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?
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.