Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 25 



until, in 1938, he was specifically asked to describe all diseases that 

 have a psychiatric aspect or component. 



These findings are true not only of the Mohave, but of primitives 

 in general, all of whom view practically every form of malaise, be it 

 physical or psychic, as an illness that the shaman is qualified to diag- 

 nose and to treat. In fact, one is almost tempted to suggest that, 

 especially in tribes that had no effective pharmacopoeia to speak of, 

 the shaman treated primarily the psychic components of every illness, 

 and was capable of alleviating physical ailment only by reducing the 

 patient's anxiety and by increasing liis will to live. Otherwise ex- 

 pressed, the most ancient tool in the primitive "physician's" therapeu- 

 tic armamentarium was probably a kind of magically tinged "bedside 

 manner," rather than even ineffective drugs or other "positive" thera- 

 peutic maneuvers. Historically expressed, the first medical practice 

 was presumably a strictly phychiatric one, so that, as in modern edu- 

 cation (Devereux, 1956 a), the most recent therapeutic philosophies 

 actually represent a naturalistically oriented return to the most primi- 

 tive of all medical philosophies. 



It is now proposed to describe the major diagnostic procedures of 

 the Mohave Indians, it being understood that the same diagnostic 

 techniques and criteria are utilized in all forms of illness, be they 

 psychic, psychosomatic, or purely somatic. 



Difficulties of diagnosis. — Mohave diagnoses are sometimes very 

 hard to make, because a patient's illness may include the salient 

 symptons of several major disease entities. For instance, if a 

 woman dreams about snakes, this usually suggests that she suffers 

 from hikwi : r. If she also has menstrual disturbances, and dreams of 

 her childhood as well, these symptoms may suggest hiwey lak 

 nyevedhi :. Finally, if she also had an affair with an alien, this will 

 make the Mohave shaman suspect that she has the ahwe : hahnok ail- 

 ment. Such etiological complications led Mohave diagnosticians to 

 differentiate between "straight" (simple) diseases and "diseases that 

 are not straight" (mixed conditions), usually involving witchcraft. 



A second major diagnostic difficulty is that a shaman who refuses to 

 treat an insistent prospective patient, perhaps because he feels he is 

 not qualified to treat that particular disorder or has been consulted 

 too late (McNichols, 1944), runs the risk of having his refusal viewed 

 as prima facie evidence that he, himself, had caused his prospective 

 patient's illness (see pt. 7, pp. 387-426). He may therefore make the 

 diagnosis that the patient demands from him and may undertake the 

 treatment, hoping for the best. 



Last, but not least, there are sometimes also theoretical differences 

 between two shamans regarding the etiology of a given disorder, al- 

 though in such cases it is usually possible to show that, at least on the 



