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ROBERT T

HIS IO R yo:!; ..,;,1.'". ,!'c)";,,, Many of the rituals that provide both a frameworkand a meaningful cultural healing experience incuranderismo date to healing practices contemporaryto the beginning of the Christian tradition and even.into earlier Judeo-Christian writings. Other healingpractices derive from the European Middle Ages,including the use of traditional medicinal plWts andmagical healing practices in wide use at that time.

The Moorish conquest of Southern Europe is vis-ible in the cultural expression of curanderismo. Somecommon Mexican American folk illnesses originatedin the Near East and then were transmitted through-out: the Mediterranea:n, such as belief in mal de ojo, or

the evil eye (the magical influence of staring at some-one). Ho~eopathic remedies for common heal~conditions such as earaches, constipation, anemia,cuts arId bruises, and burns were brought fromEuro?e to the New World to be passed down to.the

Curanderismo, from the Spanish verb curar (to heal),is a broad healing tradition found in MexicanAmerican communities throughout the UnitedStates. It has many historical roots in common withtraditional healing practices in Puerto Rican andCuban American communities, as well as traditionalpractices found throughout Latin America. At thesame time, curanderismo has a history and a set oftraditional medical practices that are unique toMexican cultural history and to the MexicanAmerican experience in the United States.

Seven historical roots are embedded in modemcuranderismo. Its theoretical beliefs partly trace theirorigins to Greek humoral medicine, especially theemphasis on balance, and the influence of hot andcold properties of food and medicines on the body.

578

579CHAPTER 30 Latin American Curanderismo

within curanderismo. There also is sig-sharing of beliefs with Aztec and other

American cultural traditions in Mexico. Somefolk illnesses treated in pre-Columbian times,

as a fallen fontanelle (caida de fa moIler a) andthe blockage of the intestines (empacho) are

The pharmacopeia of the Newis important in curanderismo (and added

the plants available for treatment ofin Europe from the 1600s to the present).

where both curanderos and their patients have exten-sive knowledge of the medical system in urban andrural areas. However, unlike attitudes reported in ear-lier studies of the area (Madsen, 1961; Rubel, 1966),curanderos and their patients accept the use of mod-em medicine. These multiple environments of curan-derismo praCtice create a complex healing systemwith core elements that are common to each placeand modifications that respond to local cultural,poliqcal, and legal circumstances.

The earliest syst.e~atic research was done oncuranderismo in the late 1950s, when modem med-icine was inaccessible, or only recently available tosigriificant segments of the Mexican American popu-lation. Since that time, the efficacy of modem med-icine has been demonstrated empirically numeroustimes, so it is an integrated part of the cultural system,although many access barriers still exist to prevent itsfull use by everyone. These barriers reflect the samereasons that the holistic health movement and thecharismatic healing movements are becoming inc-reasingly popular. Although traditional healers inMexican American communities believe that modemmedicine is as capable in certain types of healing, theirexperience shows that their own practices are not rec-ognized in hospitals and clinics and that they canaccomplish those same tasks better than modemmedicine. Thus, curanderismo and modem medicineoften assume complementary roles in the minds ofthe curanderos and their patients, although not nec-essarily in the minds of the medical professio~ ofthe area.

their own

Finally, curanderismo is clearly a deeply rooted.healing system, but it also actively exists

the modem world. Biomedical beliefs, treat-and practices are very much a part of cur~-

and are supported by curanderos. On thebetween the United States and Mexico, it is

I for infections and otherThese healers also use information obtained

and other sources to provide the best'on preventive efforts such as nutrition and..

I" I';

j.,

pIndividual healers vary greatly in their knowledge

practices that stem from each of these sevensources. The overall system of curan-

is complex and not only maintains itslink to the past but evolves toward accom-

well.Intellectu~J Trad;t;on

Traditional Mexican American healers perceive healthand illness to contain.. a duality of "natural" and"supernatural" illnesses. This duality forms the theo-retical base on which curanderismo is constructed.The natural source of illness is essentially a biomed-ical model of illness that includes lay interpretationsof some diseases inspired by Mexican American cul-ture. Biomedical aspects such as the germ theory ofdisease, genetic disorders, psychological conditions,and dietary causes for medical conditions are acce-pted. These natural illnesses are treated by physicianswith herbal remedies. A parallel supernatural sourceof illness also is recognized by this healing tradition.These illnesses are not considered amenable to treat-

-the Lower Rio Grande Valley of Texas for15 years. That information is enhanced byother regions near the U.S.-Mexican bor-

and from Mexican American communities inNebraska, Chicago, and Florida. Multiple

environments, both rural and urban, havethe practice of cur4ilderismo. Alger (1974)

outco~e of urbanized curan-

~ medical system, but this mimicry does notto any significant extent in southern Texas,

: 580 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

1

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"'"is seeing other women, Men bringProblems of ";~!

"a""more physical nature; such as stomach Pain~iJ(

headac~es,weakness, and bladder dysfunction,1\1e~~~,',also bang problems that deal directly with work":~;they need to find a job, Cannot get ~ongwith peopl~~i~at work, or are havmg trouble setting up a business,'~~;;;!The wife rarely is the focal point o( their problerns..~1\~The total list of problems presented to cutanderos;:'includes almost every situation that can be thought";~~of as an uncomfortable human condition, Curan~~~jderismo seems to play an important, cultura1iYce~~i

appropriate psychotherapeutic role in Mexican:j~American communities (GaIvin'and Ludwig, 1961;,

Klineman, 1969; Torrey, 19.72). ,~;"i,Another element of curanderismo that forms ani!"

important intellectual foundation for its practices i~C:~the concept that healers work by virtue of "a gift ot~'

healing" (el don) (Hudson, 1951; Madsen, 1965;,JiRomano, 1964; Rubel, 1966), This inherent ability':}allows the healer to practice his or her work, espe-~:':

C c"ccially in the supernatural area. In the past this wa.ij~{believed to be a gift from God, However, a ser;u]ir,c~~interpretation of the don is competing with themore'~Utraditional explanation, Many healers still refer to thec~~Jdon as a gift from God and support this premise with);(c

""c'"Biblical passages (Corinthians 12:7 and James 5:14),'~~:but other healers explain the don as an inborn traitJtl,'that is present in all humans, just like the ability to ':],

"""sing, run, or talk, Almost any person can do theS~ci'1ithings, but some do them better than others, and a,~'M

""'"Jfew people can do them extremely well. Curanderos,'!~,according to this theory, are the individuals with ,~'i!1 ;better ability to heal than is normative for the popu2';~~rlation as a whole. Healers refer to this concept ~,~1~;"developed abili' ti' es" ',,'~1ii

.c"i"ji!jIAnother element cornrnon to Hispanic-based fo~'.1

medicine is the hot-cold syndrome (Currier, 196~;c~~1

Foster, 1953; Ingham, 1940). This belief system is n9t;~~~:"""cl"cornrnon in southern Texas (Madsen, 1961), wher~~;

the only indications of a hot-cold syndrome fOUfi4,c,'7~ ;among the patients were scattered folk beliefs, su~h,::;~'!iJ:as not eating citrus during menses, not ironing bar~:c',7,:;1foot on a cement floor, or taking a cold shower after ;)'.~1prolonged exposure to the sun. None of these be"lie,f~ '"~)was organized systematically or shared extensivelr'l!twithin the Mexican American population. In ,other,,~areas, there is extensive knowledge and use of thiS ~.",J\:tem of classifying foods, tteatments, ana elementS O~:l~l'illnesses to provide the basis for deciding which re~e'-,i]'~:,dies apply to specific illnesses. "'!'~c:

mggroWorandof<malfoIl.voickIlothe

ment by the medical establishment. They can berepaireg only by the supernatural manipulations ofcuranderos. The curanderos fault the scientific med-ical system for its failure to recognize the existence ofmagic or of supernatural causation. One curanderocommented that as many as 10% of patients in men-tal institutions were really embrujados (hexed orbewitched), and because physicians could not recog-nize this condition, it went untreated. This curanderowas willing to test his theory scientifically in any waythat the mental health professionals set up as aresearch project. However, the mental health pro-fessionals were not willing to allow the tests to beconducted because of their attitudes toward curan-derismo.In this case, it appeared to the anthropolo-gists that the curanderos had a stronger belief andtrust in science, even when it was directed at thesupernatural, than the physicians and other healthprofessionals.

Supernaturally induced illnesses are most oftensaid to be initiated by either evil spirits (espiritosmaiDs) or by brujos (individuals practicing antisocialmagic). They form a significant part of the curan-deros' work; these healers explain that any particularillness experienced by a patient could be causedtheoretically by either natural or supernaturalprocesses. For example, they believe there is a natu-ral form of diabetes and a form that is caused by asupernatural agent, such as a brujo. The same is truefor alcoholism, cancer, and other diseases. Iden-tifying the nature of the causal agent for a particularillness is a key problem for the curandero. Someidentify more supernatural causes for illnesses, an~others take a more biomedically balanced approach.In either case, there is much less dichotomizing ofphysical and social problems within curanderismoth~ within the medical care system (Holland, 1963;Kiev, 1968).

Curanderos routinely deal with problems of asocial, psychological, and spiritual nature, as well asphysical ailments. Many cases overlap into two ormore categories. Bad luck in business is a commonproblem presented to curanderos. Other problemsinclude marital disruptions, alcoholism or alcoholabuse, infidelity, supernatural manifestations, can-cer, diabetes, and infertility. One healer distin-guishes between the problems presented by womenand men. The central focus of the problems broughtby ~omen is the husband; the husband drinks toomuch, does not work, does not give them money, or

enc(""or

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581CHAPTER 30 Latin American Curanderismo

IHEORFTTCA T. RA,~I~;

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mit, channel, and focus mental vibrations (vibracionesmentales) in away that "f/ouldaffect the patient's men-tal or physical condition direcdy. Both patients andhealers are confident that the curanderos can effect acure from a distance using this technique.

The three levels are discrete areas of knowledgeand behavior~each necessitating the presence of a sep-arate gift for healing. They involve different types oftraining and different methods of dealing with boththe natural and the supernatural world. The materiallevel involves the manipulations of traditional magi-cal forces found in literature on Western witchcraft.Spiritualism involves the manipulation of a complexspirit world that exists parallel to our own and themanipulation of corrientes espirituales, spiritual cur-rents that can both heal and provide information ordiagnosis from a distance. The mental level necessi-tates the control and use of the previously mentionedvibraciones mentales. Thus the levels are separate meth-ods of diagnosing and treating human problems thatare embedded into a single cultural tradition.

Not all problems can be dealt with successfullyusing each level. An example of this is serious alcoholabuse (Trotter, 1979; Trotter and Chavira, 1978).Alcohol abuse and alcoholism are treated by curan-deros using techniques of both the material and themental level. The techniques of the spirituai level,however, were considered ineffective in dealing withalcohol-related problems. Therefore, if one has the donfor working with the spiritual level alone, he or she isexcluded from the process of curing alcohol problems.

One theme that is common to the practices of allthree levels is the use of energy to change the patient'shealth status. On the material level, this energy oftenis discussed in relation to the major ritual of thatlevel, known as the bamda or limpia (a "sweeping" or"cleansing"). In this ritual a person is "swept" fromhead to foot with an object that is thought to be ableeither to remove bad vibrations (vibraciones malos) orto give positive energy (vibraciones positives) to thepatient. The type of object used (e.g., egg, lemon, gar-lic, crucifIX, broom) depends on the nature of thepatient's problem and whether it is necessary toremove or to replace energy. On the spiritual level, theenergy used for both diagnosis and healing is the pre-viously mentioned corrjeiites espirituales. The mentallevel is almost totally oriented around generating andchanneling vibraciones mentales. The following sec-tions provide more detail on the ~tual practices ofthe curandero's work on each level.

The community-based theoretical structure forcuranderismo has three primary areas of concentra-tion, called levels (niveks) by the healers: the materialleyel (nivel material), the spiritual level (nivel espiritual)~and the mental level (nivel mental). More curanderoshave the don for working at the material level, whichis organized around the use of physical objects to healor to change the patient's environment. This theoret-ical area can be subdivided into physical and super-natural manipulations. Physical treatmentS are thosethat do not require supernatural intervention toensure a successful outcome. Parter as (midwives), hue-seros (bone setters),yerberos (herbalists), and sobadores(people who treat sprains and tense muscles) are 4eal-ers who work on the nivel material and effect cureswithout any need for supernatural knowledge orpractices. All the remedios caseros (home remedies)used in Mexican American communities are part ofthis healing tradition.

The supernatural aspect of this level is involved incures for common folk illnesses found in MexicanAmerican communities, such as susto~ empacho~ caw demollera~ espanto~ and mal de ojo. These illnesses areunique to Hispanic cultural models of health and ill-ness. This area of healing also ihcIudes th~. spells andincantations that are derived out of medieval Europeanwitchcraft and earlier forms of magic, suCh as thecabala, that have been maintained as supernatural heal-ing elements of ci.1randerismo. Supernatural manip-ulations involve prayers and incantations in conjunctionwith suCh obje~ as candies, ribbons, water, fIre, cruci-fIXes, tree branches, herbs, oils, eggs, and live animals.These treatments use a combination of common objectsand rituals to cure health problems.

The spirituallev~l (nivel espiritual) is an area ofheal-ing that is parallel to ttIechanneling found in New Agegroups and in shamanistic healing rituals around theworld (Macklin, 1967, 1974a, 1974b, 1974c; Macklinand Crumrine, 1973). Individuals enter an altered stateof consciousness and, according to the curanderos,make contact with the spirit world by one or all of thefollowing methods: opening their minds tq spiritvoices, sending their spirits out of the body to gainknowledge at a distance, and allowing spirits the use ofthe body to communicate with this world.

The mental level (nivel mental) is the least oftenencountered of th~ three levels. One healer describedworking with the mental level as the ability to trans-

582 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDIC.INE

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The material level is the easiest of the three levels todescribe; it is the most extensively practiced and themost widely reported. At this level the curanderomanipulates physical objects and performs rituals (ortrabajas) spells). The combination of objects and ritu-alsis widely reco~ed by Mexican Americans as hav-ing curative powers. Practitioners of the material leveluse common herbs, fruits, nuts, flowers, animals andanimal products (chickens, doves, and eggs), andspices. Religious symbols, such as the crucifIX, pic-tures of saints, incens~, candles, holy water, oils, andsweet fragrances, are widely used, as are secular items,such as cards, alum, arid ribbons. The curanderoallows the patients to rely extensively on their ownresources by prescribing items that either are familiaror have strong cultural significance. Thus a signifi-cant characteristic of the objects used at the materiallevel is that they are common items used for dailyactivities such as cooking and worship.

;,Curanderos prescribe herbs most frequently as''

teas, baths, or poultices. The teas act as a sort of form:~ative chemotherapy. Borraja (borage, Borajo officialiS~)4 for example, is taken to cut a fever; flor de tila) a:mild sedative, is taken for insomnia;yerba de lagolond:'rina (Euphorbia prostrate Ait.) is used as a douche forvaginal discharges; and peilos de elate ~e used for kid::c:l:""ney problems. Herbal baths usually are prescribed to'V,;;deal with skin diseases; fresno (ash tree, Fraxinus!~1":

'-.-'dspecies) is used to treat scalp problems such as'~;eczema, dandruff, and psoriasis; and linaza is pre:t~scribed for body sores. For specific sores such as boilS;'\f'malva (probably a Malvastrum) leaves are boiled until]Ut:soft and then applied to the sores as a poultice. Other;;~herbs are used as decongestants. A handful of oregano;~(oregano, orcgenum vulgare L.) is placed in a hurnidi-';tier to treat someone with a bad cold. ;::1'

','Some herbal lore is passed on as an oral tradition:'!

)"and other information is available in Spanish-,;j'language books for Mexico that are wid~ly circulated"';among both curanderos and the public (Arias;,!Wagner). These works describe and classifynumerous~herbs. Herbal remedies are so important to Mexican'7fAmerican folk medicine that their use often is con-fused with the art of curanderismo itself by the massculture. Indeed, some curanderos known as yerberosor yerberas) specialize in herbs, but their knowledgeand skills go beyond the mere connection of one dis-!ease to one herbal formula. For curanderos to be gen-;uine, even at the material level, an element of!mysticism must be involved in their practice. HerbsTare typically used for their spiritual or supernatural;!properties. Spiritual cleansings (ban'idas) often are~given with ruda (Ruta graveolens Lh romero (rosemary,!Rosmarinus officianalis L.), and albacar (sweet basil, ;'Ocimum basiticum L.), among others. Herbs are used as;amulets; verbena (verben~ Verbena officinalis L.b worn :as an amulet, is used to belp open a person's mindtojlearn and retain knowledge. ~~

Some curanderos have successful practices on the )rnateriallevel without resorting to the use of herbs.;,Some nonherbal treatments are described in the fol-11,lowing section. ' \"

Natural Illnesses and Herbal CuresCuranderos recognize that illnesses can be broughtabout by natural causes, such as dysfunction of thebody, carelessness or the inability of a person to per-form proper self-care, and infection. Curanderos atthe material level use large amounts of medicinalherbs (plantas medicinales) to treat these natural ail-ments. Some traditional curanderos classify herbs ashaving the dichotomous properties considered essen-tial for humoral medicine, based on a hot-cold classi-fication system common throughout Latin America(Foster, 1953). They use these dual properties to pre-scribe an herb or combination of herbs, depending o~the characteristics of the illness. If a person's illnesssupposedly is caused by excessive "heat," an herb with"cold" properties is given. Conversely, if a person's ill-ness is believed to be caused by excessive "coldnessand dryness," a combination of herbs having "hotand wet" properties is administered.

Other curanderos recognize herbs for their chem-ical properties, such as poisons (yerbdl del coyote,Karwinskia humbo/dtuna Roem. et Sch. h hallucinogens(peyote, Lophaphora williams Lem. h sedatives (/lor de tila,Talia mexicana Schl.)~ stimu1~ts(:)1+'fba del trueno h and

'cpurgatives (cascarasagrada).These individuals refer tothe beneficial chemical properties of the herbs thatallow them to treat natural illIiesses.

Supernaturally Caused Illnesses and RitualCuresSupernatural illnesses, which occur when supernatU-ral negative forces damage a person's health, some-times can be confused with natural illnesses. Onehealer stated that these supernatural illnesses may

RituwCurandral cur~

583CHAPTER 30 Latin American Curanderismo

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rituals. These cleansings are designed to remove thenegative forces that are harming the patient, whilesimultaneously giving the patient the spiritualstrength necessary to enhance recovery. Patients arealways "swept" from head to toe, with the curanderomaking sweeping or brushing motions with an egg,lemon, herb, or whatever object is deemed spirituallyappropriate. Special emphasis is given to areas inpain. While sweeping the patient, the curanderorecites specific prayers or invocations that appeal toGod, saints, or other supernatural beings to restorehealth to the patient. The curandero may recite theseprayers and invocations out loud or silendy.Standardprayers include the Lord's Prayer, the Aposdes' Creed,and Las Doce Verdades de Mundo (The Twelve Trutlls ofthe World). '

The following description of a bamda illustrateshow the material objects, the mystical power of theseobjects, the invocations, the curandero, and thepatient come together to form a healing ritualdesigned for a specific patient and a specific illness: Inthis case, five eggs, four lemons, some branches ofalbacar (sweet basil), and oil were used. To begin thehealing process, the lemons and eggs were washedwith alcohol and water to cleanse them spiritually.Before beginning the ritual, the participants wereinstructed to take off their rings, watches, and otherjewelry; high-frequency spiritual and mental vibra-tions canproduceJelectrical discharges on the metal,which might disturb the healing process. The sweep-ing itself is done by interchanging an egg and a lemonsuccessively. Sweeping with the egg is intended totransfer the problem from the patient to the egg bymeans of conjures (conjures) and invocations (recha-sos). The lemon is used to eliminate the trabajo (magi-cal harm) that has been placed on the patient. Thepatient is swept once with albacar (sweet basil) thathas been rinsed in agua preparada (prepared water).This sweeping purifies the patient, giving strengthand comfort to his spiritual being. The ritual ends bymaking crosses with aceite preparado (specifically pre-pared oil) on the principal joints of the patients, suchas the neck, under the knees, and above the elbow.This oil serves to cut the negative currents and vibra-tions that surroUnd the patient, which h~ve beenplaced there by whoever is provoking the harm. Thecrosses protect against the continued effect of thesenegative vibrations. Agua preparada is then rubbed onthe patient's forehead and occiput (cerebro) to tran-quilize and to give mental strength. All the objects

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be hexes that have b.een Rlacedon the .person by anI~;ene~y. Supernatural influe?ces also ~~rupt a. per-~~rson s mental health and his or her liVing enVlron-~!ILment.

Physicians cannot cure a supernatural illness.: The curandero usually deals with social disruption,

personality complexes, and sometimes, serious psy-chologicaldisturbances. One healer gave the follow-ing description of a case that contained several ofthese elements:

This patient worked for the street maintenancedepartment of (a small city in south Texas). Everyday a(ter work a voice would lead him out into thebrush and sometimes keep him there until 2:00 am.This activity was wearing out the man and his fam-ilyand he was going crazy. A bad spirit was follow-ing this man and would not leave him alone. Theman was cured, but it took three people to curehim: myself, a friend, and a master (maestro) fromMexico. This man was given three banidas each dayfor seven days, one by each of us. The tools' usedwere eggs, lemons, herbs, garlic, and black chick-ens. The man was also prescribed herbal baths andsome teas todrlnk. He was also given a charm madefrom the haba mijrina designed to ward off anymore negative influences which might be directedat him. This patient regained his sanity.

AlSo, a number of illnesses are both supernatu-rally caused and of a supernatUral nature and can betreated on the material level. The following account isan example of such an illness and cure:

My brother-in-law was working at a motel. ..inWeslaco. When he started working they laid off thisother guy who had been working there for severalyears. This guy didn't like it, and he's been knownto be messing around with black magic. I don'tknow what he did to my brother-in-law, but everyother day he'd have to be taken home becaus-e hewas sick. He started throwing up, had shaky knees,and weak joints. So my mother and I went over tosee this lady in Reynosa, and she told my motherjust what to do. My sister rubbed her husband witha lemon every night for three days. She also gavehim some kind of tea. ...On the third day, a bigblack spot appeared on the lemon, so we threw itaway, and he's been fine ever since.

n~; ~tuals and the Material LevelCuranderos use several types of rituals for supernatu-ral cures. The barrida is one of the most common

584 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

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ried over into another type of ritual system used on'the material level, ve/acione) or burning candles to pro.'duce supernatural results. The velaciones and the col:'ored material objects used in the sortilegios tie into the'energy theme that runs throughout curanderisIno,because the colors and objects are believed to havespecific vibratory power or energy that can affect thepatient when activated by the incantations used inconjunction with the objects. For example, blue can-dles are burned for serenity or tranquility; red candlesare burned for health, power, or domination; pinkcandles are burned for good will; green candles areburned to remove a harmful or negative influence;'and purple candles are burned to repel and attack badspirits (esPi?;itus obscuros) or strong magic. Once the'proper color of candle has been chosen to producethe proper mental atmosphere, the candles arearranged in the correct physical formation and actiovated by the conjuros y rechasos. If a patient asks forprotection, the candles might be burned in a triangle,which is considered to be the strongest formation,one whose influence cannot be broken easily. If theywant to dominate someone-a spouse, a lover, or anadversary-the candles might be burned in circles.Other formations include crosses, rectangles, anasquares, depending on the

1970).Another relatively common use of candles is

diagnose problems by studying the flame orridges that appear on the melted wax.be swept with a candle while the healer recitesinvocation asking the spirit df the patientmaterial being to be investigated for anyspiritual problems that may be affecting theThis ritual also can ..used in a bamda. Lighting the candleobject after the bamdacause and extent of the patient's problems.if a petitioner asks

ures or other messages that point to the

patient's problems.One of the organizing principles

level of curanderismo is synchronicity "'"Christianity (Ii general and the Catholic Churchparticular. Special invocations often are directedsaints or spirits to bring about desired results.example, San Martin de Porres is asked to --poverty, San Martin Caballero to ensure successbusiness, San Judas Tadeo to help in ~

used in the bamda are then burned to destroy thenegative influences or harm transferred from the

patient.Another common titual is called a sahumerioJ or

"incensing." The sahumerio is a purification tite usedprimarily for treating businesses, households, farms,and other places of work or habitation. This ritual isperformed by treating hot coals with an appropriateincense. The curandero may prepare his or her ownincense or may presctibe some commercially pre-pared incense, such as el sahumerio maravilloso (mirac-ulous incense). A pan with the smoking incense iscarried throughout the building, making sure that allcorners, closets, and hidden spac.es, such .as under thebeds, are properly filled with smoke. While incensing,the healer or someone else recites an appr:opriateprayer. If the sahumerio maravilioso is used, the prayeroften is one to Santa Marta, requesting that peaceand harmony be restored to the household. Afterthe sahumerioJ the healer may sprinkle holy water onthe floor of every room in the house and light a whitecandle that stays lit for 7 days. The sahumerio is anexample of the curandero treating the general socialenvironment, seeking to change the conditions of thepersons who live or work there. Incensing of ahQuseremoves negative influences such as bad luck (sala-cioms), marital disruptions, illness, or disharmony.For business and farms, incensing helps ensure suc-cess and growth and protects against jealous com-petitors. These tituals are designed to affect everyonein the environment that has been treated.

Another type of ritual, called a sortilegio(conjure),uses material objects such as ribbons to tie up thenegative influences that harm the curandero'spatients. These negative influences are often personalshortcomings, such as excessive drinking, infidelity,rebellious children, unemployment, or any otherproblem believed to be imposed by antisocial magic(un trabajo). One sortilegio that I observed requiredfour ribbons in red, green, white, and black, eachapproximately 1 yard in length. The color of each rib-bon represents a type of magic, which the curanderoscan activate to deal with specific problems. Red magicinvolves domination, green deals with healing, whitewith general positive forces, and black with negativeor debilitating forces.

When working with a specific area of magic, oneuses material objects that are the appropriate colornaturally or that have been made that color artifi-cially. The co~or-based diviSion of magic also is car-

585CHAPTER 30 Latin American Curanderismo

sitUations, and Santa Marta to bring harmony to ahousehold. Ritual materials used by the Church, suchas water, incense, oils, and candles, are extensivelyused by folk healers. The ways in which these reli-gious objects are used and the theories for their effi-cacy closely mirror the concepts found within thehealing mlnistry of the Church, which are not incom-patible with European witcpcraft, from which curan-derismo partly derives.

,..on'1

';'I;')ro-~

col;it1the J;

~~I~~,

'i~~

ar~:jlce;,~bad~

c,1[fth ,..ell

,,'liS'-'::t;uce."

:di~for~

g lerj',:1\

on:;"hey,1

'-ahJ:les.':

The Spiritual Level (NivelE,piritual) ~

~:(~Curanderos

who have the don for working on the spir-:1 itUal level (nivel espiritual) of curanderismo aJ;e less[ii numerous ~~ those who work on the material level.ii;t:These

pracnnoners also must go through a develop-i;! mental period '(desarrollo) that can be somewhat trau-;: matico Spiritual practices in communities revolve)caround a belief in spiritual beings who inhabit; another plane of existence but who are interested in1

::7 'making contact wi~ the ~hysical world p~riodically..c Healers become a direct link between thIS plane ofI

existence and that other world. In some cases thecuranderos claim to control these spirit beings, andin other cases they merely act as a channel throughwhich messages pass. Some of these practices are car-ried out by individual healers, whereas other activities

...occur in conjunction with spiritual centers (centros~: espiritistas) that are staffed by trance mediums andfi other individuals with occult abilities. These centersc't~:often work through two prominent folk saints: El

: Nino Fidencio &om Northern Mexico and Don,'; p dri J ill fi h T (M kli"c~ e to aram 0 rom sout em exas ac n,I\;,J974a, 1974b, 1974c). This trend in visiting spiritual-list centers appears to be relatively recent, not having~'..~been reported during the 1950s and 1960s by those, c~ doing research on Mexican American folk medicine~c(Clark, 1959; Madsen, 1964; Rubel, 1960, 1966).}~' The practice of spiritualism rests on "soul con-

cept," a belief in the existence of spirit entitiesderived from once-living humans. The soul isthought to be the immortal component, the life and

cpersonality force of humans, an entity that continues~ to exist after physical death on a plane of reality sep-~arate from the physical world. This concept is impor-l;tant not only to curanderismo but also to the~,religions and mystical beliefs found in all Western

Cultures.

~

of

586 ,FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

Cu..;.1;;;,;(Iir;,,';

D ~!i~~~"II " J; ,t.

, ""

I;'il.;;

ic,:c

I ccIc

I;;I'", ..I :

,g" ,

, '

{:,f''., ",

~

I

..

~

,"'

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Thfcliejthe]Icessimrecitheocc;ne\\

thecur;tho

(Trotter and Chavira; 1975a). Once a temple has beenestablished, it may house from 1 to 20 mediums. Themore mediums, the better; otherwise, a medium mayhave to let his or her body be used by too many dif-ferent spirits, exhausting them and laying them ope;to supernp.tural harm. Larger temples might havefour or five videnntes (Clairvoyants), as well as themedium$, and might be putting several apprenticesth~ough desarrollO at the same time. Many of theaccounts provided to these authors about spiritualhealing were from individuals who had had experi-ences with spiritual temples in Mexico. Some templeswere located in Espinaso) the home of El NinoFidencio and a center of pilgrimage for mediumspracticing in his name, and others were in urban Cen-ters such as Tampico and Mexico City. Large numbersof people make pilgrimages to these healing centersin Mexico to deal with health care problems that theyhave not resolved in the United States.

One healing center is called Roca Blanca) after thespirit th3ct speaks most often in that place. The owner,Lupit~ founded it about 30 years ago, after discover-ing her ability to cure. She was granted permission topractice by a spiritual association. The followingreport is from a visitor to Lupita's healing center:

I went to this place simply because I was curious. Iwas swept with albacar and the medium was at myside. While I was being swept, the medium wentinto trance. The sister who was sweeping me askedthe spirit who he wanted to talk to. He said, "withthe one you are sweeping." Then, the sister f'Inishedsweeping me and directed me to talk with the per-son who was addressing me. When she (themedium in trance) talked to me, she sounded like aman. He asked me, "Do you know who I am?" Ihave a cousin who got killed in a place in Tampico."You must be my cousin," I said. "Yes, exactly, I amyour cousin." "LO9k," he said, "You have come herewith your husband." On other occasions I reallyhad been there with my husband, mother and dif-ferent relatives. "You have come here with yourhusband because you think he is hexed and that iswhy he is sick. But that's not true. He has a physicalillness that the doctor'can cure. Don't believe it'sanything bad."

He said, "I'm going to prove who lam by com-ing to your house. Tell my cousin I'm going to seeher." You see, I have a sister who's not nervous at alland who isn't afraid of anything. On Tuesday, asmy sister was leaning by the window watching a tel-evision show, she felt someone embrace her. Sheturned and saw no one.

nature of the individual, only to his or her ability tocommUnicate with the spiritual realm. Weakcerebrosrepresent a danger for anyone who wants to become amedium. Only rare individuals demonstrate mediu-mistic potential spontaneously and can practice asmediums without further training. Therefore, curan-deros often test their patients and friends for this giftof healing, and those with the gift are encouraged todevelop their ability.

The development of this ability is c~e'd desarrolloand is a fairly lengthy process that might last from 2months to more than 6 months initially, with peri-odic refresher encounters often available from themaestro (teacher). Desarrollo is a gradual process ofincreasing an apprentice's contact with the spiritworld, giving the apprentice more and more experi-ences in controlled trances and possessions, as well asthe knowledge necessary to develop and protect theapprentice as a spiritualist.. The teacher also is respon-sible for giving the apprentice knowledge at a ~afepace. The curandero does not always explain whateach sensation means; each person, as he or sheclevel-ops, becomes more sensitive to the environment. Theapprentice must expect to encounter odd sensations,such as bright lights, noises, changes in pressure, andother sensations associated with developing powers.At the end of these desarrollo sessions, the conversa-tion reverts to social chatting for some time beforethe ~pprentice leaves. This developmental processcontinues, with variations, until the apprentice is afully developed medium;

Fully developed mediums control how, where,and when they work, and several options are availableto them. Some me~ums work alone and treat onlyfamily problems (Box 30-1); others might use theirabilities .only for their own knowledge and gratifica-tion. Some mediums work in groups with othermedi1.lms or with other persons whom they believehave complementary spiritual or psychic powers.Some mediums work in elaborate spiritual centers(centros espiritistas) that are formal churches, often ded-icated to a particular spirit (e.g., Fidencio, FranciscoRojas, Don Pedrito Jaramillo). The spiritual centersand the activities surrounding them take on the majoraspects of a formalized religion.

Sometimes a trance session is open to more thanone person at the same time. This group session canbe carried out by a lone curandero but more often isfound at spiritual centers. The process of the devel-opment of these centers is described elsewhere

HAPTER 30 Latin American 587anderismo'"'1'1",;: has been

urns. The"0;uum may

..nany dif7lem open

ght have~ll as .the

'prentlces"lY of the..spmtUaI

.d experi-,

e templesEI Nino,

mediumsrban cen-:

numbers(

g cente~cthat they'

R()X~n-1Curandero,'"

after the(

:Ie Owner,.

discover-.,tissionto:allowing~nter:

ions. I; at my1 went

~~kedcc oth,Wi

rushedIe per-e (thei like a1m?" I

rnpicooy,Iamle here

reallyId dif-1 yourthat is

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ing". ..'... ; C ~"

c

'~"!j

~

These spiritual centers vary according to their size,their owners, and the spirits who are associated withthem, but there is considerable regularity in the serv-ices they perform. Sometimes mediums prescribesimple herbal remedies for physical problems. Theserecipes are virtually identical to the ones presented inthe previous section on...,the material level, although,occasionally, it is said that a spirit will recommend anew use for an herb. The mediums might suggest thatthe patient perform the already familiar rituals ofcuranderismo, such as the bamda. The spirits arethought: to be able to influence people's lives directly,

I,'~:~

, com-to sees at all

iay,asg a tel-'r. She

in addition to imparting knowledge about remedies.The curanderos state that spirits control spiritUalcurrents (Comentes espirituales) and mental vibrations(vibraciones mentales); they can manipulate thepatient's health by directing positive or negativeforces at them from the spiritual realm.

During spiritUal sessions observed at a developingspiritual center in southern Texas, a. spirit repeatedlypresented himself over the course of several weeks totreat several patients. One of these patients was a manwith lower back pain. One week the spirit told him tobuy a bandage and bring it to the next session. The

588 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

iobserver, and finally, the existence and purpose ofmediums' associations. ; into

healearoUldiagrTheyor shlearnotherparaI

Tvidu~rathetothjifiedcanst

wor~

The Mpnt~1 T,pvpl,Ni1Jel Ment~

Conducting observational, descriptive, and experi-mental research on the practices of the mentalleve[has proved to be the most difficUlt task in exploringall the aspects of curanderismo. The mental level hasthe fewest rituals and the least outward compleXbehavior associated with it. To date, it has the fewe$tpractitioners, which severely limits the number of peo-ple who could be approached for an opportunity toinvestigate the phenomenon. All the cases the authorobserved "followed a similat pattern. For example:

Mter the curandero chatted with the patient andasked them about the basic problem, he asked thepatient to state her complete name (el nombre com-pleto). The curandero wrote the name on a piece ofpaper. Sitting behind the desk he used for consul.tations, he leaned his arms on the' desk, bent for.ward slighdy, closed his eyes, and concenttated onthe piece of paper. Mter a few minutes, he openedhis eyes, told the patient more about his or herproblem, and stated that it was being resolved.

The curandero stated that he. had learned to usehis mind as a transmitter through desarrollo. Hecould channel, focus, and direct vibraciones mentalesat the patient. These mental vibrations worked intwo ways-one physical, one behavioral. If he wasworking with a physical illness, such as cancer, hechanneled the vibrations to the afflicted area,which he already had pinpointed, and used thevibrations to retard the growth of damaged cellsand accelerate the growth of normal cells. In a caseof desired behavioral changes, he sent the vibra-tions into the person's mind and manipulatedthem in a way that modified the person's behavior.

-The curandero gave an example of one such case inwhich a husband had begun drinking excessively,was seeing other women, was being a poor father to Ihis children, and was in danger of losing his job. C

The curandero stated that he dominated the man'sthought processes and shifted them so that thehusband stopped drinking to excess, and became amodel husband and father (Trotter, 1981, p. 473).

Till

Tbetdiseafolkdeter\dero~holisthe iextenenVlrChri~

(canc(ritu,andtthenthat;inter:derivthat,healifrom

phys:A

variaexplaSOfia.

abilitreric,atior:undewoul

man did so, but then the spirit chided him for not fol-lowing instructions correctly. The bandage was toonarrow and not long enough. The man wasinstructed to buy a new bandage and place it on thewindow ledge to catch the morning dew, which isthought to have healing properties. He then was toplace a glass of water under the head of his bed and ajar of alcohol at the side of the bed He was to wraphimself in the bandage according to given instruc-tions and lie quietly on his bed f°l:: no less than 2hours, during which time the spirit prQmised to visithim and complete the cure. The man followed theseinstructions and stated that he did gain relief fromhis back pain. The same spirit treated a young collegegirl who periodically had asthma attacks. The girl'smother, a regular member of the group, brpught herto the session. The spirit, in the person of themedium, stood and clasped the girl's head with onehand on he~ cerebra and the other on her forehead,sending Comentes espirituales through her brain. Thespirit then told her to take a sip of agua preparada andsit back down in the circle. The treatment was suc-cessful in overcoming this particular attack, and themother mentioned after the session that these curesrelieved her own asthma for several months.

Another patient requested a social and emotionaltreatment. Her husband recently had begun to prac-tice witchcraft (btujeriah and she was worried that heor his friends might attack her or members of herfamily. A considerable amount of tension existedbetween the couple's families. She felt under contin-1ial stress and had gone to a doctor for help. Thephysician prescribed a mild sedative, which she hadtaken for 3 weeks without relie£ The medium's spiritprobed her mind and told her to take three sips ofagua preparada to break any spells that had been caston her. The spirit promised to provide her with pro-tecpon and help from the spiritual realm to counter-act anything that her husband might do. Sheappeared to be content with the spirit's activities onher behalf and was gready relieved.

Several aspects of the spiritual level have not beencovered in this brief description but are described inmore deta1l elsewhere (Trotter, 1975). These aspectsinclude the ~~tua1 techniques of testing for el don) thephysical and supernatural dangers of trance medi-umship, the acquisition of spiritual protectors toovercome those dangers, detailed desctiptions of thetrance state froin the subjective perspective of the devel-oping me4ium 3,Ilcd the objective perspective of an

There also are a number of syncretic beliefs drawnfrom other alternative healing traditions-such ~New Age practices, the "psychic sciences," andEastern philosophy-that have been incorporated

589CHAPTER 30 Latin American Curanderismo

lrpOse system provides a common starting point and com-mon objectives.

~ SETTINGS FORC U RAN D E RI S M 0HEALING SYSIFM,..

into this area of curanderismo. For example, somehealers state that they are able to perceive "auras"around people and that they can use these auras todiagnose problems that patients are encountering.They conduct the diagnosis on the basis of the coloror shape of the patient's aura. Some state that theylearned these practices from other healers, whereasothers indicate that they learned them from books on

parapsychology.The mental level is practiced most often by indi.;

vidual healers working with individual patients,rather than in groups. It appears to be anew additionto this healing system and does nor have, as yet, a cod.ified body of ritual associated with it. It thereforeconstitutes an area in which additional descriptivework will be necessary to unify healers' behavior.

i experi-

iltallevel~loringlevel has

complexQe fewest~r of peo-

turiity to~e author

:lple:

It anded the'"ecom-iece ofonsw-:it for-red on

pened:>r herd.to uslo. Hentale!:ediIe was;er, he

area,:d thel cellsa casevibra-llated.avior.ase in

sively,her tos job.

an's mLt theamea

~73).

Theoretical Unification

Tbe three levels of curanderlsmo unify the theories ofdisease and illness f<;>und in the Mexican Americanfolk medical model. They create a framework fordetennining the therapeutic approaches of curan-deros in southern TeXas. The ~ystem emphasizes aholistic approach to treatment and relies heavily onthe intimate nature of the referral system and theextensive personal knowledge of the patient's socialenvironment that is not:mallyheld by the curandero.Christian symbols and theology provide both tools(candles, incense, water) and organization models(rituals, prayers, animistic concepts) for the materialand the spiritual levels, but not to a similar degree forthe mental level. An eneT2:j concept is the central ideathat integrates the three levels and forms a systematicinterrelationship among them. This energy conceptderives f:rom belief in forces, vibration, and currentsthat center in the mind of those who have the gift forhealing and that can be transmitted to cause healingfrom a distance, by affecting the patient's social,physical, spiritual, or psychological environment.

All three levels of healing are still evolving, Thevariations in the practices of curanderismo can beexplained partly by differences in the curanderos'per-sonality, differences in their treatment preferences orabilities, and differences in their emphasis on theo-reticalor ~erieritial approaches. There also are vari.,ations produced by individual interpretations of anunderlying body of theory. A study of these variq.tionswould be useful, now that the underlying theoreti~al

Curanderismo is a community-basedhealii1g system.It is complex and widespread. At one level, it may bepracticed in any area where Mexican Americans knowabout it. Part of this healii1g tradition is the informa-tion that is spread throughout the Mexican Americanculture on home treatments for common physicalailments (colds, flu, arthritis, asthma, diabetes) andfor common spiritUal or "folk illnesses" (susto) mal deojo) and empacbo). This is analogous to the biomedicalinformation that is spread throughout all Europeancultures,includirig the Mexican American~ture,where the home is the first line of defense for thediagnosis of illnesses that eventually might necessi-tate a physician or hospital. On the other hand, someaspects of curanderismo require the use of speciallocations, preparations, and tools. This is especiallytrue of spiritUal practices on the spiritual level andfor the effective treatment of supernatural harm onthe material level.

The first setting where this knowledge is used is athome. When people become ill, they use their existingcultural model of health and illness to come up withsolutions. One type of solution is home diagnosisand home treatment. Therefore, both biomedicalconcepts and folk medical concepts are appliedimmediately, and home treatments are attempted. Inthe case of curanderismo, this often results in the useof home remedies (remedio caseros) that have been partof the culture for generations, especially herbal cures.When the diagnosis identifies a magical Qr supernat-urally caused illness, the ~ess results in a home-based ritual. These interventions are done bymothers, grandmothers, cousins, friends, or knowl-

edgeable acquaintances.Illnesses that appear to be too serious to handle at

home, both natUral and supernatUral, are taken toprofessional healers who, have a locally widespreadreputation for being able to treat both biomedical andtraditional health care problems. Most of these heal-ers work in a silent, but positive, partnership withphysicians, although the physicians often are unawareof the link. The curanderos interviewed in various

5 drawnh '5UC as 'If

5," and";"poratedj...,(

590 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

studies of Mexican American folk medicine are con-sistent in their positive regard for modem medicine.They consistently refer patients to modem health careservices, where they see the efficacy of that approachto be equal to or greater than their own. At the sametime, they note significant differences in the models ofhealth and illness between their own practices andmodem medicine, especially in the areas of supernat-ural illnesses, in addressing social (marital, business,interpersonal) problems and in dealing with psycho-logical problems. In these cases the treatments takeplace either in the patient's home or work environ-ment or in special workrooms established by thecuranderos as part of their practices. The cure mightcall for working directly in the environment that isaffected. In other cases the venue of choice is thecurandero's area because the cure depends on carefulpreparation and protection from outside influences.These work areas contain altars, medicinal plants,tools for supernatural rituals, and other items, and theatmosphere is considered most beneficial for the heal-ing process, particularly in the case of supernaturalproblems and treatments (Trotrer and Chavira, 1981).

H.a.n

Herbasuper:Americaserosder alldies h;activitandL,biochtstrate,medicsmalllack 0

proJecherbalnitiesgraphi1988;BrOwP

Ththe us'cold, vdirect!dies, sdiuretJanalgeantibavitamiantipaeffecti'omme

,theraptices 01usefulicine.

RESEARCHAND EVALUATIONAPPROACHFS

Addj,EpidOf alltionalresearcfolk i1Mexiccquencl:frightetraced

American folk medicine, published primarily in1960s (Clark, 1959a; Currier, 1966; Kiev, -

Madsen, 1961, 1964; Romano, 1965; Rubel,1964, 1966). These authors produced descriptivebaseline data on the prominent folk medical prac-tices of Hispanic communities in the United States.They provide an initial view of curanderismo that is C4irich in descriptions of Mexican American folk ill-~nesses, such as Justo, empacho, mal de ojo, caida rle'i:mpllera, hilis, and espanto (Nail and Speilberg, 1967). 'These works generally treat traditional healing in'Mexican American communities as a body of know I-'.edge that is widely distributed throughout the cul-~ture, rather than as a theoretical healing system:.r~Therefore the works consider the consensual data onc{what is available to a significant segment of the exist': l'ing Mexican American population but spend less...time describing the professional actions of curan-c;;:deros, because these mass cultural phenomena are 1:'generally thought of as having themes or unifying j'elements rather than a theoretical structure. Thisviewpoint is well represented in articles about curan-derismo and its form and function within MexicanAmerican communities (Clark, 1959b; Edgerton,et al., 1970; Foster, 1953; Martinez and Martin, 1966;Torrey, 1969).

Later research maintains the strengths of thisapproach but adds folk theoretical concepts. Earlyepidemiological approaches to folk illnesses give anidea of the geogtaphical spread and variation inbeliefs, illnesses, and healing rituals, whereas laterstudies identify or discuss the common deno~a-ctors that unify curanderos: their underlying percep-tion of illness. Traditionaltechniques were used to gather the data for these

,.studies, primarily participant observation and inter-viewing over prolonged periods.used personal netWorks to identify individualswere known locally as healers. Emphasis often wasplaced on finding individuals who were full-timehealers rather than talking to those who treated oDlyfamily members and neighbors. Therefore a reran;,dero can be defmed as an individual who is recog-nized in his community as having thewho sees an average of five or more patients a day,and who has knowledge of and uses the theoretical,structure described in this chapter.be viewed as both specialists and

The research that is available on curanderismo is broadin interest and historical depth. Unlike specific healingtechniques, such as acupuncture, which can be studiedin relation to specific illnesses with relative ease, curan-derismo is a complex brew of both theoreticalapproaches to healing and an interrelated set of heal-ing techniques.. The techniques range from herbalcures, which must be approached from an ethnophar-macological perspective; to rituals, which can be stud-ied symbolically as projective psychiatric techniques; tomethods such as massages, natural birth, nutritionalprescriptions, and dietary practices. Some studies haveinvestigated the scientific efficacy of the practices ofcuranderismo, whereas others have approached it froma sociopolitical or symbolic viewpoint. Some practiceshave not been studied at all. Therefore, although theefficacy of some parts of the system is clearly defffied,other parts remain to be explored.

Early research on curanderismo can be found inthe classic anthropological works on Mexican erable amount of research attention.

591CHAPTER 30 Latin American Curanderismo

~

"',,,)rac.

"!!iates,

( ill-

~~67)..gowl-cul-

,citern:'!aoni

xist-,

powerful glance: taking away some of the vital essenceof a susceptible person; empacbo.. a blockage of theintestines caused by eating the wrong type of food atthe wrong time or by being forced to eat unwantedfood; and caw de la mollera.. a condition of fallenfontanelle in infants. A number of others also are welldermed, if not ~ commonly studied, but these fourreceive most of the research attention.

The epidemiology and the cognitive models ofthese illnesses have been well documented (Rubel,1964; Trotter, 1982, 1985; Weller et al., 1993). Theseillnesses have been studied both singly and in combi-nation (Baer et al., 1989; Logan and Morrill, i979;Rubel et al., 1984; Weller et al., 1993), in terms of theircognitive sotructure within and between Hispanic cui"tural groups, their frequency of treatment, belief andmention in various communities, and their relation-ships to medical conditions and to the treatment ofmedical conditions (Collado-Ardon et aI., 1983;Trotter, 1991; Trotter et al., 1989). In the case of sustoJclear evidence indicates that it is linked directly toserioUs morbidity patterns in Latin American com-munities and acts as an excellent indicator that bio-medical personnel should investigate m~ltipleconditions and problems among patients complain-ing of its symptoms. Caw de la molleraJ on investiga-tion, is a folk medicine label that corresponds tosevere dehydration in infants caused by gastrointesti-nal problems. It is life threatening and, when identi-fied by parents, is an excellent indicator that the childshould be brought in immediately for medical care.Empacbo is a severe form of constipation based on itsdescription and is treated with numerous remediesthat cause diarrhea- Because it is thought to be ablockage of the intestines, the purgative effect ofthese remedies signals that treatment has been effe:c-tive.. To date, no studies have linked mal de ojo to anybiomedical condition; however, because the symp-toms include irritability, lethargy, and crying, someconnection may be made in the future.

r~:.are..,

YIng

This

Herbal and chemical treatments for both natUral andsupernatural illnesses are common in MexicanAmerican communities. More than 800 remedioscaseros have been identified on the U.S.-Mexican bor-der alone (Trotter, 1981a, 1981b). Many of the reme-dies have been tested for biochemical and therapeuticactivities (Etkin, 1986; Trotter, 1981, 1983; Trotterand Logan, 1986)~ Overall, the remedies are not onlybiochemically active; more than 90% have demon-strated therapeutic actions that matched the folkmedical model for their uses. At the same time, only asmall proportion of the herbs have been tested; Thislack of informa,tion is being overcome by an ongoingproject to stUdy the efficacy of the complete range ofherbal cures available in Mexican American commu-nities (Graham, 1994), by use of combined ethno-graphic and biomedical methods (BroWner et al.,1988; Croom, 1983; Ortiz de Montellano andBrowner, 1985; Trotter, 1985).

irE: The exceptions to the general rule of efficacy are~the use of remedies for illnesses such as the common-0.-

~t cold, where the remedies relieve symptoms but do notw,: directly treat the illness. The actions of these reme-,"'c{t!;dies, some of which are described earlier, include""~Y:; diuretics, treatments for constipation, abortifacients,

~(analgesics, sedatives, stimulants, cough suppressants,~antibacterial agents, coagulants and anticoagulants,, vitamin and mineral supplements, and plants with

antiparasitic actions. Most have proved safe andi~;;effective when used in the manner described and rec-.",'-," ommended by the curanderos. This area and the

~r;~ilierapeutic, cultUrally competent counseling prac-\""CT tices of the healers are the most clearly acceptable and

;"usefulapproaches for articulation with modem med-;4 ,!cine.

Additional Information onPn;rlo ;,..l,..r.-y, ,..1:' lJ,..117 Tll_~~~~~ .-~""""""'o1 ...,..,ft. 11,1,..,""..",

Healing and P~¥chi;ltr¥Of all the complex axeas of Mexican American tradi-tional healing, the one that has received the mostreseaxch attention has been the study of commonfolk illnesses that axe experienced and treated inMexica,n American communities. The most fre-quendy reported axe SustOJ an illi1ess caused by a,'frightening

event; mttl de ojOJ an illness that can betraced to the Neax East, which involves a magically

Another area of significant endeavor in curanderismois the identification of parallels and areas of compati-bility between the processes and rituals of curan-derismo and the use of psychiatry in cross-cultUralsetting~ (Kiev, 1968; Klineman, 1969; Torrey, 1969;Trotter, 1979; Velimirovic, 1978). The parallels are

~\:

592 FUNDAMENTALS OF COMPLEMENTARY AND INTEGRATIVE MEDICINE

clear, especially when healers concentrate on psycho-logical conditions that they recognize from theirknowledge of psychology and psychiatry. A number ofsuccessful collaborations have been conducted in thisarea between traditional healers and individuals frommodern medical establishments in several states.

Mack!NtEs

Mack!MIn,

Mack!M

Mack!aliZaCOI

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mo

MadseA"

Madse11

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MartiIMt

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mE

13Romar

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Romar, sai

Rubel.mt

RubeJfu

.RubelAu

Torrey.PS)

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Eth

Unexpected Cnn.~eql;ence~

It is clear that Mexican American folk medicine con-tains a very high ratio of useful, insightful, and cul-turally competent healing strategies that work well inHispanic communities. As seen previously, theserange from proven herbal cures to therapeutic modelsto culturally important labeling systems that can helpphysicians identify the cultural labels for certain typesof biomedical problems. The complexity of curan-derismo ensures that these findings will increase.

At the same time, no health care system exists thatdoes not have side effects and unexpected results. Withallopathic medicine, these range from the birth defectsof thalidomide to dreadful side effects ofchemother-apy and the limited ability of psychology to deal withchronic me~tal health conditions such as alcohol anddrug abuse. In curanderismo, allopathic conditions arenot the bulk of its use, and a few unexpected conse-quences have been discovered in treating empacho (Baerand Ackerman, 1988; Baer et al, 1989; Trotter, 1983b).These occurrences are rare but must be taken intoaccount and understood within the overall culturalcontext of curanderismo and within the context of themuch more pervasive positive benefits that the com-munities derive from having these alternative healthcare practices available.

With the complexity and the diversity of practiceswithin this traditional healing system, there remains agreat deal of useful and insightful research that can beconducted beneficially in relation to curanderismo.

AcknowledgmentsThe initial phase of the research findings reported bythe author was supported by a grant from theRegional Medical Program of Texas (RMPT GrantNo. 75-108G). Further efforts at data collection weresupported by the Texas Commission on Alcoholism,Pan American University, and the author himsel£

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