Appalachian Folk Medicine

Mary Butler Stone


I.  Keywords

            Folk medicine, superstition, Appalachia, Folk-lore, culture, remedies, alternative medicine, herbal medicine

II.  Abstract

        Appalachian folk medicine is a system of healing made up of beliefs and practices that are transferred by oral tradition through families and communities.  It was developed in response to a lack of access to modern medical care and combines homemade remedies with superstition and religious beliefs.  It is characterized by its lack of structure or central authority and is becoming less prevalent in today’s society due to more affordable and more accessible health care. 

III.  Scope and Purpose

            A general definition of folk medicine is a collection of cures that are handed down by oral tradition and other similar means of heritage and are considered outside of mainstream medicine.  Appalachian folk medicine sprung up from the need for health care.  In pre-industrial Appalachia, doctors and modern medicine were rare and inaccessible as well as expensive, so people relied on traditional home remedies and superstitious practices to alleviate pain and to cure disease.  Practices such as using turpentine and brown sugar to cure worms and the use of magnetism to stimulate the body to heal itself are common for many minor illnesses. 

            The most common aspect of Appalachian folk medicine, however, is the widespread use of herbal and homemade medicines that are believed to have healing powers.  It relies on local roots, flowers, fruits, bark, leaves, and seeds that could be gathered and then combined or treated so as to make them suitable for healing.  Tonics were those formulas that were believed to have positive effects on health and life in general (Greene, 62).  One example of a common tonic is yellowroot, believed by many to give strength and was also used to treat a sore throat.  Yellowroot in modern medicine has been found to cause paralysis, gastrointestinal complaints, respiratory failure, and death if consumed in large quantities (Cook).  Other examples of common folk medicines are:  ginseng, used to treat kidney problems and colic; sarsaparilla root for rejuvenation; and pennyroyal, which was used to treat stomach problems and to cause miscarriages in pregnant women.  Sassafras, garlic, spearmint, Lard, snakeroot, and kerosene are also remedies that are still widely used in Appalachia today. 

            The other distinct part of Appalachian folk medicine is behavior based on superstitious beliefs.  Though this is not as common today as in the early 1900’s, it has had a large impact on the culture and medical practices of Appalachia.  Appalachian superstitions based in healing generally involve a certain ritual that is supposed to magically relieve the ailment, but may not necessarily directly involve the body.  For example, to get rid of warts, carve one notch in a stick for every wart you have and then bury the stick.  Similarly, tying a string around a persimmon tree is supposed to get rid of chills.  Other superstitious beliefs set out rules that are designed to prevent illness:  if you sweep under the bed of a sick person, that person will die, or if you let birds use your hair for nesting material, you will go crazy. 

IV.  Authority Structure           

A.  Sources and Criteria of Valid Knowledge

            Folk medicine is a predominately oral tradition passed down through generations within communities and families.  It is practiced in individual homes and often by particular members of the local community such as the midwife who is designated to aid in childbirth.  It gains its validity from tradition, inheritance and sometimes religion.  Pearsall describes folk medicine as having “all the authority of a strong family sanction.  They seem reasonable because they are familiar and because everyone can cite many cures accomplished by them” (Strain, 14).  This analogy means a lot, given that most of Appalachian culture is centered around the family and that having the same “blood” as another person means as much as any contract. 

The combination of a lack of education with the strong religious beliefs of most Appalachian communities lends support to the acceptance of revelations, often in the form of dreams, as another reliable source of information and guidance.  Often illnesses and injuries will be treated based on a vision or a “sign.”  Signs can be anything from a red sky to a dog howling with a spectrum of interpretations as equally broad. 

Although no gifts belong exclusively to one individual or another, often there are individuals who are assigned or inherit certain responsibilities and who may or may not have more experience with particular remedies or tasks than the community at large.  One of the best examples of this is the midwife.  Midwives are usually, but not exclusively, older women who are well-known and trusted by the entire community.  The job of midwife was to care for pregnant women both before and during the birth and was often inherited within a family or simply became the responsibility of a particular woman in the community, more or less by default, if she had particular experience or luck with childbirth. 

B.  Methods of Inquiry

            The tradition of folk medicine is characterized by its oral tradition and lack of well-defined practices.  Erika Brady describes medical folklore as:

a tendency to deal with informal cultural aspects of group behavior.  These cultural aspects of group behavior can pertain to either a specific community or an identifiable group within a larger society that is not protected from change but has maintained a certain “consistency of for over time” (Strain, 11).


Knowledge is handed down from old to young through story-telling, practice or apprenticeship, and general day to day life.  The practices of folk medicine in Appalachia do not typically require any empirical observations at all for the remedy to be considered valid under the system.  It need only be attested to by the older generations of the community or sometimes only coincidentally related to a success story.  “Revelations” were typically taken as the word of God, although the criteria for a valid revelation are pretty unclear.   Certainly those who acted as the local ministry had some authority on the matter, but depending on their particular status in the community, they did not always have the final say. 

C.  Institutions and Professional Structure

            The practice of folk medicine in Appalachia is becoming less and less common because of the development of better roads and more access to affordable health care.  The system of folk medicine is based in practices handed down like the lessons of right and wrong and how to interact within the community.  It is not an official and structured system of knowledge and the preservation lies with the older generations to pass it on to the younger ones.  Inevitably knowledge is lost or changed with each new generation.  Discrepancies arise between methods because of the lack of a central authority, either a person or written documents. 

IV.  History

        Appalachia is a region extending from Mississippi to New York and includes eleven states within its official boundaries.  The population of Appalachia is chiefly descended from Scottish and Irish immigrants who came to Appalachia to escape persecution and to find a better life.  They brought with them a collection of superstitious beliefs, strong religious principals, and an emphasis on the family unit as the core of society.

It is the rocky, inaccessible terrain of the Appalachian Mountains which gave rise to the isolation of the communities that existed within the region and lead to the cultural deviance from “normal” society.  The lack of significant cultural or commercial linkages that existed with other societies, particularly prior to the Industrial Revolution, lead to the creation of a unique culture often seen as backward and old-fashioned.  One of the first famous articles written on Appalachian people describes the way Appalachia is viewed from the outside.  “They were ‘our contemporary ancestors,’ our ‘eighteenth century neighbors’ who had just awakened from a long ‘Rip Van Winkle sleep,’ pure Anglo-Saxons ‘beleaguered by nature’ in ‘Appalachian America,’ one of ‘God’s grand divisions’” (Lewis, 21).  Due to the lack of a significant influx of different people, Appalachia was allowed to develop its own very distinctive culture. 

            The mountaineers owned and farmed their own land, creating very self-sufficient family units that need not rely on outside economy for the most part.  This self-sufficiency contributed to both the isolation of the region, and to the high level of poverty (Lewis, 25-6).  When problems arose, individuals turned to their family for solutions.  Collecting and making remedies themselves was both more convenient and less expensive. The family preserved the knowledge of what is supposed to work for each ailment and as new things were tried and proved successful, new remedies would be passed on to the next generation. 

            The tradition of folk medicine in Appalachia is still very much alive today, even among those patients also seeking modern healthcare.  One study, done in the early 1980’s, polled 170 patients in rural and urban clinics in southwestern West Virginia.  Seventy-three percent of the patients claimed that they had used one of the study’s listed remedies within the last twelve months, with an average of four and a half remedies per person (Cook).  Trends in the use of alternative and folk medicines are currently on the rise due to a lack of faith and distrust in modern medicine.

V.  Representative Examples of Argumentation

Appalachian folk medicine is defended from a platform of observation, tradition, superstition, pride, access, and/or ignorance.  Usually it is from some combination of these things that people tend to choose this system of knowledge and practice over another, particularly when it comes to modern medicine.  It is safe to say that some traditional folk remedies do actually work to treat various pains or illnesses and many have actually led to practices and medicines in the modern medical world.  In these cases, folk medicine can be defended with actual fact and observations.  However, folk medicine is often practiced simply for the sake of tradition or superstition.  There is a fundamental belief that the system works and that if the traditions are not followed, things will be worse, either from lack of aid or from bad luck.  Economics and accessibility are also causes of choosing folk medicine over alternatives.  The Appalachian region, particularly in times before modern transportation, creates a lack of access to alternative health care as does the higher cost of most medical care. 

Pride and ignorance are the greatest cause of distrust that many Appalachian people feel toward modern medicine.  Many people choose their traditional medicine because other methods are unfamiliar and thus untested.  Pride often prevents them from seeking help from others, especially those that are not relatives or members of their community. 

VI.  Suggested Position in Comparative Scales 

a)  Tradition (1) ……………….Testimony (10):  3

            Appalachian folk medicine relies almost entirely upon tradition and remedies that are passed down, but often personal testimonies are also incorporated into the system as well.

b)  Centralized authority (1)……………….Decentralized authority (10):  10

            Folk medicine is practiced and handed down through families and small communities, without any central authority to combine or validate remedies. 

c)  Emphasis on invisible realities (1)………Emphasis on material realities (10):  7

            Appalachian folk medicine focuses more on the outcome of healing, so remedies that can be associated with positive results are more valid than others, however there is also a strong element of superstition which emphasizes the influence of a magical power that influences luck. 

d)  Spiritual or moral objectives (1)………..Pragmatic objectives (10):  10       

            Folk medicine aims to heal its patients.

e)  Divine power (1)……………Power in individuals (10):  9                                                   With the exception of superstitious power, the power of folk healing is exclusively in the particular remedy and thus the individual applying the remedy, assuming they know how to do it correctly, can produce the desired outcome.             

VII.  Bibliography

Primary Sources

Giardina, Denise.  “Appalachian Images:  A Personal History.”  Confronting Appalachian Stereotypes.  Ed. Billings, Dwight B., Norman, Gurney, & Ledford, Katherine.  Lexington, Kentucky:  University Press of Kentucky, 1999.  161-173.


This source provided some history of the region and the culture from a personal perspective.  It was a description the author’s family and life in Appalachia.   


Stekert, Ellen J.  “Focus for Conflict:  Southern Mountain Medical Beliefs in Detroit.”  The Urban Experience and Folk Tradition.  Ed. Paredes, Americo & Stekert, Ellen J.  Austin, Texas:  University of Texas Press, 1971.  95-136. 


This article gave a description of the conflicts between modern medicine and the practices of the Appalachian people, for example, they often do not seek modern medical care because their pride insists that they rely on their own methods of care.  This is important in understanding Appalachian folk medicine because the culture is a large reason why it developed to the extent that it has. 


Secondary Sources

Cook, Cheryl, MD. & Baisden, Denise, MD.  (September, 1986).  Ancillary Use of Folk Medicine by Patients in Primary Care Clinics in Southern West Virginia.  Southern Medical Journal, Vol. 79.


This source provided examples of several common folk medicines and their side effects and presented a study that showed the prevalence of their use in modern Appalachian clinics. 


Greene, Sarah M.  “Non-Timber Forest Products Marketing Systems and Market Players in Southwest Virginia: A Case Study of Craft, Medicinal and Herbal, Specialty Wood, and Edible Forest Products,” diss.  Virginia Polytechnic Institute, 1998. 


This was a thesis paper that provided information on some specific remedies used in Appalachia and how folk medicine relates to modern medicine. 


Lewis, Richard L.  “Beyond Isolation and Homogeneity:  Diversity and the History of Appalachia.”  Confronting Appalachian Stereotypes.  Ed. Billings, Dwight B., Norman, Gurney, & Ledford, Katherine.  Lexington, Kentucky:  University Press of Kentucky, 1999.  21-39.  

This essay provided a lot of history of the region of Appalachia and its culture.  This was particularly helpful in determining why folk medicine exists in Appalachia


Strain, Catherine B.  “Folk Medicine in Southern Appalachian Fiction,” diss.  East Tennessee State University, 2002. 


This was a thesis paper that I used for background about Appalachian folk medicine and a little about the region and culture.  I also used the paper’s bibliography to help find sources on my topic. 


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