ABORIGINAL AMERICAN MEDICINE, NORTH OF MEXICO*

By ROBERT CARLISLE MAJOR, M.D. NEW ORLEANS, LOUISIANA

AD there been, on one of mit a detailed description of the medi- Columbus’ ships, a twen- cine of even a single tribe, considered tieth-century scholar, well de novo. It may be possible, however, to grounded in the anthropol- indicate how the practices of the abo- ogy and the medical history of rigines,the Old north of Mexico, fit into the WorldH but entirely unacquainted with scheme of primitive medicine in gen- the New, he could have, after a brief eral, the outlines of which have been so glance at the people who greeted him, clearly drawn by the late Dr. Fielding predicted with amazing accuracy their Garrison. He has written: concepts of disease and their methods of The common point of convergence of combating it. Nor must any supernatu- all medical folk-lore is animism, i.e. the ral communion with the Thunder Bird notion that the world swarms with invis- have preceded such divination, for the ible spirits which are the efficient causes identity of all forms of primitive medi- of disease and death. Primitive medicine cine, regardless of time or place, is now is inseparable from primitive modes of re- so well established as to be axiomatic. ligious belief. If we are to understand the Whether one accepts the convergence attitude of the primitive mind toward the theory of Bastian which affirms the ap- diagnosis and treatment of disease, we must recognize that medicine, in our sense, pearance of identical ethnic phenomena was only one phase of a set of magic or in different relations of space and time mystic processes designed to promote hu- as due to spontaneous development of man well-being, such as averting the wrath certain elemental ideas common to of angered gods or evil spirits, fire-making, primitive man everywhere, or whether making rain, purifying streams or habi- one accepts the convection or diffusion tations, fertilizing soil, improving sexual theory of Ratzel which holds no pri- potency or fecundity, preventing or re- mary elemental thought or action pos- moving blight of crops and epidemic dis- sible to primitive races but that each eases. These powers, originally united in one person, were he god, hero, king, sor- race has derived something from its cerer, priest, prophet, or physician, neighbors in space or from its prede- formed the savage’s generic concept of cessors in time, or whether one accepts “making medicine.” A true medicine- something of both, there remains the maker, in the primitive sense, was the oft-confirmed finding that in different analogue of our scientific experts, philan- places and at different times, the essen- thropists, and efficiency engineers, a gen- tial traits of primitive medicine have eral promoter of human prosperity.19 been alike in tendency, differing only in He might have added that the pros- unimportant details. perity was sometimes that of the indi- The scope of this paper does not per- vidual to the detriment of the group. * Read before the Osler Club of Saranac Lake, N. Y., March 1, 1938. It is much to be regretted that so few or the like but spinne out the threed of of the early observations, made before their dayes to a faire length, numbering profound alterations had been wrought threescore, four-score, some a hundred in the Indians' mode of life, are of what years, before the world’s universall sum- we are pleased to call scientific charac- moner cite them to the craving Grave. ter. Comment of early and emotionally He later professes never to have seen uninvolved travelers is exceedingly frag- “one that was borne either in redun- mentary. Much of what was written dance or defect a monster, or any that came from one of two groups, those to sickness had deformed, or casuallie whom there could be no good among made decrepit, saving one that had a these heathen and those who, outraged bleared eye and an other that had a by the cruel ravages of the white man’s wenne on his cheek.’’53 greed, his diseases, his firearms, and his Ebe best evidence is, like Wood’s, firewater, would almost lead one to be- negative, having to do with the diseases lieve that a civilization surpassing that the aborigines did not have, but Wood of ancient Greece or Rome was being was an avowed enthusiast and the more destroyed. Then, there is the point, em- conservative opinions of such students phasized by Yager,55 that the Indian en- as Colonel Ashburn and Dr. Hrdlicka joyed a little fun at the white man’s should probably be given more weight. expense by wilfully giving him fantastic Ashburn1 is convinced that: explanations for puzzling behavior. Prior to the coming of the white man And throughout all this history runs and the negro, America was a land almost the difficulty of language, poorly under- free from infectious diseases. Death on the stood on both sides and fruitful of mis- wholesale scale came only from war, understanding. drought, Hood and famine, and on the It seems desirable, at this point, to small scale mainly from accidents and in- consider existing knowledge of Indian juries, the mishaps and complications of morbidity and of the ills to which he childbearing, the sacrifice of captives and was subject. As might be anticipated, old age. most accounts fail to distinguish sharply It is of interest that he credits malaria between the pre-Columbian and the to the invaders, as well as yellow fever post-Columbian, with resulting confus- and dengue, Africa being the chief ion. source. Smallpox, typhus, scarlet fever, William Wood, one of our very first diphtheria, measles, whooping cough, promoters, came to New England in cholera, typhoid, tuberculosis, and gon- 1629 aRd in 1633 returned home and orrhea likewise seem to have come with wrote a book to induce Englishmen to the agents of civilization and found vir- settle in the new country. Of the health gin soil, with the usual disastrous effects of the natives, he says: under such conditions. Coupled with such negative evidence The Indians be of lusty and healthfull bodies, not experimentally knowing the is the overwhelming indication that the Catalogue of those health-wasting diseases whites met no diseases considered, by which are incident to other countries, as them, new. Whether or not syphilis is Feavers, Pleurisies, Callentures, Agues, a gift from the Indian, taken back to the Obstructions, Consumptions, Subfumiga- Old World by Columbus, is an old con- tions, Convulsions, Apoplexies, Dropsies, troversy, too involved to be entered Gouts, Stones, Toothaches, Pox, Measels here. At least, the later settlers and ex- plorers were well acquainted with the ease, asthma, disease of the heart or pox and no evidence has been found in arteries, varicose veins or hemorrhoids, this study of pre-Columbian syphilis. glandular affections of the breast, pro- It is agreed that there was little, ex- static enlargement, hernia, disease what- tremely little, if any, cancer among the ever of the sexual organs, appendicitis, pure Indians. peritonitis, or ulcer of the stomach. He What was apparently arthritis, gener- observed little skin disease, rare insan- ally described as rheumatism and neu- ity, no leprosy, and no pathological ralgia, was common. The remedies used obesity. with considerable effect, as will be Dr. Benjamin Rush37 commented on brought out later, suggest rheumatoid reports of many examples of extreme or infectious arthritis, but the studies of old age in both sexes and adds, “It is re- paleopathologists reveal hypertrophic markable that age seldom impairs the or osteoarthritis as well. faculties of their minds.” Analysis of Gastrointestinal disturbances of a not many skeletons, however, has led to too serious nature, commonly attrib- modification of the belief in Indian uted to alternating periods of starva- longevity and, of course, infant mortal- tion and gluttony, were likewise com- ity was high. mon. Stone45 reviewed the subject and be- There was much conjunctivitis, said lieves that obesity, arteriosclerosis, heart to be due to irritation from smoke-filled disease, endocrine disorders, and insan- dwellings and, in the Southwest, from ity were recognized sporadically but sandstorms. considered curiosities and that rickets Mechanical traumata and burns are occurred fairly commonly. His evidence not peculiar to an industrial age. of rickets is not set forth. On the con- Among the Indians of Ohio and trary, skeletal remains indicate absence Pennsylvania, Heckewelder21 remarked of rickets but presence of so-called sym- the absence of gout, gravel and scrofula. metrical osteoporosis. Among the New England tribes, Roger The Iroquois at Quebec in 1535-36 Williams50 could hear of no calculus, are said to have cured the scurvy of Car- which he attributed to the “corne of the tier’s crew with an infusion of bark and country.” Alexander Henry,13 adopted limbs of the hemlock spruce, implying among the Ojibway in 1763 and fa- familiarity with the disease. This ac- miliar also with the Ottawa, saw “never count is somewhat apocryphal and data a case of dropsy, gout, or stone.” Mc- on deficiency states are few. Most ob- Laughlin,28 long in charge of the Stand- servers who comment at all describe in- ing Rock agency, says the Sioux, in the sanity as rare and very humanely old days, “never had a cold.” However, treated. It is true that captives some- colds, bronchial affections, inflamma- times feigned insanity to escape torture tion of the lungs, and pleurisy are fre- or death. However, these comments sug- quently mentioned, their exact relation gest that (1) the point was missed that to contact with the whites being unde- the frankly insane were treated with termined. awe and respect rather than with hu- Hrdlicka23 in a thorough study of the manity, and (2) Indian behavior was all Southwest tribes found them still re- considered so bizarre that minor devia- markably free of physical defects, with tions from what the Indians considered little or no serious liver or kidney dis- normal were unnoticed. Evidence accumulates that: an enviable degree of freedom from in- 1. Fhe casual and frequently en- fections, from cancer, from degenerative countered assertion that there is an in- diseases in general, and from the dan- crease in mental disease as a symptom of gers of childbirth. the stress and strain of modern life in The professional organization and Western civilization, in contrast to a practices of a single tribe will be out- relatively low incidence in primitive lined in some detail, to provide a basis people, is unwarranted. for later comparison between tribes of 2. The incidence of suicide is, or was, widely divergent cultures and modes of greater among primitive peoples, in- life. The ()jibway, belonging to the Al- cluding the Eskimos and American In- gonquian linguistic family and inhabit- dians, than among civilized people. ing at various times the present states of This primitive suicide, however, must Minnesota, Wisconsin and Michigan, not be taken exclusively as evidence of a has been selected, partly because of its psychopathological phenomenon but medial position in point of culture and also as a cultural phenomenon. partly because it has been so carefully 3. The Indians were not the stoic and studied by Hoffman.22 phlegmatic characters of the tales which In contrast to some tribes with many have had so much to do with shaping and some with none, the ()jibway has a our ideas but psychically unstable, emo- single medicine society or fraternity, the tional, credulous people, beset on every Midewiwin or Grand Medicine Society, hand by real and even more important the traditions and rituals of which con- imaginary dangers and subject, in rela- stitute the group or organized religion tion to their own cultural pattern, to as of the tribe. much or more psychic stress than we. Among the ()jibway, four classes of Childbearing was relatively easy with medicine men are identified, all related few complications, limited largely to ab- in a curious way. In the order of their normal presentations and these rela- importance, these are the Mide (mem- tively rare. Stone45 says that eclampsia, bers of the Midewiwin), the Jessakkid, puerperal sepsis, and postpartum hem- the Wabeno and the Mashkikikewini- orrhage were unknown among full- nini (herbalists). blooded Indians. However, sepsis oc- The Mide will be considered later. curred with the very rare instances of Members of the Jessakkid group work retained placenta, according to Engel- alone and have no relationship with mann, and excessive blood loss also oc- each other as such. The individual prac- curred but no fatal examples were met tices his art for anyone presenting the in this study.1517 necessary fee. He goes through no ini- Contrary to Wood’s enthusiastic state- tiation. His gift, it is believed, comes ment, not only dental caries and tooth- from the Thunder God and is given ache were known but also pyorrhea only at long intervals to a few chosen with extensive alveolar resorption. The youths during the period of fasting and frequency and severity of these afflic- visions. He can look into the future, tions seem to have varied directly with learn the affairs and the intentions of the degree of dependence upon agricul- men, prognosticate success or failure of ture and a maize diet. hunters, warriors, or others in their un- It is apparent, even from this brief dertakings, and call from any human treatment, that the aborigines enjoyed being, far or near, the soul, depriving the victim of reason and even life. He ployed flexible ceremonies, altered to has a great reputation for disengaging suit the occasion. In some tribes they himself from the most intricate bind- would have been considered witch doc- ings of ropes and similar feats of leger- tors with more opprobrium attached. demain. He obtains his information and The Mashkikikewininini had what performs his dubious services by com- was considered the simplest calling of municating with the turtle, his personal any of these groups—a knowledge of the manido, and through the turtle with mysterious properties of plants, herbs, numerous malevolent manidos, particu- roots, and berries, revealed for a fee. larly the Thunder Bird. Manido, the While not so stated by Hoffman, it Ojibway word for spirit, is probably seems from collateral evidence that this more familiar in one of its other forms, class also practiced the surgery of the manitou. When the prophet holds office day. Many are women and, whether hours, he seats himself in his special men or women, most are members of cylindrical lodge; the structure begins the Midewiwin. to sway violently from side to side; It is apparent, as we come to consider thumping noises are heard from within, the Midewiwin or Grand Medicine So- denoting the arrival of the manidos; ciety, that it is a singularly tolerant and and then come many voices and laugh- all-embracing order, a sort of Academy ter. With the stage thus set, the peti- of the biological, occult, and related tioner may put his request from a point sciences. outside the lodge, the medium within Fhe ritual of the organization is answering if he sees fit. The Jessakkid’s based upon the tribal traditions of the power consists in invoking evil, while cosmogony and a belief in the thought- the Mide’s lies in averting evil. It is sel- ful consideration of the Great Spirit for dom, if at all, that a Mide becomes a the Indian. In spite of some haziness in Jessakkid but the reverse can and does the record, it is clear that the Ojibway occur. had long ago angered the Great Spirit The Wabeno is an individual practi- who had sent a deluge, and that Mina- tioner who is prompted to enter his pro- bozho, the Great Rabbit, had interceded fession by a dream or vision during the in their behalf. This intercession took period of fasting in youth. His routine the form of the gift of the Midewiwin activities include furnishing hunting with its mysteries, symbols and para- medicine, love charms, and the like, to- phernalia, to ward off disease and pro- gether with medical magic of a sinister mote the tribal welfare. The gift was nature. From a hunter who has been made through the otter, now high in successful through his assistance, the their esteem. Wabeno collects a choice share of the It must be remembered that the first game, and so on. To aid in sustaining important event in the life of every In- his reputation, he performs sleight-of- dian youth is the undertaking of a soli- hand tricks such as safely handling red- tary fast, lasting several days. During hot stones and placing his hands in boil- the course of this fast, the neophyte ing water. A raffish sort of character, he enters a hysterical or ecstatic state, usu- often attained respectability and dig- ally productive of dreams or hallucina- nity in the community by joining the tions. Fhe object first seen in such a Midewiwin. state, animate or inanimate, although The two groups just mentioned em- the former is preferred, is of great sig- nificance and its spirit is adopted as a ceremonies and a sweat lodge for the personal guardian. Some symbol of this purification of candidates, the latter lo- spirit is carried thereafter. Now there cated due east of the main entrance of may be an indication in this experience the former, are required. that the subject is fitted to become a The candidate receives instruction in Mide. If so, application is made, the all- many sessions, each of which calls for important matter of fees is arranged, an much tobacco smoked by the preceptor instructor from the Society is appointed, with proper sacrificial rites. One session and a long period of apprenticeship is may teach the history, traditional sig- begun. From that time on. the applicant nificance, and uses of the drum. Others is busy collecting the means of paying deal with the sacred rattle, the Migis his initiation fee, special fees to his in- shell, and the rest of the paraphernalia, structor, and the costs of various feasts. and still others with plants: their identi- This method of being “called” is not fication, properties and methods of ex- obligatory. One of the Jessakkid or hibition. Only part of this latter infor- Wabeno mentioned may successfully mation goes with each degree. apply, as may an acceptable member of For four days before initiation, the the tribe without special gift except the candidate is purified and mentally pre- ability to collect the necessary property. pared by sweat baths and the observance Schoolcraft claimed to have been ini- of certain taboos. Then tests are made tiated into the Midewiwin, and a con- to determine the Great Spirit’s attitude. siderable literature has since collected It is of interest to note here, to be dis- to prove that he was indulging a well- cussed later in the light of the ethics and known penchant for exaggeration. consecration of the medicine men, that fhe society admits both sexes and in obtaining the signs of divine ap- boasts four distinct degrees. The de- proval they resort to sleight-of-hand grees beyond the first are essentially tricks in a closed meeting with no pub- repetitions, with augmented power for lic implications. the holder due to being again “shot with Too lengthy to describe in detail, the the Migis,” the small white shell which initiation consists of a prodigious is the sacred symbol of the Midewiwin amount of singing, presentation of gifts, and the immediate source of its mem- dancing, drumming, and rattling, all bers’ grace. Also, the greater the pro- according to a well-defined program and longation and repetition of any ritual, with strict regard to every word and ac- the greater its efficacy. The fee for ini- tion. The climax comes with the sym- tiation into the second degree is twice bolic shooting of the Migis from the that for the first; the third, three times; medicine bags of the officiants. The re- and the fourth, four times. cipient falls, apparently lifeless, only to Birch-bark records are preserved, the be revived by touches from the medi- delicate incised lines of which represent cine bags and to produce a shell previ- pictorially, in mnemonic fashion, the ously secreted in his mouth. Then, after sacred instructions of Minabozho. In being presented with a new medicine earlier days, there were strictly pre- bag of otter skin, he demonstrates his scribed patterns for painting the face for newly acquired power by dramatically each degree, but this fundamentalist striking down each of his fellow mem- doctrine has suffered. A lodge built to bers. There is perfect cooperation well-established specifications for the throughout. The medicine bag contains objects of magical power: amulets, effi- successfully treated at home by a Mide gies, sacrecl songs inscribed pictorially and if the patient or his family can pay on birch bark, and natural curiosities. a fee equivalent to the initiation fee of Hoffman pictures, as an example, the the first degree, the entire society con- leg of a goshawk with supernumerary sults over him in the sacred lodge. If he appendages. appears worse, doleful singing and rat- A first degree Mide, unable to pay the tling are continued until death ensues, fees for higher degrees, may purchase but if he begins to look better, the sing- additional fragments of knowledge from ing grows more boastfid in tone. If im- individuals of higher degree. It seems provement continues, initiation is car- that this insistence on payment is not ried out and the patient devotes his entirely mercenary but in accord with future to the practices and teachings of the belief that, when a secret or remedy the Midewiwin. has been paid for, it cannot be passed on One last method of attaining mem- for nothing, lest its virtue be lost or im- bership is for the father or mother of a paired. youth, who is in training and who dies, The higher degrees will not be de- to be initiated in the dead one’s stead. scribed further. Only after a Mide has To give an idea of the relative num- reached the third degree does he under- bers of these various practitioners, Hoff- take, with confidence, the cure of dis- man cites the Menomoni whose organi- ease by magic. Provided with four or zation is similar to the Ojibway. In a more tubular bones (leg bones of large tribe of 1500, the Mide number ap- birds, 4 to 5 inches in length) and forti- proximately 100, the Wabeno only 2 fied by fasting and prayer, the Mide gets and the Jessakkid 5. down on all fours beside the patient. Now in what features is this account Vociferous use of voice and rattle causes representative of Indian medicine as a the evil manido to take refuge in some whole, and what principles of all primi- particular part of the patient’s anatomy. tive medicine are illustrated? Then the end of one of the bones is In primitive medicine, etiological touched to this spot, the mouth is ap- concepts unfold with religion. There is plied to the other end, the bone is sud- a state in religious development be- denly struck with the flat of the hand, tween pantheism and monotheism char- and it is apparently driven down the acterized by a Great Spirit with ranks of operator’s throat. This is repeated with lesser spirits, good and evil. This state is each of the bones and the fourth, being clearly seen in the beliefs of the Ojib- allowed to protrude from the mouth is violently sucked upon with grimace and way and was so universally prevalent contortion. Then, having swallowed the throughout the area under discussion as demon, he crawls away retching and ap- to require no further comment. The eti- pearing to suffer, spits out the bones, ology which has everywhere accom- gives further directions as to the con- panied such a stage and which is evident duct of the patient, receives his fee, and among the Indians may be classified as departs. Such directions usually involve follows: some abstinence or other salutary dis- 1. Disease as the result of the independent cipline. activity of a spirit of whatever rank: This description represents indi- a. Of a naturally malevolent nature, vidual practice. If a patient cannot be acting capriciously b. Of a benevolent nature, acting in mass of evidence. This is not to be taken punishment for violation of some as a denial of much rational practice taboo or for some neglect everywhere but an affirmation, as will 2. Disease caused by a spirit acting at the be brought out more clearly in connec- behest of a human agent tion with drug therapy, of a prevailing 3. Disease attributable to the souls or tendency to ascribe supernatural cause spirits of individuals: and effect to very simple things. a. Due to the activity of the unhappy or offended spirit of a dead Indian We have seen in the ()jibway account b. Due to the loss of the sufferer’s own most of the methods by which medicine soul by: men or medicine women find their way (1) Theft by a spirit working at the into the profession. Heredity played a behest of a human agent significant role among only part of the (2) Accidental separation by inter- tribes. For instance among the Maidu ception of the soul when absent of California, all the children of a sha- from the body, as during sleep. man either became shamans or invited Such a system goes hand in hand with death from the offended spirit which shamanism. The term, shaman, vari- had been the source of the father’s ously explained as a Persian word mean- power. Swanton says that the shaman ing pagan and, more probably, as Tun- usually obtained his position from an gus for medicine man, was originally uncle, inheriting his spiritual helper applied to the medicine men or exor- just as material wealth.47 While matri- cists of Siberian tribes; then on this con- lineal inheritance was predominant in tinent to the intermediate between man the totemic organization, this statement and the supernatural among the tribes seems to apply chiefly to the West Coast. of Alaska and the Northwest Coast; and Standards of medical education finally has come to be used synony- varied between wide limits. At one ex- mously with the term medicine man in treme is the shaman who, because of a its broadest sense.47 dream or some other remarkable experi- It is extremely difficult to determine ence, is born full-fledged, and at the how much, if any, sickness, exclusive of other is the graduate or licentiate of a system with a long period of instruction wounds, fractures, dislocations, and the such as the Mide of the ()jibway. like in which cause and effect are ap- Medicine men, whether acting indi- parent, was actually attributed to natu- vidually or collectively in a society, were ral causes without the implication of generally believed to owe their peculiar some magical influence. There is abun- power to the ability to summon and use dant evidence, for instance, that the In- to their ends a spirit which was a perma- dian was given to bouts of gluttony, suf- nent and personal asset. It was possible, fered ill effects, and very rationally through this personal spirit, to com- resorted to emetics and purgatives. municate with any number of other and Some authors (Stone, Yager, Bradley, sometimes more powerfid spirits and Corlett) believe that especially among possibly enlist their aid, as witness the the Eastern and New England tribes Jessakkid whose business was transacted there was a considerable amount of through the turtle. simple therapy without admixture of Various types of specialization arc to magic. If so, it represents a degree of de- be noted, but only three instances will velopment not in accord with the great be mentioned. The Hupa had two kinds of shamans, diagnosticians and thera- practices which enabled the medicine pists. I he Neotka had two kinds of man to withdraw gracefully from a therapists, those who cured when sick- hopeless case or establish a poor prog- ness was caused by an enemy or when it nosis. Opler32 cites the Apache shaman entered the patient in the form of an who, called to see a youth with far- insect and those who restored a wander- advanced tuberculosis (this is a modern ing soul to the body. Among the Iro- observation), resorted to legerdemain to quois were a number of independent demonstrate to those present that he was medical societies. If the patient was not unable to be of any assistance. He thrust cured by the ministrations of a herbal- two eagle tail feathers down the sick ist, a clairvoyant was called to make a boy’s throat and then shook worms from diagnosis and designate the proper so- their ends. These worms were large and ciety to treat the case. active and indicated, according to the Because of his powers for evil as well shaman, that they were hungry, that as good, the shaman was feared as well they had already eaten up the youth’s as respected, emphasis varying in differ- lungs, and that recovery was unthink- ent tribes. The evidence is usually in able. Parker34 describes the procedure or favor of his having collected large, even a medicine man of the Guardians of the exorbitant, fees, their size being deter- Little Waters, a Seneca society. Water is mined by the wealth of the patient and collected from a running stream by dip- his relatives. Sometimes the patient’s en- ping from the crests of the ripples in the tire possessions, plus much of his rela- direction of the current. This avoids an- tives’, would be spent for an elaborate tagonizing any of the forces in the water. ceremony lasting many days. Payment, With a miniature ladle, he dips three while it often assumed the guise of a times from the packet of sacred medi- gift, was usually made in advance. This cine and drops the powder on the sur- lucrative practice was not without its re- face of the water in three spots, the sponsibilities and, in fact, its dangers. points of a triangle. “If the medicine In the Northwest, payment was received floats the omen is good, if it clouds the in advance but was necessarily returned water the results are considered doubt- to the family if the patient died. More- ful and if it sinks speedy death is pre- over, if the shaman was detected by the dicted as a certainty and the remaining relatives of a person whom he had medicine is thrown away.” harmed by magic, he could give ma- Ehe Ojibway practice illustrates an- terial satisfaction or brave their wrath. other feature common to Indian and to Elsewhere, dissatisfied relatives could primitive medicine in general, i.e., dif- have a case reviewed by the attendant’s ferent methods of treatment, depending confreres and, if malpractice was recog- on the patient’s ability to pay. nized, the offender faced the anger and A characteristic of primitive medi- sometimes the violence of the bereaved. cine men and one encountered regularly In spite of their cleverness in finding in this study is the use of sleight-of-hand themselves loopholes, medicine men did tricks, not only in connection with ac- occasionally pay with their lives for fail- tual therapeutic procedures but in ures or mistakes in judgment and must, many ceremonies and not infrequently more frequently, have suffered loss of as individual improvisations. An ex- influence. ample of this sort is the much-quoted Two examples will be noted here of observation of Spencer.42 A Walapi medicine man (perhaps needing to re- fellows and took part in the general store a prestige hard hit by some mis- tribal activities. Some were great war- take) might announce that he had no riors by strength of arms as well as by further use for his intestines. He would superior cunning and, at least, in some then and there, to the horror of the on- tribes and in spite of other income, he lookers, draw from his mouth yard after worked at hunting, fishing, or agricul- yard of intestines. He had rolled several ture, like the rest. yards of thread-like sinew into a bolus It is difficult to ascertain just how and swallowed it several hours before, much the Indians knew about anatomy one end being fastened to a twig be- and physiology, but their knowledge tween his teeth. In the stomach, the ma- was not startling. Perhaps it is wise to terial swelled to such proportions that recall dates of just two publications, the it could be mistaken for intestine and, “I)e fabrica humani corporis” of Ve- naturally, it was immediately thrown salius in 1543, and the “De motu cor- into the fire. dis” of Harvey in 1628. It would appear, on superficial ex- Yager55 quotes Cushman’s story of a amination of what has been said, that Choctaw who, falling over a log, con- the medicine men were shameless ex- ceived that his leg was injured because ploiters of their credulous fellow men, he found that the kneecap moved when but such does not seem to have been the he rubbed it, and adds that, if true, this case. A certain amount of mental con- proves a belated experience of bodily tortion is necessary to achieve the con- ills but nothing as to the aboriginal clusion that a man practicing such pal- knowledge of anatomy. pable imposition as pretending to Ebe Indians had names for most of remove from a patient's body a stone the organs and according to School- which he has previously hidden in his craft40 the Algonquian dialects indicate, own mouth can be other than a knave. by their words for lungs and liver, ob- The Rev. Jette,24 a missionary to the servation of the textures of these tissues. Central Alaskan tribe of the Ten’a, Special properties were attributed to the clung to the idea that their shamans heart, such as the seat of thought, emo- were the prototype of our modern tion, or goodness, by various tribes. racketeers. His views may have been a They are said to have been able to dis- trifle colored by the shamans’ stubborn tinguish between arteries and veins, and opposition to his proselytism. At any the “jugular” and femoral arteries and rate, the great weight of evidence is on the aorta were given a name meaning the other side, i.e., that the shaman was “having no ears” because, when severed, as credulous as his clients, with just as they did not heed any remedies. firm belief in supernatural agencies; There is no reason to believe that the that he was deeply imbued with the medicine man knew any more about spiritual nature of the deceptions he anatomy or physiology than the layman. practiced; and that he believed himself Primitive pathology, in general, con- acting under divine or spiritual guid- ceives of disease due to something pro- ance. That there was some chicanery jected into the body, disease due to and extortion, too, there can be no something taken from the body, and dis- doubt. ease due to sympathetic magic, acting at Except during actual engagement in a distance. Since, in this classification, ceremonial, the shaman dressed like his the perils of the soul fall in the final analysis under the third heading, it is encountered. It is rather pathetic to find not clear that Indian pathology in- the long-suffering mouse in the role of cluded the second, i.e., disease due to laboratory animal. The possibly guilty something taken from the body and ex- ones are named over to a field mouse in emplified by the Australian savage’s a cage and the mouse nods his head predilection for the adrenal fat of his when the correct name is called. Some- enemies. More complete knowledge times diagnosis was made by summon- might indicate that this, as well as the ing a spirit and inquiring of it. other concepts mentioned, actually ex- Of the technique of purely supernatu- isted among our subjects. ral healing ceremonies, little more need Search for the anatomical changes ac- be said. There is a temptation to multi- companying these spiritual ills yields lit- ply the examples of these bizarre and tle except that the soul is being eaten interesting psychological phenomena, and, if the disease is fatal, the eating is of which many exist. Some of the cere- complete. Somewhat more specific were monies, particularly those of the South- the ideas of those tribes which believed west, had much beauty of symbolism that a spirit, rather than entering the and dancing which has been described body itself to cause disease, projects a in glowing terms. The sand paintings, snake or some animal even to the size the ceremonies attending peyote bean of a bear into the victim to gnaw his intoxication, fire dances, and so on, all vitals. The mode of action of the many include much of medical interest. The inanimate objects so projected into the performances of the Ojibway may be body is not clear except that their pres- taken as fairly typical. ence could give rise to pain. We have no Always in primitive medicine there evidence of post-mortem examinations has been a strong mixture of effective among the Indians, such as are found in herbalism, bone setting, crude surgery, crude form among some primitives, not and midwifery, along with the magical. even the examination of the viscera of This was very true of the Indians and animals for purposes of augury. their more rational therapy has been es- Fhe diagnostic procedure of the pecially well summarized by Stone45 and medicine man follows naturally the pat- by Corlett.10 tern of his etiological and pathological We will briefly dismiss the wide- beliefs. The symptomatology stressed is spread use of cornmeal, pollen of thule, considerably at variance with modern and powdered malachite which was of ideas, dealing largely with the character purely sacrificial or magical nature. of the patient’s dreams, while the anam- With these belong the amulets and fe- nesis is concerned with the violation of tishes. taboos, failure to apologize to the spirit More interesting and wide in its rami- of every animal killed, failure to observe fications is the doctrine of signatures, a religious ceremony, and possible ene- the conception that disease may be mies seeking harm to the patient. The cured through the agency of something available diagnoses are few. In case a in nature which suggests by its appear- hostile charm in the possession of an ance the symptoms or the part affected. enemy is the trouble, the identification Recognizable in all primitive medicine, of the enemy is essential and, among the its many examples among the Indians Northwest tribes described by Niblack31 defy recountal. We find inflamed skin calls for one of the few laboratory tests dusted with hot ashes or touched with live coals; a preparation of clematis, be- their invention finally failed, wotdd cause of its hair-like blossom, used to have left no man alive. The plants, prevent falling hair; dry pharyngitis friendly to man and hearing what the treated with a decoction of spiny animals had done, determined to defeat thistles; a twisted piece of wood laid these evil designs. Each tree, shrub, upon the body of a person in convul- herb, even the grasses and mosses agreed sions; a piece of a tree struck by light- to furnish a remedy for some of the dis- ning placed on a fractured extremity; eases of the animals’ devising. Thus did and milkweed given in cases of faidty medicine originate and the plants, every lactation. one of which has its use if we only knew Among the Eskimo, part of the prepa- it, furnish the antidote for the evil ration of a girl at puberty is wearing a wrought by the revengeful animals. cord around the waist from which hang Youngken56 has catalogued several the heads of the femurs of a porcupine hundred drugs used by the North to make later parturition easy. The American Indians, fifty-six of which porcupine is said to bear its young with- were still included in the 1924 edition out effort, only momentarily interrupt- of the U. S. Pharmacopeia or National ing its walk. Similarly, the Hopi place Formulary. Many of this extensive list the skin of a weasel, an animal which are not now believed to have any ap- glides easily through difficult channels, preciable activity, and the post hoc in the room with a woman in labor. propter hoc fallacy was in its usual These last are fetishes, of course, but prominent position. partake of the signature idea.6,45 Only a few of the more striking drugs The Lenape had the notion that for and methods can be mentioned. In an emetic the water used "must be fevers, treatment consisted of rest, drawn up a stream; if for a cathartic, sweating, purgation, diuresis, febri- downward.”21 The Algonquians of the fuges, and liquid diet or no food at all. St. John River held that eating dog- Complete abstinence from food during meat, the dog being regarded as a brave any illness was common and sometimes animal, would impart courage.13 Yager led to actual death from starvation. The says that "much of the so-called ‘canni- Plains and Great Lakes tribes added balism’ noted here and there among phlebotomy. The febrifuges, given as a primitive Americans, turns evidently copious draft of the decoction, are rep- upon this idea.”55 resented by the dogwood of the Ottawa All the Indians, whether medicine and Chippewa, containing an estimated men or not, had some knowledge of 30 grains of cinchona to the dose, and commoner remedies, while proprietary the willow of the Pima, Apache, Mo- preparations were the rule among the have, Winnebago, and Dakota, rich in initiated. Mooney,29 in his study of the salicin. Cherokee, particularly the Cherokee In gastrointestinal disturbances, formulae which were preserved in writ- emetics and cathartics were routinely ing due to Sequoya’s development of used. In fact, daily emesis was a neces- an alphabet, tells their story of the sary part of the personal hygiene of origin of herbal medicine. Briefly, the some tribes. Emesis also loomed large animals, outraged by their injuries at in purification ceremonies. Many effec- the hands of man, conferred and de- tive drugs were used for this purpose, vised various diseases which, had not a decoction of the scorched leaves of the holly being the most typical. Tickling earth in which steam was generated by the pharynx was also practiced. Such pouring water on heated stones. Hot effective purgatives were found in use springs from Alaska to Mexico were as cascara sagrada among the California highly prized. tribes, the American aloe in Virginia, The care of the pregnant and par- and jalap among the Delawares. A few turient woman varied a great deal with tribes, notably the Missouri River locality and the mode of life. In the group, administered enemata. nomad tribes she received scant atten- In any case of scanty urine, whether tion, while among the Pueblo people or not associated with edema, a decoc- she was given much consideration. tion of a diuretic was used, e.g., sumac Labor is generally described as short or juniper. and easy, although the careful records For arthritis, sweat baths were used of Hrdlicka show that this was not al- in conjunction with hot poultices or ways the case. Practically all conceiv- some form of counterirritation applied able postures were assumed during to the affected joints. One such poultice labor. External manipulation, often of contained the crushed leaves of winter- very forceful character, was employed green. The Carolina Indians buried the commonly but internal maneuvers were member in hot mud. Counterirritants rare. Some form of pressure was regu- might take the form of vesicants such as larly applied to the uterus during the the crushed leaves of the pasque flower third stage, apparently anticipating of the Dakota and Omaha-Poncha, or Crede. Traction on the cord was used moxas. Moxas are usually attributed to gingerly, when at all. Usually the cord the Chinese or Japanese. The Indians was not severed until after delivery of attached cones of fir twigs or puff balls the placenta. Frightening the patient to the skin and ignited them. with loud noises or the induction of Narcotics were understood best in sneezing or vomiting were used to ex- the Southwest but the daturas were pedite delivery. widespread, being found even in Vir- The Indians’ treatment of traumatic ginia where the stramonium variety states seems to have been, on the whole, gained the name Jamestown or Jimson admirable. Fractures were splinted and weed. The red beans and peyote beans dislocations reduced with logical manip- of the Southwest were used in an organ- ulations. It is interesting that use was ized way to induce a state closely in made of the relaxation of the skeletal tune with the supernatural. The da- muscles during emesis in the reduction turas were used variously to produce of fractures. holy delirium in the priests, a state of Surgery was limited by crude stone forgetfulness in certain initiation cere- instruments and rudimentary knowl- monies for young men, as an aphro- edge of anatomy. Abscesses were incised. disiac for young women in some cere- Trephining was not practiced north of monial dances, and as an anodyne. Mexico in Columbian times although Alcohol seems to have been unknown some effort has been made to show that except in the region bordering on Mex- the art had been known and lost. Cau- ico and there was of little significance. terization and the use of cobwebs were Sweat baths were an integral part of known in checking hemorrhage. The Indian life in health and disease. use of the ligature seems to have been Lodges were built of bark, skins, or limited to some of the North Carolina tribes who are said to have done partial of the role of the male in the fertiliza- foot amputations to prevent the escape tion of the female, as evidenced by some of slaves, ligating with sinew. Sutures primitives. were widely employed and the use of Some of the features of direct medi- drainage in the closure of certain deep cal interest in a people living in a Stone wounds was understood. Amputations Age culture have been superficially ex- were generally limited to digits. amined. Their medicine was as good as One of the most interesting of primi- could be expected and, freed from its tive customs is the couvade,36 or male grosser superstition, would not have childbed, which ordains that the father, been so far inferior, in its practical re- at the birth of a child, take to his bed sults, to that of their conquerors. We and there behave as if he were suffering look in vain for any outstanding con- the pangs of labor. Various restrictions tribution and that is natural in the very of activity and diet precede and follow order of things. What is left of the pure this confinement, while in the mean- or nearly pure Indian medicine has of time the mother gets up and goes about recent years been discovered as a fruit- her duties. Among some peoples, no- ful field for research by the psychiatrists, tably the Indians of Ecuador, the offering a greater homogeneity and sim- mother has to go through labor outside plicity for testing some of the psycho- the house while the father is tenderly logical concepts and interpretations cared for within. North of Mexico, the used to explain behavior in a more custom has been found only in Green- complex civilization. It is they, too, who land and among the Pacific Coast tribes are probably more justly analyzing and of California. evaluating the Indian medicine man Another widespread primitive con- than has been previously done. There is cept is that of the scapegoat, the belief at least a suggestion in the evidence that disease can be gotten rid of by in- available that: ducing it to leave the body of the suf- 1. Functional mental disease, par- ferer and enter that of another person, ticularly fear and compulsion neuroses, or any animate or inanimate object. hysteria, and hypochondriasis, was This idea is inherent in a number of much more common than the early ob- Indian customs. For instance, Henry servers suspected, and Kelsey,25 writing of the Indians of the 2. I he Indian was progressing in the Hudson’s Bay Territory in 1691, ob- direction of limiting the elaborate mag- served that they would not step over ical procedures to cases of functional anyone for fear of acquiring disease. mental disease where it probably has Other primitive concepts could be considerable value and of relying more discussed in relation to the Indian, if on herbalism and its realistic accesso- space permitted. Colors were significant ries in organic disease. in Indian psychology and medicine. His favorite magic number was four. The Refe re nc es Evil Eye idea was not prominent. Asso- 1. Ash bu rn , I’. M. How disease came with ciation of disease with natural phe- the white man. Hygeia, 14:205-207; nomena was seen to some extent as 3lo-312; 43^'44°’ 193®- 2. Bourke , J. G. Fhe Medicine-Men of the manifestations by the spirits dwelling Apache. Smithsonian Inst., Bur. of Eth- in the wind, thunder, and the like. nology, 9th Ann. Rep., 1887-88, pp. There seems to have been no ignorance 451-595- 3- Bourke , J. G. Distillation by early Amer- ture patterns. Am. J. Psychiat., 92:1291- ican Indians. Am. Anthropologist, y: 1310, J936- 297-299, 1894. 21. Heckew elder , J. History, etc., of Indian 4. Brad le y , AV. T. Medical practices of the Nations Who Once Inhabited Pennsyl- New England aborigines. J. Am. Phar- vania, etc. Phila., 1876. Quoted by maceut. Assoc., 25:138-147, 1936. Yager. 5. Brooks , H. The medicine of the Amer- 22. Hoff man , W. J. The Midewiwin or ican Indian. J. Lab. & Clin. Med., 19: “Grand Medicine Society” of the Ojib- i-23> 1933- way. Smithsonian Inst., Bur. of Eth- 6. Brow n , B. H. Practice among the Es- nology, 7th Ann. Rep., 1885-86, pp. kimos. Calif. & Western Med., 46:259- !49-299- 261, 1937. 23. Hrdl ick a , A. Physiological and Medical 7. Catl in , G. North American Indians. Observations among the Indians of Edinb., Grant, 1926, 2 vols. Southwestern United States and North- 8. Coolidge , D., and Cooli dge , M. R. The ern Mexico. Smithsonian Inst., Bur. of Navajo Indians. Boston, Houghton Ethnology, Bull. 34, 1906-07. Mifflin, 1930. 24. Jette, J. On the medicine-men of the 9. Conv erse , H. M. Myths and Legends of Ten’a. J. Roy. Anthrop. Inst. Great the New York State Iroquois. Ed. and Britain & Ireland, 37:157-188, 1907. annot. by Arthur Caswell Parker. Bull. 25. Kel se y , H. Journal Undertaken by 125, New York State Museum, 1908. Henry Kelsey. Quoted by Riddell. 10. Corl et t , W. T. The Medicine Man of 26. Malin ows ki , B. Crime and Custom in the American Indian. Springfield, Savage Society. N. Y., Harcourt, Brace, Thomas, 1935. 1926. 11. Cully , J. The California Indians: Their 27. Malinow ski , B. Sex and Repression in Medical Practices and Their Drugs. J. Savage Society. N. Y., Harcourt, Brace, Am. Pharmaceut. Assoc., 25:332-339, 1927. 1936- 28. Mc Laug hlin , J. My Friend the Indian. 12. Cushm an , H. B. History of the Choctaw, Boston, 1910. Quoted by Yager. etc. Greenville, Tex., 1899. Quoted by 29. Mooney , J. The Sacred Formulae of the Y ager. Cherokees. Smithsonian Inst., Bur. of 13. Drake , S. G. Indian Captivities. Auburn, Ethnology, 7th Ann. Rep., 1891. 1850. Quoted by Yager. 30. Morgan , L. H. League of the Iroquois. 14. Emmart , E. W. An Aztec medical trea- N. Y., Dodd, Mead, 1922. tise, the Badianus manuscript (Codex 31. Nibla ck , A. P. The coast Indians of Barberini, Latin 241). Bull. Inst. Hist. Southern Alaska and Northern British Med., 3:483-506, 1935. Columbia. Smithsonian Rep., 1888. 15. Eng elma nn , G. J. The third stage of Misc. Doc., House of Rep., 50th Cong., labor: an ethnological study. Am. J. 2nd Sess., 142, Part 2. Obst., 14:303-322, 1881. 32. Ople r , M. E. Some points of comparison 16. Eng elma nn , G. J. Pregnancy, parturi- and contrast between the treatment of tion, and childbed among primitive functional disorders by Apache sha- people. Am. J. Obst., 14:602-618, 828- mans and modern psychiatric practice. 847, 1881. Am. J. Psychiat., 92:1371-1387, 1936. 17. Eng elma nn , G. J. Massage and expres- 33. Parker , A. C. Secret medicine societies of sion or external manipulations in the the Seneca. 4m. Anthropologist, 11: obstetric practice of primitive people. 161-185, 19°9- Am. J. Obst., 15:601-625, 1882. 34. Par ker , A. C. Neh-Ho-noh-tci-noh-gah, 18. Fraz er , J. G. The Scapegoat. (Golden The Guardians of the Little Waters, a Bough, pt. 6.) London, Macmillan, Seneca Medicine Society. N. Y. State 1913- Mus. Bull., 125:157, 1908. 19. Garris on , F. H. History of Medicine. Ed. 35. Ridd el l , W. R. Some Indian medicine 4, Phila., Saunders, 1929, pp. 20-21. two hundred and forty years ago and 20. Hallo wel l , A. I. Psychic stresses and cul- now. Med. Record, 144:329-330, 1936. 36. Roth , H. L. On the signification of Smithsonian Inst., Bur. of Ethnology, couvade. J. Anthrop. Inst. Gt. Brit. & Bull. 30, 1907 (Pt. 1), 1910 (Pt. 2). Ireland, 22:204-241, 1893. 48. Wak efiel d , E. G., and Del ling er , S. C. 37. Rush . B. An Oration, delivered Feb. 4, The probable adaptation of utilitarian 1774, before the American Philosophi- implements for surgical procedures by cal Soc. Phila., Crukshank, 1774. the “Mound Builders’’ of Eastern Ar- 38. Saff ord . W. E. Narcotic Plants and kansas. J. Bone & Joint Surg., 18:434- Stimulants of the Ancient Americans. 438. 1936. Ann. Rep., Smithsonian Inst., 1916, 49. Wakef iel d , E. G., and Del lin ger , S. C. pp. 387-424. Artefacts Found Among the Remains 39. Saf fo rd , W. E. Daturas of the Old World of the Mound Builders. Ball. Inst. and New: An Account of Their Nar- Hist. Med., 5:452-460, 1937. cotic Properties and Their Use in 50. Willia ms , R. A key into the Language, Oracular and Initiatory Ceremonies. etc. Coll. R. I. Hist. Soc’y (reprint). Ann. Rep., Smithsonian Inst., 1920, pp. Quoted by Yager. 537’5^7- 51. Winst on , E. Fhe alleged lack of mental 40. Schoo lcraf t , H. R. Indian Tribes of the diseases among primitive groups. Am. United States. Philadelphia, Lippin- Anthropologist, 36:234-238, 1934. cott, 1851-57, 6 vols. 52. Wissl er , C. North American Indians of 41. Sigeris t , H. E. American Medicine. N. Y., the Plains. Handbook Ser., No. 1, Am. Norton, 1934. Mus. Nat. Hist., N. Y., 1912. 42. Spe nce r . C. Ecclesiastical Institutions. 53- Wood , W. A True, Lively and Experi- Cap. v. Quoted by Bourke. mental Description of That Part of 43. Ste inme tz , S. R. Suicide among primitive America, Commonly Called New Eng- people. Am. Anthropologist, 7:53-60, land. London, Cotes, 1635. Repr., 1894. Prince Society, Ed. by Charles Deane, Boston, 1865. Quoted by Bradley. 44. Stev ens on , M. C. The Zuni Indians, 54. Wrigh t , J. Medicine of primitive man. Their Mythology, Esoteric Fraternities, Medical Life, 39:243-294; 383-422; 440- and Ceremonies. Smithsonian Inst., Bur. of Ethnology, 23rd Ann. Rep., 472, !932- 55. Yager , W. E. The Oneota. Medicine in 1901-02. the Forest. Oneonta, N. Y., 1911. ton e 45. S , E. Medicine Among the American 56. Youn gke n , H. W. The drugs of the North Indians. Clio Medica. N. Y., Hoeber, American Indian. Am. J. Pharmacy, ’932- 96:485-502, 1924; 97:158-185; 257-271, 46. Ston e , E. Medicine among the Iroquois. •925- Ann . Med . Hist ., n. s., 6:529-538, 1934. 57. Zilboorg , G. Suicide among civilized and 47. Swanton, J. R. Sections in Handbook of primitive races. Am. J. Psychiat., 92: American Indians North of Mexico, 1347-1369, 1936.