Several recent studies have contributed significantly to our understanding of traditional African medical systems (e.g., Peterson, in press; Ulin and Segali, 1980; Imperato, 1977). Concurrently, medical sociologists (e.g., Conrad and Schneider, 1980; Conrad, 1976) have examined the role of the American medical establishment in the exercise of social control. Their definition of social control as “the means by which society secures adherence to social norms” implies the power to impose a particular definition of the world on its members. This definition is central to the purpose of this paper, which is to describe and analyze in a West African context the use of prayers, amulets, and charms in the distribution of health services, and, at the societal level, their role in social control. In Dyula medicine social control operates primarily as a collection of beliefs, morals, and internalized norms all subsumed under the rubric of self-controls; and relational controls which include such every day interactions as gossip, ridicule, and group support.

The worksite for this study was Bondoukou, a city in eastern Ivory Coast that was, until the colonial reorganization, the largest city in Gyaman. The kingdom of Gyaman was founded toward the end of the seventeenth century by the Abron fleeing the nascent confederation of Asante states. From their settlement some ten kilometers south of the present city of Bondoukou, the Abron gradually extended their hegemony over the autochthonous peoples and the Dyula at Bondoukou who were all Muslims and mostly traders. The Dyula were recent settlers, having emigrated from the collapsing market city of Begho during the preceding half century.