‘Pasma’ update

Many years ago I wrote a book “Revisiting Usog, Pasma, Kulam,” which is now out of print but I’ve been asked if I was going to update it. I guess I should, especially because I’m seeing all kinds of variations on the illnesses I wrote about back in 1997.

Folk illnesses are ailments that are not recognized by the mainstream medical system. Health professionals will dismiss them as “all in the mind” but for people who believe in these folk illnesses, they are very real, causing pain and distress, sometimes, as in the case of bangungot, even causing death.

I won’t be going into bangungot, especially since I’ve written about that condition in my previous column Pinoy Kasi. Today, I wanted to zero in on pasma, following a recent research field trip in Benguet. I was there to research on people’s perceptions of the environment, another fascinating topic which I’ll save for other columns.

Pasma came up during an early morning conversation I had with the caretaker of the bed and breakfast I was staying in when she commented about my being barefoot. I explained I forgot to pack in slippers but I was all right barefoot.

Oh, but she was quite distressed, warning I would get pasma and citing herself as an example. Older people, she explained, were more prone to suffering adverse effects from an interaction of hot (your warm feet) and cold (the floor) and suffer body pains, especially around the joints. It sounded like arthritis to me which is indeed more common with older people but I had not heard, in the past, about arthritis being caused by pasma, which is attributed to the hot and cold interaction.

The caretaker quickly found a pair of slippers and our pasma discussion picked up again when I asked her if she was from Benguet. Turned out she was actually from Caloocan in Metro Manila and that her previous work was as a “yaya” (nanny) to 16 dogs, hard work she lamented and she said the dogs caused another kind of pasma, stretching her arms out she showed me the tremor in her hands.

In my many years as a medical anthropologist, I had associated the tremors of pasma with manual labor, mainly with doing laundry and, in the days of typewriters, with secretaries. Again, hands are warm or mainit and when you do the laundry or typing, you’re exposed to cold water and that is blamed for pasma and the tremors. The risks are higher for laundrywomen because, besides the washing, there’s also ironing, this time the reverse, hands are cold (especially from laundry) and then exposed to the heat from ironing.

When my driver joined us for breakfast he volunteered another type of pasma, this time “pasma sa ihi” (pasma in urination) explaining this as dysuria or difficulty urinating. I asked if this was the same with “balisawsaw,” another Tagalog folk illness and he said yes but it was an old term.

I smiled remembering how, many years ago, when I was doing HIV/AIDS education with sex workers, they would talk too about condoms causing pasma, in particular to the male. The genitals are hot (really hot) and you aggravate the heat with condoms if you bathe with cold water after sex, producing pasma. I would joke back, so what happens, does it cause tremors there?

Through the years, I’ve realized folk illnesses are ways of explaining ailments through naturalistic terms like hot and cold. Even more importantly, they become idioms of distress, ways of expressing one’s anxieties about work (being a yaya to dogs, being a laundrywoman) and life (growing old). There are all kinds of pasma, my driver explained as we drove back to Manila and I thought, indeed they are, maybe even new ones coming up. I asked him if COVID was associated with pasma and he gave an enthusiastic yes. When I asked how, he said, sudden weather changes, sudden cold or sudden heat, allowed COVID to emerge.

Times change and folk illnesses like pasma are there, ready to be used to explain what seems unexplainable and to express alarm over the growing uncertainties and risks of our times.

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