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While folk and biological medical systems have come to be recognized and discussed as cultural systems, insufficient attention has been directed toward clarifying the understanding of culture appropriated by medical anthropology. Utilizing research findings on reproductive illiness behavior among Haitian women, this article discusses the limitations of the medical culturalist perspective and argues instead for a critical understanding of culture that is attentive to the shaping influence of political economy, history, and social relations on human experience. Folk illness categories and symptoms among Haitian women are found to reflect changes in these three contexts.