Cultural Diversity in Health-Curandero/a

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Curanderismo, from the Spanish verb curar (to heal), is a broad healing tradition found in in Mexico and Mexican American communities throughout the United States. It has many historical roots in common with traditional healing practices in Puerto Rico and Cuba, and in other Latin-American communities, as well as with traditional practices found throughout Latin America. At the same time, curanderismo has a history and a set of traditional medical practices that are unique to Mexican cultural history and to the Mexican American experience in the United States. It represents a blending (syncretism) of traditional indigenous practices of the Aztec civlization of ancient Mexico with Spanish influ- ences from Medieval Europe and the Classical Period in Ancient Greece-Rome, as well as from modern biomedi- cine and even “complementary and alternative” medicine.

Curanderismo has seven cultural historical roots (Table 39-1). Its theoretical beliefs trace their origins partly to ancient Greco-Roman humoral medicine, also reflected in Arabic Unani medicine (Chapter 32), especially the empha- sis on balance and the influence of hot and cold properties of food and medicines on the body. Many of the rituals in curanderismo date to healing practices that were contem- porary to the beginning of the Christian tradition and even into earlier Judaic writings. Other healing practices derive from the European Middle Ages, including the use of traditional medicinal plants and magical healing practices in wide use at that time. The Moorish conquest of Spain is visible in the cultural expression of curanderismo (see Chapters 32 and 40). Some Mexican American concepts of folk illnesses originated in the Near East and then were transmitted throughout the Mediterranean, such as belief in mal de ojo, or the “evil eye” (the magical influence of

39 C H A P T E R Latin American Curanderismo R O B E R T T. T R O T T E R I I

M A R C S. M I C O Z Z I

staring at someone). Homeopathic remedies for common health conditions such as earaches, constipation, anemia, cuts and bruises, and burns were later brought from Germany and Europe to the Americas to be passed down to the present time within curanderismo. There is also sig- nificant sharing of beliefs with Aztec and other Native American cultural traditions in Mexico (see Chapters 37 and 38). Some of the folk illnesses treated in pre-Columbian times, such as a fallen fontanelle (caída de la mollera) and perhaps the blockage of the intestines (empacho), are parts of this tradition. The pharmacopeia of the New World is also important in curanderismo (and added significantly to the plants available for treatment of diseases in Europe from the 1600s to the present). Some healers (curanderos) keep track of developments in parapsychology and New Age spirituality (see Chapter 42), as well as acupuncture and Asian healing traditions, and have incorporated these global perspectives into their own practices. Curanderismo is a deeply rooted traditional healing system that actively exists within the modern world. Western biomedical beliefs, treatments, and practices are very much a part of curanderismo and are supported by curanderos. On the border between the United States and Mexico, it is not unusual for healers to recommend the use of prescription medications (which can often be purchased in Mexico over the counter) for infections and other illnesses. These healers also use information obtained from television and other sources to provide the best advice on preventive efforts such as nutrition and exercise and on explanations for biomedical illnesses.

Individual healers vary greatly in their knowledge of the practices that stem from each of these seven historical sources. The overall system of curanderismo is complex

644 fundamentals of complementary and alternative medicine

cannot recognize this condition, it goes untreated. This curandero is willing to test his theory scientifically in any way that the mental health professionals would be willing to set up as a research project. However, the mental health professionals are not willing to allow the tests to be con- ducted because of their negative attitudes toward curan- derismo. In this case, it appears that curanderos have stronger belief and trust in science, even when directed at the supernatural, than do physicians and other health professionals.

Supernaturally induced illnesses are most often said to be initiated by either espiritos malos (evil spirits) or by brujos (individuals practicing malign magic; see also Chapter 42). These illnesses form a significant part of the curanderos’ work; these healers explain that, theoretically, any particu- lar illness experienced by a patient could be caused by either natural or supernatural processes. For example, they believe there is a natural form of diabetes and a form that is caused by a supernatural agent, such as a brujo. The same is true for alcoholism, cancer, and other diseases. Identify- ing the nature of the causal agent for a particular illness is a key problem for the curandero. Some identify more supernatural causes for illnesses, and others take a more biomedically balanced approach. In either case, there is much less separation of physical from social problems with curanderismo than with the medical care system. Curande- ros routinely deal with problems of a social, psychological, and spiritual nature, as well as physical ailments. Many cases overlap into two or more categories. Bad luck in busi- ness is a common problem presented to curanderos. Other problems include marital disruptions, alcoholism or alcohol abuse, infidelity, supernatural manifestations, cancer, diabetes, and infertility. One healer distinguishes between the problems presented by women and men. The central focus of the problems brought by women is the husband; the husband drinks too much, does not work, does not give her money, or is seeing other women. Men bring problems of a more physical nature, such as stomach pain, headaches, weakness, and bladder dysfunction. Men also bring problems that deal directly with work; they need to find a job, cannot get along with people at work, or are having trouble setting up a business. The wife rarely is the focal point of their problems. The total list of problems presented to curanderos includes almost every situation that can be thought of as an uncomfortable human condition.

Curanderismo healers work by virtue of “a gift of healing” (el don) (Hudson, 1951; Madsen, 1965; Romano, 1965; Rubel, 1966, 1964, 1990). This inherent ability allows the healer to practice his or her work, especially in the supernatural arena. In the past this was believed to be a gift from God. However, a secular interpretation of the don is competing with the more traditional explanation. Many healers still refer to the don as a gift from God and support this premise with Biblical passages (Corinthians 12 : 7 and James 5 : 14), but other healers explain it as an inborn trait that is present in all humans, just like the ability to sing,

and not only maintains its cultural link to the past but also evolves toward accommodation with the future (Table 39-1).

The earliest systematic research was done on curande- rismo in the late 1950s, when modern biomedicine was either inaccessible or only recently available to significant segments of the Mexican American population. Since that time, modern medicine has become a more integrated part of the cultural system, although there are still many access barriers. These barriers to access are the same reason that the holistic health and charismatic healing movements are becoming increasingly popular. Although traditional healers in Mexican American communities now believe that modern medicine is as capable in certain types of healing, their experience shows that they can accomplish those same tasks better than modern medicine.

NATURAL AND SUPERNATURAL Traditional Mexican American healers perceive health and illness to be related to a duality of “natural” and “super- natural” causes. This duality forms the theoretical base on which curanderismo is constructed. The natural source of illness is essentially seen as a biomedical construct that includes lay interpretations of some diseases inspired by Mexican culture; biomedical ideas such as the germ theory of disease, genetic disorders, psychological conditions, and dietary causes for medical conditions are accepted. These natural illnesses are treated with herbal remedies. Supernatu- ral sources of illness are also recognized by this healing tradition. These illnesses are not considered amenable to treatment by the medical establishment. They can be repaired only by the supernatural manipulations of curan- deros. The curanderos fault the scientific medical system for its failure to recognize the existence of magic or of supernatural causation. One curandero comments that as many as 10% of patients in mental institutions are really embrujados (hexed or bewitched), and because physicians

TABLE 39-1 Seven Pillars of Curanderismo

From Ancient Aztec Folk illnesses, indigenous medicinal plants

From Spain: Ancient Greco-Roman Balance of the four humors,

hot and cold Arabic (Moorish in

Spain) Malign magic, personalistic

causes of illness European Medieval Herbal remedies, magical

healing From Europe and the

United States: Germany Homeopathy United States Prescription drugs available

OTC New Age Spirituality, CAM, Asian

medicine

CHAPTER 39 Latin American Curanderismo 645

The mental level (nivel mental) is the least often encoun- tered of the three levels. One healer described working with the mental level as the ability to transmit, channel, and focus mental vibrations (vibraciones mentales) in a way that would affect the patient’s mental or physical condition directly. Both patients and healers are confident that the curanderos can effect a cure from a distance using this technique.

The three levels are discrete areas of knowledge and behavior, each necessitating the presence of a separate gift for healing. They involve different types of training and dif- ferent methods of dealing with both the natural and the supernatural world. The material level involves the manipu- lations of traditional magical forces found in literature on Western witchcraft (in Chapter 42).

Spiritualism involves the manipulation of a complex spirit world that exists parallel to our own and the manipu- lation of corrientes espirituales, spiritual currents that can both heal and provide information or diagnosis from a distance. The mental level necessitates the control and use of the previously mentioned vibraciones mentales. Thus the levels are separate methods of diagnosing and treating human problems that are embedded in a single cultural tradition.

Common to the practices of all three levels is the use of energy to change the patient’s health status. On the mate- rial level, this energy often is discussed in relation to the major ritual of that level, known as the barrida or limpia (a “sweeping” or “cleansing”). In this ritual a person is “swept” from head to foot with an object that is thought to either remove bad vibrations (vibraciones malos) or give positive energy (vibraciones positives) to the patient. The type of object used (e.g., egg, lemon, garlic, crucifix, broom) depends on the nature of the patient’s problem and whether it is necessary to remove or to replace energy. On the spiritual level, the energy used for both diagnosis and healing is the previously mentioned corrientes espirituales. The mental level is almost totally oriented around generat- ing and channeling vibraciones mentales.

The material level is the easiest of the three levels to describe; it is the most extensively practiced and the most widely reported. At this level the curandero manipulates physical objects and performs rituals (or trabajas, spells). The combination of objects and rituals is widely recog- nized by as having curative powers. Practitioners of the material level use common herbs, fruits, nuts, flowers, animals (chickens, doves), animal products (eggs), and spices. Religious symbols, such as the crucifix, pictures of saints, incense, candles, holy water, oils, and sweet fra- grances, are widely used, as are secular items, such as cards, alum, and ribbons. The curandero allows the patients to rely extensively on their own resources by pre- scribing items that either are familiar or have strong cul- tural significance. Thus a significant characteristic of the objects used at the material level is that they are common items used for daily activities such as cooking and worship.

run, or talk. Almost any person can do these things, but some do them better than others, and a few people can do them extremely well. Curanderos, according to this theory, are the individuals who are better at healing than the pop- ulation as a whole. Healers refer to this concept as “devel- oped abilities.”

Another element common to Hispanic-based folk medi- cine is the hot-cold syndrome (Currier, 1966; Foster, 1953; Ingham, 1940), such as not eating citrus during menses, not ironing barefoot on a cement floor, or taking a cold shower after prolonged exposure to the sun. There is exten- sive knowledge and use of this system of classifying foods, treatments, and elements of illnesses to provide the basis for deciding which remedies apply to specific illnesses.

THREE LEVELS The community-based practice of curanderismo has three primary areas of concentration, called levels (niveles) by the healers: the material level (nivel material), the spiritual level (nivel espiritual), and the mental level (nivel mental). More curanderos have the don for working at the material level, which is organized around the use of physical objects to heal or change the patient’s environment. This theoretical area can be subdivided into physical and supernatural manipulations. Physical treatments are those that do not require supernatural intervention to ensure a successful outcome. Parteras (midwives), hueseros (bone setters), yerbe- ros (herbalists), and sobadores (people who treat sprains and tense muscles) are healers who work on the nivel material and effect cures without any need for supernatural knowl- edge or practices. All the remedios caseros (home remedies) are part of this healing tradition.

The supernatural aspect of this level is involved in cures for common folk illnesses, such as susto, empacho, caída de mollera, espanto, and mal de ojo. These illnesses are unique to Hispanic cultural models of health and illness. This area of healing also includes the spells and incantations that are derived out of medieval European witchcraft (see Chapter 42) and earlier forms of magic, such as the cabala, that have been maintained as supernatural healing elements of curanderismo. Supernatural manipulations involve prayers and incantations in conjunction with such objects as candles, ribbons, water, fire, crucifixes, tree branches, herbs, oils, eggs, and live animals. These treatments use a combi- nation of common objects and rituals to cure health problems.

The spiritual level (nivel espiritual) is parallel to the chan- neling found in New Age groups (neo-Shamanism) and in shamanistic healing rituals around the world (Macklin, 1967, 1974). Individuals enter a trancelike, altered state of consciousness and, according to the curanderos, make contact with the spirit world by one or all of the following means: opening their minds to spirit voices, sending their spirits out of the body to gain knowledge at a distance, and allowing spirits the use of the body to communicate with this world.

646 fundamentals of complementary and alternative medicine

mary, Rosmarinus officinalis L.), and albacar (sweet basil, Ocimum basiticum L.), among others. Herbs are used as amulets; verbena (verbena, Verbena officinalis L.), worn as an amulet, is used to help open a person’s mind to learning and retaining knowledge.

Some curanderos have successful practices on the mate- rial level without resorting to the use of herbs. Some non- herbal treatments are described in the following section.

Supernatural Illnesses and Ceremonial Cures

Supernatural illnesses, which occur when supernatural negative forces damage a person’s health, can sometimes be confused with natural illnesses. One healer stated that these supernatural illnesses may manifest as ulcers, tuberculosis, rheumatism, or migraine headaches, but in reality, they are believed to be hexes that have been placed on the person by an enemy. Supernatural influences also disrupt a person’s mental health and his or her living envi- ronment. Physicians cannot cure a supernatural illness. The curandero usually deals with social disruption, per- sonality complexes, and sometimes, serious psychological disturbances.

Also, a number of illnesses are both supernaturally caused and of a supernatural nature but can be treated on the material level.

Sweeping, “Smoking,” and Conjuring

Curanderos use several types of rituals for supernatural cures. The barrida is one of the most common rituals. These cleansings are designed to remove negative forces while simultaneously giving the patient the spiritual strength necessary to enhance recovery. Patients are always “swept” from head to toe, with the curandero making sweeping or brushing motions with an egg, lemon, herb, or whatever object is deemed spiritually appropriate. Special emphasis is given to areas in pain. While sweeping the patient, the curandero recites specific prayers or invocations that appeal to God, saints, or other supernatu- ral beings to restore health to the patient. The curandero may recite these prayers and invocations out loud or silently. Standard prayers include the Lord’s Prayer, the Apostles’ Creed, and Las Doce Verdades del Mundo (The Twelve Truths of the World). Many of the tools used in bar- ridas are plants that are available in people’s yards, while others can be purchased at local yerberias (hierberias) or botanicas (Figure 39-1).

The following description of a barrida illustrates how the material objects, the mystical power of these objects, the invocations, the curandero, and the patient come together to form a healing ritual designed for a specific patient and a specific illness:

In this case, five eggs, four lemons, some branches of albacar (sweet basil), and oil were used. To begin the healing process, the lemons and eggs were washed with alcohol and water to cleanse them spiritually. Before

NATURAL ILLNESSES AND NATURAL CURES Curanderos recognize that illnesses can be brought about by natural causes, such as dysfunction of the body, care- lessness or the inability to perform proper self-care, and infection. Curanderos at the material level use medicinal herbs (plantas medicinales) to treat these natural ailments. Some traditional curanderos classify herbs as having the dichotomous properties considered essential for humoral medicine, based on a hot-cold classification system common throughout Latin America (Foster, 1953). They use these dual properties to prescribe an herb or combination of herbs, depending on the characteristics of the illness. If a person’s illness is supposedly caused by excessive “heat,” an herb with “cold” properties is given. Conversely, if a per- son’s illness is believed to be caused by excessive “coldness and dryness,” a combination of herbs having “hot and wet” properties is administered.

Other curanderos recognize herbs for their chemical properties, such as poisons (yerba del coyote, Karwinskia hum- boldtuna Roem. et Sch.), hallucinogens (peyote, Lophaphora williamsii Lem.), sedatives (flor de tila, Talia mexicana Schl.), stimulants (yerba del trueno), and purgatives (cascara sagrada). These individuals refer to the beneficial chemical properties of the herbs that allow them to treat natural illnesses.

Curanderos prescribe herbs most frequently as teas, baths, or poultices. Borraja (borage, Borajo officialis L.), for example, is taken to cut a fever; flor de tila, a mild sedative, is taken for insomnia; yerba de la golondrina (Euphorbia prostrata Ait.) is used as a douche for vaginal discharges; and peilos de elote are used for kidney problems. Herbal baths are usually prescribed to deal with skin diseases; fresno (ash tree, Fraxinus species) is used to treat scalp prob- lems such as eczema, dandruff, and psoriasis; and linaza is prescribed for body sores. For specific sores such as boils, malva (probably a Malvastrum) leaves are boiled until soft and then applied to the sores as a poultice. Other herbs are used as decongestants. A handful of oregano (oregano, Ore- genum vulgare L.) is placed in a humidifier to treat someone with a bad cold.

Some herbal lore is passed on as an oral tradition, and other information is available in Spanish-language books that are widely circulated among both curanderos and the public. These works describe and classify numer- ous herbs. Herbal remedies are so important to Mexican American folk medicine that often their use is confused with the art of curanderismo itself by the mass culture. Indeed, some curanderos, known as yerberos or yerberas, specialize in herbs, but their knowledge and skills go beyond the mere connection of one disease to one herbal formula. For curanderos to be genuine, even at the mate- rial level, an element of mysticism must be involved in their practice. Herbs are typically used for their spiritual or supernatural properties. Spiritual cleansings (barridas) often are given with ruda (Ruta graveolens L.), romero (rose-

CHAPTER 39 Latin American Curanderismo 647

are properly filled with smoke. While incensing, the healer or someone else recites an appropriate prayer. If the sahume- rio maravilloso is used, the prayer is often one to Santa Marta, requesting that peace and harmony be restored to the household. After the sahumerio, the healer may sprinkle holy water on the floor of every room in the house and light a white candle that stays lit for seven days. The sahumerio is an example of the curandero treating the general social environment, seeking to change the conditions of the people who live or work there. Incensing of a house removes negative influences such as bad luck (salaciones), marital disruptions, illness, or disharmony. For business and farms, incensing helps ensure success and growth and protects against jealous competitors. These rituals are designed to affect everyone in the environment that has been treated.

Another type of ritual, called a sortilegio (conjure), uses material objects such as ribbons to tie up the negative influences that harm the curandero’s patients. These nega- tive influences are often personal shortcomings, such as excessive drinking, infidelity, rebellious children, unem- ployment, or any other problem believed to be imposed by antisocial magic (un trabajo). One sortilegio required four ribbons in red, green, white, and black, each approximately 1 yard in length. The color of each ribbon represents a type of magic, which the curanderos can activate to deal with specific problems. Red magic involves domination, green deals with healing (green is the color associated with medi- cine in ancient Greece-Rome, spiritual healing in Islam, and is reflected in Western academic symbolism, as well as Latino practices today), white with general positive forces, and black with negative or debilitating forces.

When working with a specific area of magic, a curandero uses material objects that are the appropriate color natu- rally or that have been made that color artificially. The color-based division of magic is also carried over into another type of ritual system used on the material level, velacione, or burning candles to produce supernatural results. The velaciones and the colored material objects used in the sortilegios tie into the energy theme that runs throughout curanderismo, because the colors and objects are believed to have specific vibratory power or energy that can affect the patient when activated by the incantations used in con- junction with the objects. For example, blue candles are burned for serenity or tranquility; red candles are burned for health, power, or domination; pink candles are burned for good will; green candles are burned to remove a harmful or negative influence; and purple candles are burned to repel and attack bad spirits (espiritus obscuros) or strong magic. Once the proper color of candle has been chosen to produce the proper mental atmosphere, the candles are arranged in the correct physical formation and activated by the conjuros y rechasos. If patients ask for protection, the candles might be burned in a triangle, which is considered the strongest formation, one whose influence cannot be broken easily. If they want to dominate someone—a spouse, a lover, or an adversary—the candles might be burned in

beginning the ritual, the participants were instructed to take off their rings, watches, and other jewelry; high- frequency spiritual and mental vibrations can produce electrical discharges on the metal, which might disturb the healing process. The sweeping itself is done by interchang- ing an egg and a lemon successively. Sweeping with the egg is intended to transfer the problem from the patient to the egg by means of conjures (conjuros) and invocations (recha- sos). The lemon is used to eliminate the trabajo (magical harm) that has been placed on the patient. The patient is swept once with albacar (sweet basil) that has been rinsed in agua preparada (prepared water). This sweeping purifies the patient, giving strength and comfort to his spiritual being. The ritual ends by making crosses with aceite preparado (specifically prepared oil) on the patient’s principal joints, such as the neck, under the knees, and above the elbow. This oil serves to cut the negative currents and vibrations that surround the patient, which have been placed there by whoever is provoking the harm. The crosses protect against the continued effect of these negative vibrations. Agua pre- parada is then rubbed on the patient’s forehead and occiput (cerebro) to tranquilize and to give mental strength. All the objects used in the barrida are then burned to destroy the negative influences or harm transferred from the patient.

Another common ritual is called a sahumerio, or “incens- ing.” The sahumerio is a purification rite used primarily for treating businesses, households, farms, and other places of work or habitation. This ritual is performed by treating hot coals with an appropriate incense. The curandero may prepare his or her own incense or may prescribe some com- mercially prepared incense, such as el sahumerio maravilloso (miraculous incense). A pan with the smoking incense is carried throughout the building, making sure that all corners, closets, and hidden spaces, such as under the beds,

Figure 39-1 Hierberia (McAllen, Texas, June 2008).

648 fundamentals of complementary and alternative medicine

auspices of “John of God.” Through what is known explic- itly as Spiritism, John of God and his disciples clearly describe that they are channeling healing energy from a divine source. Adherents see this approach as more appro- priate for mental health than Western biomedical forms of psychotherapy, and more broadly, there is a movement that sees Spiritism as a global panacea for the health care system.

The practice of spiritualism rests on “soul concept,” a belief in the existence of spirit entities derived from once- living humans. The soul is thought to be the immortal component, the life and personality force of humans, an entity that continues to exist after physical death on a plane of reality separate from the physical world. This concept is important not only to curanderismo but also to the religions and mystical beliefs found in all Western- derived cultures.

The soul is alternatively described by curanderos as a force field, ectoplasm, concentrated vibrations, or group of electrical charges that exist separately from the physical body. It is thought to retain the personality, knowledge, and motivations of the individual even after the death of the body. Under proper conditions the soul is ascribed the ability to contact and affect persons living in the physical world. Although souls occasionally can be seen as ghosts or apparitions by ordinary humans, they exist more often in the spiritual realm previously mentioned. Some people view this realm as having various divisions that are associ- ated with positive or negative connotations (e.g., heaven, limbo, purgatory, hell). Other people see the spiritual realm as parallel to the physical world. They state that the spiritual is a more pleasant plane on which to live, but few attempt any suicidal test of this belief. One healer com- mented that “spirits” (espiritos) and “souls” (almas) are the same thing. These spirits’ activities closely parallel their former activities in this world. Because the personality, knowledge, and motivation of the spirits are much the same as they were for the living being, there are both good and evil spirits, spirits who heal and spirits who harm, and both wise and foolish spirits.

These spirits might communicate with or act on the physical plane. Some have left tasks undone in their physi- cal lives that they want to complete; others want to help or cause harm; and many want to communicate messages to friends and relatives, telling them of their happiness or discontent with their new existence. Therefore, curanderos with the ability to work on the spiritual realm become the link between these two worlds. Some curanderos believe that there are multitudes of spirits who want to communi- cate with the physical world, and they tend to hover around those who have the don to become a medium, waiting for an opportunity to enter their bodies and possess them. This situation explains the cases of spirit possession among various cultures. Individuals who become possessed are people with a strong potential to be trance mediums who have not had the opportunity to learn how to control this condition.

circles. Other formations include crosses, rectangles, and squares, depending on the results desired.

Another relatively common use of candles is to diagnose problems by studying the flame or the ridges that appear in the melted wax. A patient may be swept with a candle while the healer recites an invocation asking the patient’s spirit to allow its material being to be investigated for any physi- cal or spiritual problems that may be affecting the person. This ritual can also be performed by burning objects used in a barrida. Lighting the candle or burning the object after the barrida helps the curandero reveal the cause and extent of the patient’s problems. Similarly, if a petitioner asks for candling, the wax of the candles burned for the velacione may be examined for figures or other messages that point to the source of a patient’s problems.

One of the organizing principles of the material level of curanderismo is synchronicity with Christianity in general and the Catholic Church in particular. Special invoca- tions often are directed at saints or spirits to bring about desired results. For example, San Martin de Porres is asked to relieve poverty, San Martin Caballero to ensure success in business, San Judas Tadeo to help in impossible situa- tions, and Santa Marta to bring harmony to a household. Ritual materials used by the Church, such as water, incense, oils, and candles, are extensively used by folk healers. The ways in which these religious objects are used, and the theories for their efficacy, closely mirror concepts found within the healing ministry of the Church, which are actu- ally not incompatible with European witchcraft (see Chapter 42), from which curanderismo partly derives.

The Spiritual Level (Nivel Espiritual)

There are fewer curanderos who have the don for working on the spiritual level (nivel espiritual) of curanderismo than those who work on the material level. These practitioners also must go through a developmental period (desarrollo) that can be somewhat traumatic. Spiritual practices in communities revolve around a belief in spiritual beings who inhabit another plane of existence but who are inter- ested in making contact with the physical world periodi- cally. Healers become a direct link between this plane of existence and that other world. In some cases the curande- ros claim to control these spirit beings, and in other cases they merely act as a channel through which messages pass. Some of these practices are carried out by individual healers, whereas other activities occur in conjunction with spiritual centers (centros espiritistas) that are staffed by trance mediums and other individuals with occult abilities. These centers often work through two prominent folk saints: El Niño Fidencio from northern Mexico and Don Pedrito Jaramillo from southern Texas (Macklin, 1974). This trend in visiting spiritualist centers appears to be relatively recent, also extensively seen in Brazil now, not having been reported during the 1950s and 1960s by those doing research on Mexican American folk medicine.

Since the 1960s, other spiritualist centers have devel- oped in Latin America, for example, in Brazil, under the

CHAPTER 39 Latin American Curanderismo 649

Larger temples might have four or five videntes (clairvoy- ants), as well as the mediums, and might be putting several apprentices through desarrollo at the same time. Some temples are located in Espinazo, the home of El Niño Fiden- cio and a center of pilgrimage for mediums practicing in his name, and others are in urban centers such as Tampico and Mexico City. Large numbers of people make pilgrim- ages to these healing centers in Mexico to deal with health care problems that they have not resolved in the United States.

One healing center is called Roca Blanca, after the spirit that speaks most often in that place. The owner, Lupita, founded it about 30 years ago, after discovering her ability to cure. She was granted permission to practice by a spiri- tual association.

These spiritual centers vary according to their size, their owners, and the spirits associated with them, but there is considerable regularity in the services they perform. Some- times mediums prescribe simple herbal remedies for physi- cal problems. These ingredients are virtually identical to the ones presented in the previous section on the material level, although, occasionally, it is said that a spirit will rec- ommend a new use for an herb. The mediums might suggest that the patient perform the already familiar rituals of curanderismo, such as the barrida. The spirits are thought to be able to influence people’s lives directly, in addition to imparting knowledge about remedies. The curanderos state that spirits control spiritual currents (cor- rientes espirituales) and mental vibrations (vibraciones men- tales); they can manipulate patients’ health by directing positive or negative forces at them from the spiritual realm.

The Mental Level

The mental level has the fewest rituals and outward, complex behaviors associated with it. To date, it also has the fewest practitioners. All the cases follow a similar pattern. For example:

After the curandero chatted with the patient and asked about the basic problem. He asked the patient to state her complete name (el nombre completo). The curandero wrote the name on a piece of paper. Sitting behind the desk he used for consultations, he leaned his arms on the desk, bent forward slightly, closed his eyes, and concentrated on the piece of paper. After a few minutes, he opened his eyes, told the patient more about her problem, and stated that it was being resolved.

The curandero stated that he had learned to use his mind as a transmitter through desarrollo. He could channel, focus, and direct vibraciones mentales at the patient. These mental vibrations worked in two ways—one physical, one behavioral. If he was working with a physical illness, such as cancer, he channeled the vibrations to the afflicted area, which he already had pinpointed, and used the vibrations to retard the growth of damaged cells and accelerate the growth of normal cells. In a case of desired behavioral changes, he sent the vibrations into the person’s mind and manipulated these vibrations in a way that modified the

The ability to become a medium is thought to be cen- tered in the cerebro, that portion of the brain found at the posterior base of the skull (anatomically, the cerebellum, which controls coordination and spatial orientation). Those with the gift are said to have a more fully developed cerebro, whereas those without it are said to have a weak cerebro (un cerebro débil). This weakness has no relationship either to the intelligence or to the moral nature of the indi- vidual, only to his or her ability to communicate with the spiritual realm. Weak cerebros represent a danger for anyone who wants to become a medium. Only rare indi- viduals demonstrate mediumistic potential spontaneously and can practice as mediums without further training. Therefore, curanderos often test their patients and friends for this gift of healing, and those with the gift are encour- aged to develop their ability.

The development of this ability is called desarrollo and is a fairly lengthy process that might last from two months to more than six months initially, with periodic refresher encounters often available from the maestro (teacher). Desarrollo is a gradual process of increasing an apprentice’s contact with the spirit world, giving the apprentice more and more experiences in controlled trances and posses- sions, as well as the knowledge necessary to develop and protect the apprentice as a spiritualist. The teacher also is responsible for giving the apprentice knowledge at a safe pace. The curandero does not always explain what each sensation means; each person, as he or she develops, becomes more sensitive to the environment. The appren- tice must expect to encounter odd sensations, such as bright lights, noises, changes in pressure, and other sensa- tions associated with developing powers. At the end of these desarrollo sessions, the conversation reverts to social chatting for some time before the apprentice leaves. This developmental process continues, with variations, until the apprentice is a fully developed medium.

Fully developed mediums control how, where, and when they work, and several options are available to them. Some mediums work alone and treat only family problems Others might use their abilities only for their own knowl- edge and gratification. Some mediums work in groups with other mediums or with other persons whom they believe have complementary spiritual or psychic powers. Some mediums work in elaborate spiritual centers (centros espiritistas) that are formal churches, often dedicated to a particular spirit (e.g., Fidencio, Francisco Rojas, Don Pedrito Jaramillo). The spiritual centers and the activities surrounding them take on the major aspects of a formal- ized religion.

Sometimes a trance session is open to more than one person at the same time. This group session can be carried out by a lone curandero but more often is found at spiri- tual centers. Once a temple has been established, it may house from 1 to 20 mediums. The more mediums, the better; otherwise, a medium may have to let his or her body be used by too many different spirits, exhausting him or her, and laying the medium open to supernatural harm.

650 fundamentals of complementary and alternative medicine

spiritual or “folk illnesses” (susto, mal de ojo, and empacho), analogous to the biomedical information that is spread throughout all European cultures, including the Mexican American culture, where the home is the first line of defense for the diagnosis of illnesses that eventually might necessitate a physician or hospital. On the other hand, some aspects of curanderismo require the use of special locations, preparations, and tools. This is especially true of spiritual practices on the spiritual level and for the effective treatment of supernatural harm on the material level.

The first setting where this knowledge is used is at home. When people become ill, they use their existing cul- tural model of health and illness to come up with solu- tions. One type of solution is home diagnosis and home treatment. Therefore, both biomedical concepts and folk medical concepts are applied immediately, and home treat- ments are attempted. In the case of curanderismo, this often results in the use of home remedies (remedios caseros) that have been part of the culture for generations, espe- cially herbal cures. When the diagnosis identifies a magical or supernaturally caused illness, the illness results in a home-based ritual. These interventions are done by mothers, grandmothers, cousins, friends, or knowledge- able acquaintances.

Illnesses that appear to be too serious to handle at home, both natural and supernatural, are taken to profes- sional healers who have a locally widespread reputation for being able to treat both biomedical and traditional health care problems. Most of these healers work in a silent, but positive, partnership with physicians, although often the physicians are unaware of the link. The curande- ros consistently refer patients to modern health care ser- vices when they see the efficacy of that approach to be equal to or greater than their own. At the same time, they note significant differences in the models of health and illness between their own practices and modern medicine, especially in the areas of supernatural illnesses, in address- ing social (marital, business, interpersonal) problems and in dealing with psychological problems.

In these cases the treatments take place either in the patient’s home or work environment or in special work- rooms established by the curanderos as part of their prac- tices. The cure might call for working directly in the environment that is affected. In other cases the venue of choice is the curandero’s area because the cure depends on careful preparation and protection from outside influ- ences. These work areas contain altars, medicinal plants, tools for supernatural rituals, and other items, and the atmosphere is considered most beneficial for the healing process, particularly in the case of supernatural problems and treatments.

HOME REMEDIES Herbal and chemical treatments for both natural and supernatural illnesses are common in Mexican American

person’s behavior. The curandero gave an example of one such case in which a husband had begun drinking exces- sively, was seeing other women, was being a poor father to his children, and was in danger of losing his job. The curan- dero stated that he dominated the man’s thought pro- cesses and shifted them so that the husband stopped drinking to excess and became a model husband and father.

There also are a number of syncretic beliefs drawn from other alternative healing traditions—such as New Age practices, the “psychic sciences,” and Asian philosophy— that have been incorporated into this area of curande- rismo. For example, some healers state that they are able to perceive “auras” around people and that they can use these auras to diagnose problems that patients are encountering. They conduct the diagnosis on the basis of the color or shape of the patient’s aura. Some state that they learned these practices from other healers, whereas others indicate that they learned them from books on parapsychology.

The mental level is practiced most often by individual healers working with individual patients, rather than in groups. It appears to be a new addition to this healing system and does not have, as yet, a codified body of ritual associated with it.

The three levels of curanderismo unify the theories of disease and illness found in the Mexican American folk medical model. The system emphasizes a holistic approach to treatment and relies heavily on the intimate nature of the referral system and the extensive personal knowledge of the patient’s social environment that is normally held by the curandero. Christian symbols and theology provide both tools (candles, incense, water) and practice models (rituals, prayers, animistic concepts) for the material and the spiritual levels, but not to a similar degree for the mental level. An energy concept is the central idea that inte- grates the three levels and forms a systematic interrelation- ship among them. This energy concept derives from belief in forces, vibration, and currents that center in the mind of those who have the gift for healing and who can transmit to cause healing from a distance, by affecting the patient’s social, physical, spiritual, or psychological environment.

All three levels of healing are still evolving. The varia- tions in the practices of curanderismo can be explained partly by differences in the curanderos’ personality, differ- ences in their treatment preferences or abilities, and differ- ences in their emphasis on theoretical or experiential approaches.

WHERE HEALING HAPPENS Curanderismo is a community-based healing system. It is complex and widespread. In the United States, for example, it may be practiced in any area where Mexican Americans know about it. Part of this healing tradition is the informa- tion that is spread throughout the Mexican American culture on home treatments for common physical ailments (colds, flu, arthritis, asthma, diabetes) and for common

CHAPTER 39 Latin American Curanderismo 651

diarrhea. Because it is thought to be a blockage of the intestines, the purgative effect of these remedies signals that treatment has been effective. Mal de ojo has not been associated with a specific biomedical condition; however, symptoms include irritability, lethargy, and crying, and a connection to mental health may be made by such observations.

Latin American folk medicine contains useful, insight- ful, and culturally competent healing strategies that work well in Hispanic communities. These treatments range from proven herbal cures to culturally meaningful ways of labeling illness systems.

In light of the sophisticated means for identifying and addressing essentially spiritual problems as well, curande- rismo appears to routinely exceed the limited ability of Western psychiatry and psychology to deal with chronic mental health conditions as well as alcohol and drug abuse. The practices of curanderismo to draw together meaningful influences from seven different sources of worldwide healing traditions also demonstrates its ability to incorporate and integrate culturally meaningful approaches in an era when integration of “alternative” thera- pies is the current fashion in recognizing age-old healing traditions in the Western world.

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FOUR COMMON FOLK ILLNESSES Of all the complex areas of Mexican American traditional healing, the one that has received the most research atten- tion has been the study of common folk illnesses that are experienced and treated in Mexican American communi- ties. The most frequently reported are susto, an illness caused by a frightening event; mal de ojo, an illness that can be traced to the Near East that involves a magically power- ful glance taking away some of the vital essence of a suscep- tible person; empacho, a blockage of the intestines caused by eating the wrong type of food at the wrong time or by being forced to eat unwanted food; and caída de la mollera, a condition of fallen fontanelle in infants.

These illnesses have been well documented (Rubel, 1964; Weller et al, 1993) both singly and in combination (Baer et al, 1989; Weller et al, 1993). Susto is linked directly to serious illness patterns in Latin American communities and acts as an indicator that biomedical personnel should investigate multiple conditions and problems among patients complaining of its symptoms. Caída de la mollera, on investigation, is a folk medicine label that corresponds to severe dehydration in infants caused by gastrointestinal problems. It is life threatening and, when identified by parents, is an indicator that the child should be brought in immediately for medical care. Empacho is a severe form of constipation treated with numerous remedies that cause

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