The perverse refusal of the Ashanti to conform to Western psychiatric norms of depression is also found among the Yoruba. It is clear that for the Ashanti and Yoruba the constellation of symptoms operationalized as depression in Western society has become an existential issue, a natural product of the vicissitudes of life. Meditation on revulsion is a long and ancient tradition in Buddhism and is known in the texts and commentaries as asubha bhavana, asubha meaning ‘foulness’ or ‘impurity’. The lay virtuosos or upasakas discussed earlier have read texts such as that of Kisa Gotami, and they have resorted to sil, a temporary movement away from domestic living, and into meditation. Western medicine has enormous prestige and cultural significance in modern society. Moreover, parallel to the culture of Western medicine are the institutions that it creates, for example, wards for taking care of the mentally sick.