So<.SC;.Med. Vol. 24,No. 4, pp. 293-301.

1987 0277-9536/87
$3.00+0.00
Prmted m Great Britain. All rights reserved Copyright 0 1987 Pergamon J~urnak Ltd

THE AMBIGUITY OF SYMBOLS IN THE STRUCTURE

OF HEALING
CAROL LADERMAN
Department of Sociology and Anthropology, Fordham University, Bronx, NY 10458, U.S.A

Abstract-In his article, ‘The Effectiveness of Symbols,’ L&i-Strauss contends that the details of a Cuna
birth incantation evoke specific physiological responses from parturient women, aiding them through
difficult labors. His argument, which analyzes the incantation as a text divorced from its social setting,
has drawn criticism from students of Cuna society on a number of substantive points, primarily centering
around the difficulties that the special linguistic form of ritual language would present to a non-adept,
If the patient lacks a thorough comprehension of the mythic details, how can the incantation change her
physiological processes?
In an attempt to evaluate the effect of myth upon a woman in labor, this article calls upon Cuna and
Malay ethnographic data, and presents a Malay birth incantation as interpreted by the ritual practitioner
who recited it. Following a discussion of the non-semantic aspects of the incantation and the extent to
which the patient shares the interpretation of the healer in both the Malay and Cuna societies, recent
biomedical studies are cited in support of hypotheses concerning the physiological and biochemical effects
of myth m the management of childbirth.

Key ~~ords~hildbirth. symbolism, physiology and biochemistry, Southeast Asia, Cuna

L&i-Strauss celebrated analysis of a Cuna birth being instructed by the healer (an ‘incantation
incantation [I], which purports to show how belief in knower’ rather than a shaman, since the cure involves
a myth can assist a woman in labor to deliver her neither trance nor possession). The patient herself
child, is based upon a text (the Mu-lgulu) that had may be asleep, suffering too much to listen, or not
passed through many hands before it reached Lkvi- even present during part of the recitation [5]. Finally,
Strauss. The song was recited by an old ‘shaman’ to how could L&G-Strauss judge the effectiveness of
an uninitiated bilingual Cuna Indian who translated these symbols on the outcome of childbirth, since he
it literally into Spanish. The Spanish version was was never present before, during, or after their reci-
revised by Holmer [2] and translated into English. tal?
Basing an interpretation upon a text several times L&vi-Strauss can be criticized, as well, for his
removed from its source presents serious problems treatment of the incantation as an entity apart from
since: its social setting, for ignoring the roles and statuses
of the participants, and for making unsubstantiated
Like so many other species of literary composition of a
claims regarding the relative ease of childbirth among
magical or mystical nature. the song of Mu-Igala cannot be ‘native’ women compared to those of Western soci-
rightly understood except by the medicine man himself or eties.
by those initiated by him. It is possible to make a thoroughly In an attempt to evaluate the effect of myth upon
literal translation of its contents, but its hidden meaning a woman in difficult labor, after briefly discussing the
remains secret on many points [3]. protagonists in the drama of childbirth in Cuna and
Malay societies I will present a Malay birth incanta-
In other words. a complete translation, including tion (jumpi) which I collected in the state of Tren-
these hidden meanings, is possible only when the gganu, Malaysia. An important point of discussion
ritual practitioner who spoke the words is willing to will be the extent to which a parturient woman shares
reveal his knowledge to the translator. the healer’s interpretation of an incantation. Since I
Even the literal accuracy of the translation has tape-recorded the jampi as it was recited to a woman
been brought into question by ethnologists special- in childbed, read my transcription back, later, to the
izing in the San Blas Cuna [4], who have also healer who recited it to check its accuracy, and was
criticized L&i-Strauss hypothesis on a number of instructed by him in its meaning and symbolism, the
substantive points [4, 51. How can the physiological interpretation I shall present is essentially that of the
experiences of the woman in labor correspond to healer rather than my own.
details of the myth, as L&i-Strauss contends, when Following a discussion of the character of the
the incantation is not directed to the woman, who message sent, the attributes of its sender, and the
does not understand the ritual (‘stick-doll’) language beliefs and expectations of the recipient, I shall
it is phrased in, but to a set of wooden dolls, who suggest a framework in which to discuss some possi-
presumably do? These dolls are believed to carry out ble avenues for the effectiveness of symbols in the
the business of curing. on the spiritual plane. after successful completion of childbirth.
293
294 CAROL LADEKMAN
THE CtiI\;A ,AND THE kill-IGA1.A
The Cuna Indians belong to one of those rare
societies in which women are economically indepen-
dent, have considerable influence in politics and
ritual, are outspoken and eloquent in public gather-
ings, and provide a product (mola.~. appliqued blou-
ses) which is not only a source of income and prestige.
but the most important symbolic marker of the
culture [6]. Besides having their own public gather-
ings. they attend village-wide meetings at which
certain women reputed to commune with the spirits
can influence public policy through announcements
of the spirits’ communications. During the course of
these communal meetings, specialists often chant in
ritual forms of language which are interpreted to the
audience. These congresses arc considered to be
especially valuable for women, who surround the
chanters and are periodically exhorted not to sleep.
but to ‘listen well’ [5, 61.
The coming of age of a Cuna girl is the occasion
for the most important event in Cuna life. Although
there is no feast or ceremony connected with the
birth. puberty or other significant times in a boy’s life.
girls’ families hold feasts when a daughter’s nose and
ears are bored for rings. and at her first menstruation.
as well as in celebration of her puberty [6. 71. A Cuna
father proudly announces his daughter’s menarche in
the public gathering house and holds a village-wide
feast which is an abbreviated version of the puberty
ceremony yet to come, lacking the ritual elements
that are a feature of that rite of passage [6]. The
puberty feast is an elabordtc undertaking. requiring
the cooperation of the entire community in providing
food. drink and services. Some fathers take jobs in
Panama City or the Canal Zone to cam enough for
the great celebration. the only occasion at which
Cuna are permitted to get thoroughly drunk. The
puberty ikar (ritual chant. literally ‘way’), ostensibly
addressed to flutes, is heard by the pubertal girl and
all those present. as is a curing ikar (called ‘the way
of sobering up’). One of the most important roles in
the rites is that of the IL’!.a women who cuts the girl’s
long hair in the short style of womanhood. She and
the midwife (7~77~) occupy basic and central roles in
Cuna life.
The Cuna midwife is not only a specialist in
obstetrics. skilled in the management of childbirth
and the use of medicines. she is also a ritual adept.
Sometimes. however, the problems connected with a
difhcult delivery go beyond her expertise. obliging her
to call in a further authorithy who knows the proper
chant (the Mu-Igala) that WIII send the spirits of the
stick dolls on their mission of healing. Although his
role does not conform to the classical definition of a
shaman (he does not achieve trance or send his own
spirit on a quest). I will refer to him by that title.
following Levi-Strauss’ usage.
*Although I use the term ‘Mdays‘ for the sake of con-
venience. readers should hc aware of the fact that my
data is based primarily upon my own fieldwork in the
state of Trengganu during the years 1975 77 and 1982.
Variations in belief and behavior occur in other states
of Malaysia (see e.g. note * on p. 295).
The Mu-Igala recounts the coming of the shaman
to the house of birth (specially constructed in a
secluded part of the village [4]) and subsequent events
in great detail. I will give only a brief description here.
since the complete text is available [3]. The chant
begins with the midwife’s conversation with her
patient, It follows the midwife as she leaves for the
shaman’s house and persuades him to accompany her
to the house of birth, where he seats himself below the
patient’s hammock and burns the cacao beans whose
smoke gives him courage to fact the supernatural. He
must send the spirits of the stick dolls who dwell in
a box placed beneath the hammock to the house of
Muu, the spirit of childbirth whose name is also the
midwife’s title. Muu, represented as an old woman. is
essential to procreation. since she is responsible for
fetal development. Occasionally, however. she and
her helpers become attached to a child and refuse to
give it up. She causes pain to the mother by sending
cold winds to blow through her body, “strong
enough to carry off a tree trunk” [3]. The spirits of
the stick dolls trick Muu into a drunken stupor while
they search through her house. locate the spirit of the
fetus. and journey back to earth [4]. Muu herself must
not be allowed to leave her abode; her absence would
mean future sterility for the woman in labor. The
chant recounts the shaman’s search for medicinal
plants to stop the woman’s flow of blood. and the
midwife’s examination and cleansing of her genitals.
The dangerous high winds have changed to gentle
gold and silver breezes that accompany the baby’s
birth, as the chant comes to a close [3].
Although the Mu-Igala suggests that during child-
birth the Cuna woman, ordinarily active and asser-
tive. has become a passive arena for the contest
between the hero-shaman and the forces of Muu. it
is not quite accurate to say that Muu’s abode is,
“literally, the vagina and uterus of the pregnant
woman” [I]. The picture of the house of Muu.
peopled with threatening animals and powerful spir-
its. is meant to describe a real place--a spirit house
invisible to human eyes. It also describes the mother’s
womb. It exists at once on both the physical and
spiritual planes. Since relationships between the phys-
ical and spiritual worlds are analogous in Cuna
thought, the Mu-Igala acts as a script for action on
both planes simultaneously [4. 61. While the deeds of
the stick dolls are taking place in the spirit world that
is also the woman’s womb, the midwife’s minis-
trations as depicted in the incantation are taking
place in the world of reality but are made more
efficacious by the chanter’s song.
THE MAI.AYS* AND ‘THE JAMPI
Girl and boy babies are equally welcome in a
Malay family and neither sex is given preferential
treatment in regard to food or medical attention.
Malay familes whose children are all of the same sex.
whether male or female. often adopt a child of the
opposite sex to “make their families complete.” Nev-
ertheless. in many ways rural east coast Malay society
is the mirror image of Cuna society. Women con-
tribute to the family income by working at farming.
rubber tapping, marketing. and artifact-making, but
none of these is notably prestigious in either the
 Ambiguity of symbols in the structure of healing
economic or symbolic sphere. Two of the more
lucrative occupations, fishing and lumbering, are
closed to women. In those open to both sexes, women
can usually expect to receive considerably lower
wages than men. In my research site, during the years
1975-77, a day’s agricultural work paid M$5.00 to a
man, M$3.50 to a woman. Women’s work rarely
brought in more than MFIi70.00 a month, while male
sawmill workers earned M$150 to M$400.
Marriage is no guarantee of financial or emotional
stability, since a man need only pronounce the Mus-
lim t&k (I divorce thee) to dissolve the marriage.
Unless his divorced wife is pregnant, he must main-
tain her for only three months, during which time he
may decide to take her back (see [8,9, lo] for further
details about Malay marriage and divorce). The bulk
of female employment is related to land, and only a
small percentage of that land belongs to women.
Many women lose access to the land upon divorce
and are obliged to work as hired hands and/or
depend upon their parents for support until they
remarry. Older women with young children who
remain unmarried and cannot depend on parental
support may suffer particularly severe economic loss
as a result of divorce.
The Malay womanly ideal is circumspect, modest
and deferent, and those who deviate too far from the
norm run the risk of divorce. A woman may be
outspoken at home, her husband may respect her
advice, and she may have some control over the
family pursestrings, but she will hesitate to speak out
in public, or overtly influence local politics, even if
invited to do so [I 11.
Ciirls’ rites of passage, such as the clitoridotomy,
done when they are about 40 days old, and the ear
boring, when they are four or five, are minimally
celebrated, most often with light refreshments for the
immediate family. Unlike a boy’s circumcision, which
is accompanied by religious observances, elaborate
preparations and feasting, a girl’s ‘circumcision’ is a
minor matter: the midwife makes a tiny incision in
the clitoral hood after she has performed the rites that
release the mother and child from the dangers of
childbirth.
Circumcision, for a boy, is a ceremonial event of
the utmost importance. Often the candidate is dressed
in princely clothes, similar to those he will wear at his
wedding, and, indeed, in former times circumcision,
which changed a boy into a man, was a prelude to
marriage. After his circumcision, a boy is prohibited
from eating certain foods until his wound heals-the
same categories of food that women avoid after
childbirth, the most important event of their lives.
Menarche, a significant turning point in Cuna
society, is not a ritual occasion for Malays. No
celebrations mark the day, no food restrictions are
observed, and girls may perform their usual house-
hold tasks. A menstruating women is restricted only
in regard to prayer and fasting. She may not offer the
five daily prayers required by Islam and she is excused
from fasting during Ramadan, although she must
make up the missed time by fasting during sub-
*An informant in the state of Kedah told Banks [41] that
a baby is formed first in its father’s stomach.
295
sequent days. Attaining puberty is important, since it
makes a girl a candidate for marriage and changes
her behavior. She will no longer bathe naked with her
brothers or play rough and tumble games with the
boys; she will often take to wearing long skirts and
downcast looks and exhibit an increasing acceptance
of the role she will soon play: that of the modest and
diffident Malay wife. It is, however, neither a time for
rejoicing nor a time for seclusion or observance of
taboos. Unlike the Cuna. Malays consider childbirth,
rather than first menstruation or the attainment of
puberty, the significant event that changes a girl into
a woman.
Malay beliefs concerning conception graphically
illustrate their views of the essential nature of male
and female. Humanity is formed of earth and par-
takes of animal nature (lza~ja nefiu). but our pos-
session of rationality (&al) makes us higher than the
angels. Although both men and women have akal
and hawa nafsu, developed states of self-control and
rationality are masculine qualities, while bodily hun-
gers are associated with women. It is, therefore, more
appropriate for a baby to begin life within its father’s
brain, a highly developed source of akal, than in its
mother’s womb, the most animal-like part of human-
ity.* Malay men are believed to be pregnant for 40
days before their wives take over the task, and many
clearly ‘remember’ craving special foods. Once a
woman is pregnant, both she and her husband are
cautioned against actions that may prove risky for
the developing fetus. Husbands are warned that
sitting in the doorway may close the entrance to the
womb by the working of sympathetic magic; wives
are advised that tying a scarf around one’s throat
might cause the umbilical cord to loop around the
baby’s throat and choke it. A father’s tie to the child
is equal in strength and intensity to a mother’s,
although it becomes somewhat more attenuated as
pregnancy advances.
Most Malay women deliver their babies at home
(or at their mothers’ homes), with a midwife in
attendance (either a traditional village midwife, a
government midwife, or both at once). Malay mid-
wives have traditionally occupied a position of high
status. The Ninety-Nine Laws of Perak. compiled in
the 18th century, state that “Muslims must feed the
district judge, the officials of the mosque, the homoh
[traditional healer] and the bidan [midwife]” [12].
Although neither the bomoh nor the bidan are pres-
ently entitled to financial support, they are both
addressed by an honorific (‘[ok) and treated with
respect by their clients and neighbors.
In the seventh month of pregnancy, a prospective
mother presents the midwife of her choice with a
small present (usually a couple of dollars and the
ingredients of betel quids), to assure her services
during labor, childbirth and the postpartum period.
She is summoned at the start of labor, examines her
patient, and, depending upon her judgment as to
whether the labor is proceeding normally, and how
imminent the birth is likely to be, she may either leave
the patient, returning later, or stay from the begin-
ning of labor until the birth of the baby. If the
laboring woman is a primapara. the midwife is likely
to remain constantly in attendance, no matter how
long it takes. I, myself, spent 24 hr assisting a tradi-
296 CAROL LADERMAN

tional midwife with a particularly difficult case; she ease the course of birth. Where the spirit goes the
had been summoned 5 hr earlier. body must follow, and so the baby is encouraged to
The Malay midwife, like her Cuna counterpart, is make its way into the world. Incantations are recited.
not only skilled in nursing and obstetrics, she is also but not with the intention of compelling behavior.
a ritual practitioner and adept of the supernatural physical or spiritual, or of hastening the un:imely
whose ‘inner knowledge’ may be applied to problems arrival of a child who is ‘not quite ripe.’ The birth
outside the sphere of childbirth. A popular saying, “If incantation presented below was not a method of
you are giving birth, you should listen to the mid- wresting the soul of the laboring woman or her child
wife,” uses the midwife as the exemplary expert. She from supernatural entities; it did not involve any
is listened to because of her knowledge, accumulated heroics on the part of the bomoh; he neither com-
over years of successful practice, and not because of manded nor tricked the spirits, nor did he consider it
any power to compel behavior. A midwife’s advice is necessary to employ his own spirit familiars on this
always respected, but a mother’s wishes take pre- occasion. Recitation of the jampi was meant to
cedence; she has the final decision, the birth atten- enhance the safety of mother and child by bringing
dant, whether midwife or bomoh, only assists. A them into a more harmonious relationship with the
Malay woman, ideally deferential and compliant in Universe, and, at the same time, keep the mother’s
most situations, reaches an acme of personal auton- mind on holy matters instead of on her pain.
omy during childbirth. She may lie down, sit or move The assembled women, friends and relatives of the
about until birth is imminent; she may eat and drink laboring woman giving birth to her first child. had
whatever and whenever she desires; she may use or tried their best to calm the young mother’s apprchcn-
discard traditional practices (such as typing a sash sions during her long and painful labor, assuring her
above the fundus of the uterus to keep the baby from that her ordeal would soon be over and exhorting her
rising) as she sees fit. The Malay mother’s autonomy to pray. rather than moan or cry, during con-
is not eroded even if its exercise may lead to her death tractions. As the labor continued, the woman’s
(see [8] for further details). strength diminished, and she found it increasingly
Although, generally speaking, the midwife feels difficult to maintain the proper decorum expected of
fully competent to deal with any natural or super- a Malay woman in labor.? The attending midwife
natural problem that might arise during childbirth, suggested that the family call in Pak Daud, a neigh-
an occasional case may go beyond her capabilities as boring bomoh.
sole practitioner and she will recommend that her After the bomoh arrived. he knelt on a mat beside
patient’s family call upon the services of a bomoh. the laboring woman. his manner soothing rather than
Bomoh who assist at difficult births have access to commanding, and his voice clearly audible as he
different, sometimes more sophisticated, treatments spoke the following words. During his recitation. the
than do midwives, but their methods are no more woman’s moans ceased. her expression cleared. she
coercive.* One bomoh of my acquaintance called the appeared to gather further strength. and her baby
baby’s semangat (vital essence or spirit) as part of his was born within a half hour of the jampi’s end.
technique, using the same sound Malays use to call In the Name of God. I want to begin by putting a secret m
their chickens (kurr, kurr). Semangat, like chickens. its proper place. 1, the physician. had not yet been born The
do not always respond to calls or entreaties, but Light had not emerged from the Darkness. The tight was
should the bomoh be successful his treatment might manifest only within God. The earth and sky had not yel
been parted. The Heavenly Throne was not yet erected. The
Book of Fate had not yet been written. had not been
revealed. Heaven and Hell were unknown at that time. I. the
*Malay culture casts the birth attendant in the position of physician, ask that skill be added to luck. according to
respected assistant to a client, in contradistinction to the ancient decree. I ask that it may fall to me to be a physician
Western obstetrician, an authority whose decisions, and healer, as I utter praises to the Lord.
although they may be open to suggestion along the way. When the Light of Faith had just been lit. when the Divine
are ultimately final. The non-coercive nature of the birth Pen had started to write to inscribe the Book of Fate into
jampi is highly congruent with Malay etiquette which the Hadith, explaining Heaven and Earth. there came three
brands unsolicited advice (from anyone) as rude inter- Utterances. The first Utterance turned into iron. the second
ference with individual autonomy; with Malay attitudes Utterance. the Breath of Life, the third Utterance was
towards healers (patients are not obliged to follow their semen. The semen swelled and glistened like a white sail and
recommendations or to remain loyal to any particular became foam. The foam staved in the Sea of God’s Man for
bomoh or midwife); and with the Malays’ laissez-faire untold ages. for 70,000 years.
attitude towards ‘breaking taboos’ [8]. Although one First it was the Sea of Practice, second. the Sea of Expcri-
might agree with Scheffelin [13] that, in a certain sense, cnce. third. the Sea of Thought, fourth, the Sea of Reason.
all ritual modes of communication are coercive, I believe fifth, the Sea of Coitus, sixth: the Sea of Tiredness. seventh.
that elaboration of this point within the present context the Sea of Patience, eighth. the Sea of Foam. The foam was
would obscure rather than illuminate the material. carried by the wind, tossed by the waves, by the seven rolling
tUnlike the behavior of many women in American hospi- waves, by the groundswell. Where wilt the foam land? It
tals, screaming, crying or complaining during labor is lands on the Banks of Desire, where the young TL(tree grow’s
extremely rare in a Malay home. The moaning and in the golden land, in the kingdom of Rajah Bali. Stream of
complaining of the young mother to whom this jampi Desire.
was recited would be considered decidedly mild by Then the Angel Gabriel came down. He took up the foam
American standards. Of the dozens of births I witnessed and stood before the Light of Muhammad. “My Lord, what
in Malaysia, the only case in which a mother indulged is within this foam? Its color is fine. of four kinds. seven
in noisy, all-out screaming was that of a deaf-mute colors.” Then Muhammad said, “Oh, Gabriel, if you w’ant
giving birth to an illegitimate child. said to be the result to know what is inside this foam, go fetch the strongest
of a rape. Persian steel. cut it in two, break it in four. shred it in five.”
 Ambiguity of symbols
So Gabriel fetched the strongest Persian steel He cut it in
two, broke it in four, shred it in five. Inside was revealed a
human pair. The husband was called First of All Pilgrims,
the wife was called Lady White Dressed in Flowers. You are
truly the first seeds of life, the original Winds of Desire.
Then Gabriel himself took up the foam. In his own hands
he held it for 40 days. Its name was Light of Command.
Then Gabriel thrust it into the father’s brain, for 40 days in
the father’s brain. It fell to his eyes, Light of Lights. It fell
to his chest, True Sultan, happy center of the world. It fell
to his big toe, King Phallus is its name.
Then it is that you must pray, 40 times a day, 40 times a
night. Then it is that you fall into your father’s womb, 40
days, di wadi mani manikam. From di comes earth, from
wadi comes water, from mani comes fire, from manikam
comes air.
Then you fall into your mother’s womb, nine months, ten
days. The first month you are called Dot, the second month,
Light of Beginning, the third month, Light of the Soul, the
fourth month, Light of the Countenance, the fifth month,
Light of the Womb, the sixth month, Abdullah the Slow, the
seventh month bow to the right, bow to the left. Bow to the
right, you are a son; bow to the left, you are a daughter. The
eighth month, Light of Birth, the ninth month, your outline
is plain, the tenth month, out you come.
You have all 20 attributes of Muhammad. You know your
mother’s body. You open your eyes and utter three prayers.
The first utterance lifts the soul to the breast, the second
utterance, the Breath of Life, the third lifts the Vital Forces
to the breast. May all that you feel be good. You breathe
in the five Vital Forces and wave your arms thrice. You
carry a compass within you from the day you first stand in
the magic pentacle with the letters al$ lam, za, rub, lullah.
You call upon your friends Gabriel, Michael, Israfel, Israel,
Ali, Omar, Osman, Abu Bakar, Kiraman Katibin.
THE BOMOH’S INTERPRETATION
This jampi links the creation of the universe to the
birth of the baby for whom it is recited. It begins in
the vastness of space, before the universe had taken
form, before life had begun. Even then the Light of
Muhammad existed, making him first among proph-
ets in his spiritual body and last in his physical body.
The judgments of the Book of Fate had already been
inscribed in the Hadith,* proving the primacy of
Islam among all religions. Seventy thousand years,
the time that elapsed between the first moment of
Creation and the beginning of humankind, represents
the vastness of God’s time, the week of Creation
expressed in human terms.
Malay jampi speak of both the universe without
and the world within Man. The sea may be the Sea
of Creation, the actual South China Sea, the human
bloodstream, or all of them at once. The Heavenly
Throne is also the heart of humanity, the place where
God is enthroned. One must always remember that
everything the bomoh talk about is contained within
our own bodies (dalam diri kita).
The wind and the waves in the jampi are not only
those which flowed at the moment of Creation, they
*The Hadith is a collection of traditions about the sayings
and deeds of Muhammad.
tNyawa is related to the Greek pneuma, both conceptually
and etymologically.
in the structure of healing 297
are also the Inner Winds that form our characters,
and the winds of desire and waves of sexual ex-
citement within the human breast. The golden coun-
try is the woman’s body; the ru trees, whose foliage
resembles pubic hair, are the female genitalia. When
the foam (semen) reaches the golden country, the
second Creation takes place. The first human couple
appears, an ideal pair. He is the First Haji; she is his
pure and virtuous wife.
The third recounting of the act of Creation tells of
the conception and development of the particular
child awaiting birth. A creature composed of the four
universal elements, earth, air, fire, and water, the
baby has developed from its earliest beginnings inside
its father’s brain through all the stages of gestation
within its mother’s womb. First it is a dot, a speck so
small it cannot be seen. In the second month it is a
lump of blood just beginning to take form but still
lacking a soul. That is why many Malays feel that
until the third month, when the fetus receives its soul,
abortion is not a sin. During the next three months
the fetus takes on human shape; by the sixth month
the waiting parents begin to feel as though the
pregnancy has gone on for a long time and yet the
end is not in sight (which is why the fetus is then
called Abdullah the Slow). By the seventh month a
midwife can tell the baby’s sex by feeling whether it
is located primarily on the left or right side of its
mother’s womb. The right, associated with purity and
rationality, is the side on which male babies develop;
the left, reserved for dirty tasks connected with our
animal nature, is the female’s side.
The baby’s 20 characteristics are the outward signs
of humanity, contrasted in mystical writings with the
hidden esoteric aspects or true essence. The three
prayers uttered by the newborn at the close of the
incantation echo the Three Utterances of God in the
beginning. They endow the child with the inward
components of his being. The first is the soul (ruh),
which departs from the body at death. The second is
the Breath of Life (nyawa).t The baby must inhale
nyawa within seconds after birth or his body will not
be animated. The third is the Vital Force (semarzgat)
that pervades the universe and all of Creation. Its
close association with the body leaves semangat
vulnerable to depletion if one is startled, ill or over-
worked. Loss of semangat, in turn, leaves the body
vulnerable, open to spirit attacks which would not
succeed if directed against whole, healthy people.
The five vital forces and the five points of the magic
pentacle are the five senses. The inner compass refers
to the course one’s life will take due to the dictates
of fate, to the conscience that keeps one on the proper
path, and to the directional systems employed by
bomoh and midwives (see [8] for details). Alif stands
for Allah, and lam completes God’s Name. Za, ruh
and lullah (the last is not a letter but a variant of
ila’llah) stand for Azrael, the angel of death, to
remind us of man’s mortality even at the moment of
birth, and for zikir ruh Allah, the soul remembers and
praises God. The newborn calls upon his friends, the
four archangels Gabriel, Michael, Israel and Israfel,
and the Four Companions of the Prophet Muham-
mad, Ali, Omar, Osman and Abu Bakar:Kiraman
Katibin are the Recording Angels; one records good
deeds, the other, evil.
298 CAROL.LALXKMAN

THE PROBLEM OF ‘MEANING’ of girls’ puberty festivities [5]. Cuna women, there-
fore. have been frequently exposed to the language of
The foregoing exegesis, while interesting in its own ikar before they become clients of a shaman during
right, cannot support the claim that the message of childbirth. Much of the figurative vocabulary in
an incantation can evoke physiological changes in its curing ikar is far from arcane. For examtk ‘hat’ may
recipient. Such a claim must rest or fall on evidence stand for ‘brainpower. ’ ‘angry person’ f:or ‘cbil spir;t
showing shared understandings on the part of the or sickness’. Moreover. although ikar involve vocab-
sender and the recipient. The question of ‘meaning,’ ulary quite distinct from colloquial Cuna. much of
moreover, must include a consideration of the send- the content of the songs is not esoteric but. rather.
ers’s attributes, the expectations of the recipient, and consists of detailed descriptions of ordinary events
the content of the incantation in relation to the larger phrased in everyday banal speech. Ordinary Cuna.
cultural setting, as well as linguistic aspects of ritual although they do not understand an ikar in absolute
and metaphoric language. detail. as L&i-Strauss believed. are aware of its
The exegesis itself evoked a strong reaction from structure and purpose. and. to a greater or lesser
an anonymous reader of an earlier version of this degree, understand some of its language. Children. as
paper, who insisted on the necessity of justifying its well as adults, imitate ritual specialists for fun, pro-
inclusion at a time when the ‘meaning centered’ ducing remarkably accurate mimicries of their lin-
approach to ritual is being criticized (e.g. [ 131). Re- guistic style [6].
cently, Foucault has even called for a “refusal of Pak Daud’s iampi does not employ a special
analyses couched in terms of the symbolic field or the linguistic mode or ritual vocabulary. It corresponds
domain of signifying structures. and a recourse to less to the stereotype or II spell (sccrct. muttcrcd. not
analyses in terms of the genealogy of relations of meant to bc understood by its human audience.
force, strategic developments, and tactics” [ 141. Bloch addressed to supernatural cntitics. lacking in poetic
[I 51 believes that the efficacy of symbols in ritual is to structure), than it does to the stcreotypc of a prayer
be located in their non-semantic, rather than seman- (audible, employing ;I series of metaphorical images
tic, content. But one must keep in mind that rituals [16]). But while PaL Daud (respected as a pious
span the gamut from those in which action dominates teacher of Koran as well as a powerful bomoh)
(such as mass participation in communal rites) to commented that this type of jampi would satisfy cvcn
those performed with words alone. as is often the the most orthodox Muslim.* he and his audience
case in healing incantations (see also [16]). For the placed It in a ditfcrcnt category from .cc~mhnh~~r~g
latter, the content of these words. while not the sole (recitation of the tive obhgatory Muslim daily
determiner of ‘meaning,’ is of prime importance. prayers) and r/otr (supplementary prayers). both ad-
Students of Cuna language and society. writing in drcsseti to .4llah.
the 197Os, contended that a woman’s hearing of the Pak Da11d’5 v,or&. addI-csscd to his human audi-
Mu-Igala, addressed to a set of dolls resting bcncath cncc. are not sacred m the scnsc o!‘Islamic prayer. but
her hammock, rather than to the parturient woman are. ncvcrthelcss. bclicved to carry power; ;I powc~-
herself, could not evoke particular physiological reac- that proceeds from the bomoh’s breath. the outward
tions since it is couched in a linguistic mode unknown manifestation of his rrr~@ (Inner Wind). Many eth-
to the patient. who. moreover, may be sleeping or nographers of magic have remarked on the im-
wracked with pain during its recitation [4. 51. But portance of the magician’s breath as the medium 01
even in the ethnographies of the 70s there were the magical force (e.g. [17. 181). East coast Malays
indications that the separation of everyday and ritual make the connection explicit. No one, they say. can
speech among the Cuna is far from complete. The successfully function In any calling without having
linguistic characteristics of the ceremonial varieties inherited the appropriate Inner Wind. This is partic-
overlap the colloquial phonologically. syntactically ularly vital in the case of bomoh (and midwives).
and semantically, sometimes involving particular whose Inner Wind emerges during treatment of their
prefixes or suffixes, vowel elisions and elongations, patients and allows them to transfer its efficacy,
syncopation and consonantal change. Chanting con- through the breath, to substances used in treatment
gresses, meant especially for women, feature ritual and. directly. to the patient’s hody. in the form of
words not used in colloquial language. A ‘translator’ words and pufTs 01‘ air. The power of the word
interprets the message for the non-adept. Those who emanates. moreover. from the quality of the bomoh‘s
want to learn ikar study with knowers until they arc voice as well as from what he says. His voice rings
able to perform an exact replica of their instructor‘s out: his words are meant to be heard.
speech. Their success is then proclaimed during a Ethnographers of Southeast Asia have stressed the
chanting congress by the teacher. who gives a long importance of secrecy in the workings of magic.
speech describing the entire learning process. Curing Cuisinier 119; cf. IO] averred that Malays consider
ikar, spoken in ritual language, may be performed for secrecy a condition for success, necessitating the use
personal pleasure, and are often part of the entertain- of mumbling and whispering when reciting spells.
ment, as well as the necessary ritual accompaniment. Marc recently, Errington [21] remarked that in LLIWU
(Indonesia) whispers have a higher status as a ritual
medium than clearly audible words: Atkinson’s Sul-
*The work of the bomoh has become increasingly objet-
awesi ritual instructors stressed accurate memo-
tionable to orthodox Islam in Malaysia [42]. Pak Daud
IS unhappy about the cognitive dissonance he experi- rization and sccrecv [Z!].
ences in his dual roles as Koranic teacher and bomoh. In the northcas; \tates of peninsular Malaysia,
yet he does not hesitate to leave his Koranic students however. two traditions of magic exist side by side:
to minister to a patient’s needs. some homoh muttt’r their words swiftly and under
 Ambiguity of symbols in the structure of healing
their breath; others speak loudly in measured tones.
The former insist that their students learn spells
exactly, decline to discuss their content or to elucidate
the meaning of unusual (ritual) words; the latter are
not dismayed by a measure of variation in either their
students’ or their own recitations of jampi, and are
willing to discuss the content of incantations and to
gloss ritual words into the vernacular.* Individual
bomoh of both traditions have their devoted follow-
ers; ‘whisperers’ as a group are not granted higher
status. On the contrary, the ‘speakers’ privately mock
the ‘whisperers” mumbling and secretive attitude as
owing to their desire to hide a lack of knowledge.
The most salient difference between the two tradi-
tions is that the ‘speakers’ also functioned as per-
formers in the Malay opera (Muk Yang), the shadow
play (wayang k&t), and the Main Peteri (spirit-
raising seance)-and often in more than one. Al-
though the Mak Yong and the wayang kulit are most
often performed for their entertainment value, and
the Main Peteri functions primarily as a curing ritual,
exponents of all these genres combine the roles of
entertainer and spirit medium. Each genre contains a
feast for spirits (berjumu) within its repertory, whose
aim is propitiation of entities that might otherwise
bring epidemics or other misfortunes upon a village
[23]. These be@nu represent only a fraction of Mak
Yong and wayang kulit performances; however, even
ordinary performances, attended by an audience
which has bought tickets in pursuit of an evening’s
entertainment. must begin with the invocation of
spirits, and end with their dismissal. Since these jampi
are addressed to non-human entities, they are often
(but not always) spoken in lower tones than the rest
of the performance: it is immaterial whether the
human audience listens to them or not. Participants
in all forms of Malay performance arts utilize set
phrases as part of their equipment; they are, however,
granted wide latitude in devising improvisations on a
theme. The ‘speakers’ ofjampi continue this tradition
in their practice of the healing arts.
Pak Daud, respected for his Islamic piety and his
knowledge of jampi, is also renowned as a master of
spirits (minduk) in the shamanic seance (Main Pe-
teri). He acts as interlocutor, conducting dialogues
with the spirits who speak through the lips of the
entranced shaman. A successful minduk must be able
to speak clearly and forcefully, and to sing sweetly to
the accompaniment of a spike fiddle. Pak Daud is
eminently qualified, having played the romantic lead
in the Malay opera during his youth, and still re-
taining the performer’s dignified good looks and com-
manding presence. As other students of Malayo-
Indonesian culture have indicated (e.g. [21, 241) the
mere sound (hunyi) of a beautiful voice is considered
to produce an effect upon its listeners. The im-
portance of the voice was brought home to me
forcefully during the course of a Main Peteri. Several
ritural specialists, including a young novice, took
turns putting patients into trance. The novice was
*Besides interviewing bomoh and their students, I, myself,
studied with both ‘whispering’ and ‘speaking’ bomoh.
t1 do not mean to imply that this is ‘the true’ meaning.
299
signally unsuccessful. Clients explained to me later
that there was nothing wrong with what he said, the
difficulty lay in his unmelodious voice which jarred
the ears and prevented the harmonious state of mind
and body that allows one to trance. Although, as
Errington remarks [21], ideally sound, meaning and
effect can be thought of as an inseparable whole (the
word ‘bunyi’ encompassing the concepts of sound,
melody, meaning. content, purport [25, 26, 27]), in
practical terms each aspect can be judged and found
satisfying or wanting.
In Pak Daud’s view, the words themselves are not
permanently fixed and in danger of losing their
efficacy if they are not learned and employed ver-
batim; their power lies in their contextual meaning
rather than in their inflexible recitation. The language
of his jampi is reminiscent of hikuyat (Malay legends
read aloud to audiences) in its flowing poetic state-
ment; its use of metaphor relates it to Malay poetry
(frequently love lyrics), still composed in the coun-
tryside, which uses literary, historical and mythic
allusions to make subtle points; and to the everyday
language of the village, which can be cryptic to an
outsider’s ears (even to city Malays) in its use of
elision and irony and references to proverbs. Al-
though the speech of village Malays, such as Pak
Daud and his patients, may be a particularly salient
example, metaphor is a normal linguistic phenom-
enon of everyday speech, not related merely to lite-
rary or ritual modes [28]. Furthermore, many Malays
have had intimate contact with jampi as practitioners
as well as patients, having learned a short spell or two
for their personal use.
While Pak Daud’s jampi does not employ a ritual
vocabulary, it does make extensive use of polysemy,
the multivocality that Turner [29] called a ‘fan’ of
meanings (a particularly apposite phrase, since, like
a fan, it can conceal part of its contents within itself
or spread out to display its fullness). These multi-
layered meanings were explained to me at great
length by Pak Daud. I wondered to what extent his
patient shared this range of meanings. When I ques-
tioned the young mother, she remembered the
bomoh’s incantation but did not recall it in detail.
After listening to my tape she explained that the
jampi spoke about the creation of the universe, the
creation of humanity, and the creation of a baby, but
her understanding of the chant was not the complex,
learned exposition given to me by the bornoh.?
Malays are accustomed to the interplay between the
macrocosm and the microcosm in magic and philos-
ophy: they know that when a bomoh speaks of the
sea it is not merely the place to sail a boat, that the
mountain is also the human head, the fields the
human heart. Prior conception of a child within its
father’s brain is common, and not esoteric, knowl-
edge. But the ‘inner’ meaning of the ru trees, the
golden country, Rajah Bali (the legendary killer of
the Mad Buffalo in one of the shadow play stories;
according to the bomoh the Mad Buffalo is a
personification of negative emotions allowed to run
wild), and other details which the bomoh considered
significant, were not apparent to his patient. If the
symbols had been effective-and I believe they had-
their power lay in their ambiguity, their polysemy,
rather than their specificity.
300 CAKOL LADERMAN

THE LIFE OF THE BODY, THE LIFE slow down and even stop uterine contractions [31].
OF THE MIND For example. rabbits. who normally expel their litters
While their roles and mythology are strikingly within the space of IO min. stopped after the birth of
dissimilar in many respects, the incantations of both the first of the litter for up to 2 hr in rcsponsc to the
Malay bomoh and Cuna shaman provide a rationale presence of a stranger. When the disturbing presence
for the woman in protracted labor which puts her was removed. the rest of the litter was born within the
pains into a meaningful context with a promised next 20 min. The prolongation of labor due to fear is
satisfactory ending, rather than allow them to be felt associated with a much higher than normal perinatal
as unproductive and chaotic torment. Her experi- mortality rate. Studies involving deer, horses. cattle,
ences have already placed her outside the normal rats and dogs have demonstrated similar responses to
temporal scheme. The first stage of labor. from the those noted by Naaktgeboren [32].
onset of regular contractions of the uterus until the Human uterine dysfunction or inertia appears with
cervix is fully dilated, seems alternatively to take a characteristic patterns at difErent phases of labor. In
very long time and no time at all. For the woman in the latent phase (0 3 cm of cervical dilatation). the
labor there is no sense of living through an ordinary contractions are often intense, regular. painful and
60min hour. The second stage, the period from ineffectual. In the active phase (4cm to full cervical
complete cervical dilation through the baby’s birth, dilatation), the contractions tend to bc irregular. mild
can seem unimaginably long.* The medicine man, and unproductive [33]. Epinephrine production ap-
whether Malay or Cuna, recognizing the woman’s pears to be the biochemical pathway for uterine
time dislocation, provides her with the device of dysfunction. The higher the anxiety lcvcl of the
mythic time. a time controlled by a rationality be- woman in labor, the more cphinephrine is produced.
yond everyday appearance. in which to rally her resulting in lower contractile actiklty and longer
forces and concentrate her efforts for a successful phase two labors [34].
conclusion to her labor. The medicine man’s incantation. by reducing the
Clearly, the healer and his incantation engage the laboring woman’s anxiety. may thereby reduce her
mind of his patient and affect her emotions. The epinephrine production. With her fears under con-
effects of ritual. however. are not limited to the mind: trol, her uterine inertia may be counteracted and the
neither does physiological experience have ‘a life of its- normal functioning of productive contractions re-
own’ 1301. The mind and bodv work in concert: the stored. Biochemical changes in a woman‘s body late
symbolic universe I have described works simulta- in pregnancy prepare her to cxpericnce labor with a
neously on different aspects of the situation. On a minimum of pain. Levels of cndorphins. substances
psychological level, it gives the appearance of regu- produced in the brain with a shape and effect similar
larity and control to a problematic social and biolog- to that of morphine. incrcasc significantly during Ihc
ical process. But an argument that depends exclu- last trimester [35], peaking during the later stages of
sively upon psychological factors cannot contribute labor 136-381. These cndorphins. and other cndo-
significantly to an understanding of the effect of gcnous opioids. such as /I-lipotropin. also clevatcd
symbols upon the outcome of childbirth. Therefore. during childbirth [39], can mask pain. rcducc its
following Freud’s suggestion that psychological memory, and induce a state of euphoria. They ma)
terms must one day be replaced by physiological and also counteract the effects of the high levels 01
biochemical concepts [cited in I]. I shall suggest a catecholamines on the cardiovascular system 1381.
framework. based upon recent physiological and It has long been known that the admlmstration of
biochemical studies, in which to discuss such possible pharmacologically inactive substances can result in 21
avenues for the efficacy of the medical-ritual prac- wide range of physiological responses and is partlcu-
titioner’s treatment. larly valuable for the control of pain. The analgesic
Naaktgeboren’s studies of psychogenic factors in a effect of these placebos is owing to the production of
variety of animal births demonstrate how{ fear can the endogenous opioids which they trigger in many
patients’ brains [40]. This placebo cfrect may not be
limited to the application of material substances but
may be evoked as well by the power of words. In
*I have experienced this time distortion during each of my addition to reducing epinephrine production. the
own labors, and have been assured by other women medicine man’s incantations may also change his
during informal interviews that it is a common experi-
patient’s biochemistry by encouraging her body to
ence.
tThe importance of meaning in the efficiacy of an incanta- produce higher levels of endogenous opioids than
tion was illuminated experientially for me when I was ordinarily occur in the course of normal labor.
placed in trance by a shaman during the course of a The power of the word to allay the patient’s fear
Main Peteri. The method involved reciting pieces of the and modify her biochemistry depends upon the pa-
legend of an archetypal character whose attributes were tient’s internalization of its symbolic content. The
considered by the shaman to be congruent with mine, identification of the universe with the Cuna woman’s
within the framework of an incantation. My response
genitals, the correspondence of the Malay woman’s
was taken by the shaman to mean not only that his
birth experience and the creation of the world, those
diagnosis of my personality was correct, but also that
I now truly understood the content and meaning of his
elements of the incantation that are common knowl-
recitation. The same technique (which also employs edge and others which resonate with meanings of
darkness, incense, and regular percussive noises. gener- which the patient may not be fully aware are of vital
ally considered to be conducive to trancing). used on a importance to the recipient of the healer’s m_cssage.t
visiting colleague who had not internalized the symbolic Since the incantation IS not merely a collection ot
content of the recitation. was unsuccessful. words whose efficacy rests upon their being spoken
 Ambiguity of symbols in the structure of healing 301

exactly, but, rather, a poetic statement whose com- 17. Malinowski B. Coral Gardens and Their Magic, Vol. II:
plexity of meaning is based on complexity of thought, The Language of Magic and Gardening. Indiana Univer-
it is polysemic by its very nature. One cannot, sity Press, Bloomington, 1965.
therefore, seek to explain its workings by referring to l* Errington S. Embodied Sumange’ in Luwu. J. Asian
the necessity of communicating it in a ‘very precise Srud. XLII, 545-570, 1983.
and intense way’ so that the patient becomes “psy- 19. Cuisinier J. Danses Mugiques de Kelanrun. Institut
D’Ethnologie, Paris, 1936.
chologically aware of its smallest details” [l]. Incan-
20. Endicott K. M. An Analysis oJ’Ma/a~’ Magic,. Clarendon
tations cure by analogy, not through their specificity Press, Oxford, 1970.
but by their ‘fan’ of meanings, their multi-layered 21, Errington S. A study of genre: meaning and form in the
nature and the ambiguity of their symbols. Malay Hikayat Hang Tush. Ph.D. dissertation, De-
partment of Anthropology, Cornell University, 1975.
Acknowled~emenrs-Research on which this article is based 22. Atkinson J. M. Knowledge, power, and social relations
was supported by the Social Science Research Council, the in the Wana Hills. Unpublished manuscript, 1984.
Danforth Foundation, National Institute of Mental Health 23. Sweeney P. L. A. The Ramayana and the Malay
Training Grant 5 F3 I MH05 352-03, and by the University Shadow-Play. The National University of Malaysia
of California International Center for Medical Research Press, Kuala Lumpur, 1972.
through research grant AI 100541 to the Department of 24. Siegel J. Shadow and Sound: The Historical Though!
Epidemiology and International Health, University of of a Sumatran People. University of Chicaeo Press.
California, San Francisco, from the National Institute of Chicago, 1979. _
Allergy and Infectious Disease, National Institutes of 25. Wilkinson R. J. A Malay-English Dictionury. Mac-
Health, U.S. Public Health Services. It was done under the millan, London. 1959.
auspices of the Institute for Medical Research of the Malay- 26. Awang Sudjai Hairul and Yusoff Khan Kumus Len-
sian Ministry of Health. Special thanks go to Marina gkap. Pustaka Zaman Sdn. Bhd., Petaling Jaya, 1977.
Roseman and Gabriel Laderman for reading and commen- 27. Iskandar T. Kamus Dewan. Dewan Bahasa dan Pus-
ting on an earlier version of this paper. taka, Kuala Lumpur, 1970.
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