| Traditional medicine is still alive in Mexico. The natives, who preserved this tradition most faithfully, were the target of programs to make them adopt biomedicine in the mid 20th century which sometimes implicated healers. The failure to adopt modern medicine, the worldwide movement in favour of traditional medicine, the incapacity of the government to offer health care to all its population led to a new politics in the 80s: the creation of associations of healers. Their objectives are the promotion, the safeguard and the legalization of traditional medicine. Thus was born in Cuetzalan the Sociedad de Solidaridad Social de Medicos Tradicionales Indigenas de la Sierra Norte de Puebla Maseualpajti, mostly made up of Nahuas. Their activities include consultations for the population, a botanical garden a drugstore of plant-based products, a herbarium and the training of its members.;We have recourse to concepts of acculturation theory as regards the external source of change within the context of interethnic relations, and the examination of their effects, precisely through the influence of biomedicine and its clinical model. Furthermore, the analytic framework is constructed from the notion of institutionalization, while drawing significant parameters from the ethnomedical literature. We study the effects of the rules of operations of the Sociedad Maseualpajti and its constraints while taking into account the interindividual differences of the healers as to their previous experience, their specialty, their motivations, etc. All the dimensions of a medical system are examined as well as the patient's attitudes in the two contexts (the Sociedad in Cuetzalan and the villages or hamlets). The method used is the comparison of the work of the healers in these two environments. To a lesser extent, it defines a process in progress.;The results show that the healers maintain their way of practice in their own villages. The knowledges are minimally affected in the two environments. In Cuetzalan, each has seen the expansion of his practice, without losing its idiosyncrasy, or without acquiring all possible knowledge; there was no uniformisation. The most notorious impoverishment is seen in the therapist-patient relation, which is less intimate in Cuetzalan, but especially which does not allow a real follow-up nor the performance of some practices in particular those which concern the shamans. Many activities of the Sociedad Maseualpajti involve plants, but in a new perspective and expertise. These activities did interest little the healers, and as a consequence, they escaped important transformations in this domain. The association, comprised of healers, has shown little activity in the recruitment of apprentices. In the long-term, impoverishment of traditional medicine is inevitable if it were to be transmitted only through this type of structure. Another change would be the recognition of the healer by a committee of peers rather than by the patients themselves, and the decline of legitimation through the ideology ofthe supernatural election.;Key words: ethnology, ethnomedicine, traditional medicine, healers, Nahuas, Mexico.;This new form of practice is different from tradition: its proximity to biomedicine, the collective rather than the individual practice of the healers and, above all its institutional dimension. The main issue of this thesis is to study the impact ofthis innovation on traditional medicine. One would expect a standardization and a simplification of the practice in Cuetzalan; the introduction of techniques or knowledge in their natural environment of practice; the impossibility of proceeding with certain treatments in the context of the Sociedad, in particular those of the shamans; the access of the healers to knowledge coming from their peers, and for a certain clientele, satisfaction for services received. |
