Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 29 



cumstances and partly on the nature and development of the illness 

 itself. 



(i) / may he ill. — The first diagnostic step is the patient's self-definition as a 

 sick person. A given individual may sustain an injury, such as a horse kick; 

 he may notice an unequivocal sign of illness, such as a urethral discharge, in- 

 dicative of hiku:pk (i. e., in this instance, gonorrhea); he may experience 

 malaise and a digestive disorder of an ambiguous character (i. e., suggesting 

 hiwey lak, ahwerhahnok or some other illness); he may have a distinctly 

 pathogenic dream of a well-defined type (e. g., a dream of cohabiting with a dead 

 relative) ; or else he may simply remember a highly disturbing anxiety dream 

 of a relatively nonspecific nature. At this point the Mohave begins to wonder 

 whether or not he is ill. 



(2) A7n I ill? — The patient's first action is to consult members of his own 

 family, who usually agree with his estimate that he is, in fact, ill. Sometimes, 

 however, they urge him to consult a shaman whom they happen to know, in 

 order to ascertain whether or not, e. g., his disturbing dream is actually a sign 

 of illness. In such instances the patient does not appear to consult a particular 

 shaman on the grounds that he specializes in the treatment of a certain disorder, 

 but simply visits any shaman he happens to know, in order to find out whether 

 or not he is, in fact, ill. 



(3) / may have a particular illness. — In some instances, where the first symp- 

 toms are unequivocal as in hiku : pk, or else strongly suggest that the illness 

 may be, e. g., hikwi : r, the patient, usually acting with the knowledge and upon 

 the advice of his kin, consults a particular shaman, who specializes in the treat- 

 ment of the illness which the patient thinks he has ; i. e., just as an American 

 with a broken leg consults an orthopedist and not an internist, so a supposedly 

 nonpregnant Mohave woman who has certain dreams and also certain symptoms 

 of pregnancy (Cases 45 and 46) consults a hiwey lak nyevedhi : specialist and 

 not, e.g., an expert on hiku:pk. (See also item 7, below.) 



(4) You probably have a particular illness. — The shaman whom the patient 

 consults either in order to ascertain that he is, in fact, ill or about to become 

 ill, or else because he thinks he has a certain illness which that shaman is qual- 

 ified to cure, may tentatively agree that the patient does probably have some 

 particular illness. In such instances, if the shaman happens to specialize in the 

 cure of that illness, he agrees to try to treat the patient for that illness. In 

 other instances he decides that the patient probably suffers from an illness which 

 he is not qualified to treat, and refers him to a suitable specialist. In still other 

 instances, the shaman may declare that there is nothing wrong with the patient. 

 Thus, Ahma Huma : re, as well as Kwathany Hi : wa, correctly decided that 

 their respective patients, who consulted them because they thought they had 

 hiwey lak nyevedhi :, were actually simply pregnant (Cases 45 and 46). (Cf. also 

 MeNichols, 1944). 



(5)7 will ascertain whether you do, in fact, have this illness, by treating you. — 

 At first, the shaman usually makes only a tentative diagnosis, to be confirmed 

 by the effectiveness of the treatment. If the therapy is fully effective, the diag- 

 nosis is automatically confirmed. If it utterly fails, it is held that the patient 

 waited too long before consulting a shaman (MeNichols, 1944), or that (in 

 cases of witchcraft) the patient did not cooperate sufficiently with his therapist, 

 or that the witch is more powerful than the therapist, or, finally, that the initial 

 diagnosis was incorrect. In the first and second instances, the diagnosis is held 

 to be correct, and the patient is taken to another practitioner of the same 



