Medicines and the prescription of medicines are an ordinary part of daily life. Yet prescribing is an act that is imbued with a very strong symbolic value and which is therefore never ordinary.

This cultural dimension is not limited to patients who come from faraway or traditional cultures: no one can truly escape it, including those who are doing the prescribing.

The cultural entanglements are complex, blending together highly diverse influences tied to individual and collective experiences, but they are also probably very much structured around the principle of double causality and around the meaning attributed to disease.
 
In medical anthropology, according to the theory of double causality, disease can be represented as having two causes: a "natural" and a "non-natural" cause. So-called natural causes are based on scientific explanations, while so-called non-natural causes refer to divine intervention, ancestors or evil spells.
 
If there is a double causality for disease, therapies also are seen as having a dual nature, which partly explains the many facets of medicines. "Destructive" medicines are seen as "destroying" diseases or germs, while "constructive" medicines are seen as building the patient up.

The symbolic dimension of medicines can also be examined via various examples: a medicine’s colour, the placebo effect, self-medication, the pact between the patient and the healthcare professional, etc.

In this highly technologised age, this adage from Corneille’s play "The Liar" is more timely than ever: "The manner of giving is worth more than the gift".

These themes and many others are covered (in French) in the special section in the August issue of La revue Prescrire, entitled "Overmedication of society: a concern for all".

> Table of contents of the August issue (in French)

©Prescrire 1 August 2017

"Médicamentation de la société : l'affaire de tous - Tous acteurs, tous prescripteurs" Rev Prescrire 2017 ; 37 (406) : 593-638. (Pdf in French, subscription to French edition required)