo Prasad and Amit Kumar Tyagi Traditional medicine: the goldmine for modern drugs (Advanced Techniques in Biology and Medicine, 2015) Hashim Ghalib The hunt for the next Artemisinin (TDR News, 2007)

Duncan Graham-Rowe Biodiversity: endangered and in demand (Nature, 2011) [get nature link]

Stepha McMullin and others Trade in medicinal tree and shrub products in three urban centres in Kenya (Forests, Trees and Livelihoods, 2012)

Rachel Wynberg and others (eds) Indigenous peoples, consent and benefit sharing: lessons from the San-Hoodia case (Springer, 2009)

Ryan Abbott Documenting traditional medical knowledge (World Intellectual Property Organization, 2014)

Anand Chaudhary and Neetu Singh Intellectual property rights and patents in perspective of Ayurveda (Ayu, 2012)

Ethel Chitindingu and others A review of the integration of traditional, complementary and alternative medicine into the curriculum of South African medical schools (BMC Medical Education, (2014)

José O Rivera and others Use of herbal medicines and implications for conventional drug therapy medical sciences (Alternative and Integrative Medicine, 2013)

Jon Tilburt and Ted Kaptchuk Herbal medicine research and global health: an ethical analysis (Bulletin of the World Health Organization, 2008)

Bhushan Patwardhana and Ashok D. B. Vaidya Natural products drug discovery: Accelerating the clinical candidate development using reverse pharmacology approaches (Indian Journal of Experimental Biology, 2010)

Alan Harvey and others The re-emergence of natural products for drug discovery in the genomics era (Nature Review Drug Discovery, 2015) [get link from Nature?]

Caroline da Rosa Traditional medicine and complementary/alternative medicine in primary health care: the Brazilian experience In: Oreste Capelli (editor) Primary Care at a Glance – Hot

Promoting Access to Medical Technologies and Innovation Intersections between public health, intellectual property and trade. World Health Organization, World Intellectual Property Organization and World Trade Organization. Reprinted with index, 2013 https://www.who.int/phi/PAMTI_WHO-WIPO-WTO.pdf https://www.scidev.net/global/systems/editorials/the-imperatives-for-traditional-medicine.html

World Intellectual Property Organization www.wipo.int Online WIPO bookstore: www.wipo.int/ip-outreach/en/publications

World Heal;th Organization www.who.int/phi/en/

World Trade Organizatiom www.wto.org Online WTO bookshop: http://onlinebookshop.wto.org

“Making traditional medicine truly mainstream — incorporating its knowledge into modern healthcare and ensuring it meets modern safety and efficacy standards — is no easy task and is far from complete…..

….Indeed, it is no easy task, not least because modern health systems are built on the legal and procedural frameworks inherited from the developed world. They may serve the purpose of advancing and propagating modern medicine but they are not necessarily conducive to promoting traditional practices

For the two systems to work in greater harmony on a large scale, we need a global effort to break down the legal, regulatory and conceptual barriers that support the promotion of modern medicine at the expense of traditional practices.”

https://www.scidev.net/global/systems/editorials/the-imperatives-for-traditional-medicine.html