A loss of consciousness for most of a 4-day period characterizes a culture-bound syndrome known as ha ko botika that occurs among the Ngawbere, an indigenous population of northwestern Panama. The afflicted person remains immobile and does not eat, drink, speak, or respond to stimuli after onset of illness; then the afflicted person gradually begins to resume normative functioning and returns to participation in Ngawbere society. The 4-day illness represents the classic, more extreme form of "dreaming illness" among the Ngawbere, who recognize a number of other, less serious health problems that they associate with disvalued dream motifs. The preventive measures performed for dreaming illness in general and the treatment used specifically for ha ko botika are described, and the biobehavioral implications of the occurrence and treatment of the latter are discussed.
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