The Kiss of Death

inward in a damming effect of centripetal movement. The health of Andeans is believed by them to be a continual exchange of fluids with animals and plants, because they breathe the same air. For example, Kallawaya diviners communicate symbolically with the earth by blowing on their ritual offerings, which are then burned inside the earth shrines. Symbolically, breathing in and out is the means by which Kallawayas become united with their animals, land, and plants. Among a different ethnic group of ritualists, the people ofAusangate in southern Peru call their shamans samayuh runa, “people possessing breath” (Jorge Flores, in Custred 1979). These shamans commune with the hill spirits by taking deep breaths. Breathing in is the way knowledge and power are received from the spirit, and breathing out in ritual context is the way they place themselves in the offering made to the earth.

Within the first millennium, humoral theories in Europe, Asia, and Africa held similar assumptions that the body’s physiology is a distillation process in which productive fluids are distilled from primary fluids of food, air, and liquids, and toxic fluids are eliminated in sweat, urine, and feces. These humoral theories, especially the Hippocratic-Galenic ones, assumed that the humors (blood, phlegm, black bile, and yellow bile) were regulated according to principles of balance.

Kallawayas echoed European humoral theory in regard to fievre (fever), and they still treat acute cases of Chagas’ disease with cooling remedies. Andeans are primarily concerned with balancing the hot with the cold in dealing with fievre, rather than recognizing the fact that it could refer to parasitemia (parasites in the blood) and distinguishing acute phases of malaria, Chagas’ disease, and leishmaniasis. They refuse to bathe someone with a high fever in alcohol, which for them is classified as a hot remedy and should never be used to treat a hot disease (fievre). Because chagasic parasitemia is deadly for infants, health workers need to recommend a therapy that Andeans classify as cool, such as chamomile teas and baths (however, this varies with the region).

Andean humoral theory differs from Hippocratic-Galenic theory in that health is seen not as a balance of humors but a processional motion of concentration and dispersal of the humors (air, blood, and fat) (see Bastien 1985, 1987a). Health is the maintenance of this centripetal and centrifugal motion, and sickness is associated with either loss of fluids or the inability to dispel fluids. Andean pharmacopeia is complete with herbal mates (teas) ingested to increase fluids, and enemas and purges to expel fluids. Incidences of chagasic congestion of the colon, esophagus, and heart provide a physiologically based etiology corresponding to Andean ethnophysiology. This explains why traditional healers use purges and enemas to relieve the megasyndromes of Chagas’ disease. It also provides some insights into their curing rituals.

Kallawaya herbalists employ concepts of hydraulics and centripetal and centrifugal motion in regard to the empirical use of medicinal plants. They attribute problems to the accumulation of fluids within the central organs. Herbalists determine hydraulic forces by taking the pulse. One elderly herbalist, Juan Wilka, classifies bloods as strong, weak, frightened, and exhausted. In one instance, he diagnosed the pulse of a patient as weak because a landslide had thinned her blood with water. He suggested that she receive new blood by transfusion. Kallawaya herbalists refer to the qualities of blood according to four symbols: hot, cold, wet, and dry. These qualities refer to the blood being too fast (hot), too slow (cold), too thick (wet), and too thin (dry). Herbalists diagnose these qualities by reading the pulse. Sometimes they combine qualities: hot and wet blood is associated with energetic people and refers to fast-moving blood with much fat. Herbalists frequently associate symptoms of Chagas’ disease, especially empacho, with a pulse that is cold and wet. This implies that primary and secondary body fluids have accumulated and are unable to flow properlythere is need for strong emetics and purgatives.

An Herbal Cure?

Bolivian herbal doctor Nicolas Carrasco claims to have cured patients of Chagas’ disease with an herbal remedy called “Regenerator” (Zalles 1996). This discovery shows how the path to medical cures sometimes begins in ethnomedicine. Carrasco was born in Sucre in 1902 and lived to the age of ninety. He studied medicine at the Universidad Mayor de San Francisco Xavier in Sucre and received his medical degree in 1927. He received a doctorate in medicine in Ecuador for his studies concerning the use of aralan in the treatment of cancer. He received recognition from the mayor of Cochabamba in 1983 for his medical discoveries.

Bolivian doctors disregarded his discoveries, and Carrasco wrote of “an environment of incomprehension” among them to his findings. Carrasco practiced both biomedicine and ethnomedicine. He was a mestizo who basically adopted European clothing and spoke Spanish, although he spoke and thought more like a Quechua Indian. He identified closely with native curanderos and treated all classes, peasants, cholos, and mestizos. (Bolivia has a highly stratified class system, which at the time separated ethnomedicine from biomedicine along class lines.) On weekends he traveled to native communities to search for cures. He asked yachajs and jampiris for herbal remedies to test on his patients.

While he was in the Caranavi region of the Yungas (the eastern lower slopes of the Andes, noted for coca production), he learned from jampiris about the medicinal qualities of a resin from the fruit of the Rotan palm tree (Calamus drago), called Sangre de Drago (Blood of the Dragon). Sangre de Drago has a dark red color, hence its name, and contains many active ingredients, including draconine and benzoic acid, therapeutically used for their astringent and hemostatic properties (Carrasco 1984:8). There is considerable debate about the remedy and its components. Manuel de Luca, famous Kallawaya herbalist of La Paz, identified Sangre de Drago as Croton roborensis HBK and said that it should be used sparingly to treat Chagas’ disease, because it destroys red blood cells. He claimed it improves the immune system. Other herbalists refer to it as Sillu supay (Devil’s Seat), Kuru kuru, and Llausa mora, and frequently employ palm leaves to bathe someone suffering from susto (soul loss), a frequent symptom of depression or fatigue related to Chagas’ disease. The plant’s seeds are toasted, crushed, put into a small glass of pisco liquor, and drunk daily. This purges the body of toxic fluids, changing cold and wet blood into hot and dry. According to their ethnophysiology, it accelerates the centrifugal forces in the body (see Figure 11). The seeds can be crushed, making a salve that relieves rheumatism. Active ingredients of fresh seeds are acetic acid (like vinegar), butyric acid (like arnica oil), glyceride (like soap), and croton oil (castor oil), forming a powerful purgative.[7]

Combining ethnomedicine with biomedicine, Carrasco refined the herbal remedy for Chagas’ disease and reworked the ingredients of Sangre de Drago until he had concocted a “secret” recipe, which he called “Regenerator.” He tested it on his patients, injecting it into their muscles and observing its effects on arthritis, cancer, and Chagas’ disease.

Bolivian herbalists develop their skills by learning from other herbalists and through practice. When they treat a disease with an experimental herb, they give the patient small doses to observe its effects over several weeks. If a patient dies in treatment, they are held responsible. Bolivians practice retributive justice, and an herbalist may be killed by relatives of the deceased. Herbalists generally refuse to treat anyone they are unsure of curing; and this apparently works to the disadvantage of terminally ill patients. In instances of those chronically ill with Chagas’ disease, however, herbalists and victims are concerned less with its potential fatality than they are with the victim being unable to work. Illness for Andeans is basically a condition when they cannot work, and Western biomedicine’s definition of illness does not apply with Bolivian peasants who have tuberculosis and Chagas’ disease.

At first, Carrasco claimed that Regenerator cured several illnesses, as suggested by the following remark from a doctor: “If Carrasco was a serious scientist, he would only investigate cancer, but he indiscriminately injects Regenerator into patients of all diseases” (Zalles 1996). Oblivious to biomedical ethics, they blamed him not for experimenting on humans but for not focusing on cancer, a disease of upper-class Bolivians. They begrudgingly admitted that Carrasco was a “scientist of sorts” and that Regenerator had therapeutic potential.[8]

In spite of the medical doctors’ criticism, Carrasco continued to experiment on patients. Bolivians