Healers & Indigenous Medicine (2000 BCE+)

Picture this: you live in a rural area of Ecuador and you have come down with a significant illness, developing a large rash on your lower leg and a fever. Your first trip is to the local curandero, a professional herbalist. After you relate your symptoms and a history of your illness, you are sent away until the next day while the healer sleeps and dreams about the exact combination of herbs that will cure your ailment. Although the curandero has treated many of your afflictions in the past, this time his herbal concoction proves to be of no use, and the healer refers you to the nearest clinic, where you are diagnosed by a western-trained nurse and given a shot of penicillin. Nevertheless, you remain nervous about your condition and decide to visit the local shaman who, by imbibing copious amounts of tobacco, goes into a trance in which benevolent spirits instruct him how to cure you (see the source 'Shaman in Ecuador'). He then performs some chants, blows smoke onto you, and massages and sucks on the ailing parts of your body. The shaman may then take a dried llama fetus to the shrine of a mountain deity to appease it. Soon, you feel much better.

The medical practices of shamans and curanderos vary significantly by region, but there are a few common themes in their approach to treating illness. One widely shared philosophical aspect of indigenous medicine is an emphasis on humoral pathology, the balance between hot and cold, wet and dry elements in one's body, in diagnosing and treating illness. If, for example, a disease is believed to be the result of overexposure to hot elements, the treatment--based on the principle of opposites--must increase the cold.

In much of Latin America, efforts are being made to integrate the work of herbalists, midwives, shamans, and biomedical doctors in order to provide efficacious and affordable medical care to the rural population. Until recently, doctors trained in western biomedicine have disparaged indigenous practices, or ethnomedicine, as the superstitions of an ignorant people that were pernicious to the spread of modern medical techniques. Yet many doctors with biomedical backgrounds are now traveling to developing countries to study traditional practices while, at the same time, indigenous healers are integrating biomedicine into their repertoires. Mutual exchange of ideas as well as mutual referrals between practitioners of bio- and ethno-medicine is proving a successful way to ensure rural health care.

According to cultural anthropologist Joseph W. Bastien, illness is both a physical and cultural phenomenon. Proponents of biomedicine tend to consider their treatments to be rational and universal, yet many studies have proven that ethnomedicine can and often does work. Knowledge of botanical drugs has been acquired and transmitted by generations and the psychosocial aspects of ritual treatments are known to increase one's chances of recovery as well. Shamans are now considered to be equally capable of curing mental ailments as psychiatrists (not to mention being more affordable) and in regions where people can be seen by indigenous healers or a biomedical clinic, curanderos and shamans are more effective at treating chronic diseases. Residents who can chose between bio- or ethno-medicine tend to do so on the basis of which type of malady they have. For example, to treat rheumatism--the recurring swelling of ones joints--rural Indians usually chose to visit curanderos who use a soothing herbal poultice which has been proven to ease the pain. Antibiotics have likewise proven themselves, so fevers and infections are generally the domain of biomedicine, while illnesses considered to be caused by spirits or curses, such as headaches, remain the specialty of the indigenous healers (Bastien 1992).

Ethnomedicine is still the primary form of care for about 90% of the rural population in developing countries. Although biomedical advances can contribute much to the care of patients in these areas, it is important that Eurocentrism not be the guiding principle behind western efforts. Ethnomedicine, just like biomedicine, has survived for centuries because empirical testing has proven that it works. Integration of traditional and Western medicine promises to improve not only the health care of people in developing countries, but people throughout the first world as well.

Questions for further exploration:

1. Compare the hot-cold dichotomy of Latin American curanderos with that of classical Greece. What evidence is there that humoral pathology may have been transmitted from Europe with colonization and what might this imply about "indigenous" medicine in general? (See: Foster, George M. "On the Origin of Humoral Medicine in Latin America." In Medical Anthropology Quarterly, New Series, Vol. 1, no. 4 (Dec., 1987), p. 355-393).

2. Like several other aspects of science in Latin America, the introduction of biomedicine to traditional practices has not been straight-forward, but has been fraught with resistance, accommodation, and adaptation. Using an example from either the early colonial period (e.g. the Inca or Aztec conquests) or from recent efforts by practitioners of biomedicine (e.g. the Rockefeller Foundation or clinics in Central America), make an argument for how new concepts were integrated into traditional ones in that specific context.

3. Have the practices of indigenous healers influenced modern biomedicine? If so, how? If not, why not?

4. How have indigenous healers affected medicinal trends in Latin America, such as the idea of tropical medicine?

Further reading:

Appel, Ted C. "The Curandero and the Sukya: Native Healers in Nicaragua." Medical Anthropology Newsletter. 8: 2 (February 1977): 16-19.

Bastien, Joseph W. Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia. Salt Lake City: University of Utah Press, 1992.

Foster, George M. "On the Origin of Humoral Medicine in Latin America." Medical Anthropology Quarterly, New Series. 1: 4 (December 1987): 355-393.

Ortiz de Montellano, Bernardo R. Aztec Medicine, Health, and Nutrition. New Brunswick: Rutgers University Press, 1990.

Palmer, Steven Paul. From Popular Medicine to Medical Populism: Doctors, Healers, and Public Power in Costa Rica, 1800-1940. Durham, Duke University Press, 2003. 

Seggiaro, Luis A. Medicina Indigena de America. Buenos Aires: Editorial Universitaria de Buenos Aires, 1969. 

Sowell, David. The Tale of Healer Miguel Perdomo Neira: Medicine, Ideologies, and Power in the Nineteenth-Century Andes. Wilmington, DE: Scholarly Resources, 2001.

Aztec Healing Practices

Date: 1557
Owner: University of New Mexico Press
Source Type: Images
 

DIGITAL ID: 13063

Aztec Obstetrics

Date: 1557
Owner: University of New Mexico Press
Source Type: Images

 

These illustrations from the Florentine Codex show several of the tasks of Aztec midwives, specialists who cared for pregnant women, delivered babies, and provided medical care for infants. Midwives were--and continue to be--some of the most important and competent medical practitioners among American indigenous groups. Midwives were responsible for both obstetrics (caring for a pregnant mother) and the birthing process, and employed herbs and hands-on remedies to do as much as possible to ensure the health of both mother and newborn.

As obstetricians, midwives performed both physical and spiritual services for the expectant mother. Prayers, chants, and culture-specific injunctions (such as orders to avoid looking at red objects) were performed in conjunction with steam baths and massages, including an external version (the process of rotating a fetus in utero) if she thought it would be a breach birth (Seggiaro, 1977). If the birth itself (performed in a squatting stance or with the mother kneeling) proved too slow, Aztec midwives administered an herb to incite contractions, montanoa tomentosa (or 'woman's medicine'). Modern tests on animals with this drug have shown that it does indeed speed labor (Ortiz de Montellano, 1990).

 Midwives continue to oversee births among rural Indian groups in Latin America and--like herbalists--are beginning to work together with practitioners of allopathic medicine in order to provide primary care at the village level. Modernizers in the nineteenth and twentieth centuries tried to suppress these female medical professionals as backward witches, yet the crucial nature of their work, the lack of medical faciliities in many rural areas, local women's networks and even, at times, the State have kept them in prominence and allowed the perpetuation of their ancient skills.

Reference:

Ortiz de Montellano, Bernardo R. Aztec Medicine, Health, and Nutrition. New Brunswick: Rutgers University Press, 1990.

Seggiaro, Luis A. Medicina Indigena de America. Buenos Aires: Editorial Universitaria de Buenos Aires, 1969.


DIGITAL ID: 12329

 

Aztec Zodiac Man

Date: 1530
Owner: Wellcome Library, London
Source Type: Images

 

This sixteenth century painting, created by Spaniards, portrays Aztec zodiac signs and the body parts that they affected. Each of the twenty symbols represented one of twenty cyclical name-days of the Aztec calendar. Yet this image, like many other sources from the early post-conquest era, is problematic because it conflates European ideas of astrology with those of the Aztecs. European astrology, built off a tradition at least as old as Egypt, did associate different cosmic bodies with specific human diseases. Mars, for example, was tied to the gallbladder. The spiritual aspect of Aztec medicine, however, had illness result from one's relationship with the equilibrium of the entire universe, and though these signs did belong in the Aztec zodiac, they probably did not have the meanings attributed to them here.

Although the Aztecs did consider supernatural causation to be a valid source of illness, they thought of health holistically, a confluence of natural and supernatural forces. Spirits and deities could make one sick as a form of punishment that was not entirely distinguishable from a physical cause, such as overexertion. Highly contagious and fatal diseases were almost always seen as divine in origin, the Spanish-brought smallpox epidemic being the most well known example of this belief. The apparent immunity of Europeans to these scourges added credence to Christianity on the part of the natives, a circumstance that helps to account for the surprisingly fast conversion of much of Mesoamerica.

Reference: Ortiz de Montellano, Bernard R. Aztec Medicine, Health, and Nutrition. New Brunswick: Rutgers University Press, 1990.

CITATION: Kingsborough, Edward King. Antiques of Mexico (London, 1831). Credit: Wellcome Library, London. L0020862.

DIGITAL ID: 13030

 

Ecuadorian Shamans

Date: c. 2000
Owner: Amazanga School of Guayusa
Source Type: Images

 

The blending of indigenous medical practices with those of the modern West has become an important theme amongst people and organizations committed to improving the healthcare available in rural areas of developing countries. This exposition brought together herbalists and shamans from many Latin American countries as well as practitioners of ethnomedical techniques from throughout the world, such as acupuncture, vaporizations, and even tarot card readings.

International meetings that create dialogue among healers from different countries and traditions are becoming more common as many individuals from the first world are increasingly interested in learning how to practice indigenous medicine. This mutual exchange of ideas about healing was commonplace in the colonial era, when Europeans often sought out the advice of Indian curanderos on medicinal plants and Native Americans co-opted classical European ways of understanding the body, like the system of humors. With the self-conscious efforts of Latin American nations to modernize near the end of the nineteenth century, indigenous medicine became anathema, a symbol of backwardness that was actively suppressed. Only in recent decades, thanks in part to expositions such as this, have indigenous and bio-medicines once more begun to find a middle ground.

CITATION: Ecuadorian shamans Don Rafael Santi and Donna Lucilla Vargas. Image copyright Amazanga School of Guayusa.

DIGITAL ID: 12738

 

Indian Bloodletting

Date: 1699
Owner: John Carter Brown Library, Brown University
Source Type: Images

 

This plate, based on a drawing made by Lionel Wafer during a visit to Panama in 1699, depicts an Indian method of bloodletting as a cure for an unnamed illness. According to historian Luis A. Seggiaro, bloodletting was independently practiced in various ways by healers throughout the world to cure many forms of sickness. Although methods varied between particular regions and cultures in pre-Columbian America, bloodletting was practiced by almost all of them (Seggiaro, 1977). The use of a small bow and arrow, as shown in this engraving, was peculiar to Panama. The Aztecs, for one, believed that snorting powdered tobacco (snuff) in sufficient quantity to cause gushing nose bleeds was a way to relieve the pain of a headache, while the Tupi of Brazil punctured the back and buttocks to drain out several maladies in a controlled stream of blood.

Historian of medicine Bernardo R. Ortiz de Montellano considers bloodletting, at least among the Aztecs, to be part of a larger system of medical practice which emphasized an etiological, or cause and effect, approach to healing. Headaches were thus the result of a buildup of blood in the brain (the cause) that led to painful pressure in the head (the effect). To ease the pain, they sought to treat its cause, too much blood in the head (modern studies also suggest that some migraines could be the result of blood clots in the brain) (Ortiz de Montellano, 1990). Etiological approaches are the basis of much modern medicine. The fact that bloodletting might actually have cured some maladies helps to explain why this dangerous technique was practiced in the Americas, ancient Greece, and even Europe as late as the early nineteenth century.

Reference:

Ortiz de Montellano, Bernardo R. Aztec Medicine, Health, and Nutrition. New Brunswick: Rutgers University Press, 1990.

Seggiaro, Luis A. Medicina Indigena de America. Buenos Aires: Editorial Universitaria de Buenos Aires, 1969.

CITATION: Wafer, Lionel. "A new voyage and description of the isthmus of America." 1699. London: Printed for James Knapton, at the Crown in St. Paul's Church Yard. Courtesy of the John Carter Brown Library at Brown University.

DIGITAL ID: 12390

 

Indians Curing the Sick

Date: 1590
Owner: Granger Collection, The
Source Type: Images

 

This 1590 engraving by Theodore de Bry depicts a variety of healing techniques practiced by Florida Indians. The man on the mat in the picture's bottom left is having his skull cut open (trepanned) by the surgeon leaning over him, a procedure believed to relieve severe headaches or bleed-out infections. The person laying face down on the right is inhaling a fumigation made from burning herbs, and the woman standing on the left is drinking an herbal tonic. These techniques were probably very old, but with the arrival of Europeans and their new diseases, Indians tried adapting them to treat unprecedented imported conditions like smallpox.

Although fumigations and simple brain surgery might seem like rather unusual medical practices, it is perhaps even less familiar to modern sensibilities that the man in the back of the engraving is smoking tobacco for medicinal purposes. Despite modern bio-medical evidence as to the harmful effects of tobacco, this mild narcotic was almost universal in pre-Columbian medicine in the Americas and continues to be used for healing in rural areas with large Indian populations. Shamans, curanderos, and even bonesetters are known to smoke tobacco to a point of delirium in order to induce dreams that will instruct them as to the cause or potential cure of an illness. After receiving their vision, a healer can use tobacco for a multitude of afflictions: it could be rubbed into an insect or snake bite to slow infection, induce nasal bleeding to relieve headaches, made into plasters to soothe ulcers, and the smoke could be blown into the wounds, nose, ears, and eyes for a spiritual cure and mild anesthetic. In the centuries immediately following European conquest, many whites promoted the curative powers of tobacco, which was considered to be one of the potential botanical wonder drugs from the New World. Although there is more than enough evidence that the habitual use of tobacco causes several life-threatening conditions, health is regulated by both physical and mental influences, and the controlled application of tobacco by a professional healer may indeed be medically viable.

Reference: Robicsek, Francis. The Smoking Gods: Tobacco in Maya Art, History, and Religion. Norman: University of Oklahoma Press, 1978.

It is also interesting to note that de Bry and many other European artists portrayed Native Americans as muscular paradigms of health. In a way, this is a testament to the success of American diet and medicine, but it also reflected European stereotypes that Indians lived in an uncorrupted state of nature, a kind of primitive Eden. Just like the stereotypes that labeled all Indians as savages, the notion that Indians were physically or morally superior because of their distance from Europe was a Eurocentric generalization that reflected European presuppositions far more than actual circumstances.
   
CITATION: Indians tending their sick by trepanning to remove diseased blood and fumigation to remove toxins from diseases contracted from Europeans, including syphilis and smallpox. Engraving, c. 1590, by Theodore de Bry from his "Historia Americae." Courtesy of the Granger Collection, NY. ID: 0036899.

DIGITAL ID: 12393

 

Peruvian Trepanned Skulls

Date: c. 1300
Owner: Library of Congress
Source Type: Images

 

This photograph shows anthropologist William H. Egberts examing a collection of ancient skulls at the Smithsonian in 1926. These skulls have undergone a medical procedure known as trephination, or trepanning, in which a small hole is drilled through the bone of a living individual's head. Many skulls of Indians from the pre-Columbian Andes have been found with evidence of this primitive form of brain surgery, but the exact reason for its practice is unknown. Various Amerindian groups also did several other medical and ritual proceedures to the skull; ancient Peruvians, for example, used boards and weights to shape an infant's skull at birth into a cone shape while Mayans in the Yucatan would honor their staple crops of maize and beans by molding their babies' skulls to the shape of either a kernel of corn or a single legume.

Anthropologists have posited several explanations for why people with only stone tools to work with would go to such pains (both for the surgeon and--especially--the patient) to drill holes in skulls, a practice that was quite widespread amongst Neolithic peoples throughout the world. General answers, such as the expulsion of evil spirits, curing headaches, or combating insanity are the most widely accepted rationales for this difficult procedure that, most likely, often resulted in the patient's death. The surgeon's tools, namely small stone awls and drills, have been found during archaeological digs in the Andes.

It should be kept in mind, however, that trephination, like other aspects of indigenous medicine, may well be the result of generations of empirical observation by skilled surgeons that produced positive results, and cannot be dismissed as mere superstition or savagery.

CITATION: Several treppanned skulls. Library of Congress Prints and Photographs Division, LC-USZ62-115187.

DIGITAL ID: 12394

 

Peruvian Witches

Date: 1615
Owner: Royal Library of Denmark, Copenhagen
Source Type: Images

 

This c. 1613 drawing by Felipe Guaman Poma shows Catholic Peruvian blacks, a man and a woman, praying to the Virgin Mary. Female worship, however, became highly controversial in seventeenth century Peru, where many women of all races, including the scandalous "veiled women" (or tapadas), hybridized diverse elements of Christian, Andean, and African religion into new and unique forms. Their practices were usually condemned as witchcraft by colonial officials and many of the most prominent women (usually non-whites) were tried and convicted. The most disturbing aspects of these practices for officials and Inquisitors was their "Indianness;" they invoked Andean gods directly (often combined with Christian relics and prayers) and called upon the disposed and deceased Incan king in many of their rites. Such nativism threatened the colonial order that the viceroyalty sought to enforce.

These purported "witches" were also specialized healers and herbalists who combined the traditions of America, Africa, and Europe. Much of the notoriety they received was related to what were perhaps their two most (in)famous substances: love potions and coca. Coca has long been a key element to Andean divining and healing rituals, yet its use by these notorious women changed its image into that of a diabolic narcotic, one that was decidedly Indian and thus dangerous. The fact that coca was often used in rituals meant to invoke the Inca king underscored how these deviant women unnerved colonial leaders. The association of coca and other indigenous herbs with witchcraft and "Indianness" proved to have a lasting legacy, one that encouraged the censure and denigration of Indian healing practices for centuries to come.

Reference: Silverblatt, Irene. Modern Inquisitions: Peru and the Colonial Origins of the Civilized World. Durham: Duke University Press, 2004.
 
CITATION: Drawing 275. Devout black Christians from the stock of unacculturated black slaves from Africa ("Guinea") say the rosary before an image of the Virgin Mary. In Guaman Poma, Felipe. Nueva Coronica y Buen Gobierno. 1615. Courtesy of the Royal Library of Denmark.

DIGITAL ID: 13022

 

Source References

Publications

Appel, Ted C. "The Curandero and the Sukya: Native Healers in Nicaragua." Medical Anthropology Newsletter. 8: 2 (February 1977): 16-19.


Armus, Diego. Entre medicos y curanderos: cultura, historia y enfermedad en la America Latina moderna. Buenos Aires: Ed. Norma, 2002.


Arnold, David. Imperial Medicine and Indigenous Societies. Manchester: Manchester Univ. Press, 1988.


Avila, Elena and Joy Parker. Woman Who Glows in the Dark: A Curandera Reveals Traditional Aztec Secrets of Physical and Spiritual Health. New York: Tarcher, 2000.


Bastien, Joseph W. Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia. Salt Lake City: University of Utah Press, 1992.


Bastien, Joseph. Healers of the Andes: Kallaway Herbalists and their Medicinal Plants. Salt Lake City: University of Utah Press, 1988.


Few, Martha. Women Who Live Evil Lives: Gender, Religion, and the Politics of Power in Colonial Guatemala, 1650-1750. Austin: University of Texas Press, 2002. 


Foster, George M. "On the Origin of Humoral Medicine in Latin America." Medical Anthropology Quarterly. 1 (1987): 355-393.


Foster, George M. "The Origin of Humoral Medicine in Latin America." Medical Anthropology Quarterly. 1: 4, New Series (December 1987): 355-393.


Huber, Brad R. and Alan R. Sandstrom, Eds. Mesoamerican Healers. Austin: University of Texas Press, 2001.


Huber, Brad R. and Alan R. Sandstrom. Mesoamerican Healers. Austin: University of Texas Press, 2001.


Morgan, Lynn M. "International Politics and Primary Health Care in Costa Rica." Social Science and Medicine. 30: 2 (1990): 211-219.


Napolitano, Valentina. Migration, Mujercitas, and Medicine Men: Living in Urban Mexico. Berkeley: University of California Press, 2002.


Olmos, Margarite Fernandez and Lizabeth Paravisini-Gebert. Healing Cultures: Art and Religion as Curative Practices in the Caribbean and its Diaspora. New York: Palgrave Macmillan, 2001.


Ortiz de Montellano, Bernard. Aztec Medicine, Health and Nutrition. New Brunswick, NJ: Rutgers University Press, 1991.


Ortiz de Montellano, Bernardo R. Aztec Medicine, Health, and Nutrition. New Brunswick: Rutgers University Press, 1990.


Palmer, Steven. From Popular Medicine to Medical Populism: Doctors, Healers, and Public Power in Costa Rica, 1800-1940. Durham, NC: Duke University Press, 2003.


Peredo, Miguel Guzman. Medical Practices in Ancient America; Practcas Medicas en la America Antigua. Mexico, D.F.: Ediciones Euroamericanas, 1985.


Quetel, Claude. History of Syphilis. Baltimore: Johns Hopkins University Press, 1992.


Seggiaro, Luis A. Medicina Indigena de America. Buenos Aires: Editorial Universitaria de Buenos Aires, 1969. 


Silverblatt, Irene. Modern Inquisitions: Peru and the Colonial Origins of the Civilized World. Durham: Duke University Press, 2004. 


Sowell, David. The Tale of Healer Miguel Perdomo Neira: Medicine, Ideologies, and Power in the Nineteenth-Century Andes. Wilmington, DE: Scholarly Resources, 2001.


Torres, Eliseo "Cheo" and Timothy L. Sawyer, Jr. Curandero: A Life in Mexican Folk Healing. Albuquerque: University of New Mexico Press, 2005.


Torres, Eliseo "Cheo." Healing with Herbs and Rituals: A Mexican Tradition. Albuquerque: University of New Mexico Press, 2006.


Werner, David. "Health Care and Human Dignity: A Subjective Look at Community-Based Rural Health Programs in Latin America." Contact. 3 (1980): 91-105.


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Films and Videos

Secrets of the Lost Inca Mummies (Warner Home Video, 2002)