Syncretism in Miao Healing: Bridging Shamanic Practices and Scientific Treatments with Religion, Ritual, and Local Knowledge

: The Miao (Hmong) community in Southwest China, deeply entrenched in a religious belief system acknowledging the omnipresent spiritual essence and venerating ancestor worship, perceives life as a harmonious blend of the “soul” and the “body”, intricately interwoven and mutually rein‑ forcing. Within this cultural milieu, shamanism and healing practices form an inseparable nexus, epitomizing a worldview characterized by the harmonious coexistence of gods, spirits, ancestors, ghosts, and shamans. This study scrutinizes the syncretism employed by the Miao to address ill‑ ness, bridging shamanic practices and scientific treatments with religion, ritual, and local knowledge. Through methodologies such as autoethnography, participant observation, and in‑depth interviews, the research explores a Miao woman’s healing journey, synthesizing shamanic traditions with sci‑ entific interventions to reveal the nuanced interplay between traditional customs, environmental influences, and health beliefs. Despite encountering challenges like limited healthcare access and high costs, numerous Miao people seek assistance from shamans, underscoring the community’s re‑ silience in navigating the intricate interrelationship between traditional practices and modern health‑ care systems. By emphasizing the significance of syncretism, this study contributes to a nuanced understanding of how the Miao seamlessly integrate shamanic practices with scientific treatments, fostering improved intercultural communication and cultivating culturally sensitive healthcare prac‑ tices, ultimately enhancing the overall well‑being of the Miao community.


Introduction
Fang, a 45-year-old Miao 1 woman, is highly skilled in handcraft arts and has been recognized as an intangible cultural inheritor of Miao traditions in Guizhou Province, China.Residing in a picturesque and environmentally conscious Miao Village surrounded by rivers, mountains, and rich Miao culture, she successfully operates a homestay business.This venture allows her to share her exceptional handcraft skills, contribute to family income, and has earned her accolades such as "The Most Beautiful Craftsman" and the title of "Provincial Level Arts Craftsman" from government, social enterprise, and cultural departments.In May 2020, Fang received a diagnosis of breast cancer.Despite being in the early stages, the required treatment is estimated to cost over 200,000 yuan and extend for at least seven months.This financial burden is particularly challenging for a rural family dependent on farming and handicrafts in China.Is it a spiritual approach or a modern scientific treatment for the illness?Raising two children in college and high school, Fang is confronted with steep medical expenses that surpass her financial capacity.This has prompted her to explore alternative approaches, including seeking assistance from a traditional Miao doctor (literally, Miao shaman/spirit healer/ritual expert). 2  The Miao people, rooted in a belief system that recognizes the spirit in all things and practices ancestor worship, perceive life as a combination of a "soul" and a "body" intri-cately connected and complementary (Zhang 2023;Conquergood and Thao 1989).Illness or mental distress is often attributed to a lost soul or a soul detached from the physical body due to shock or demonic abduction (Ma 2012).Traditional Miao medicine combines witchcraft and conventional remedies.For Miao shamans (spirit healers/ritual experts), "witching" is akin to shamanism, not only as a spiritual healing method but also as a diagnostic tool, incorporating rituals such as burning eggs and conversing with ancestral spirits for complex ailments (Holman 2020).In the face of modernization, marketization, and secularization, many Miao individuals find themselves living in a demystified universe.The gods, spirits, and ancestors no longer actively participate in daily life.Despite this, numerous cultures across history still regard the soul as a tangible and influential entity (Postert 2010).Fang's situation exemplifies the need to adapt healing practices in the context of modern challenges.As the Miao community grapples with the erosion of traditional beliefs, it becomes essential to reconsider the cultural significance of the sacred and explore ways to integrate it with modernization, secularization, and commercialization.In navigating her economic limitations against the backdrop of modern medical conditions, Fang may need to adjust her healing practices gradually.This entails acknowledging the coexistence of witchcraft (shamanism) and modernity, adopting a holistic approach to healing, and strategically leveraging cultural resources to preserve Miao traditions amidst changing circumstances.
The Miao community in Fang's surroundings grapples with persistent challenges despite advancements in modernization and living conditions.Environmental pollution, notably through pesticide use and inadequate distribution of medical resources, primarily biomedicine, remains a significant issue.When illness strikes, Miao families encounter obstacles such as limited access to medical care, high costs, and challenges in securing appointments with skilled medical professionals.Consequently, many turn to Miao shaman for assistance (Helsel 2019).In Miao villages, the enduring struggle against nature and various diseases has given rise to a rich culture of Miao traditional medical knowledge.Tens of thousands of Miao shamans in the Miao community emerge as pivotal figures, not only addressing the difficulties in accessing medical care within the Miao vernacular society but also serving as vital repositories of local medical knowledge, wisdom, and skills (Postert 2010;Wu 2010).
A survey conducted across nine counties and cities in Guizhou's Qiandongnan Prefecture, including Kaili, Huangping, Shi Bing, Zhenyuan, San Sui, Jianhe, Leishan, Danzhai, and Majiang, uncovered significant insights.Approximately 100,000 rural residents in these areas possess knowledge of multiple Miao medicines, with over 10,000 capable of diagnosing, collecting, and treating patients.Additionally, more than 10,000 individuals operate clinics or sell medicines in designated stalls, contributing to public health in towns and cities.Among them, over 4000 individuals balance medical practice with farming and other professions (Zhang 2006).Despite variations in age, literacy, income, and knowledge transmission among the numerous Miao folk physicians, common characteristics in medical knowledge transmission emerge.These include a substantial number of Miao folk physicians, proficiency in recognizing herbs, a predominant education level of middle and high school, and a significant proportion aged over 40.Notably, they exhibit expertise in treating diverse and complex diseases, relying on medicinal prescriptions rooted in ancestral traditions with a long history.
However, a concerning trend emerges regarding the transmission of medical knowledge to the younger generation.More than half of Miao folk healers have not passed down their acquired knowledge, and a significant majority of young Miao individuals exhibit reluctance to engage in the study of Miao medicine.This hesitancy is linked to the belief that extensive learning results in fatigue, particularly given the vast amount of traditional Miao knowledge that must be learned.Remarkably, Miao shamans (literally, shamans/spirit healers/ritual experts) charge low fees, often accepting non-monetary items like roosters and wine or adhering to local traditions, even though their practice is not formally legalized.Despite this, Miao healers enjoy widespread recognition in Miao vernacular society.
Survey data from 402 farmers, township cadres, and residents in Qiandongnan Prefecture reveal that 70% of farmers, 38.7% of township cadres, and 191 residents consider local Miao folk physicians their primary choice for medical care (Zhang 2006).These survey findings underscore the widespread existence of Miao local medical knowledge as a valuable ethnic and cultural resource in Miao vernacular society.It is continually acknowledged by both the "sick" and the "healers", showcasing the irreplaceable social function of Miao medicine (Ma 2008).Miao physicians play a dual role as crucial inheritors of local medical knowledge and practitioners actively contributing to the enrichment of traditional medical practices, improvement of medical skills, and the overall health promotion in Miao vernacular society (Cha 2003).
This research documents how Miao women employ holistic approaches to address illness in a modern, disenchanted society and explores how the Miao community integrates its belief system with Western healthcare practices.As an academic affiliated with institutions in Guizhou, China, I identify as a local Chinese, albeit not a member of the Miao ethnic group.From an anthropological perspective, this research endeavors to scrutinize the "other" culture for insights into one's own cultural milieu, thereby enriching the social and cultural concepts that underpin the conception of health.My ongoing curiosity pertains to the strategies employed by the Miao populace in navigating the interface between traditional ritualistic efficacy and modern biomedical interventions, particularly in addressing the dialectical tensions between religious convictions and secularized lifestyles.Focusing on a Miao woman's personal healing experience, the study reveals the dynamic interplay between traditional practices and contemporary healthcare, showcasing the Miao people's resilience (Bryant-Davis et al. 2014).In examining their belief system, the research uncovers a profound connection between spirituality, cultural traditions, and well-being.The interplay between traditional beliefs and Western healthcare is crucial in understanding the holistic health framework embraced by Miao.Emphasizing the Miao people's rootedness in their cultural heritage and nature, the study promotes an understanding of diverse health paradigms.Syncretism is identified as crucial, providing a framework to comprehend coexistence and allowing healthcare professionals to approach Miao communities with cultural sensitivity.In a word, the research enhances understanding of how Miao integrates traditional practices in a modern context, emphasizing the importance of syncretism for improved communication and culturally sensitive healthcare practices, ultimately promoting holistic well-being.

Literature Review
In the protracted course of history, the indigenous beliefs of the Miao ethnic group have encompassed totemic reverence, animism, ancestor veneration, and a belief in spirits and deities, coalescing into a conceptual framework that integrates notions of natural, societal, and spiritual attributes within the human experience (Desantiago 2020;Bird-David 1999).This ideological construct significantly permeates the quotidian existence and productive endeavors of the Miao community, concurrently shaping their perceptions and responses to afflictions.Within the Miao cosmology, the human corporeal entity is dichotomized into discernible material and imperceptible spiritual components.The material constituents encompass palpable and visible elements such as muscles, bones, flesh, blood, skin, hair, water, and corresponding visceral structures (Her 2005).In contradistinction, the spiritual domain encapsulates intangible facets of human consciousness, volition, and sagacity.The coeval existence of these spiritual and material dimensions constitutes the elemental demarcation between organic and inorganic entities (Zhang 2023;Lee and Tapp 2010).Among living organisms, human spirituality attains the pinnacle of development and dynamism, thereby asserting dominion over the natural milieu, with the soul representing the foundational substrate of this spiritual essence (Plotnikoff et al. 2002).
The doctrinal tenets pertaining to the soul derive from the epistemological domain of witchcraft studies (Boyer 2021;Richter et al. 2017).Within the purview of witchcraft doctrines, the human soul emanates from a prenatal ontology, while the corporeal form is ascribed to the postnatal realm, thereby constituting two disparate ontological systems (Ross 2020).The cessation of human life is construed as the demise of the corporeal vessel, while the soul is deemed imperishable, perpetuating through cycles of transmigration (James 2020).Consequently, the historical ethos of the Miao culture underscores a predilection for exultation and a nuanced indifference toward matters of life and death.In the context of maladies, a pronounced inclination towards witchcraft rituals is discerned, eclipsing a more circumspect reliance on medical interventions.This sentiment is encapsulated in the local literature, wherein the inscription alludes to the prevalent Miao belief in shamans and the trepidation associated with malevolent spirits, elucidating that maladies are construed as manifestations of spiritual possession (Guo et al. 2021), as articulated in the dictum: "The Miao people customarily believe in witches and fear ghosts.When a person is sick, it is said to be possessed by a ghost…" (Li and Wang [1801] 2019).This cultural inclination toward spiritual explanations for maladies underscores the profound influence of traditional beliefs and daily practices within the Miao community (Lor et al. 2017).The doctrinal tenets reveal a complex interplay between spiritual traditions and contemporary realities, shaping the Miao people's approach to life, death, and overall well-being (Cheu 2021;Zhang 2023).
(1) Animism, ancestor worship, and Miao culture The Miao live in an environment of karst topography in southwestern China, filled with mountains, creeks, lakes, and caves.The climate of this region is warm and humid.The average annual temperature is between 14-19 • C; the annual rainfall is between 1000-1600 mm.Such regions are classified as highland subtropical warm and humid zones.The Miao characterizes the relationship between humans and nature as a relationship between child and mother.They view the sky, the earth, and nature as types of deities; animals and plants are believed to be their ancestors (Zhang 2023;Desantiago 2020).All beings (including animals, plants, mountains, rivers, and lakes) are believed to have thoughts and feelings similar to those of humans (Ma 2011;Luo 2009).In this light, the Miao believe that they can communicate and dialogue with these other beings (Tapp 2001).The Miao venerate the spirit of butterflies, chickens and water buffalo; they believe that trees, including willows, maples, chestnut trees, cyclobalanopsis, cedars, pines, and others, have a preternatural power to shower down prosperity and fortune on them (Dubost et al. 2019).The maple is an object of particular Miao veneration.They also believe that the maple is a holy tree by the sprits of the Miao ancestor Chiyou (蚩尤) and endowed with special psychic powers.For this reason, the drums that are used in ancestor rituals are made principally of maple.Beating a maple drum is believed to create a bridge to the souls of their ancestors (Ho 2012;Xing 2007).Furthermore, some Miao prefer to use a maple pillar as the major support of their house; there is a belief that a maple pillar can protect their offspring and help them to thrive and grow.Most Miao villages have tall, straight maple trees spreading their roots near the village well or near the entrance of the village.These maples are venerated as patron deities who have the power to shower down on the village many blessings that will bring peace to the community and fertility to the village women (Ma 2011;Xing 2007;Luo 2009).The core tenet of Miao cultural beliefs centers around the veneration of ancestors, specifically through the practice of ancestor worship.This belief system postulates the enduring nature of ancestral souls, attributing to them supernatural agency capable of influencing the prosperity or adversity experienced by their progeny.Within the cognitive paradigm of the Miao, the various facets of the human experience, including birth, aging, illness, and death, are ascribed to spiritual causation, particularly emanating from spectral entities known as ghosts.The execution of Miao healing rituals is predominantly geared towards leveraging the ancestral forces to expel malevolent spirits, thereby realizing objectives such as the amelioration of maladies and the preservation of tranquility (Guo et al. 2021).In the context of local Miao healing ceremonies, the role of the shaman assumes a paramount significance.The shaman functions as a conduit, facilitating communication between descendants and ancestral spirits and, thus, serving as an intermediary in the ex-change of desires and intentions between the living and the departed (Plotnikoff et al. 2002;Helsel 2019).
(2) Integration of soul and body in Miao cosmology Throughout an extensive historical trajectory, the Miao ethnic group has cultivated a nuanced conceptual framework that harmoniously intertwines natural, social, and spiritual attributes within the human experience (Grey 2007).This intricate belief system exerts a profound influence on the daily lives and productive endeavors of the Miao community, concurrently shaping their perceptions and responses to afflictions.Central to their cosmological worldview is the collective designation of uncontrollable supernatural forces as "dliangb (鬼神)", encompassing the indigenous spiritual system, foreign cultural spirits, and malevolent entities originating from the deceased, commonly known as "death uglies" (Her 2005).Within the Miao conceptual paradigm, the essence of human natural attributes is encapsulated in the concept of "soul" (dliux, 魂), constituting the fundamental aspect of an individual (Her 2005).The Miao perceive the amalgamation of the soul and the physical body as the formation of a unified natural being.The Miao philosophy posits that life consists of harmonious coexistence between the "soul-body" and the "flesh-body", with these two components intricately connected and mutually reinforcing.Instances where an individual's body exhibits anomalies or experiences mental aberrations are commonly construed as the result of the soul being lost or the soul-shell departing (i.e., the detachment of the soul-body from the flesh-body, being seized by another life entity) (Her 2005).Factors such as fright or malevolent entities hijacking the soul are considered the primary causes of soul loss or soul-shell detachment.At the moment of birth, the soul resides within the flesh-body, appearing in the form of a shadow, termed "dliux naix (灵魂)", or "human soul", also known as the "living soul".During one's earthly existence, the living soul constitutes the fundamental force that sustains bodily survival and vitality.Infants, shortly after birth, exist in a phase of simple bodily growth, during which the connection between the living soul and the body is not firmly established, resulting in frequent occurrences of "soul loss" or even premature death.As the ten-month gestation period concludes, the various organs of the human body gradually develop, and only by the age of 12 does the living soul genuinely integrate with the flesh-body.The robustness of the living soul, manifested as the strength of the soul's power, directly influences the stability of the flesh-body and mental consciousness (Dubost et al. 2019).Likewise, the potency of the living soul is contingent upon the state of the flesh-body.During periods of deep slumber, the living soul autonomously departs from the flesh-body to engage in its own activities, giving rise to dreams.When subjected to fright or harm, the living soul may passively "fall off" temporarily from the body, resulting in abnormal mental activities such as confusion or illness.If the living soul remains detached for an extended duration, individuals may manifest suboptimal health conditions, including pallor, emaciation, lifelessness, and, in extreme cases, endangering one's life.In summation, the Miao people's conception of humanity interweaves across three dimensions: the physical body, the "dliux" (魂, living soul), and the "dliangb" (鬼神, malevolent entities).They exhibit a nuanced understanding of the boundaries and relationships between spirits and ghosts (Zhang 2023).The "dliux (魂)" does not inherently pose a threat to normal human life; however, it transforms into "dliangb (鬼神)" only under specific circumstances, giving rise to various adverse events and circumstances.Over an extended period, the majority of the Miao people have attributed deviations from personal bodily health and the occurrence of disasters and crises in real life to the influence of "dliangb (鬼神)".Different manifestations, impacts, and consequences of various "dliangb" result in distinct ritualistic treatments and sacrificial ceremonies.Hence, the diverse elements present in these ceremonies are intricately linked to spirits, monsters, and other entities, aiming to establish communication, negotiation, confrontation, and even manipulation of the will of these "dliang (鬼神)" (Zhang 2023).The ultimate goal of ritualistic healing is to exchange health and peace with these entities through sacrifices, aiming for a complete life cycle and fulfilling the societal value needs of a harmonious and unified social order (Lan and Hou 2022).
(3) Synergy of shamanic practices and scientific treatments in traditional Miao medicine The discussion on shamanism navigates the complexities of defining and understanding the roles of shamans across diverse cultures.While the terms "shaman" and "shamanism" present challenges in their application and universality, they are commonly used comparatively to denote ritual experts in various communities globally.These experts typically serve as community leaders, healers, and intermediaries with the spirit world (Holman 2020;Moua 2020;Plotnikoff et al. 2002).Among the Miao people, shamanism is a traditional healing practice passed down through generations.Shamans play a crucial role in diagnosing and treating illnesses by communicating with spirits (Lemoine 2011).According to Jacques Lemoine (2008), Miao shamanism functions as a form of psychotherapy, addressing deep-seated psychological and emotional issues associated with illness (Lemoine 2008).Ultimately, Miao shamanism offers a structured framework for healing, restoring balance and well-being to individuals within the community (Moua 2020).Within the therapeutic domain of traditional Miao medicine, a prevalent modality is characterized by the convergence of shamanistic methodologies with healing pursuits, denoted in the Miao vernacular as "ghet xangs ghab naok (巫师)".The term "ghet xangs" (巫师, 祭司, 鬼师) designates individuals engaging in activities associated with spirits, commonly recognized as shamans, while "ghab naok (灵魂, 鬼魂)" conveys the essence of "souls" or "ghosts", synonymous with "fangb yang".Consequently, "ghet xangs ghab naok" signifies individuals endowed with the capability to traverse to the spirit world with the assistance of other souls (Zhang 2023).The application of the term "shaman" is apt, given the alignment of their capabilities and activities with those traditionally ascribed to shamans.As expounded by Bai Xingfa (Bai 2004), these practitioners demonstrate the capacity to "bridge the celestial and terrestrial realms, communicating with both humans and spirits".In addition to their abilities to "discern life and death, foresee years and months like deities", they engage in ritualistic elements such as song and dance, overseeing activities encompassing sacrificial rites, divination, and supplications.These roles extend to dispelling malevolent forces, invoking blessings, averting disasters, predicting abundance or scarcity, and providing medical treatment, constituting integral facets of their customary functions (Helsel 2019).For Miao healers, the term "wū (巫)" (literally, shaman/spirit healer) serves not merely as a conduit for spiritual therapy but also as a diagnostic instrument.During the implementation of the egg-burning therapeutic method, practitioners incorporate elements of incense paper burning, recitation of shamanic incantations, and the inference of a patient's ailment based on the physical characteristics of the burned egg.In instances of complex and diagnostically challenging conditions, Miao villagers seek the guidance of shamans to conduct rituals, engaging in dialogues with ancestral spirits to discern the roots of illnesses.While pharmacological treatments remain integral, the incorporation of shamanistic practices is believed to synergistically enhance treatment efficacy, emphasizing the concept of "shén yào liǎng jiě (神药两解)" ("spirit and medicine working together") (Zhang 2023).
This amalgamation of shamanism and healing practices is inherently intertwined with the Miao cultural construct, where life is perceived as a harmonious coexistence of the "hen 魂" ("soul") and the "shēn 身" ("body"), along with the cultural norm of "xìn wū wèi gu treatments and sacrificial ceremonies.Hence, the diverse elements present in these ceremonies are intricately linked to spirits, monsters, and other entities, aiming to establish communication, negotiation, confrontation, and even manipulation of the will of these "dliang (鬼神)" (Zhang 2023).The ultimate goal of ritualistic healing is to exchange health and peace with these entities through sacrifices, aiming for a complete life cycle and fulfilling the societal value needs of a harmonious and unified social order (Lan and Hou 2022).
(3) Synergy of shamanic practices and scientific treatments in traditional Miao medicine The discussion on shamanism navigates the complexities of defining and understanding the roles of shamans across diverse cultures.While the terms "shaman" and "shamanism" present challenges in their application and universality, they are commonly used comparatively to denote ritual experts in various communities globally.These experts typically serve as community leaders, healers, and intermediaries with the spirit world (Holman 2020;Moua 2020;Plotnikoff et al. 2002).Among the Miao people, shamanism is a traditional healing practice passed down through generations.Shamans play a crucial role in diagnosing and treating illnesses by communicating with spirits (Lemoine 2011).According to Jacques Lemoine (2008), Miao shamanism functions as a form of psychotherapy, addressing deep-seated psychological and emotional issues associated with illness (Lemoine 2008).Ultimately, Miao shamanism offers a structured framework for healing, restoring balance and well-being to individuals within the community (Moua 2020).Within the therapeutic domain of traditional Miao medicine, a prevalent modality is characterized by the convergence of shamanistic methodologies with healing pursuits, denoted in the Miao vernacular as "ghet xangs ghab naok (巫师)".The term "ghet xangs" (巫师, 祭司, 鬼师) designates individuals engaging in activities associated with spirits, commonly recognized as shamans, while "ghab naok (灵魂, 鬼魂)" conveys the essence of "souls" or "ghosts", synonymous with "fangb yang".Consequently, "ghet xangs ghab naok" signifies individuals endowed with the capability to traverse to the spirit world with the assistance of other souls (Zhang 2023).The application of the term "shaman" is apt, given the alignment of their capabilities and activities with those traditionally ascribed to shamans.As expounded by Bai Xingfa (Bai 2004), these practitioners demonstrate the capacity to "bridge the celestial and terrestrial realms, communicating with both humans and spirits".In addition to their abilities to "discern life and death, foresee years and months like deities", they engage in ritualistic elements such as song and dance, overseeing activities encompassing sacrificial rites, divination, and supplications.These roles extend to dispelling malevolent forces, invoking blessings, averting disasters, predicting abundance or scarcity, and providing medical treatment, constituting integral facets of their customary functions (Helsel 2019).For Miao healers, the term "wū (巫)" (literally, shaman/spirit healer) serves not merely as a conduit for spiritual therapy but also as a diagnostic instrument.During the implementation of the egg-burning therapeutic method, practitioners incorporate elements of incense paper burning, recitation of shamanic incantations, and the inference of a patient's ailment based on the physical characteristics of the burned egg.In instances of complex and diagnostically challenging conditions, Miao villagers seek the guidance of shamans to conduct rituals, engaging in dialogues with ancestral spirits to discern the roots of illnesses.While pharmacological treatments remain integral, the incorporation of shamanistic practices is believed to synergistically enhance treatment efficacy, emphasizing the concept of "shén yào liǎng jiě (神药两 解)" ("spirit and medicine working together") (Zhang 2023).
This amalgamation of shamanism and healing practices is inherently intertwined with the Miao cultural construct, where life is perceived as a harmonious coexistence of the "hen 魂" ("soul") and the "shēn 身" ("body"), along with the cultural norm of "xìn wū wèi guı̌ 信巫畏鬼" ("believing in shamans and fearing ghosts").An illustrative example derived from the "Hóng Miáo Guī Liú Tú 红苗归流图" ("Red Miao Returning Flow Chart") (A Lin 2008) compiled during the Kangxi era of the Qing Dynasty provides 信巫畏鬼" ("believing in shamans and fearing ghosts").An illustrative example derived from the "Hóng Miáo Guī Liú Tú 红苗归流图" ("Red Miao Returning Flow Chart") (A Lin 2008) compiled during the Kangxi era of the Qing Dynasty provides insights into the pivotal role of shamans in Miao belief systems.The depiction of the "Xuán shū bo bìng 悬梳卜病" ("hanging comb divination for illness") ritual in the chart underscores the Miao's conviction in the efficacy of shamanistic practices, asserting that illnesses are often attributed to spiritual causes.This ritual involves the suspension of a comb with a thread, and the observation of its movements aids in discerning the nature and severity of the ailment.Subsequently, a shaman is invoked to offer supplications (Guo et al. 2021).In this context, the distinctive therapeutic characteristics associated with the integration of shamanism are intricately linked to the Miao cultural framework, which perceives life as a dual existence of corporeal and spiritual dimensions, perpetuated by customs em-phasizing a belief in shamans and a wary reverence for ghosts.Miao ritualistic healing predominantly operates within familial, patrilineal lineage, village, and regional marriage circle units.The process typically commences with elder family members autonomously assessing symptoms, and deciding whether the patient requires the assistance of a healing practitioner known as "ghet xangs" (巫师, 祭司, 鬼师).While these therapeutic rituals ostensibly address individual ailments, they effectively serve as collective healing endeavors.The local Miao community posits that individual well-being is intrinsic to collective health, and any individual affliction can disrupt the normal functioning of societal order (Plotnikoff et al. 2002).Consequently, each kinship group bears the responsibility and obligation to aid individuals in their recuperative journey toward health.In examining the relationship between healing practitioners and the recipients of treatment, a mutual and equitable dynamic prevails.Shamans and the afflicted share an emotional resonance, with neither possessing absolute authority.The process involves an exchange of opinions and negotiations regarding the therapeutic rituals.Upon the recovery of the patient, symbolic offerings of rice or remuneration are ceremonially returned to the family of the healed, symbolizing the accumulation of merit, prestige, and social standing for the shamans.In conclusion, the distinctive feature of integrating shamanism into healing practices within Miao cultural contexts resonates with their conceptualization of life as a harmonious interplay between the "hen 魂" ("soul") and the "shēn 身" ("body").This cultural amalgamation finds resonance with the customary adherence to the belief in shamans and a cautious reverence for the supernatural realm.

Study Context and Methodology
Fang lives in a Miao village, Gazhai, Located in Danzhai County, Guizhou Province.The total area of the Gazhai village is 5.6 square kilometers, with 154 households and 678 people.In the composition of income in 2019, about 70% of the income comes from men going out to work, 80% of the elderly staying at home, and 90% of the women have mastered the superb traditional batik skills.About 40% of the women work in batik handicrafts to increase their family income while accompanying their children to study in the county.Fang is one of the outstanding handcraft women in Gazhai.Fang started his batik handcraft when she was eight or nine years old, followed her elders to make batik, and at that time, she made batik handcrafts by herself.2014, she and a dozen women in the village jointly set up a batik cooperative, and they all made batik while doing farm work.However, the cooperative could not find outlets in the deep mountains, and in the first few years, her annual income was only more than 2000 yuan.So, she and her family started a family stay business specializing in receiving tourists who come to experience batik handcraft and rural life.With the help of her children, she has learned to use cell phone translation software to communicate with foreign tourists from all over the world.By 2016, more than 500 people could be accommodated at her home during the peak tourist season of winter and summer vacations every year, charging 150 yuan per person per day.This increased her family income, but in 2020, she found out that she suffered from breast cancer and medical expenses were more than 100,000 yuan; the disease is under control, but the burden on the family is very heavy.At this difficult time, handmade batik craft became Fang's main economic income and the spiritual encouragement of artistic creation in her free time.
I first encountered Fang while working on the Citi-Guizhou Ethnic Women Handicraft project in 2020, which aims to empower local ethnic women by harnessing their traditional handicraft skills, such as embroidery, needlework, and batik, to enhance their family income.Through this project, I gained insight into Fang's handcraft talents and personal life.Despite being illiterate and not proficient in verbal communication, I witnessed how Fang adeptly utilized her traditional skills to convey her understanding.Examining Fang's batik arts, it became evident that Miao traditional culture was deeply ingrained, exhibiting resilience against the influences of modernization and commercialization (Bryant-Davis et al. 2014).Through her work, I gleaned insights into various Miao rituals and belief systems embedded in her daily practices.However, I observed a gap in her knowledge related to environmentally friendly.For instance, Fang's diagnosis of breast cancer raised concerns about her use of glyphosate as a daily herbicide to eliminate weeds around her house, as well as her consumption of wild vegetables from treated areas.However, based on common modern medical knowledge, breast cancer can arise from various factors such as genetic mutations, aging, family history, and lifestyle choices, among others.While there is no available data on cancer rates and herbicide use specific to the area, cautionary messages from local authorities suggest potential risks.It's essential to acknowledge the multifaceted nature of breast cancer causation, and neither I nor Fang's doctors have definitively linked her diagnosis to glyphosate use.Our intention is to raise awareness and offer friendly reminders.Fortunately, Fang has discontinued her use of glyphosate.While seeking biomedical treatment at a local modern hospital, she simultaneously held the belief that the onset of her cancer might be attributed to her house or family being influenced by unclean spirits, according to Miao culture.To substantiate her beliefs, she recounted recent events in her family, such as disrespecting an ancestor during a worship ceremony, violation of local Miao sexual taboos with men and women sleeping together in the same room in the stay-home business, and encounters with evil spirits attempting to disrupt her family life.This research approach involved a qualitative exploration of Fang's life, combining participant observation and in-depth interviews to unravel the intricate interplay between her traditional practices, environmental choices, and health beliefs.The aim was to provide a nuanced understanding of the cultural context influencing her actions and decisions.
In this article, I pursue Fang's religious healing autoethnographically, which enables us to record her healing practices engaging with modern biomedical treatment and conventional remedies among the Miao community.Fang's autoethnography highlights the individual experience, presenting lived experiences and embodied practices through studied, focused, and critical reflection.This retrospective power is one of the strengths of autoethnography methods: Like oral narration, it links decades of life experience with deep introspective self-reflection, relying on the self-conscious self-examination of personal experiences and the insights of personal reflection over many years (Butz and Besio 2009).Such methods are here particularly pertinent because, in Fang's case, it is hard to use the biomedical standards to analyze the perception of disease and measure the efficacy of medical treatment; instead, her case should be placed in the context of the local Miao culture, religious rituals, and individual experiences.Based on patient-centered self-adjustment and individual experience, this research explores the understanding and psychological adjustment of illness and physical rehabilitation in the local culture and re-examines the means of physical treatment, the process of healing, the expectation of treatment, and the evaluation criteria.This autoethnographic method, on the other hand, manifests self-subjectivity and expresses self-consciousness by describing the personal experiences of the researched as both an insider and an outsider (Ellis et al. 2011), focusing on describing the researcher's own perceptions and practices at an individual level, regards personal thoughts, feelings, stories, and observations as a way of understanding the social context, and explores the interaction between the self and the cultural context through the presentation of self-feelings and thoughts (Adams et al. 2015).

Gazhai Village: Tradition, Culture, Beliefs, and Medical Challenges in Miao Community
Gazhai Village, where Fang resides, is emblematic of a traditional Miao community wherein 90% of Miao women possess the skill of crafting batik by hand.This village preserves an entire traditional handcrafted ecological chain encompassing the production of indigo, cloth weaving, wax application, and dyeing.In national tourism promotion efforts, the inhabitants of Gazhai proudly assert it as a locale with "abundant fish and pristine water", aspiring to attract more individuals to partake in the batik craftsmanship and appreciate the favorable ecological surroundings, beliefs, and cultural cognitions.Fang articulates, "Gazhai village is analogous to three siblings, alongside the adjacent Ga Do and Ga Mo villages".Historically, their migratory patterns were driven by the pursuit of areas blessed with fertile water and grasslands.As their ancestors transitioned from Ga Do to Ga Mo, eventually reaching the hill presently occupied by villager Yang's residence, they encountered an obstacle in the form of a river.Upon attempting to cross to the current Gazhai Village Council location, they discovered an abundance of fish in the river.After crossing, they found their raised pants filled with fish.Notably, Gazhai village, nestled against the mountainside, features a dragon pool replete with water and grass.Feng Shui observations reveal that the village's topography resembles two fish converging head to tail, their bodies adorned with trees, while an encompassing river meander resembles a dragon.The shaman interpreted this as a providential gift, designating Gazhai as a place "devoid of water scarcity, abundant in fish, and flourishing with grass".Consequently, they relocated to the present Gazhai village, instituting rules that prohibit tree felling and the alteration of the fish-shaped landscape.Two incidents underscore the village's perceived divine protection: firstly, during road construction, earth-moving near the fishtail resulted in unfortunate deaths, prompting the village to appease the gods through offerings, averting further fatalities.The second incident involved an attempt to fell a thousand-year-old maple tree; the tree bled upon cutting, instilling terror and dissuading further attempts.
Addressing the question of why batiks in Gazhai Village predominantly feature motifs such as flowers, birds, fish, and insects, Fang and the village elders expounded, "Gazhai Miao views mountains, rivers, and people as divine entities, warranting cautious depiction.Birds, flowers, fish, and insects are chosen because they symbolize nourishment.The villagers believe these elements should coexist in love and harmony, mirroring human relationships.For instance, a fish's tail transforms into a bird's wings, aspiring for the fish to soar like a bird, and a bird's belly is depicted as a fish's, envisioning the bird swimming akin to a fish.The overarching ethos emphasizes mutual love and cooperation, fostering a joyful existence".Despite the idyllic portrayal of Gazhai's mountains, waters, and rich Miao culture, along with local nature worship, religious beliefs, historical recollections, and ecological awareness, a somber reality surfaces through Fang's revelation of breast cancer, attributed to modernization and prevalent scientific knowledge.The pervasive use of pesticides by locals poses health threats, resulting in elevated instances of illness and challenging diseases.The Miao community, inhabited by Fang, confronts environmental pollution and inadequate distribution of medical resources, primarily Western medicine.Accessing medical care becomes a formidable task for many Miao people due to challenges such as cost, appointments with skilled doctors, and reliance on Miao shamans (Cha 2003).The Miao, having long grappled with nature and diverse ailments, have cultivated an extensive culture of Miao medicine and traditional medical knowledge, engendering numerous Miao folk shamans across the community.These individuals not only serve as the primary grassroots responders to the healthcare challenges within the Miao society but also act as crucial repositories of localized medical knowledge, wisdom, and skills.
A survey conducted in Guizhou's Qiandongnan Prefecture, where the Miao population is concentrated, revealed a significant presence of Miao folk physicians, demonstrating diverse knowledge in Miao medicine (Zhang 2006).While variations exist in age, literacy, income, and knowledge transmission, commonalities include recognition of herbs, modest educational background, and a focus on treating various ailments, from cancer to cardiovascular diseases.A noteworthy observation is that many Miao physicians, predominantly aged over 40, have not passed their medical knowledge to the younger generation, and a substantial portion of youth expresses disinterest in learning traditional medicine (Zhang 2006).Despite lacking legal validation, these Miao healers enjoy widespread acknowledgment in Miao vernacular society.According to a questionnaire survey of 211 farmers, 191 township cadres and residents in nine counties and cities in Qiandongnan Prefecture, "70% of the farmers, 38.7% of the township cadres, and the township residents regarded the local Miao folk healers as their first choice for medical care (Zhang 2006).This underscores the intrinsic value of Miao medicine as a precious ethnic cultural resource, acknowledged and continuously constructed by both the "healers" and the "sick" within Miao vernacular society.The indispensable social function of Miao medicine is evident in its role in enriching Miao traditional medicine knowledge, fostering Miao physicians as crucial inheritors and practitioners and ultimately enhancing the physical well-being of the people in Miao vernacular society.

Fang's Healing Experience and the Ritual Practices
In the aforementioned context, the etiology of Fang's breast cancer is posited to be partially attributed to pesticide abuse.Initially, Fang pursued biomedical treatment at a local contemporary hospital.However, after a few months, the financial burden of the exorbitant medical expenses, exacerbated by the absence of basic health insurance coverage, prompted her to explore alternative avenues.In consonance with the traditional culture of the Gazhai Miao community, Fang sought recourse in Miao medicines, a prevalent healing approach within the local cultural milieu.Fang articulated, "My neighbors repeatedly emphasized that my breast cancer could be a consequence of uncleanness or malevolent spirits.While operating our homestay business for five years, instances of guests engaging in intimate activities within the premises or engaging in behaviors deemed displeasing to the spirits of our ancestors were cited.It was suggested that my soul had become detached and lost due to demonic abduction, serving as a cautionary reminder.Consequently, I was advised to enlist the assistance of the Miao shaman to perform a ritual aimed at expelling the perceived malevolent forces".Fang's narrative underscores a pivotal shift in her health-seeking behavior-a departure from the external support and the prevalent scientific biomedical discourse towards a reliance on the religious and belief systems ingrained within the Miao community.This transformation, embedded in Fang's psyche and corporeal being, prompted her to seek solace in the reservoir of traditional cultural knowledge.Confronted with the limitations of modern biomedical approaches and compounded by financial constraints, Fang opted to engage the Miao shaman in a ritualistic intervention for both the treatment of her illness and the expulsion of perceived malevolent forces.Fang's account of her healing process unfolds as follows: The Gazhai Miao community, deeply rooted in their cultural practices, ascribes to a worldview where fundamental aspects of human existence-birth, old age, sickness, and death-are intricately entwined with supernatural forces, particularly the influence of ghosts.Central to their cultural repertoire are the Gazhai healing ceremonies, meticulously orchestrated to expel these perceived malevolent entities and demons.This ceremonial process relies significantly on ancestral power, with the overarching objectives of alleviating diseases and safeguarding societal harmony.A linchpin in this intricate cultural practice is the shaman, who assumes an extraordinary and central role as a mediator, channeling the desires of the living to the spirits of the ancestors.The shaman operates as a pivotal medium", establishing a communicative bridge between the present generation and their ancestral predecessors.The entire healing ceremony unfolds through a systematic four-phase progression: identification of the ailment, preparation, exhibition, and conclusion.
(1) Diagnosing phase Fang's diagnosis of breast cancer became a turning point, prompting her and her family to seek recourse from traditional a Miao shaman due to financial constraints and fear associated with conventional cancer treatment.This pivotal decision underscored Fang's reliance on traditional healing practices, reflecting a coping mechanism ingrained in cultural norms.As noted by Jacques Lemoine (2011), the Miao shaman diagnoses the cause of the patient's disease and provides initial remedies.By establishing their sphere of power with spirit helpers, they incorporate the essential cognitive tool of the Journey through the Beyond.This tool enables them to solve the patient's problem, including retrieving lost souls, expelling illness agents, and reconstructing the patient's body image (Lemoine 2011).Adhering to local customary law, the family engaged a shaman to ascertain the malevolent spirits afflicting Fang.The process, known as "looking at the rice", involved a divinatory ritual where Fang presented a bowl of rice and monetary offerings to facilitate the shaman's assessment.The ensuing dialogue with ancestral spirits led to the identification of the spirit responsible for Fang's affliction.The shaman, interpreting patterns on the rice surface, elucidated the nature of Fang's malady, the malevolent spirits involved, and the prescribed remedy.Recalling the process, Fang mentioned, "The shaman initially inquired about my recent activities, family events, and visitors to our home.Subsequently, he adopted an alternative approach to discern the cause of my illness by examining a bowl of rice.The shaman began the process by placing a bowl of rice on a surface, reciting a mantra, rotating the bowl clockwise three times, and then overturning it onto a dustpan for sifting.Pausing at this point, he analyzed the distribution of rice grains to deduce the nature of the affliction.According to his final interpretation, it seemed that individuals with impure intentions had introduced malevolent spirits into our home, possibly during recent homestay business.The recommended course of action was to expel these spirits for the healing of my illness".
(2) Preparation phase Upon identifying the malevolent spirits, Fang's family embarked on the preparation stage, gathering essential items for the healing ceremony as directed by the shaman.These items included white and red paper, symbolic animals (rooster, duck, fish), a bucket of rice, monetary offerings, pork, incense, candles, wine, and snacks.Noteworthy during this preparatory phase was Fang's seclusion from external interactions, emphasizing the ritual's solemnity while maintaining her usual routine.Fang explained, "The purpose of preparing these items is to honor our ancestors and the wandering spirits around our family house, especially if our family is facing harm.According to the shaman, the calamities in our home are signals that our ancestors require offerings from their descendants.Additionally, there might be malevolent spirits haunting our home, intentionally causing trouble and making us and our family unwell.In Miao belief, the blessings received by individuals are attributed to their ancestors, and it is essential to offer timely sacrifices to these ancestors and various spirits.Neglecting this piety leaves us unprotected, making us susceptible to malevolent spirits and illnesses.Therefore, sincere and careful sacrifice preparations are crucial, selecting only the best items.This way, the power of our ancestors will once again be with us, enabling us to overcome evil spirits and restore peace and health".
(3) Exorcism phase The pinnacle of the healing ritual resides in the exorcism stage, marked by the shaman's preparatory visit to Fang's residence.The shaman meticulously cut white and red paper, securing them with bamboo sheets.The ceremonial room, a sacred space, featured a table adorned with rice and monetary offerings, cut paper, wine, symbolic animals, incense, and paper money.The shaman's strategic positioning opposite the door enhanced the ceremony's solemnity, with participants gathered around, fostering a collective sense of spirituality.The exhibition stage commenced with the shaman covering Fang's face with a black cloth, invoking incantations, and entering a heightened spiritual state.Embarking on a spiritual journey to the ancestral realm, the shaman occasionally communicated with an interpreter, usually a relative versed in Miao history, facilitating dialogue between the shaman and participants.In the ancestral realm, the shaman sought assistance to locate the patient's spirit and facilitate its return to the earthly realm.The symbolic return, marked by the identification of a spider, denoting a human spirit, engaged participants in a search within the ceremonial room, signaling the successful reunion of the patient's soul.The shaman concluded by escorting the ancestor's soul back to its dwelling place.Additional requests to the ancestors, expressed through trigram divination, involved seeking blessings for the household and exorcising evil spirits.The negotiation process, symbolized by playing trigrams, required achieving a combination of yin and yang before the shaman could safely return the ancestral soul to its residence.Lemoine (2008) emphasizes that dur-ing this exorcism, the shaman, while in a trance, exhibits a split, multiple personality.For example, as he recounts the unfolding of his journey, he listens to his own words as if they were spoken by his informing spirit and endeavors to visualize the successive images they conjure.Upon the trance's conclusion, he separates from his spirit helpers and reverts to ordinary reality with a diagnosis and a set of provisional measures taken in the spiritual realm, which he may communicate to his patient.If the diagnosis corresponds with the affliction, the patient experiences relief and may soon after seek the shaman's healing performance once again (Lemoine 2008, p. 24).
(4) Concluding phase Post the return of ancestor souls, Fang's family meticulously arranged ceremonial items as guided by the shaman.Ritual sacrifices, symbolizing gratitude to ancestral spirits, were performed with the ceremonial killing of roosters, ducks, and boars.The shared communal consumption of offerings, inclusive of all participants, symbolized the equitable distribution of prosperity among the community.The entire Gazhai Miao ghost-catching ceremony emerges as a complex tapestry of symbolism.The symbology embedded in white and red paper, trigrams, branches, roots, and spiders encapsulates a multiplicity of meanings.The dichotomy between white paper (death) and red paper (life) symbolizes the perpetual cycle of existence, while trigrams function as a means of communicating with ancestral spirits.Various ceremonial items, from branches and roots to white and red paper, signify the infusion of "magic power" by ancestors to repel ghosts and evade malevolent spirits.The spiders, emblematic of human souls, reinforce the ceremony's depth of symbolism.The ostensibly curative nature of the Gazhai ritual, focused on reclaiming the patient's soul for physical restoration, transcends into a symbolic realm where the ceremony becomes a cultural expression, encapsulating wishes, ideas, and a distinctive worldview.This symbolic act, rooted in addressing the psychological needs of the local Miao people, endures in the Gazhai Miao community, maintaining cultural significance despite the encroachment of science and modern medical knowledge.Significantly, the coexistence of traditional healing practices alongside modern medicine underscores the Gazhai Miao's adherence to a holistic knowledge system, laden with cultural connotations emphasizing the interconnectedness of spirit, body, and the integration of witchcraft and medicine.
When asked about the potential curative effects of shamanic rituals, Fang explained, "The shaman reads rice divination, burns incense and paper money as offerings to ancestors, and then calls upon spirits during the ritual.If the disease is alleviated, the shaman attributes it to evil spirits leaving the body.If not, the shaman suggests stubborn spirits, linking it to past misdeeds.Continued rituals seek forgiveness for healing.The shaman, emphasizing personal responsibility, connects the disease to one's behavior.Despite skepticism, shamans play a psychological role, providing a calming presence.Their advice, such as suggestions for changing behavior or the environment, helps relieve psychological stress.Belief in the shaman enhances the effectiveness of psychological recovery".Fang's autoethnography reveals that modernization has ingrained the concept of modern medicine in the Miao region.People turn to biomedical doctors first; only if doctors are unsuccessful or unaffordable will they consult shamans.Generally, the Miao prefer combining traditional shamanic practices with scientific treatments.Patients receive medical care in hospitals while families engage shamans in rituals at home.This dual approach significantly aids patient recovery, highlighting the psychotherapeutic benefits of shamanic practices in the healing process.
To sum up, Fang's decision to invite a shaman for ghost exorcism not only aimed to alleviate the symptoms but also sought to address the root causes of her ailments.This included addressing the impurity associated with communal sleeping arrangements in a homestay business and potential transgressions during traditional rituals, underscoring the intricacies of the Miao belief system.The iterative nature of the ritual performed multiple times, paralleled Fang's biomedical treatments, resulting in a discernible improvement in her condition a year later.One year later, Fang reported feeling better in terms of physical recovery.She regained enough strength to participate in activities such as harvesting rice with fellow villagers and resumed her batik handcraft arts at home.This healing narrative underscores the Gazhai Miao's nuanced perspective, viewing modern medicine and traditional Miao shaman as integral components of their cultural life.This viewpoint is steeped in a profound understanding of the spirit of all things, the unity of soul and body, and the symbiotic relationship between witchcraft and medicine.This cultural synthesis reflects a nuanced response to the challenges of modernization within the Miao community, epitomized in Fang's journey towards a pluralistic healing paradigm (Cha 2003).Fang's narrative compellingly advocates for a comprehensive medical system within Miao society, one that transcends the boundaries of the physical and delves into the social and spiritual dimensions.The convergence of spiritual and biological factors within the Gazhai Miao's healing practices underscores a multifaceted and holistic approach to medical treatment (Hickman 2007).

Discussion and Conclusions
From Fang's healing experience, it becomes evident that, in line with the prevalent legend in the Miao region, both witchcraft and biomedical medicines are equally effective for treatment.The Miao people exhibit skill in transforming witchcraft and medicinal treatments from dichotomous opposites into a monolithic combination, thereby harnessing the unique efficacy of holistic healing (Grey 2007).In times of illness, the Gazhai Miao not only turn to modern hospitals but also seek assistance from local traditional Miao shaman.Within the local village society, Miao shaman doctors often assume the role of folk "ritual" performers, employing special witchcraft rituals to uncover the hidden "source of the disease".Through the practice of numerous rituals, the identity of the Miao shaman gradually becomes intertwined with the role of a "sorcerer".Disease treatment extends beyond reliance on medication alone; it involves the incorporation of local folk beliefs in witchcraft to diagnose and treat diseases, ultimately resulting in the identity and treatment paradigm of "shamanic practices and scientific treatments as one".From an external perspective, understanding the cultural nuances and societal functions of Miao medicine rituals proves challenging, with many categorizing them as "superstitious".However, these disease treatment rituals are closely linked to local Miao culture.Behind these rituals lies a connection to the life and spiritual beliefs of the local Miao people, showcasing reverence for ancestors, respect for gods, and serving as a continuation of the local Miao people's history, culture, and memory (Grey 2007).Fang's healing experience serves as an exemplar of the effectiveness of the local Miao "shamanic practices and scientific treatments as one" holistic approach, successfully alleviating and ultimately curing Fang's illness.
Fang's experience, combining modern biomedical medicines and witchcraft rituals, provokes contemplation.While modern biomedical treatments effectively alleviate physical pain to a certain extent, the local Miao view this as merely addressing symptoms.They believe that to treat the root cause of the disease; relevant rituals must be conducted to eliminate pain and seek spiritual stability.The guidance of witchcraft rituals is rooted in the enduring sense of ancestor worship and soul reverence within local Miao society.In reality, the assistance sought from the Miao shaman is not limited to treating illnesses but extends to family calamities.Miao shamans conduct rituals to dispel calamities and evil spirits, often involving dedications to ancestors and communication with souls.Miao shaman performs as intermediaries between the living and the dead, possessing a certain "spiritual power".Through rituals conducted by Miao shaman with this "spiritual power", the distance between individuals and ancestors is narrowed, allowing the elimination of diseases and the return of the afflicted to their original state.The identity of Miao shaman is holistic, perceived by locals as individuals with a certain spiritual power or supernatural ability in daily life while becoming intermediaries facilitating communication between humans, gods, and ancestors during ceremonies.
Approaching Fang's treatment experience from an anthropological perspective, an autoethnographic analysis yields several insights.Firstly, as the main agents of disease treatment, Miao shaman maintains a significant position in the local Miao society of Gazhai.
The local population prioritizes seeking treatment from Miao shaman, and traditional Miao medicine practices persist.Secondly, biomedical therapies coexist with Miao shamans, both practicing in parallel in Gazhai, and traditional Miao medicine remains prevalent.Miao shaman assumes multiple identities by combining pharmaceutical and witchcraft treatments, practicing on patients concurrently.Thirdly, the ancestral beliefs of ancestor worship and deity reverence persist among the Miao in Gazhai.Traditional Miao medicine intertwines with folk beliefs, with the Miao shaman embodying the concept of "witchcraft and healing as one" in the rural society of Gazhai, participating in the dualistic symbiotic healing rituals of the sacred and the secular (Dubost et al. 2019).Medication and ritual control are widely recognized by the local population as reasonable and acceptable forms of treatment.Claude Levi-Strauss once stated that the essence of therapeutic technique lies in making a given situation emotionally conceivable, thus making unbearable physical pain acceptable to the mind (Lévi-Strauss 1958, p. 217).This reflects a psychological effect of emotional and intellectual acceptance, resonating with Gazhai's shamanic healing rituals.These rituals not only embrace holistic mind-body-spirit approaches but also function as socio-cultural mechanisms for fostering community cohesion and development.Despite the potential absence of discernible biomedical effects in ritual treatment, its rationality endures within the local knowledge system, attesting to its intrinsic value within Gazhai's socio-cultural fabric.
Funding: This research was funded by the National Social Sciences Foundation of China, grant number 19ZDA174.

Institutional Review Board Statement:
The research was approved by the Citi-Guizhou Ethnic Women Handicraft Project.Ethical review and approval were waived due to the cultural context and absence of formal Institutional Review Boards (IRBs) in Chinese academic settings.Specific IRB approval codes were considered irrelevant.Nonetheless, the study maintained ethical standards consistent with anthropological research practices.Regarding the study of animals in Miao rituals, it's important to note that incorporating local symbolic customs, such as animal sacrifices, was done with careful consideration for cultural sensitivity and reverence.These practices do not present an ethnic risk within the symbolic cultural and social framework under examination.

Informed Consent Statement:
Considering that a significant portion of participants were illiterate in both Chinese and English, oral informed consent was sought from all individuals involved in the study.Written informed consent has been obtained from the patient to publish this paper.
Data Availability Statement: Data is contained within the article.

Conflicts of Interest:
The author declares no conflicts of interest.

Notes 1
The term "Miao" is used in the article to refer to a group of people who speak various Hmong-Mien languages.While its usage has been contentious, especially among the Hmong people themselves, who prefer to be called "Hmong", in certain contexts, such as in Gazhai village, China, it is not considered offensive.The author argues for respecting local preferences and indigenous perspectives in fieldwork research.Many international scholars also use the term "Miao", citing it in various works.In those works, historical and cultural complexities surrounding the term are discussed, acknowledging its usage in official classifications by Chinese authorities (Schein 2000;Diamond 1988;Tapp et al. 2004;Geddes 1976).

2
The article employs the term "shaman" to encompass various spiritual and healing roles within the Miao community, including wizards, diviners, witches, Miao doctors (苗医 spirit healers), and ritual experts.These shamans serve as spiritual healers, diagnostic practitioners, and intermediaries between the human and supernatural realms.They conduct rituals to drive out evil spirits, provide offerings to ancestral spirits, and perform ceremonial duties within lineage households.While early missionary writings often misunderstood and labeled these practices as evil, a deeper understanding of the local language and culture led to corrections in terminology.Overall, the term "shaman" is used consistently to refer to these diverse roles and practices within the Miao community (Diamond 1988;Holman 2020).
filling the societal value needs of a harmonious and unified s 2022).
(3) Synergy of shamanic practices and scientific treatments in The discussion on shamanism navigates the complexitie standing the roles of shamans across diverse cultures.While "shamanism" present challenges in their application and unive used comparatively to denote ritual experts in various comm perts typically serve as community leaders, healers, and inte world (Holman 2020;Moua 2020;Plotnikoff et al. 2002).Amon anism is a traditional healing practice passed down through ge crucial role in diagnosing and treating illnesses by communica 2011).According to Jacques Lemoine (2008), Miao shamanism chotherapy, addressing deep-seated psychological and emotio illness (Lemoine 2008).Ultimately, Miao shamanism offers a healing, restoring balance and well-being to individuals with 2020).Within the therapeutic domain of traditional Miao medi is characterized by the convergence of shamanistic methodolo denoted in the Miao vernacular as "ghet xangs ghab naok (巫师 (巫师, 祭司, 鬼师) designates individuals engaging in activiti commonly recognized as shamans, while "ghab naok (灵魂, 鬼 of "souls" or "ghosts", synonymous with "fangb yang".Conse naok" signifies individuals endowed with the capability to tr with the assistance of other souls (Zhang 2023).The applicatio apt, given the alignment of their capabilities and activities w cribed to shamans.As expounded by Bai Xingfa (Bai 2004), t strate the capacity to "bridge the celestial and terrestrial realms humans and spirits".In addition to their abilities to "discern li and months like deities", they engage in ritualistic elements suc seeing activities encompassing sacrificial rites, divination, and extend to dispelling malevolent forces, invoking blessings, ave abundance or scarcity, and providing medical treatment, con their customary functions (Helsel 2019).For Miao healers, the shaman/spirit healer) serves not merely as a conduit for spir diagnostic instrument.During the implementation of the method, practitioners incorporate elements of incense paper manic incantations, and the inference of a patient's ailment bas teristics of the burned egg.In instances of complex and diagno tions, Miao villagers seek the guidance of shamans to conduc logues with ancestral spirits to discern the roots of illnesses.W ments remain integral, the incorporation of shamanistic practi tically enhance treatment efficacy, emphasizing the concept of 解)" ("spirit and medicine working together") (Zhang 2023).
This amalgamation of shamanism and healing practices with the Miao cultural construct, where life is perceived as a the "hen 魂" ("soul") and the "shēn 身" ("body"), along with wū wèi guı̌ 信巫畏鬼" ("believing in shamans and fearing gho ple derived from the "Hóng Miáo Guī Liú Tú 红苗归流图" (" Chart") (A Lin 2008) compiled during the Kangxi era of th treatments and sacrificial ceremonies.Hence, the diverse elements present in these ceremonies are intricately linked to spirits, monsters, and other entities, aiming to establish communication, negotiation, confrontation, and even manipulation of the will of these "dliang (鬼神)" (Zhang 2023).The ultimate goal of ritualistic healing is to exchange health and peace with these entities through sacrifices, aiming for a complete life cycle and fulfilling the societal value needs of a harmonious and unified social order (Lan and Hou 2022).
(3) Synergy of shamanic practices and scientific treatments in traditional Miao medicine The discussion on shamanism navigates the complexities of defining and understanding the roles of shamans across diverse cultures.While the terms "shaman" and "shamanism" present challenges in their application and universality, they are commonly used comparatively to denote ritual experts in various communities globally.These experts typically serve as community leaders, healers, and intermediaries with the spirit world (Holman 2020;Moua 2020;Plotnikoff et al. 2002).Among the Miao people, shamanism is a traditional healing practice passed down through generations.Shamans play a crucial role in diagnosing and treating illnesses by communicating with spirits (Lemoine 2011).According to Jacques Lemoine (2008), Miao shamanism functions as a form of psychotherapy, addressing deep-seated psychological and emotional issues associated with illness (Lemoine 2008).Ultimately, Miao shamanism offers a structured framework for healing, restoring balance and well-being to individuals within the community (Moua 2020).Within the therapeutic domain of traditional Miao medicine, a prevalent modality is characterized by the convergence of shamanistic methodologies with healing pursuits, denoted in the Miao vernacular as "ghet xangs ghab naok (巫师)".The term "ghet xangs" (巫师, 祭司, 鬼师) designates individuals engaging in activities associated with spirits, commonly recognized as shamans, while "ghab naok (灵魂, 鬼魂)" conveys the essence of "souls" or "ghosts", synonymous with "fangb yang".Consequently, "ghet xangs ghab naok" signifies individuals endowed with the capability to traverse to the spirit world with the assistance of other souls (Zhang 2023).The application of the term "shaman" is apt, given the alignment of their capabilities and activities with those traditionally ascribed to shamans.As expounded by Bai Xingfa (Bai 2004), these practitioners demonstrate the capacity to "bridge the celestial and terrestrial realms, communicating with both humans and spirits".In addition to their abilities to "discern life and death, foresee years and months like deities", they engage in ritualistic elements such as song and dance, overseeing activities encompassing sacrificial rites, divination, and supplications.These roles extend to dispelling malevolent forces, invoking blessings, averting disasters, predicting abundance or scarcity, and providing medical treatment, constituting integral facets of their customary functions (Helsel 2019).For Miao healers, the term "wū (巫)" (literally, shaman/spirit healer) serves not merely as a conduit for spiritual therapy but also as a diagnostic instrument.During the implementation of the egg-burning therapeutic method, practitioners incorporate elements of incense paper burning, recitation of shamanic incantations, and the inference of a patient's ailment based on the physical characteristics of the burned egg.In instances of complex and diagnostically challenging conditions, Miao villagers seek the guidance of shamans to conduct rituals, engaging in dialogues with ancestral spirits to discern the roots of illnesses.While pharmacological treatments remain integral, the incorporation of shamanistic practices is believed to synergistically enhance treatment efficacy, emphasizing the concept of "shén yào liǎng jiě (神药两 解)" ("spirit and medicine working together") (Zhang 2023).This amalgamation of shamanism and healing practices is inherently intertwined with the Miao cultural construct, where life is perceived as a harmonious coexistence of the "hen 魂" ("soul") and the "shēn 身" ("body"), along with the cultural norm of "xìn wū wèi guı̌ 信巫畏鬼" ("believing in shamans and fearing ghosts").An illustrative example derived from the "Hóng Miáo Guī Liú Tú 红苗归流图" ("Red Miao Returning Flow Chart") (A Lin 2008) compiled during the Kangxi era of the Qing Dynasty provides de shēngtài zhìhuì y ǔ lìsh Religions 2024, 15, x FOR PEER REVIEW treatments and sacrificial ceremonies.Hence, the diverse elements pr monies are intricately linked to spirits, monsters, and other entities, communication, negotiation, confrontation, and even manipulation "dliang (鬼神)" (Zhang 2023).The ultimate goal of ritualistic healing is and peace with these entities through sacrifices, aiming for a complet filling the societal value needs of a harmonious and unified social o 2022).
(3) Synergy of shamanic practices and scientific treatments in traditio The discussion on shamanism navigates the complexities of d standing the roles of shamans across diverse cultures.While the te "shamanism" present challenges in their application and universality, used comparatively to denote ritual experts in various communities perts typically serve as community leaders, healers, and intermedia world (Holman 2020;Moua 2020;Plotnikoff et al. 2002).Among the M anism is a traditional healing practice passed down through generatio crucial role in diagnosing and treating illnesses by communicating w 2011).According to Jacques Lemoine (2008), Miao shamanism functio chotherapy, addressing deep-seated psychological and emotional iss illness (Lemoine 2008).Ultimately, Miao shamanism offers a structu healing, restoring balance and well-being to individuals within the 2020).Within the therapeutic domain of traditional Miao medicine, a is characterized by the convergence of shamanistic methodologies wi denoted in the Miao vernacular as "ghet xangs ghab naok (巫师)".The (巫师, 祭司, 鬼师) designates individuals engaging in activities asso commonly recognized as shamans, while "ghab naok (灵魂, 鬼魂)" c of "souls" or "ghosts", synonymous with "fangb yang".Consequently naok" signifies individuals endowed with the capability to traverse with the assistance of other souls (Zhang 2023).The application of th apt, given the alignment of their capabilities and activities with tho cribed to shamans.As expounded by Bai Xingfa (Bai 2004), these pr strate the capacity to "bridge the celestial and terrestrial realms, comm humans and spirits".In addition to their abilities to "discern life and d and months like deities", they engage in ritualistic elements such as so seeing activities encompassing sacrificial rites, divination, and suppli extend to dispelling malevolent forces, invoking blessings, averting d abundance or scarcity, and providing medical treatment, constitutin their customary functions (Helsel 2019).For Miao healers, the term " shaman/spirit healer) serves not merely as a conduit for spiritual th diagnostic instrument.During the implementation of the egg-b method, practitioners incorporate elements of incense paper burning manic incantations, and the inference of a patient's ailment based on t teristics of the burned egg.In instances of complex and diagnostically tions, Miao villagers seek the guidance of shamans to conduct ritua logues with ancestral spirits to discern the roots of illnesses.While pha ments remain integral, the incorporation of shamanistic practices is b tically enhance treatment efficacy, emphasizing the concept of "shén y 解)" ("spirit and medicine working together") (Zhang 2023).This amalgamation of shamanism and healing practices is inhe with the Miao cultural construct, where life is perceived as a harmon the "hen 魂" ("soul") and the "shēn 身" ("body"), along with the cu wū wèi guı̌ 信巫畏鬼" ("believing in shamans and fearing ghosts").A ple derived from the "Hóng Miáo Guī Liú Tú 红苗归流图" ("Red M Chart") (A Lin 2008) compiled during the Kangxi era of the Qing (3) Synergy of shamanic practice The discussion on shamanis standing the roles of shamans ac "shamanism" present challenges i used comparatively to denote ritu perts typically serve as communi world (Holman 2020;Moua 2020; anism is a traditional healing prac crucial role in diagnosing and trea 2011).According to Jacques Lemo chotherapy, addressing deep-seat illness (Lemoine 2008).Ultimatel healing, restoring balance and w 2020).Within the therapeutic dom is characterized by the convergen denoted in the Miao vernacular as (巫师, 祭司, 鬼师) designates ind commonly recognized as shaman of "souls" or "ghosts", synonymo naok" signifies individuals endow with the assistance of other souls apt, given the alignment of their cribed to shamans.As expounded strate the capacity to "bridge the c humans and spirits".In addition t and months like deities", they eng seeing activities encompassing sa extend to dispelling malevolent fo abundance or scarcity, and provi their customary functions (Helsel shaman/spirit healer) serves not diagnostic instrument.During method, practitioners incorporate manic incantations, and the infere teristics of the burned egg.In inst tions, Miao villagers seek the gui logues with ancestral spirits to dis ments remain integral, the incorp tically enhance treatment efficacy, 解)" ("spirit and medicine workin This amalgamation of sham with the Miao cultural construct, the "hen 魂" ("soul") and the "sh wū wèi guı̌ 信巫畏鬼" ("believing ple derived from the "Hóng Miáo Chart") (A qíngjié 苗族村寨选址的生态智慧与历史情结 [Ecological Wisdom and Historical Complex of Miao Vllage Site Selection].Guizhou Social Sciences 2011: 85-88.Ma, Yongheng 麻勇恒.2008.Miáozú dìfāng xìng yīyào zhīshì zài xiāngt ǔ shèhuì zhōng de chuánchéng y ǔ bǎohù-Y Religions 2024, 15, x FOR PEER REVIEWtreatments and sacrificial ceremon monies are intricately linked to s communication, negotiation, conf "dliang (鬼神)"(Zhang 2023).The and peace with these entities thro filling the societal value needs of 2022).
Lin 2008) compiled d qián dōngnán wéi lì 苗族地方性医药知识在乡土社会中的传承与保护-以黔东南为例 [On Inheritance and Protection of Hmong Local Medical in Local Society by Taking the Southeast of Guizhou Provinceasan Example].Journal of Kaili University 26: 20-22.