Peru as It Is (Vol. 1&2). Archibald Smith
the mind that conceives the notion of it; and, in itself, the fallacy is harmless so long as it is speculative: but the practice to which it leads is often mischievous, and it is with the latter that the practitioner has most to do.
It would, indeed, be a hopeless task for the regular practitioners in Peru to reason a Limenian doctress out of her reveries on the subject of empacho, which, when viewed by her as the exciting cause of disease, assumes a Protean character, and is visible to her imagination in mostly every case of ailment, which she, true to her favourite opinion, offers to cure in her own way.
The evil effects of a farrago of nostrums, or untimely and inappropriate medicaments applied by the help of the doctress, the educated physician is often called, but sometimes too late, to correct; and the fatal abuses thus arising have, on various occasions, called forth the public and earnest remonstrances of the highest medical tribunal of the country—but all to no purpose, the practice being rooted in vulgar favour and prejudice.
So universal, indeed, is the credit of the Limeña quacks, or curanderas, of whom La Señora Dorotea is the chief, and so general is the use of the instrument called jeringa, (through the medium of which the principal ingredients of this señora’s materia medica are confidently applied,) that it constitutes an essential and conspicuous article of domestic utility. And the great consideration in which this auxiliary is held, as a sine quâ non in the treatment of empacho, and almost every disease, renders it a topic of never-failing conversation.
As a familiar example of the abuse of the jeringa, may be mentioned the vulgar practice of resorting to it in disorders attendant on dentition. Sometimes the increased action of the bowels is indiscreetly stopped by astringents thus adhibited, and a fatal determination of blood to the head ensues; but it more frequently happens that the contrary practice is pursued, and stimulant remedies are administered, which either increase the existing disease, or transmute it into a dysentery. On such occasions the skilful practitioner may endeavour in vain to convince the mother that her child’s gastric ailment does not proceed from the presence of the dire empacho. When, as often happens during the progress of teething, children are suffered to eat all sorts of sweets, fruit, and unwholesome diet, or permitted to partake of strong food used by adults, and ill-suited to the more delicate organs of the tender child, then, no doubt, empacho or indigestion may be traced, in many cases, as a co-existing cause of the irritation and disturbance in the bowels, to which the offspring of white parents are more particularly subject in Lima. Complicated cases of this nature demand a prudent modification in treatment. Yet such instances are not so frequent as others, independent of indigestion, and in which a moderate bowel complaint is so far from being injurious that it is most salutary, as a natural protection against affections of the head during the process of teething. It is a peculiarity connected with the religious belief and popular customs of the country, that diseases of infancy and early childhood are too lightly considered by the native physician. The reason assigned for this is the devout one, that little innocents are exempted from the pangs of Purgatory, which must be borne by adults for the purification of their souls; and that therefore, for the child, it is happiness to die.
We have heard the physician offer this consolation to a weeping mother in the higher ranks of society. He softly assured her that her pretty babe would pass through Purgatory to Paradise without as much as scorching a finger in the transit.
In the lower and middle ranks especially, this religious dogma seems to stifle the natural emotions of the heart; for, evidently forgetting that even “Jesus wept,” they celebrate with music and dancing the death of the dearest object of a fond parent’s affection, who, as her child is consigned to a niche in the Pantheon, bedecks her person, grown thin by previous care and watching, and now she smiles in her robes of white, as if these were indeed no emblems of torn affection!
V. Sangria sobre el empacho.—To bleed a patient affected with empacho is, by the common consent of the vulgar, declared to be a most unpardonable blunder; and this is the meaning of the expression, “Sangria sobre el empacho!” when ejaculated in the apartments of the sick.
It will be readily imagined that, in numerous instances coming under the vulgar denomination of empacho, the subtraction of blood will be a necessary measure before purgatives can be properly or safely resorted to, with a view to remove from the bowels the irritating cause lodged there, and affecting the general system.
But to avoid the unjust criticism of uncharitable members of the profession, who are always ready to turn to their private advantage, any popular prejudice which can be called in to humble the name of fellow-practitioners more respectable than themselves, and also as a mean either to acquire or to preserve the confidence of the sick, the prudent physician will not overlook the natural effects of any known prepossession regarding blood-letting. He will so far accommodate his practice to the ideas of those who are most interested in the issue of his treatment, as to order at least one enema, when the empacho is firmly believed to exist, before he proceed to the further discharge of his professional duty, and fulfilment of the indication of the case, by ordering the lancet to be applied.
No time or advantage is lost by such a concession to the preconceived and inflexible opinion, that bleeding is particularly hurtful in those cases of illness connected with undue accumulations in the bowels: but one very important end is gained by it; since, by agreeing with the sick and their friends on an indifferent point of practice, they will more willingly submit to the application of other remedies necessary for the safety of the patient.
VI. Cosas frias y calientes.—All articles of diet, and medicaments, are by the Peruvians vulgarly divided into cold and hot; or, as the words on which we are about to comment express it, into “cosas frias y calientes.”
When the physician prescribes any particular diet or physic to a patient in Lima, he must be ready to answer many inquiries regarding the qualities of the things prescribed.
Besides professed sick-tenders, zamba housekeepers or head-servants, some women in the middle and humbler ranks, such as manteras, chocolateras, tenderas, cigareras, picanteras, pulperas, changaneras—that is, female shopkeepers, chocolate and cigar venders, with a subordinate gradation of publicans, &c.—are always ready to talk, with confounding fluency and volubility, without knowledge, concerning qualities and temperaments; and they display a natural acuteness of metaphysical capacity, with a truly peripatetic nicety of discrimination, when, in a moment of oratorical excitement, they assign to certain mixtures and drinks ideal measures and degrees of the elementary qualities. Women skilled in such mysteries, and omniscient charlatans, run over the various combinations of the cold and hot, dry and humid, and all their resulting modifications of temperature and temperament, with apparently unerring precision, and with a graduated exactness which no chemist in Europe, with every advantage of science and apparatus, can pretend to equal in his elaborate investigations into the qualities and elements of bodies either living or inanimate.
The particular temperament of the patient his intimate friends are supposed to know perfectly; and the doctor’s reply to any question that may be proposed to him on this subject will be considered, in many instances, as no bad test of his penetration and professional knowledge in other matters with which they do not presume to be themselves so well acquainted.
In conformity with such prevailing impressions, when nurses are to be selected for the children of delicate mothers, preference is given to the black women, as their blood and milk are believed to be cooler and more refreshing than the same fluids are in women of a different race. The Indian woman, on the other hand, is considered inferior to the negress as a nurse, because she is believed to be of a comparatively hot temperament and constitution. The effect of the quality of the nurse’s milk is conceived to influence the future temperament of the infant that hangs on her breast; and it is sometimes assigned as a reason why an individual is of an ardent temperament, that when a child he had been weaned, or deprived of the breast, by giving him wine—se desteto con vino.
Colour is looked upon as an indication of constitutional temperament even in the lower animals. Thus, when one in town labours under hectic fever, or consumption, he is recommended to go to the country, and drink warm milk from a black cow, because it is allowed to be more cooling and febrifuge than the milk taken from a cow of any other colour.
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