Introduction

The first two workshops in this series, ‘Science in the Forest, Science in the Past’ (SFSP I and II), were held in 2017 and 2019. The resulting studies were published by Lloyd and Vilaça (2020) and by McCarty et al. (2021), respectively. In both instances, scholars from a variety of disciplines, including social anthropology, history and philosophy of science, psychology, classics, sinology and computer science, combined to tackle a series of cross-cultural issues to do with mathematics, ontology/cosmology, philosophy and science themselves. ¹ In both workshops we raised fundamental questions to do with the nature of each inquiry, the conditions of its possibility, its goals, methods and justification. Ethnography and history give us access to what look like very different sets of ideas and practices, including, for example, mathematical ones. But we are then faced with a recurrent dilemma. Do we exclude these ideas and practices as not mathematics at all when they do not conform to the models provided by the mathematics we are most familiar with, in contemporary Western culture? Or should we rather broaden our notion of what counts as mathematics to allow for a pluralism that is not usually catered for in the narrative of the development of ‘our’ mathematics? SFSP I and II provided grounds for keeping an open mind on that type of issue and repeatedly expressed dissatisfaction with current Western hegemonic assumptions. But that leaves us, of course, with the question of what should replace those assumptions.

When, as often happens, we are faced with what appear to be radically divergent understandings adopted by different individuals or groups at different times, we have, in principle, three tactics to choose between. The first is to opt for one solution to the exclusion of any other: this is what repeatedly happened when Western understandings were confronted with indigenous or ancient alternatives, which were accordingly dismissed summarily.

The second tactic is to insist that what appear to be different solutions are actually dealing with different, ‘incommensurable’, aspects of the problems, or indeed quite different problems. This allows divergent views but at the price of claiming that they do not deal with the same or even similar issues.

Finally, we can hope to work towards a resolution which allows that each of the views we identified at the outset may have a contribution to make, not so much by offering positive insights into the problem, as by allowing, even compelling, us to reformulate the problems themselves. For this we have, of course, to be ready to revise our own starting assumptions.

It is not that we should expect that one of these three tactics is to be preferred across the board. Rather it is the case that in different contexts now one, now another offers the best approach.

The chief focus of this third workshop as we described it when we first planned it was wide-ranging, namely ‘ideas and practices related to health and well-being, including conceptions of the body, the self in relation to the world and its inhabitants, states of being, normalcy and deviations from the normal, and intelligence however manifested’ – and not just the common or garden human variety. Each of the constituent elements in the agenda thus described is problematic and so too are the possible connections between them. The question of how the different aspects in our wonderfully diverse agenda interconnect is one we shall keep an eye on as we proceed and we shall be returning to that topic in our concluding study.

However, it is obvious that on many of the topics I have mentioned the dilemma we face is particularly stark. On the one hand, these are often thought to be questions on which modern Western biomedicine (alone) can and does yield definitive answers. On the other hand, the evidence from the Forest and the Past we shall be discussing in the papers which follow challenges that, often to the point of raising doubts on whether answers are indeed to be had at all (and we can agree straight away that definitive ones at least are out of the question).

The traditional positivist starting point would be that diseases are objectively determinable and healthy and the healthy equally so. The ‘normal’ blood pressure for a male or a female of a given height, weight and age will lie between upper and lower limits, established (the claim is) by very extensive empirical evidence collected from many individuals over many years. Variations in the norm for different groups can be allowed for without jeopardising the point that there is indeed a norm, for each such group. That is just one example of the application of masses of tests that can be undertaken and that provide the basis for the whole vast programme of data-crunching that evidence-based medicine insists on. Health in this picture is essentially measurable. The unhealthy, abnormal or sick are deemed to be ‘cured’ if their results are brought back within the upper and lower limits in question.

The positivist will further point to the undoubted progress that has been made in the last century and a half or so, towards a better understanding of the causes of physical ailments and of effective treatments for them – with regard, that is, to the purely biomedical aspects of them. Malaria, tuberculosis, measles and many other conditions have been brought within the orbit of biomedical control. COVID-19 certainly presented new challenges, but even there the speed with which effective new vaccines were developed shows how successful modern biomedicine can be – at least up to a point. None of that can be denied, and yet not even the most positivist of commentators can claim that biomedicine is today or, given the possibility of new pandemics, ever will be in the future, omniscient let alone omnipotent: able fully to understand and control every condition we – or anyone else – treat as a disease.

The point is particularly clear in the area of what we call mental health where, while there is professional agreement over the degrees of severity of different complaints from depression to bipolar to schizophrenia, their causes are still very poorly understood and the reasons for the (comparative) success of certain treatments equally so: these are topics on which one of our participants has written particularly trenchantly (e.g. Luhrmann, 2001). But more fundamentally we have to factor in that what different people in different cultures at different times have considered to constitute ‘health’, ‘flourishing’ and ‘well-being’ has varied enormously. So also has what is held to be a disease or a sign or symptom of one, or of a condition requiring treatment of whatever kind that may be practised by the group in question. One of Luhrmann's collaborative projects (Luhrmann and Marrow, 2016) investigates, among other things, whether ‘schizophrenia’ (however defined) is a cross-cultural phenomenon for which the definition or the concept to settle on is, of course, the key to any tentative answer.

So what are the proper subjects to which ‘health’ and cognates and their antonyms are to be applied? In many cultures, mere physical or corporeal healthiness has often been conceived as a pale shadow, even the opposite, of true spiritual well-being. While ‘healthy’ may be thought to apply primarily to organic bodies, in many vocabularies cognate terms are used for many other items. Aristotle cited hygies (‘healthy’) as a prime example of what he called a pros hen legomenon (rendered ‘focal meaning’), neither univocal nor merely equivocal. ² It applies primarily for sure to living physical bodies (not just humans) but it is used not merely figuratively for many other items. A diet or a climate is said to be healthy if it promotes health. A complexion is healthy in the sense that it is a sign or indication of health. But Aristotle is prepared to use the terminology of things like political constitutions or societies, where he contrasts normal with deviant constitutions. As with ‘nature’ and natural, physis and physikos, Aristotle uses the terms not just descriptively but normatively. He has a very clear idea that we may be mistaken about ‘pleasure’ for instance: what is truly pleasant is not just what a healthy person finds pleasant, but what the morally sound individual does. In this story, you can be mistaken about your own subjective feelings of pleasure.

The repercussions of that last type of move, the invocation of the normative, are profound. To the question of what things can rightly be called ‘healthy’ must be added issues to do with the appropriate values to be attached to whatever is so labelled. Under the first head, we have first to delineate the range of the proper subjects to which ‘health’ and ‘healthy’ are applied. Is ‘healthiness’, for instance, a matter of relations rather than a property of substances, of collectivities as much as of individuals? How far does ‘well-being’ depend on factors beyond the individual's control? We have to bear in mind that there are philosophical traditions (not just in the West) that insist that anything that really matters is within our control: death is nothing to us, nor disease. If health is connected with healing, then that is sometimes considered to be a matter of taking thought rather than of physical interventions. Not just a matter of placebos as we shall be discussing, but of getting the philosophy right – or so the philosophers claim.

Nor is this just a preoccupation of philosophers showing off, though they provide some notable examples. There is an uncanny sense that what can be found in Zhuangzi or in Heraclitus resembles the Melanesian materials introduced by Marilyn Strathern in her study of ‘Life with and without its antithesis’ (this issue). Thus the putative author of the text we know as Zhuangzi is criticised for not going into mourning when his wife dies. But he replies that when he realised that she was just rejoining the cycles of generation and destruction everywhere present in the world, he saw how foolish it is to bewail the dead. ³ In a typically cryptic style, Heraclitus (Diels fr. 62) put it that ‘mortals are immortals, immortals mortals, the ones living the others’ death, dying the others’ life’. At least one of his points would seem to be that when a creature dies, its physical body joins physical stuff everywhere and is no longer subject to death. Conversely when that physical stuff once again forms part of a new living being, what had been ‘immortal’ becomes once again subject to dying and so mortal. To propose such a commentary is not, of course, to suggest that it exhausts the meaning of Heraclitus’ statement, let alone that it captures its spirit or style.

So one problem is to say whether or how far biomedicine can indeed serve as the yardstick by which other notions and practices are to be judged. But that immediately takes us back to our second fundamental problem. How far are alternative systems of medicine to do with what we can recognise as ‘health’ in the first place? As usual, the difficulty that any cross-cultural inquiry confronts is the inter-translatability, the mutual intelligibility, of the conceptual frameworks in question. On what basis can judgement across cultures, terminologies, cosmologies, medical ideas and practices ever be made? Will it not inevitably be mired in subjectivity, if not rank prejudice? We cannot do without judgement (it is inevitable indeed) even if we cannot produce any general rules that guarantee (up to a point) its neutrality. Yet as we have found in the other workshops in this series, by moving beyond the frontiers of our usual disciplinary and cultural boundaries we can make some progress in identifying the parochial character of some of our own usual starting assumptions. As I have expressed the point before, encountering startlingly different ideas and practices should be treated not as a threat but as an opportunity. There is no neutral vocabulary in which to discuss these matters, but we can make the most of what I call the semantic stretch of the vocabularies to which we do have access (and that's not just a matter of our own particular mother tongue).

Of course, the problem of comparability remains. But I think we have good enough grounds to resist the move that is often made, from the diagnosis of a certain incommensurability to the conclusion that the possibility of any understanding is ruled out. Incommensurability does not rule out, rather it presupposes, comparability (the side and the diagonal of a right-angled triangle are both – different – lengths), or so I have argued. Our informants can indeed throw light not just on notions of normalcy or order or harmony, or life or death indeed, but also on the values and ideals that may be attached to the items in question. There are surprises in store on both counts. What is more, we are of course dealing with matters of urgent practical interest, - ones that are needed to guide policy as we struggle to determine what needs to be done in relation to ecology, climate change and our responsibilities to the other living creatures on this planet as well as to our fellow human beings. To be sure, understanding others’ values does not entail agreeing with them: but what are the conditions for claiming that we have some understanding of them in the first place? We put ‘health’ and cognates into scare quotes, but how can we access the variety that move recognises?

The Forest and the Past have things to teach us – and not just on questions of what we call academic interest. In the studies that follow we have the chance to mount a resolutely interdisciplinary critique of a whole series of fundamental, and fundamentally problematic, concepts: life and death, consciousness, personhood, individuality as well as health and disease and well-being and cure and therapy themselves.