The scope of hunter±gatherer ethnomedicine Robert A. Voeks a , Peter Sercombe b a Department of Geography, 800 N. State College Blvd., California State University, Fullerton, CA 92834, USA b Department of English Language and Applied Linguistics, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Abstract We examined the cosmology and ethnomedical beliefs of the Penan hunter±gatherers of Brunei Darussalam on the island of Borneo. Our results suggest that they maintain a medical system that is limited in scope and detail compared to neighboring swidden rice cultivators. The Penan recognize the existence of a nearly in®nite array of mostly unnamed, animist spirits that are loosely connected with the misfortunes of humans. Although taboo violation is believed to be associated with illness, there is no strict corpus of belief in respect to spirit placation. Dream readers oer advice on the causes of illness episodes, but their recommendations are neither necessarily accepted nor rigidly enforced. At least prior to permanent settlement, the Penan appear to have suered from a limited suite of illnesses and treated them with a short list of plant medicines. We suggest that the Penans' abbreviated ethnomedical system is a function of their foraging subsistence mode. With a low population density, lack of domesticated livestock and fowl, and nomadic lifestyle, the Penan are unlikely to have suered from the array of crowd and lifestyle diseases that aict settled, agricultural societies. We hypothesize that the Penans' uncomplicated ethnomedical system, and perhaps that of other nomadic, tropical forest foraging groups, is consistent with the relatively disease-free conditions inherent to this subsistence lifestyle. 7 2000 Elsevier Science Ltd. All rights reserved. Keywords: Penan; Ethnomedicine; Hunter±gatherers; Tropical rainforests; Brunei Introduction Culturally acceptable methods of diagnosing and treating illness are fundamental human preoccupations. Within the western medical worldview, most physical illness episodes are explained in terms of germ theory and random causation. In traditional societies, how- ever, these explanations are seldom invoked in disease diagnosis and treatment (Murdock, 1980). Rather, health problems are most often associated with physi- cal manifestations of personal or group imbalances with the non-material realm Ð nature spirits and ancestral spirits Ð or as due to the malevolent actions of witches and magicians (Anyinam, 1995; Voeks, 1997). People become active participants in the main- tenance of their own physical health as well as that of their kin through vigilant attention to the relations between the material and spiritual realms. Folk ethnomedical systems underscore the profound interplay between nature and culture at one of its most fundamental levels. They are often characterized by complex etiologies, esoteric divination methods, and el- aborate healing rituals. The distinctions in western medicine between physical and spiritual health, Social Science & Medicine 51 (2000) 679±690 0277-9536/00/$ - see front matter 7 2000 Elsevier Science Ltd. All rights reserved. PII: S0277-9536(00)00012-5 www.elsevier.com/locate/socscimed E-mail addresses: rvoeks@fullerton.edu (R.A. Voeks), ser- combe@ubd.edu.bn (P. Sercombe).