The meaning of the term medicine to an American Indian is quite different from that which is ordinarily held by modern societies.  To most American Indians, medicine signifies an array of ideas and concepts rather than remedies and treatment alone.  There is no separation between religion and medicine in tribal culture and healing ceremonies are an integral part of the community experience. 

To the American Indian, the natural or correct state of all things, including man, is harmony.  Far from being dominant over nature, man is seen as interdependent with other living beings and physical forces.  All thinking is grounded in relationships.  More emphasis is given to the connectedness of one thing to another than to the individual thing itself.  To maintain a correct or natural relationship is to be in harmony.  The universe is a complex matrix of interdependence.  There is a proper set of relationships for each being, a proper existing in harmony with the universe.

George Bird Grinnell, who was intimately associated with northern Plains tribes, has written:            

“All these things which we speak of as medicine the Indian calls mysterious, and when he calls them mysterious this only means that they are beyond his power to account for. He whom we call a medicine man may be called a doctor, a healer of diseases; or if he is a worker of magic, he is a mystery man.  All Indian languages have words which are the equivalent of our word medicine, sometimes with curative properties; but the Indian’s translation of “medicine,” used in the sense of magical or supernatural, would be mysterious, inexplicable, unaccountable." 

Tribal cultures interpret disease and human suffering as disharmony.  An individual suffers because in some way he or she has fallen out of harmony.  The person who does not feel well has become out of phase with the correct relationships.

Their medical theory arises from the reasoning that the medicine man can control the forces of nature and hence make disease yield to his personal effects.  Consequentially, curative agents are medicine, but only one type of medicine, and then only when it is association with prescribed rites.  The medicine man is entrusted with ceremonies connected with birth and death, magical ceremonies, and the perpetuation of tribal lore.  He is not only the primitive doctor, but he is the diviner, the rainmaker, the soothsayer, the prophet, the priest, and in some instances the chief. Some of the better-known American Indian chiefs were in fact medicine men: Sitting Bull, Geronimo, and Cochise.

Recent years have shown a surge of interest in the therapies of traditional cultures, in patients' use of alternative medicine, and in the desire for mind-body therapies and for spiritual treatment, as well as for behavioral medicine treatments for chronic medical illness. Some hospitals have included traditional Native American healers as part of their staff. Harvard University has created a Center to study alternative medicine.

One of the spiritual practices which patients may request (especially in the American Southwest) is Native American Healing (NAH) to complement their conventional medical treatment. Some patients even voice a preference for exclusive NAH. On reservation settings, tension may exist between Native American healers and conventional physicians supplied by the Indian Health Service (IHS). Native American medicine has been practiced on the North American continent for at least 10,000 years, depending upon one's theory of origin or arrival. When Europeans arrived in North America, the native population were a healthy lot. Plagues and epidemics from Europe soon changed that, but do not mitigate against the effectiveness of Native American methods for attaining long-term survival and the treatment of chronic disease.

Native Americans stressed development of the inner life which was seen reflected in the outer world. The events of the outer world spoke to inner processes for the person. A fire is burning on the mountain. The person is in agony. An awareness comes which dissipates the agony. Rain comes to quench the fire. The events are seen as related. The fire and the rain were messages about the internal processes of the person. Such ideas are more consistent with a dynamic energy systems (DES) approach in which systems interact in complex ways, actually communicating and creating shared memory through their reciprocal effects upon each other during that communication. While preposterous to the conventional psychotherapist that a human being can communicate agony to nature, modern DES theory parallels the traditional belief that the mountain could have responded with fire and then the sky with rain, both in response to the human and now also the burning mountain.

Native healing of externally caused injuries, in which the origin of the ailment is perfectly obvious, is usually rational and often effective. In such a category are fractures, dislocations, snake and insect bites, skin irritation, and bruises.  Minor internal illnesses, such as colds, headaches, and digestive disorders are treated with herbal remedies.  In cases of persistent internal disease where the cause is not apparent, the usual Indian custom is to attribute the disease to some supernatural agency.

If ordinary medicine did not soon bring relief, they resort to shamanistic methods, such as incantations, charms, prayers, dances, the shaking of rattles and beating of drums.  The supernatural causes of disease among American Indians societies included sorcery, taboo violation, disease-object intrusion, spirit intrusion, and soul loss.  An additional disease cause, prevalent among Iroquoian tribes, is unfulfilled dreams or desires. In certain tribes and areas, some of these causes are more important than others.

Of the supernatural causes of disease, the most important are the spirits of the animals, who thus gain revenge for slights and abuses. Disrespect toward fire, such as urinating on the ashes, or spitting on it, will bring disaster.  Insults to nature bring about a specific penalty.  Human ghosts who naturally feel lonesome for their friends and relatives cause a disease, so as to provide congenial company, while an animal ghost will cause trouble if respect has not been shown to its body after it has been killed. A powerful disease-bringer is the magic used by witches to cause sickness.  Other causes of disease are dreams, omens, neglected taboos, and the evil influence attributed to woman during her catamenial period.

The practice of the medicine man relates to the plant world in several ways. Some tribes believe that spirits inspire the healer to know which curative plants to use, others that a plant is protected by the spirit" that has endowed it with medicinal properties. Offerings are often left to these spirits when the drug plant is picked. Healing is indicated by the return of the soul or by the medicine man claiming to produce the 'extracted object'. Massage and ritual 'sweat baths' are also used in the healing process. North American Indians used catnip tea for colic in babies.

As mentioned previously, the word "Medicine" has a different meaning for Native Americans. It encompasses well-being and spiritual health as well as physical health. A pipe ceremony is a ritual that Hopi Native Americans employ to pray to the Great Spirit. Great Spirit is comprised of the mother (the earth) the father (the heavens and celestial bodies) as well as the grandmothers and grandfathers. Grandmothers and grandfathers may be likened to angels. In the Hopi tradition, they are beings that have been in the universe since time began and they are thought to carry specific medicines. That is, they each have different strengths or aptitudes  which the Hopi may call upon in different circumstances.

Pipe ceremonies can be carried out at virtually any time that the practitioner desires. One way to think of them is as an active or interactive prayer session or meditation. Sometimes a Hopi shaman (medicine man) is present for the ceremony, but that is by no means a requirement. Practitioners of the Hopi faith can perform a pipe ceremony when they are grateful for an answered prayer, to ask for the health or care of a loved one, to celebrate the birth or death of a family member, to ask for clarity when making a decision, to request the healing of a friend, or to express gratitude for life's many blessings.

One of the key aspects of the pipe ceremony is to develop one's own relationship with Spirit with the understanding that Spirit will provide the tools necessary via channels such as herbs and the shaman.