Vol. VIII, No. 1, 1995

Health and Healing in the Ozarks

An Introduction

by Robert Flanders

The Ozarker returned home too early from working in the timber. He hopped into the house on one leg; the other was gone. "Cut off my leg," he announced to his wife. "What are you going to do?" she asked. "Reckon I better doctor for it," he replied.

* * *

An Ozarker went to Wyoming to herd sheep. He spent long days in the saddle, days that stretched into years. In his eighties he began to have severe back pain. On a visit to Denver, kin there insisted he go to the doctor. The physician, looking at the patient information sheet, said, "Sir, you're eighty-three years old! You can't continue to work the way you do and expect to avoid pain. "Afterward the old man complained disgustedly, "I gave him ten dollars to fix my back, and all he did was tell me how old I am!''

* * *

"Cancer, high blood pressure, heart disease, stroke, and diabetes occur in the rural Ozarks at above-average rates. A Federal Government study will seek to find out why."

--News story out of Springfield, Missouri, October 18, 1994.

These three anecdotes offer some insight into the theme of this issue. The first one, perhaps apocryphal and probably intended more for its humorous than for any medical content, portrays in its subject some very Ozarks-like characteristics. The man's excessively laconic approach to his catastrophic, life-threatening injury, together with an equally excessive understatement that he "better doctor for it," implies that while injury is to be expected, going to the doctor is not. The second, about the aged shepherd with the painful back (a true story, by the way) reveals a man who resists making cause-effect relationships between advancing age, grueling labor, and the symptom of pain. Finally, the news report raises questions: Why might a greater incidence of these mortal diseases occur in the Ozarks? Is lifestyle-----diet, drinking, and smoking come to mind--an issue? Is disease the consequence of seeking medical care too little and too late, as medical care providers say is often the case? Then a different kind of question, one about the meaning of normality and abnormality, begs to be answered. The report is of a generalization based on statistics. What is "average"? What do statisticians know about real people, like those they presume to be describing and defining?

Ozarks attitudes toward doctoring are hinted at in various reports of professional providers of dental care. A traditional Ozarks expectation has been that few people, if any, will be buried with their own teeth in their mouths. Dentists are understood to be tooth pullers, and extraction the remedy for dental problems. One doctor, recalling his practice in a rural county thirty years ago, said even a teenaged girl with a chipped tooth chose to have it pulled. An Ozarks reminiscence that came to us recently relates that the author's elderly husband had had all his teeth pulled in a mass extraction when he was still in his thirties. She recalled the incident not because of the extraction itself, but because his mouth became dangerously infected as a result. To some, dental hygiene, "preventive medicine," is a relatively new and not widely accepted idea. Dental reconstruction the same.

In preparing this issue of OzarksWatch the editors have encountered many evidences of an ambivalence with which traditional Ozarkers approach modem medicine and modem ideas about health maintenance. I say "traditional Ozarkers' advisedly. Many Ozarks traditions are present among us, including that of the most modem medical care. Healing practice of the highest quality is available in the Ozarks. Many of its practitioners are Ozarkers, true believers in its science and its ethic. But there is an old-fashioned healing tradition that will not or cannot fully accept modem medicine. Health care providers often encounter this ambivalence. Newcomers among them are often especially surprised and dismayed. One such person, in recent conversation, said simply, "the people are too backward. I cannot practice here." "Here" was a small county seat town in the rural Missouri Ozarks. She plans to go elsewhere as soon as she can.


If, in Ozarks tradition, ambivalence exists toward modem health care, what is in the tradition about non modern health and healing? Have Ozarkers been indifferent to such matters?

Of course not. Beliefs about health and healing are deeply imbedded in "old" Ozarks traditions. Can they be identified? Following are three principles that seem to inform an answer. Some of them are exemplified in this issue of OzarksWatch.

First, health is natural. It is, indeed, the essence of nature itself. At the same time, interruptions of health, whether by age, disease, or accident, are to be expected, and thus may also be considered natural, i.e. normal in the course of life. In this logic, death is fully natural too. These may be sufficient explanations of the apparent resignation and fatalism that many health care providers comment on, attitudes so anathema to their interventionist philosophy.

Second, nature is good for us. As R.B. Mullinix's Osage half-breed grandmother points out, "everything out there" is potentially useful for our health. It's just a matter of knowing what to use when, and how. Remedies and cures direct from the natural world--animal, vegetable, and mineral--are at the heart of traditional healing and nursing. (By the way, now that R.B. Mullinix has discovered OzarksWatch we can probably expect regular contributions from him.)

Third, the tradition embodies the notion of simple instrumentalism. That is, when a "remedy" is interposed in a case of pain or dysfunction, it will be an instrument leading directly to the desired result, i.e. "relief." Complex analyses of the causes and morphology of disease, or of complex, attenuated methods for its treatment, both common to modem medicine, do not accord well with such instrumentalism. Nor do the ideas of"preventive medicine'' and "healthful lifestyle."

A common instrumental remedy is alcohol. It has been a readily available drag to deaden pain. Though little mentioned in overt discourse about "remedies," alcohol may well be the most common path to "relief." Alcohol was the basic ingredient in "bitters," a concoction made by Ozarks women from traditional family recipes. Whiskey (typically homemade) was infused with various elements from nature, especially herbs, then bottled, and kept on the mantel. Though families might eschew drinking per se, they could take bitters in small quantity, as a tonic. Liniments are related to bitters, often contain alcohol, and are considered to be for internal as well as external use, efficacious alike for man and beast.

Of course, little that has been said above, or that is written in this issue of OzarksWatch, is unique or even distinctive to the Ozarks region. Traditional approaches to health and healing are probably more widespread in the world than modem medicine, even in the late twentieth century. But traditional approaches do survive in the Ozarks, this long, this late.

Ozark Life, Nov. 1931.

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