Medical Ethnobiology of the Highland Maya of Chiapas, Mexico: The Gastrointestinal Diseases 0691037418, 9780691037417

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MEDICAL M EDICAL ETHNOBIOLOGY OF THE HIGHLAND MAYA OF CHIAPAS, MEXICO

Medical Ethnobiology of the Highland Maya of Chiapas, Mexico THE GASTROINTESTINAL DISEASES

Blois Ann Berlin and Brent Berlin

WITH

CONTRIBUTIONS

BY

Xavier Lozoya, Dennis E. Breedlove, Mariana Meckes, Maria-Luisa Villarreal, Jaime Tortoriello, Jorge R. Ricardez, Luisa Majfi, Maria de Guadalupe Rodriguez, Dorothy Castille, and Robert M. Laughlin

PRINCETON UNIVERSITY PRESS' PRINCETON, NEW JERSEY

Copyright © 1996 by Princeton University Press Published by Princeton University Press, 41 W illiam Street, Princeton, New Jersey 08540 In the United Kingdom: Princeton University Press, Chichester, West Sussex AU Rights Reserved

Library o f Congress Cataloging-in-Publication Data Berlin, Elois A nn, 1937M edical ethnobiology of the Highland M aya o f Chiapas, M exico : the gastrointestinal diseases I Elois Ann Berlin and Brent Berlin ; with contributions by X. Lozoya . . . [et al.]. p. cm. Includes bibliographical references and index. ISBN 0-691-03741-8 (cl. : alk. paper) I. Gastrointestinal system — Diseases— Treatm ent. 2. M ateria medica, Vegetable— M exico— Chiapas. 3. Tzeltal Indians. 4. Tzotzil Indians. 5. Ethnobiology— M exico— Chiapas. 6. Traditional medicine— M exico— Chiapas. I. Berlin, Brent. II. Title. RC802.B47 1995 616.3'3 0 6 1 '0 9 7 2 7 5 -d c2 0 95-215 CIP This book has been composed in Tim es Roman Princeton University Press books are printed on acid-free paper and meet the guidelines for permanence and durability of the Committee on Production Guidelines for Book Longevity of the Council on Library Resources Printed in the United States o f America by Princeton Academ ic Press 1 3 5 7 9

10 8 6 4 2

Contents

L ist o f Figures

vii

L ist o f Tables

xvii

L ist o f Plates

xxiii

Preface

xxvii

Contributors

Chapter I. Introduction Maya Ethnomedicine as Science Research Setting General Overview o f M aya Ethnomedicine General Overview o f Healing Principles o f Medicinal Plants Introduction to the Gastrointestinal Conditions Conventions Employed in the Presentation o f Data on Ethnomedicine M edical Ethnobotany and Ethnopharmacology o f the M ajor M edicinal Plants Used to Treat Gastrointestinal Conditions Notes Chapter 2. The Diarrheas Terminology Watery Diarrhea M ucoid Diarrhea Bloody Diarrhea Droplet Diarrhea Lienteric Diarrhea Vomiting and Diarrhea Vomiting Other Conditions Affiliated with the Diarrheas Notes Chapter 3. The Abdominal Pains Terminology Abdominal Pain Epigastric Pain ‘Mother o f M an’

xxxi 3 3 4 52 60 67 78

80 89 91 91 93 160 186 236 249 256 265 278 280 281 281 284 326 344

Abdominal Distension Intestinal Obstruction

368 386

Chapter 4. The Worms

400

Terminology Regular Worms Flat-Headed Worms Tiny Worms Rectal Prolapse

400 401 419 427 432

Chapter 5. Summary and Conclusions

438

The Gastrointestinal Conditions Medical Ethnobotany and Ethnopharmacology o f the Major Medicinal Plants Used to Treat Gastrointestinal Conditions The Pharmacological Significance of Herbal Admixtures Perceived Medicinal Virtues o f Plants Note

445 448 449 454

Appendix: Pharmacological Activity o f Plant Species Used as Admixtures

455

GlossaryofTechnicalTerms

471

References

485

Index o f Maya Terms

501

GeneralIndex

513

438

Figures

Figure 1.1. The Tzeltal and Tzotzil Municipalities o f the Chiapas Central Highlands Figure 1.2. Chalchihuitan in Relation to Other Highland Chiapas Municipalities Figure 1.3. Data Collection Sites in the Tzotzil Municipality of Chalchihuitan Figure 1.4. Chamula in Relation to Other Highland Chiapas Municipalities Figure 1.5. Data Collection Sites in the Tzotzil Municipality of Chamula Figure 1.6. Chenalho in Relation to Other Highland Chiapas Municipalities Figure 1.7. Data Collection Sites in the Tzotzil Municipality of Chenalho Figure 1.8. Huixtan in Relation to Other Highland Chiapas Municipalities Figitre 1.9. Data Collection Sites in the Tzotzil Municipality of Huixtan Figure 1.10. Larrainzar in Relation to Other Highland Chiapas Municipalities Figure 1.11. Data Collection Sites in the Tzotzil Municipality of Larrainzar Figure 1.12. Mitontic in Relation to Other Highland Chiapas Municipalities Figure 1.13. Data Collection Sites in the Tzotzil Municipality of Mitontic Figure 1.14. Pantelho in Relation to Other Highland Chiapas Municipalities Figure 1.15. Data Collection Sites in the Tzotzil Municipality of Pantelho Figure 1.16. Zinacantan in Relation to Other Highland Chiapas Municipalities Figure 1.17. Data Collection Sites in the Tzotzil Municipality of Zinacantan Figure 1.18. Aguacatenango in Relation to Other Highland Chiapas Municipalities Figure 1.19. Data Collection Sites in the Tzeltal Municipality of Aguacatenango

4 10 12 12 16 17

20 21

22 23 26 27 28 28 32 33 35 36 37

Figure 1.20. Amatenango in Relation to Other Highland Chiapas Municipalities Figure 1.21. Data Collection Sites in the Tzeltal Municipality of Amatenango del Valle Figure 1.22. Cancuc in Relation to Other Highland Chiapas Municipalities Figure 1.23. Data Collection Sites in the Tzeltal Municipality of Cancuc Figure 1.24. Chanal in Relation to Other Highland Chiapas Municipalities Figure 1.25. Data Collection Sites in the Tzeltal Municipality of Chanal Figure 1.26. Oxchuc in Relation to Other Highland Chiapas Municipalities Figure 1.27. Data Collection Sites in the Tzeltal Municipality of Oxchuc Figure 1.28. Tenejapa in Relation to Other Highland Chiapas Municipalities Figure 1.29. Data Collection Sites in the Tzeltal Municipality of Tenejapa Figure 1.30. Most Frequently Reported Medicinal Virtues Figure 1.31. Reports of Warm Medicinal Virtues and Combined Warm and Other Virtues Figure 1.32. Frequency of Report of Medicinal Virtues Other Than Warm or Cold Figure 1.33. Treatment Reports for Plants with Warm Virtue Figure 1.34. Treatment Reports for Plants with Cold Virtue Figure 1.35. Treatment Reports for Plants with Bitter Virtue Figure 1.36. Treatment Reports for Plants with Caustic Virtue Figure 1.37. Treatment Reports for Plants with Astringent Virtue Figure 1.38. Ethnoepidemiological Reports of Highland Maya Health Problems Grouped by Major Ethnomedical Category Figure 1.39. Typical Epidemiological Report of Health Problems for the Highland Maya Region Figure 1.40. Ethnomedical Grouping of the Gastrointestinal Conditions Figure 1.41. Reports of Gastrointestinal Conditions in Ethnoepidemiological Surveys Figure 1.42. Proportion of Medical Use Reports for Species in the Traveling Herbeirium Employed to Treat Gastrointestinal Conditions Figure 1.43. Distribution of Common Names for the Gastrointestinal Conditions

37 40 40 43 44 45 46 49 50 51 61 63 64 65 65 66 67 67 68

68 71 74

75 76

Figure 1.44. Principal Plant Species Used in the Treatment of the Primary Gastrointestinal Conditions Figure 2.1. The Diarrheas Figure 2.2. Regions of the Body Relevant to the Discussion of Pain Associated with the Diarrheas Figure 2.3. Geographic Distribution of Terms for Watery Diarrhea Figure 2.4. Reported Cases of Watery Diarrhea (by Age) Figure 2.5. Demographic Profile of the Ethnoepidemiology Survey Population Figure 2.6. Signs and Symptoms Reported with Cases of Watery Diarrhea (by Sex) Figure 2.7. Treatment Types for Watery Diarrhea Reported in the Ethnoepidemiology Survey Figure 2.8. Geographic Distribution of Terms for Ageratina spp. Figure 2.9. Proportion of Medical Use Reports for Ageratina spp. as a Treatment for Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.10. Variant Folk Classifications of B. serraefolia and B. trinervis Figure 2.11. Geographic Distribution of Terms for Baccharis spp. Figure 2.12. Proportion of Medical Use Reports for Baccharis serraefolia as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.13. Proportion of Medical Use Reports for Baccharis trinervis as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.14. Geographic Distribution of Terms for Lantana spp. Figure 2.15. Proportion of Medical Use Reports for Lantana spp. as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.16. Geographic Distribution of Terms for Verbena spp. Figure 2.17. Proportion of Medical Use Reports for Verbena spp. as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.18. Variant Folk Classifications of Psidium spp. Figure 2.19. Geographic Distribution of Terms for Psidium spp. Figure 2.20. Proportion of Medical Use Reports for Psidium guineense as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.21. Geographic Distribution of Terms for Tagetes filifolia

87 92 93 94 95 96 103

112 116

117

122 123

124

125 130

131 136

137 142 143

144 147

Figure 2.22. Proportion of Medical Use Reports for Tagetes filifolia as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.23. Geographic Distribution of Terms for Helianthemum glomeratum Figure 2.24. Proportion of Medical Use Reports for Helianthemum glomeratum as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.25. Geographic Distribution of Terms for Lepechinia schiedeana (Tzotzil Municipalities Only) Figure 2.26. Proportion of Medical Use Reports for Lepechinia schiedeana as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.27. Geographic Distribution of Terms for Borreria laevis Figure 2.28. Proportion of Medical Use Reports for Borreria laevis as a Treatment for General Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.29. Geographic Distribution of Terms for Mucoid Diarrhea Figure 2.30. Signs and Symptoms Reported with Cases of Mucoid Diarrhea (by Sex) Figure 2.31. Reported Cases of Mucoid Diarrhea (by Age) Figure 2.32. Systematic Relationship between Bloody Diarrhea and Mucoid Diarrhea Figure 2.33. Treatment Types for Mucoid Diarrhea Reported in the Ethnoepidemiology Survey Figure 2.34. Geographic Distribution of Terms for Cissampelos pareira Figure 2.35. Proportion of Medical Use Reports for Cissampelos pareira in the Treatment of Mucoid Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.36. Geographic Distribution of Terms for Lepidium virginicum Figure 2.37. Proportion of Medical Use Reports for Lepidium virginicum in the Treatment of Mucoid Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.38. Geographic Distribution of Terms for Bloody Diarrhea Figure 2.39. Signs and Symptoms Reported with Cases of Bloody Diarrhea (by Sex) Figure 2.40. Treatment Types for Bloody Diarrhea Reported in the Ethnoepidemiology Survey

148 151

152 155

156 159

160 161 167 173 174 178 180

181 185

186 187 195 204

Figure 2.41. Geographic Distribution of Terms for Crataegus pubescens Figure 2.42. Proportion of Medical Use Reports for Crataegus pubescens as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.43. Geographic Distribution of Terms for Calliandra . sPPFigure 2.44. Proportion of Medical Use Reports for Calliandra spp. as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.45. Proportion of Medical Use Reports for Baccharis vaccinioides as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.46. Geographic Distribution of Terms for Acacia angustissima Figure 2.47. Proportion of Medical Use Reports for Acacia angustissima as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.48. Ethnopharmacological Properties of A. angustissima Recognized in the Treatment of Bloody Diarrhea Figure 2.49. Proportion of Medical Use Reports for Rubus coriifolius as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.50. Proportion of Medical Use Reports for Psidium guineense as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.51. Geographic Distribution of Terms for Sonchus oleraceus Figure 2.52. Proportion of Medical Use Reports for Sonchus oleraceus as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.53. Geographic Distribution of Terms for Byrsonima crassifolia Figure 2.54. Proportion of Medical Use Reports for Byrsonima crassifolia as a Treatment for Bloody Diarrhea as Compared with Other Primary Medicinal Uses Figure 2.55. Geographic Distribution of Terms for Droplet Diarrhea Figure 2.56. Frequency of Report of Droplet Diarrhea Figure 2.57. Signs and Symptoms Reported with Cases of Droplet Diairhea Figure 2.58. Treatment Types for Droplet Diarrhea Reported in the Ethnoepidemiology Survey

207

208 213

214

217

220

221 221

225

228 230

231 234

235 237 239 241

Figure 2.59. Geographic Distribution of Terms for Lienteric Diarrhea Figure 2.60. Geographic Distribution of Terms for Vomiting and Diarrhea Figure 2.61. Reported Cases of Vomiting and Diarrhea (by Age) Figure 2.62. Signs and Symptoms Reported with Cases of Vomiting and Diarrhea Figure 2.63. Treatment Types for Vomiting and Diarrhea Reported in the Ethnoepidemiology Survey Figure 2.64. Frequency of Report of Vomiting (by Age) Figure 2.65. Signs and Symptoms Reported with Cases of Vomiting Figure 2.66. Treatment Types for Vomiting Reported in the Ethnoepidemiology Survey Figure 2.67. Geographic Distribution of Terms for Arthrostema ciliatum Figure 2.68. Proportion of Medical Use Reports for Arthrostema ciliatum in the Treatment of Vomiting as Compared with Other Primary Medicinal Uses Figure 3.1. The Abdominal Pains Figure 3.2. Regions of the Body Important in Biomedical Differential Diagnosis of Abdominal Pains Figure 3.3. Geographic Distribution of Terms for Abdominal Pain Figure 3.4. Signs and Symptoms Reported with Cases of Abdominal Pain Figure 3.5. Treatment Types for Abdominal Pain Reported in the Ethnoepidemiology Survey Figure 3.6. Proportion of Medical Use Reports for Nicotiana tabacum in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.7. Proportion of Medical Use Reports for Lantana camara in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.8. Geographic Distribution of Terms for Ocimum selloi Figure 3.9. Proportion of Medical Use Reports for Ocimum selloi in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.10. Geographic Distribution of Terms for Tagetes lucida Figure 3.11. Proportion of Medical Use Reports for Tagetes lucida in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.12. Proportion of Medical Use Reports for Ageratina ligustrina in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses

256 257 261 264 266 269 274 276

277 282 283 284 292 296

300

303 306

307 309

310

Figure 3.13. Geographic Distribution of Terms for Stevia spp. Figure 3.14. Proportion of Medical Use Reports for Stevia ovata in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.15. Proportion of Medical Use Reports for Baccharis vaccinioides in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.16. Geographic Distribution of Terms for Tithonia diversifolia Figure 3.17. Proportion of Medical Use Reports for Tithonia diversifolia in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.18. Geographic Distribution of Terms for Smallanthus maculatus Figure 3.19. Proportion of Medical Use Reports for Smallanthus maculatus in the Treatment of Abdominal Pain as Compared with Other Primary Medicinal Uses Figure 3.20. Geographic Distribution of Terms for Epigastric Pain Figure 3.21. Age-Adjusted Rates of Epigastric Pain Figure 3.22. Signs and Symptoms Reported with Cases of Epigastric Pain Figure 3.23. Treatment Types for Epigastric Pain Reported in the Ethnoepidemiology Survey Figure 3.24. Proportion of Medical Use Reports for Foeniculum vulgare in the Treatment of Epigastric Pain as Compared with Other Primary Medicinal Uses Figure 3.25. Proportion of Medical Use Reports for Tagetes lucida in the Treatment of Epigastric Pain as Compared with Other Primary Medicinal Uses Figure 3.26. Geographic Distribution of Terms for Dahlia spp. Figure 3.27. Proportion of Medical Use Reports for Dahlia imperialis in the Treatment of Epigastric Pain as Compared with Other Primary Medicinal Uses Figure 3.28. Geographic Distribution of Terms for ‘Mother of Man’ Figure 3.29. Signs and Symptoms Reported with Cases of ‘Mother of Man’ (by Sex) Figure 3.30. Location of the M e’ winik = M e’ vinik Organ According to a Maya Explanatory Model Figure 3.31. Massage Treatment for Repositioning of the M e’ winik = M e’ vinik Organ Figure 3.32. Treatment Types for ‘Mother of Man’ Reported in the Ethnoepidemiology Survey

315

316

319 321

322 324

325 326 328 331 334

337

339 341

342 345 350 354 356 360

Figure 3.33. Geographic Distribution of Terms for Lobelia laxiflora (Tzeltal Municipalities Only) Figure 3.34. Proportion of Medical Use Reports for Lobelia laxiflora in the Treatment of ‘Mother of Man’ as Compared with Other Primary Medicinal Uses Figure 3.35. Geographic Distribution of Terms for Fuchsia splendens Figure 3.36. Proportion of Medical Use Reports for Fuchsia splendens in the Treatment of ‘Mother of Man’ as Compared with Other Primary Medicinal Uses Figure 3.37. Geographic Distribution of Terms for Abdominal Distension Figure 3.38. Signs and Symptoms Reported with Cases of Abdominal Distension Figure 3.39. Treatment Types for Abdominal Distension Reported in the Ethnoepidemiology Survey Figure 3.40. Proportion of Medical Use Reports for Allium sativum as an Admixture in Remedies for Abdominal Distension as Compared with Other Primary Medicinal Uses Figure 3.41. Comparison of Garlic-with-Tobacco, Garlic Only, and Garlic with Other Ingredients as Remedies for Abdominal Distension Figure 3.42. Geographic Distribution of Terms for Intestinal Obstruction Figure 3.43. Geographic Distribution of Terms for Micropleura renifolia Figure 3.44. Proportion of Medical Use Reports for Micropleura renifolia as a Treatment for Intestinal Obstruction as Compared with Other Primary Medicinal Uses Figure 4.1. The Worms Figure 4.2. Geographic Distribution of Terms for Regular Worms Figure 4.3. Frequency of Report of Regular Worms (by Age) Figure 4.4. Signs and Symptoms Reported with Cases of Regular Worms Figure 4.5. Treatment Types for Regular Worms Reported in the Ethnoepidemiology Survey Figure 4.6. Geographic Distribution of Terms for Chenopodium ambrosioides Figure 4.7. Proportion of Medical Use Reports for Chenopodium ambrosioides in the Treatment of Regular Worms as Compared with Other Primary Medicinal Uses Figure 4.8. Proportion of Medical Use Reports for Helianthemum glomeratum in the Treatment of Regular Worms as Compared with Other Primary Medicinal Uses

363

364 366

367 368 375 382

385

385 386 398

399 401 402 403 407 412 415

416

419

Figure 4.9. Geographic Distribution of Terms for Flat-Headed Worms Figure 4.10. Geographic Distribution of Terms for Tiny Worms Figure 4.11. Geographic Distribution of Terms for Rectal Prolapse Figure 5.1. Potential Sequential Relationships among the Gastrointestinal Conditions Figure 5.2. Tzeltal Responses of Medicinal Virtues of Plants and Their Associated Primary Gastrointestinal Conditions Figure 5.3. Tzotzil Responses of Medicinal Virtues of Plants and Their Associated Primary Gastrointestinal Conditions

420 428 433 439 452 453

Tables

Table 1.1. Mexican National Census Sites, Localities of Work, and Population of Chalchihuitan Table 1. 2 . Mexican National Census Sites, Localities of Work, and Population of Chamula Table 1.3. Mexican National Census Sites, Localities of Work, and Population of Chenalho Table 1.4. Mexican National Census Sites, Localities of Work, and Population of Huixtan Table 1.5. Mexican National Census Sites, Localities of Work, and Population of Larrainzar Table 1.6. Mexican National Census Sites, Localities of Work, and Population of Mitontic Table 1.7. Mexican National Census Sites, Localities of Work, and Population of Pantelho Table 1.8. Mexican National Census Sites, Localities of Work, and Population of Zinacantan Table 1.9. Mexican National Census Sites, Localities of Work, and Population of Aguacatenango Table 1.10. Mexican National Census Sites, Localities of Work, and Population of Amatenango del Valle Table 1.11. Mexican National Census Sites, Localities of Work, and Population of Cancuc Table 1.12. Mexican National Census Sites, Localities of Work, and Population of Chanal Table 1.13. Mexican National Census Sites, Localities of Work, and Population of Oxchuc Table 1.14. Mexican National Census Sites, Localities of Work, and Population of Tenejapa Table 1.15. Unique Medicinal Virtues in Tzeltal and Tzotzil Table 1.16. Key Signs and Symptoms of the Most Important Diarrheas and Worms Table 1.17. Key Signs and Symptoms of the Gastrointestinal Pains Table 1.18. Example of Evidence Tables Table 1.19. Frequency of Medical Use Responses by Major Category of Health Condition, Tzotzil Traveling Herbarium Table 1.20. Principal Species Employed in the Treatment of Gastrointestinal Disease among the Tzeltal and Tzotzil

10

13 17 21

24 27 29 34 36 38 41 44 46 50 62 77 77 79 82 83

Table 1.21. Proportion of Tzeltal Medical Use Reports for Principal Species Employed in Treatment of Particular Gastrointestinal Diseases Table 1.22. Proportion of Tzotzil Medical Use Reports for Principal Species Employed in Treatment of Particular Gastrointestinal Diseases Table 2.1. Standardization o f Ethnomedical Information on Watery Diarrhea Table 2.2. Comparison of Ethnomedical Description of Watery Diarrhea and Biomedical Clinical Picture Table 2.3. Admixtures to Prescriptions Made with Ageratina spp. as Remedies for General Diarrhea Table 2.4. Admixtures to Prescriptions Made with Baccharis spp. as Remedies for General Diarrhea Table 2.5. Admixtures to Prescriptions Made with Lantana spp. as Remedies for General Diarrhea Table 2.6. Admixtures to Prescriptions Made with Verbena spp. as Remedies for General Diarrhea Table 2.7. Admixtures to Prescriptions Made with Psidium guineense as Remedies for General Diarrhea Table 2.8. Admixtures to Prescriptions Made with Tagetes filifolia as Remedies for General Diarrhea Table 2.9. Admixtures to Prescriptions Made with Helianthemum glomeratum as Remedies for General Diarrhea Table 2.10. Admixtures to Prescriptions Made with Lepechinia schiedeana as Remedies for General Diarrhea Table 2.11. Admixtures to Prescriptions Made with Borreria laevis as Remedies for General Diarrhea Table 2.12. Standardization of Ethnomedical Information on Mucoid Diarrhea Table 2.13. Comparison of Ethnomedical Description of Mucoid Diarrhea and Biomedical Clinical Picture Table 2.14. Admixtures to Prescriptions Made with Cissampelos pareira as Remedies for Mucoid Diarrhea Table 2.15. Admixtures to Prescriptions Made with Lepidium virginicum as Remedies for Muocid Diarrhea Table 2.16. Standardization of Ethnomedical Information on Bloody Diarrhea Table 2.17. Comparison of Ethnomedical Description of Bloody Diarrhea and Biomedical Clinical Picture Table 2.18. Admixtures to Prescriptions Made with Crataegus pubescens as Remedies for Bloody Diarrhea

85

86 97 105 118 126 132 138 145 148 153 156 161 163 172

182 186 188 197 209

Table 2.19. Admixtures to Prescriptions Made with Calliandra spp. as Remedies for Bloody Diarrhea Table 2.20. Admixtures to Prescriptions Made with Bdccharis vaccinioides as Remedies for Bloody Diarrhea Table 2.21. Admixtures to Prescriptions Made with Acacia angustissima as Remedies for Bloody Diarrhea Table 2.22. Admixtures to Prescriptions Made with Rubus coriifolius as Remedies for Bloody Diarrhea Table 2.23. Admixtures to Prescriptions Made with Psidium guineense as Remedies for Bloody Diarrhea Table 2.24. Admixtures to Prescriptions Made with Sonchus oleraceus as Remedies for Bloody Diarrhrea Table 2.25. Admixtures to Prescriptions Made with Byrsonima crassifolia as Remedies for Bloody Diarrhea Table 2.26. Standardization of Ethnomedical Information on Droplet Diarrhea Table 2.27. Comparison of Ethnomedical Description of Droplet Diarrhea and Biomedical Clinical Picture Table 2.28. Admixtures to Prescriptions Made as Remedies for Droplet Diarrhea Table 2.29. Standardization of Ethnomedical Information on Lienteric Diarrhea Table 2.30. Comparison of Ethnomedical Description of Lienteric Diarrhea and Biomedical Clinical Picture Table 2.31. Standardization of Ethnomedical Information on Vomiting and Diarrhea Table 2.32. Comparison of Ethnomedical and Biomedical Description of Vomiting and Diarrhea Table 2.33. Standardization of Ethnomedical Information on Vomiting Table 2.34. Admixtures to Prescriptions Made with Arthrostema ciliatum as Remedies for Vomiting Table 3.1. Biomedical Anatomical Terms Table 3.2. Standardization of Ethnomedical Information on Abdominal Pain Table 3.3. Organs and Probable Manifestations in Cases of Abdominal Pain Table 3.4. Admixtures to Prescriptions Made with Nicotiana tabacum as Remedies for Abdominal Pain Table 3.5. Admixtures to Prescriptions Made with Lantana camara as Remedies for Abdominal Pain Table 3.6. Admixtures to Prescriptions Made with Ocimum selloi as Remedies for Abdominal Pain

218

222 226 228 231 236 238 245 248 251 254 258 263 266 278 283 285 293 301 303

Table 3.7. Admixtures to Prescriptions Made with Tagetes lucida as Remedies for Abdominal Pain Table 3.8. Admixtures to Prescriptions Made with Ageratina ligustrina as Remedies for Abdominal Pain Table 3.9. Admixtures to Prescriptions Made with Stevia ovata as Remedies for Abdominal Pain Table 3.10. Admixtures to Prescriptions Made with Baccharis vaccinioides as Remedies for Abdominal Pain Table 3.11. Admixtures to Prescriptions Made with Tithonia diversifolia as Remedies for Abdominal Pain Table 3.12. Admixtures to Prescriptions Made with Smallanthus maculatus as Remedies for Abdominal Pain Table 3.13. Standardization of Ethnomedical Information on Epigastric Pain Table 3.14. Admixtures to Prescriptions Made with Dahlia imperialis, Foeniculum vulgare, and Tagetes lucida as Remedies for Epigastric Pain Table 3.15. Standardization of Ethnomedical Information on ‘Mother of M an’ Table 3.16. Comparison of Ethnomedical and Biomedical Signs and Symptoms Table 3.17. Admixtures to Prescriptions Made with Lobelia laxiflora and Fuchsia splendens as Remedies for ‘Mother of Man’ Table 3.18. Standardization of Ethnomedical Information on Abdominal Distension Table 3.19. Standardization of Ethnomedical Information on Intestinal Obstruction Table 4.1. Standardization of Ethnomedical Information on Regular Worms Table 4.2. Admixtures to Prescriptions Made with Chenopodium ambrosioides as Remedies for Worms Table 4.3. Admixtures to Prescriptions Made with Helianthemum glomeratum as Remedies for Worms Table 4.4. Standardization of Ethnomedical Information on FlatHeaded Worms Table 4.5. Standardization of Ethnomedical Information on Tiny Worms Table 4.6. Standardization of Ethnomedical Information on Rectal Prolapse Table 5.1. General Signs and Symptoms of Gastrointestinal Conditions in Maya Ethnomedicine Table 5.2. Principal Signs and Symptoms of the Diarrheas

313 317 319 322 325 327

343 346 355

367 369 387 403 417 420 421 428 433 440 441

Table 5.3. Principal Signs and Symptoms Associated with the Abdominal Pains Table 5.4. Principal Signs and Symptoms of Worms Table 5.5. Principal Species Used to Treat Gastrointestinal Conditions among the Highland M aya of Chiapas, Mexico Table 5.6. A Tzeltal Basic Medicine Kit of Medicinal Plants for the Treatment o f the Major Gastrointestinal Conditions Table 5.7. A Tzotzil Basic Medicine Kit of Medicinal Plants for the Treatment o f the M ajor Gastrointestinal Conditions Table 5.8. Species Occurring as Admixtures with Principal Plants Used in the Treatment of Gastrointestinal Conditions

443 445 446 447 448 451

Plates

of plant specimens were drawn to life-size on a scale of 1:1. As reproduced in this book, each plate has been reduced to. 60 percent, with the exceptions of numbers 10, 12, 25, 26, 27, 35, and 44, which are at 55 percent, and number 38, which is at 50 percent of the original size.

A ll illu s tra tio n s

ALPHABETICAL ARRANGEMENT Acacia angustissima

Plate 21

219

Ageratina ligustrina

Plate I Plate 31

114 312

Ageratina pringlei

Plate 2

115

Allium sativum

Plate 41

383

Arthrostema ciliatum

Plate 26

275

Baccharis serraefolia

Plate 3

119

Baccharis trinervis

Plate 4

120

Baccharis vaccinioides

Plate 20 Plate 33

216 318

Borreria laevis

Plate 14

157

Byrsonima crassifolia

Plate 25

233

Calliandra houstoniana

Plate 18

210

Calliandra grandiflora

Plate 19

211

Chenopodium ambrosioides

Plate 43

414

Cissampelos pareira

Plate 15

179

Crataegus pubescens Plate 17 Dahlia imperialis Plate 38 Foeniculum vulgare Plate 36 Fuchsia splendens Plate 40 Helianthemum glomeratum Plate 12 Plate 44 Lantana camara Plate 28 Plate 5 Lantana hispida Plate 6 Lepechinia schiedeana Plate 13 Lepidium virginicum Plate 16 Lobelia laxiflora Plate 39 Micropleura renifolia Plate 42 Nicotiana tabacum Plate 27 Ocimum selloi Plate 29 Psidium guajava Plate 10 Psidium guineense Plate 9 Plate 23 Rubus coriifolius Plate 22 Smallanthus maculatus Plate 35 Sonchus oleraceus Plate 24 Stevia ovata Plate 32 Tagetes filifolia Plate 11

206 340 336 365 150 418 302 127 128 154 184 362 397 298 305 141 140 227 224 323 229 314 146

LIST OF PLATES

XXV

Tagetes Lucida Plate 30 Plate 37 Tithonia diversifolia Plate 34 Verbena caroLina Plate 7 Verbena litoralis Plate 8

308 338 320

134 135

NUMERICAL ARRANGEMENT

Plate 1. Ageratina ligustrina Plate 2. Ageratina pringLei Plate 3. Baccharis serraefolia Plate 4. Baccharis trinervis Plate 5. Lantana camara Plate 6. Lantana hispida Plate 7. Verbena caroLina Plate 8. Verbena litoralis Plate 9. Psidium guineense Plate 10. Psidium guajava Plate 11. Tagetes filifolia Plate 12. Helianthemum glomera tum Plate 13. Lepechinia schiedeana Plate 14. Borreria laevis Plate 15. Cissampelos pareira Plate 16. Lepidium virginicum Plate 17. Crataegus pubescens Plate 18. Calliandra houstoniana Plate 19. Calliandra grandiflora Plate 20. Baccharis vaccinioides Plate 21. Acacia angustissima Plate 22. Rubus coriifolius Plate 23. Psidium guineense Plate 24. Sonchus oLe race us Plate 25. Byrsonima crassifolia Plate 26. Arthrostema ciliatum Plate 27. Nicotiana tabacum Plate 28. Lantana camara Plate 29. Ocimum selloi Plate 30. Tagetes Lucida

114 115 119 120 127 128 134 135 140 141 146 150 154 157 179 184 206 210

211 216 219 224

227 229 233 275 298 302 305 308

Plate Plate Plate Plate Plate Plate Plate Plate Plate Plate Plate Plate Plate Plate

31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44.

Ageratina ligustrina Stevia ovata Baccharis vaccinioides Tithonia diversifolia Smallanthus maculatus Foeniculum vulgare Tagetes lucida Dahlia imperialis Lobelia laxiflora Fuchsia splendens Allium sativum Micropleura renifolia Chenopodium ambrosioides Helianthemum glomeratum

312 314 318 320 323 336 338 340 362 365 383 397 414 418

Preface I n t h i s b o o k , we document the scientific bases of highland Maya ethnomedicine. It is our hope that the findings presented here will serve as a useful balance to much of the anthropological literature on sickness and death, and especially that literature dealing with the Maya, which has tended to focus primarily on the social/religious function and symbolic significance of health/life crises. We do not deny the importance of these cosmological aspects of ethnomedicine; we do believe that to emphasize them, often to the exclusion of the more mundane aspects of sickness and health, presents a romanticized and surely incomplete picture of a people’s understanding of traditional medicine. Furthermore, ethnographic descriptions of healers’ ex­ otic prayers and incantations, to the exclusion of their equally interesting statements attesting to their detailed understanding of human anatomy, phys­ iology, and medical botany, diminishes an appreciation of the ethnoscientific knowledge of peoples in traditional societies. While an account of the em­ pirical underpinnings of the Maya ethnomedical system may lack the exotic shock appeal that interpretivist ethnographers aim for in their roles as Geertz’s “merchants of astonishment,” we believe that many readers will find the remarkable intellectual comprehension and pragmatic problem-solv­ ing ethnomedical accomplishments of the Maya to be worthy of interest— and considerable admiration. The work reported here represents the results of the sustained support and collaborative efforts of many people and institutions. First and foremost, we wish to acknowledge the cooperation that we have enjoyed from the scores of highland Maya who have worked with us from the outset of our research in 1987. We are especially grateful for the contributions of our highly quali­ fied Maya research assistants who have carried out the major part of the data collection on which our analysis rests. These individuals have spent many hours walking the trails of the rural communities of the highlands, conduct­ ing medical ethnobiological and ethnoepidemiological surveys, collecting medicinal plants for ethnobotanical and ethnopharmacological analysis, and, recently, entering much of their data in the computer databases on which the description presented here is derived. From Tzeltal-speaking municipalities, these individuals include Feliciano Gomez Santis (Oxchuc), Alonso Mendez Giron (Tenejapa), Esteban Santiz Cmz (Cancuc), Pedro Hernandez Guzman (Tenejepa), Juliana Lopez Perez (Amatenango del Valle), Martin Gdmez Lopez (Amatenango del Valle), Magdalena Giron Lopez (Tenejapa), and Juan Gomez Mendez (Chanal). Our major research collaborators from Tzotzil-speaking municipalities include Carmelino Santiz Ruiz (Chamula), Rosa Perez Perez (Chenalho),

Antonio Ruiz Hernandez (Chenalho), Lorenzo Gonzalez Gonzalez (Larrainzar), Marcos Perez Gomez (Chalchihuitan), Eleuterio Perez Lopez (Chalchihuitan), Bartolo Hidalgo Vasquez (Venustiano Carranza), Manuel Lo­ pez Hernandez (Zinacantan), Mariano Sanchez Perez (Zinacantan), and Lazaro Diaz Madrid (Zinacantan). The botanical illustrations for this work have been prepared by Nicolas Hernandez Ruiz of Larrainzar. In addition to his fine drawings, a small number of illustrations, including the one on the title page, were produced by Antonio Lopez Hernandez of Tenejapa. Technical curatorial assistance in our Ethnobotanical Herbarium of Chiapas has been provided by Domingo Sdnchez Hernandez of Zinacantan. We also wish to thank the political authorities of the Maya communities in which our research has been carried out. Municipal presidents in each of the fourteen Maya municipalities where we have studied have facilitated our daily work by providing us with their official permission to conduct our surveys and have supported us in all phases of the research. Literally hun­ dreds of Tzeltal and Tzotzil community members have also given of their time and expertise to help us in this joint endeavor. To all of these highland Maya go our deepest gratitude. Funding for this research has been generously provided by the National Science Foundation (NSF); the U.S. Agency for International Development (USAID) under grants BNS 87-03838 and BNS 90-03673; the Government of the State of Chiapas, through the kind support of former state governor, Lie. Patrocinio Gonzalez Garrido; the current governor of the state of Chi­ apas, Lie. Javier Lopez Moreno; the University of California Consortium on Mexico and the United States (UC MEXUS); the Ecological Research Cen­ ter of the Southeast (CIES); and the University of California at Berkeley’s Center for Latin American Studies. This support is gratefully acknowledged. We especially wish to acknowledge Dr. Stewart Plattner, Director of the Cultural Anthropology Program at NSF, and Dr. Arturo Gomez Pompa, for­ mer Director of UC MEXUS and recently advisor on the Mexican Tropics to Mexican President Carlos Salinas de Gotari, for their efforts on our behalf. Our studies have been conducted under collaborative agreements with the Chiapas State Department of Public Health (SSA), the State Autonomous University of Chiapas (UNACH), the Chiapas Institute of Culture (IChC), and the Chiapas Institute of Natural History (IHN). To Dr. Antonio Garcia Sanchez, former state Director of the Chiapas Public Health Department, former Rector of the University of Chiapas, and current Federal Representa­ tive from Tuxtla Gutierrez; Dr. Andres Fabregas, Director of the Chiapas Institute of Culture; and Professor Miguel Alvarez del Toro, founder and Director of the Chiapas Institute of Natural History, we extend our profound thanks. We also are grateful for the initial encouragement we received from Maestro Ramon Perez Gil, who, as Subdirector of IHN, was instrumental in establishing our research agreement with the institute.

We owe a special debt of gratitude to Dr. Pablo Fanas Campero, Director General of the Ecological Research Center of the Southeast (Centro de Investigaciones Ecologicas del Sureste, CIES), who has provided financial as well as infrastructure support for our project since 1993. Through Dr. Farias’s efforts, we have been able to establish permanent quarters for the Ethnobotanical Herbarium of Chiapas (HECH) and have developed new projects of collaboration with CIES colleagues working in the areas of bio­ diversity, agroecology, sustained economic development, and health and so­ cial change among the indigenous peoples of Chiapas. Ignacio March of CIES has kindly provided GIS expertise in the production of the maps of the highland Maya municipalities discussed here. Finally, we sincerely appreciate the detailed editorial comments of Dr. Carol Browner and Dr. Susan Weller, both of whom read with critical detail an earlier version of the manuscript and who helped us in making important changes leading to what we hope is a clearer presentation of our research results. Our editor and friend, William E. Woodcock III, has with characished manuscript in spite of numerous setbacks and time delays. Special thanks are extended to our production editor, Beth Gianfagna, and to our indexer, Len Neufeld, for a fine job on this very complex indexing task. AU of the above-mentioned individuals have contributed substantially to the vtork that we present in this monograph on Maya ethnomedicine. It is our hope that the collaborative efforts documented here will be seen as a written monument to Maya medical ethnobiological science, leading present and future generations to more fully appreciate the remarkable knowledge and understanding embodied in Maya culture, not in some distant past, but alive and sound as we bridge the distance between the twentieth and twentyfirst centuries.

NOTE ON ORTHOGRAPHY A practical orthography for Mayan words and expressions has been em­ ployed throughout this work. Consonants and vowels are pronounced ap­ proximately as they would be in Spanish. Sounds unfamiliar to both speakers of English and Spanish include the glottalized consonants (p’, t’, k’, ch’, and tz’). These phonemes are pronounced as their nonglottalized equivalents, with the addition of a rapid, explosive “click” or “pop” as the consonant is released. The Maya glottal stop, indicated by a single apostro­ phe (’), is pronounced in a way similar to that of the glottal catch separating the vowels in the English expletives uh-uh or oh-oh, or as in the pronuncia­ tion of ‘bottle’ [bah’l] in certain dialects of Boston English. Athens, Georgia 13 July 1994

Contributors

MEDICAL ANTHROPOLOGY

Elois Ann Berlin, The University of Georgia and El Colegio de la Frontera Sur MEDICAL ETHNOBOTANY

Brent Berlin, The University of Georgia and El Colegio de la Frontera Sur PHARMACOLOGY

Xavier Lozoya, Instituto Mexicano de Seguro Social Mariana Meckes, Instituto Mexicano de Seguro Social Jaime Tortoriello, Instituto Mexicano de Seguro Social Maria-Luisa Villarreal, Institute Mexicano de Seguro Social BOTANY

Dennis E. Breedlove, California Academy of Sciences Maria de Guadalupe Rodriguez, El Colegio de la Frontera Sur MEDICINE

Jorge R. Ricdrdez, Servicios Coordinados de Salud LINGUISTICS AND ANTHROPOLOGY

Robert M. Laughlin, Smithsonian Institution Luisa Maffi, University of California, Berkeley Dorothy Castille, Idaho State University PRINCIPAL BOTANICAL ILLUSTRATOR

Nicolds Herndndez Ruiz, El Colegio de la Frontera Sur CURATOR, ETHNOBOTANICAL HERBARIUM OF CHIAPAS

Domingo Sdnchez Herndndez, EI Colegio de la Frontera Sur

xxxii

CONTRIBUTORS

PRINCIPAL FIELD INVESTIGATORS

Feliciano Santis Gomez, Oxchuc Antonio Ru{z Hernandez, Chenalh6 Pedro Hernandez Guzman, Tenejapa Magdalena Giron Lopez, Tenejapa Rosa Perez Perez, Chenalh6 Carmelino Santis Ru{z, Chamula JUNIOR BOTANICAL ILLUSTRATOR

Antonio Lopez Hernandez, Tenejapa

MEDICAL ETHNOBIOLOGY OF THE

HIGHLAND MAYA OF CHIAPAS, MEXICO

CHAPTER I

Introduction

MAYA ETHNOMEDICINE AS SCIENCE E . A . B ER LIN A N D B . B ER LIN

over the past several decades in the emerging field of ethnobiology, and research in medical ethnobotany in particular, has demonstrated that ethnobiological knowledge of traditional peoples conforms in many respects to basic scientific principles (Berlin 1973, Berlin 1978, Berlin 1992, Berlin and Patton 1979, Berlin, Breedlove, and Raven 1974, Raven, Berlin, and Breedlove 1971, Quiros et al. 1990, Toledo 1988) and that recognition of the curative properties of medicinal plants is not simply unsubstantiated folklore. Since the late 1970s traditional herbal medicine has been given major emphasis by the World Health Organization, the United Nations Edu­ cational, Scientific, and Cultural Organization (UNESCO), and other inter­ national bodies (see, for example, UNCTAD/GATT 1974, NAS 1975, WHO 1979, Khan 1978a, WHO 1978b, UNIDO 1978, Attisso 1977, WHO 1978a, UNESCO 1978). Furthermore, a number of botanists, ethnobiologists, and pharmacologists have argued persuasively that new pharmaceuticals are most likely to be found in native pharmacopoeias (Chadwick and Marsh 1994, Schultes 1984, Sofowara 1982, Elizabetsky 1986, Farnsworth and Pezzuto 1983). In this volume on the medical ethnobiology of the Tzeltal and Tzotzil Indians, two Maya-speaking peoples who reside in the highlands of Chiapas, Mexico, we present evidence that confirms the scientific bases of traditional medicine. Our data show that the highland Maya have developed a large number of herbal remedies based on an astute understanding of the signs and symptoms of common disease conditions. Furthermore, the potential thera­ peutic efficacy of Maya herbal medicine is suggested by laboratory studies on the pharmacological properties affecting the agents associated with the ethnomedically identified clinical signs and symptoms that correlate closely with biomolecular medical disease categories. This volume on the Maya gastrointestinal conditions presents data from the interdependent perspectives of biocultural medical anthropology, medi­ cal ethnobotany, and pharmacology. It provides (I) an ethnomedical charac­ terization o f major gastrointestinal conditions recognized by the highland Maya; (2) a medical ethnobotanical description o f the most significant meW ork

4

CHAPTER 1

dicinal plant species used as herbal remedies for these recognized health conditions; and (3) the initial results of laboratory studies and literature surveys on the pharmacological efficacy of these herbal remedies. RESEARCH SETTING E. A. BERLIN AND D. CASTILLE

The data we present in this monograph represent part of the results of a binational, multidisciplinary research program carried out among the highland Maya during the period 1987-91. The work reported here is based on comparative research carried out in the principal Tzeltal and Tzotzil municipalities of the central Chiapas highlands (see Figure 1.1).

, ~

~\

TZOTZIL

Larrainzar ..........

...., •....-

_.....-

•._ ..L......_•••••. )

" ....,..-

v--

>-_./ ".

'( Zin.:anl,

m m

h 0

5

10

15 20 25

30 35 40 45

50 55

60

Frequency of Treatment Report (%)

N = 16 13

Figure 1.35. Treatment Reports for Plants with Bitter Virtue spasmolytic properties that have been so strongly associated with these species in our pharmacological studies (see below). This would affect not only gastrointestinal motility, but also probably alleviate respiratory symptoms through relaxation of constricted respiratory passages and reduction of paroxysmal cough response. As seen in Figure 1.36, caustic virtue is used primarily to treat rashes (such as scabies), warts, pimples, and some cutaneous fungal infections. The only gastrointestinal conditions treated with caustic virtue therapy are worms. Caustic substances are applied to teeth especially for the purpose of eating out the decay. Gastrointestinal diseases are said to damage the surface of the intestinal lining. Astringent virtue therapy promotes healing of this tissue as well as that of the eyes, respiratory tract, and mouth (see Figure 1.37). The aim is not to treat the infection but to restore tissue damaged during the infectious process. The gloss 'dental' in this and the preceding tables refers to conditions of the mouth and teeth. In this instance, soft tissues of the mouth are indicated. The complexity of the Maya system we present here, along with the gradual extension of the numbers and kinds of healing qualities reported in the literature,S lead us to conclude there is much more to be done in reaching a complete understanding of the ethnopharmaceutical principles employed by indigenous healers. Nonetheless, analysis of our data of responses to the question "Why does plant x have the power to heal?" leads to the following preliminary observations: • All medicinal plants are thought to have intrinsic properties that make them capable of healing. • The virtue of a medicinal plant is recognized by its organoleptic and symptomolytic qualities. Organoleptic qualities are recognized directly by the sense organs (e.g., taste, smell) and reactions of the skin to the plant. Symp-

INTRODUCTION

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