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Abstract Although the ethnomedical system of the Highland Maya is generally well understood, little is known about the Tzeltal Maya ethnomedical syndrome Cha'lam tsots, or 'second hair.' In an attempt to better understand the emic conceptualization, and possible biomedical equivalence of Cha'lam tsots, ethnographic data from semi-structured interviews was collected from the Tzeltal Maya municipality of Tenejapa, in the central highlands of Chiapas, Mexico. Analysis of explanatory models elicited from 20 informants revealed a generalized agreement as to the etiology, symptomatology, course, prognosis, and treatments of this illness. Analysis of these findings will help guide further research into the etiology and biomedical correlate of Cha'lam tsots. This paper concludes with a discussion of the potential significance of this approach for an ethnoepidemiological study of ethnomedical systems, and for the improvement of basic health care services. Introduction One of medical anthropology's most valuable contributions to western medicine has been to demonstrate that indigenous peoples frequently possess detailed knowledge and beliefs about the factors that influence their own health and illness. Although it is widely held that the cognitive structures underlying illness behavior and decision making are implicit in utterances that can be systematically elicited from informants (Frake 1961; Metzger and Williams 1963), much contemporary medical anthropological research has focused on symbolic and epistemological dimensions, rather than the biological and physiological realities to which these utterances refer (Browner et al. 1988). Research on the ethnoepidemiology of the Highland Maya of Chiapas, Mexico by Berlin and Berlin ( 1996) has identified an ethnomedical syndrome, Cha'lam tsots. This syndrome presents an unique opportunity to examine how an analysis of these cognitive structures of illness belief and behavior can benefit our understanding of the potential biological and physiological basis of ethnomedical syndromes. Chalam tsots 'second hair,' is a complex Tzeltal Maya health condition characterized primarily by the presence of short, bristly hairs growing close to the scalp under the normal layer of hair, and is often accompanied by severe diarrhea (Berlin and Berlin 1996). It is considered a serious, potentially fatal condition that typically affects children. Although Cha'lam tsots is associated to some extent by the Maya with gastrointestinal illnesses, it is a condition which presents an enigmatic symptomatology and unclear etiology. Currently there is no biomedical equivalent for this condition, and efforts to understand its etiology have been preliminary at best, although low serum zinc has been identified among those afflicted (Berlin and Berlin 1996). Interestingly, Cha'lam tsots is only found in the adjoining Tzeltal Maya municipalities of Tenejapa, Cancuc, and Oxchuc, in the Central Highlands of Chiapas (Figure 1). This paper reports on ethnographic research conducted in the Tzeltal Maya municipality of Tenejapa, and was designed to launch a preliminary investigation of Cha'lam tsots by eliciting the Maya explanatory model for this illness. An explanatory model describes an illness' attributed etiology, typical onset and preliminary signs and symptoms, course and evolution, prognosis, or predicted outcome, and healing strategies from the emic perspective. This study is founded on the premise that explanatory models form an important vehicle through which the complexities of ethnomedical syndromes can be explored, and by which researchers can better identify and improve the basic health care needs of societies in transition. Interpretive and Ecological Approaches in Medical Anthropology Anthropologists have generally used two distinct approaches in their study of human illness and disease: ethnomedical and ecological approaches. Cultural anthropologists often use an ethnomedical model to interpret the cultural response to disease. …

An Explanatory Model for the Maya Ethnomedical Syndrome Cha'lam tsots