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Traditional Iberian folk medicine in dermatology
Traditional Iberian Folk Medicine in Dermatology MANUEL AMEZCUA, RN
T
he consideration of folk medicine places us in a hazy domain where meanings are clouded by interests and assumptions which are often at odds with one another. This article on folk medicine in the Iberian Peninsula reveals that while there is no doubt of the vitality of the practice and the relevance of the concept, its content and function depend on the context in which it is used. Folk medicine is at once a body of practice and study. Those who practice and benefit from it in Spain also call it household or domestic medicine. In the past it gave rise to a number of written treatises which were highly diffused among popular sectors, whence its common designation medicina de pobres (of the poor) or medicina vulgar. Folk medicine today continues to be defined in contradistinction to an official system of medical knowledge, as a form which draws on both empirical principles of this official system and on magic and religious knowledge. Those who have approached folk medicine as an object of study did so, at first, with a view toward collecting data on popular practices and beliefs about health and illness (folk medicine), emphasizing the cultural values which shape these (ethnomedicine); later and more recently their investigations have also served to legitimize folk medicine as a distinct branch of medical anthropology. The purpose of this article is to review and summarize the status of research on folk medicine in the Iberian Peninsula. In the first part we suggest some key features of the relationship between folk and academic medicine and trace the history of the study of Iberian folk medicine. In the second section, we focus on skin, a subject of paramount interest and indeed specialization within Iberian folk medicine, and provide a summary of some of the most relevant and representative investigations of this subject for various regions of Spain and Portugal.
Folk Medicine as Object of Investigation The concept of folk medicine has traditionally been opposed to that of academic/professional medicine, From the Laboratory of Cultural Anthropology, University of Granada, Granada, Spain. Address correspondence to Manuel Amezcua, Apartado de Correos, nr. 734, 18080 Granada, Spain. © 1999 by Elsevier Science Inc. All rights reserved. 655 Avenue of the Americas, New York, NY 10010
limiting it to those ideas and medical practices with magical, religious, and natural (empirical) bases.1 According to Martinez-Herna´ez et al., it is a concept developed in the context of Western medicine which was subsequently borrowed by anthropology.2 Thus it was an Italian folklorist, Guiseppe Pitre, who first invented the epistemological concept in the late 19th century; prior to this time popular medical wisdom had generally been considered part of the quack heterodoxy which lay well outside the bounds of science, as superstitious falsehood indistinguishable from quackery itself. Although the concept is some 100 years old, folk medicine is still difficult to define. In Spanish, folkmedicina, folklore me´dico, and medicina tradicional are the terms scholars use to refer to a partial system which is framed between medicine and popular culture, knowledge of which is transmitted orally. Their meaning is distinct from that of medicina primitiva, which refers to non-Western native medical systems, and from that of Etnomedicina, which alludes both to a discipline and its object of research referred to any medical system, be it rural or urban3, folk or official.4
“Tesoro de Pobres” The fact that folk medicine has not been the object of systematic study until recently has precluded neither its use in the community nor its status as a body of knowledge communicated orally and via the written word. In the Iberian Peninsula, abundant texts generated over centuries by practitioners and their detractors constitute a veritable treasure for contemporary scholars. The source for the many descriptive texts about diverse dimensions of health, diseases, and their therapies is a particular type of medieval divulgative literature which provided collections of empirical knowledge for the use of common people who had no access to professional medicine. An early example of such treatises on domestic medicine is Menor dan˜o de la medicina, by Alonso Chirino (1429), one of the doctors of Juan II of Castile. This “regimiento de sanidad” (health regimen), written in the Romance style, pretends to heal diseases without medical care.5 Chirino’s work was followed by other treatises, written by both doctors and laymen, which were widely propagated and which shaped the style of the “medi0738-081X/99/$–see front matter PII S0738-081X(98)00066-2
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cine of the poor.” Tesoro de los pobres (1519) by Pedro Hispano, Tratado breve de medicina y de todas las enfermedades (1579) by Fray Agustin Farfa´n, Tesoro de medicinas (1672) by Gregorio Lo´pez, Medicina y cirugı´a racional y espargı´rica (1674) by the priest Juan Vido´s y Miro´ and the work which responds to it, Medicina dome´stica, necesaria a los pobres y familiar a los ricos (1686) by a Dr. Felipe Borbo´n—these, among others, were books of great popularity. Juan Sorapa´n de Rieros’ Medicina espan˜ola (1616), a compendium of proverbs, is worth special mention for many editions were made of it, proof of the high popular esteem in which it was held. Medicina espan˜ola constitutes a true Treatise of Dietetics.6 At another extreme of folk medicine we can situate the heterodox wisdom which gave birth to some manuals like Libro del aojamiento (evil eye treatment) o fascinologia (in a letter of 1411), by Enrique de Villena. This and other astrological and magic books were viewed as superstitious and were consequently vilified by men of the church like friar Martı´n de Castan˜eda (Tratado de las supersticiones y hechicerias, 1529), Pedro Ciruelo (Reprobacion de las supersticiones y hechicerias, 1529), and Gaspar Navarro (Tribunal de la supersticio´n ladina, 1631). These latter, repressive books gave rise to a new genre of literature which not only shunned “superstition” but also the very people and body of knowledge which gave rise to it. In short, information about popular medicine appears condensed in both prescriptive books and the writings which proscribed them. Due to their clear evolution and diversity, these are indispensable ethnographic sources. Moreover, a further genre of relevant scientific literature, known as topografı´as me´dicas, appeared during the Enlightenment. These belong to the intellectual tradition of hygenism and they provide holistic descriptions of the relationship between environment and illness; of particular interest for our purposes are references to conflict between official and domestic medicine and their practitioners, conflict which hinged on the notion of medical faults.7
Studies and Students The German anthropologist Ingrid Kuschick points out that at the time she began studying Spanish ethnomedicine (in the late 1970s), she was the first foreign scholar to contribute to the subject.1 This situation had already been noted by Padujas and his colleagues when they introduced their bibliography of Spanish Medical Anthropology in 1980. Here, they also regret that the subject had been consistently overlooked by university disciplines.8 Until very recently, then, Spanish folk medicine has received attention only from Spanish folklorists. Their work in Spain dates from the late 19th century translation of William George Black’s Medicina Popular, un capı´tulo en la historia de la cultura (1888 and ´ l1889) by the famous scholar, Antonio Machado y A
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varez (“Demo´filo”), who introduced the British folklore trend to Spain. Among the studies promptly spawned by Machado’s translation are Olavarrı´a Huarte’s article, “Superticiones espan˜olas y medicina popular” (included in the second Spanish edition of Black’s work in 1889), Dr. Manresa Olaguer Miro i Borras’ Aforı´stica me´dica catalana, confrontada ab la de altres llengues (1900) and, for Portugal, Castro Pires de Lima’s remarkable labor, Arquivio de medicina popular. Perhaps the most outstanding work is that of Salillas, who discusses the diffusion of conceptions of disease on a national level in his La fascinacio´n en Espan˜a. Brujas, brujerı´as, amuletos (1905). In the 1940s a new approach to folk medicine— one which is still in vigor today—was introduced by a new breed of scholars known as medical folklorists. With no pretensions but detailed ethnographic documentation, they focused on the collection of household remedies. I describe some of these nuevos recetarios (new prescriptions) in the second part of this article where representative works on dermatological practices are reviewed. Among the early Spanish medical folklore contributions is the immense, but scattered, corpus of Antonio Castillo de Lucas, Assistant Professor of Medical Hidrology at San Carlos University in Madrid. He focused on proverbs and sayings, characterizing them as “condensations of experience and knowledge,” and attempted to link them with certain elements of Hipocratic and Galenic medicine. The validity of these efforts are discussed by Kuschick.1 Pujadas and colleagues made an index of Castillo de Lucas’ work, coming up with more than 100 titles8, which may be further supplemented with titles such as those cited by Caballero Venzala´.9 Other pioneers in medical folklore include Victor Lis Quiben, who describes quack doctors in both rural and urban contexts in his work on Galician folk medicine8, Gallardo de Alvarez for Extremadura, and Barriola for the Basque country.10 The publication of the prominent anthropologist Carmelo Liso´n Tolosana’s Brujeria, estructura social y simbolismo en Galicia (1979) marked the beginning of ethnomedical studies in Spain and turned folk medicine into a topic of interest for anthropologists. A year later Kenny (who, prompted by the American anthropologist George Foster, published one of the first articles on ethnomedicine) and de Miguel summarized the researches to date in ethnomedicine and the sociology of medicine for Spain.11 By this time there was a seminary of folk medicine in the bosom of the Madrid Anthropological Association, but not until 1982 and under the auspices of Catalan medical or anthropological organizations were the significant contributions that anthropologists could bring to the study of practices and systems of representations involving health and illness first formally recognized and explored.12 Recently, the
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Laboratory of Anthropology of the University of Granada has organized a series of works on quackery in Eastern Andalucia. Some of these papers were presented at the international colloquium, “Creer y curar: la medicina popular,” celebrated in Granada in 199413; others appeared in the monographic edition of Demo´filo entitled Enfermedad y muerte en Andalucia.14 Once again it seems worth stressing the quality of Kuschick’s work, as hers was the first general attempt to approach folk medicine in Spain based on abundant and detailed published material. Comparing various regions of Spain and neighboring countries such as Portugal and France, the author emphasizes the diversity of interpretations of concepts and therapies which fall outside the domain of orthodox medicine. She also examines the historic layering of some popular medical practices such as the animism and worship of natural elements characteristic of the Ligurian, Iberian, Celtic, and Germanic peoples; the doctrine of humors promulgated in Iberia by Greek and Arab medicine; and the worship of saints introduced via Christain symbolism.1
The Popular and the Medical The relationship between folk and academic medicine has always been marked by conflicts turning on concepts of competence and complementarity. That doctors and practitioners of folk medicine, mostly specialists and healers, have always been in conflict has been manifested in endless polemics about the rationality of folk practices and debates over competence which often end up in court. It is known that the positivistic attitudes of some theologians and doctors lead them to classify some popular certitudes as superstitions or medical fallacy. Such intransigent attitudes are refuted by the practitioners of folk medicine, who combat them dialectically through continuous debates in the media.15 However the great debate over competence is limited to practitioners: the users of both systems seem little influenced by it, convinced that they are separate and complementary systems. Thus they may turn to them alternately for specific ills, or simultaneously for the same illness.16,17 The intransigence of the establishment against popular healing practices has repeatedly resulted in trials against those who profess to practice them publicly. The repressive attitude of the Inquisition against witches and sorcerers is well known, although in Spain—as opposed to the rest of Europe—these trials involved some consideration of the rational component of such practices, so that punishments here were somewhat less harsh than elsewhere.18 The institution of the Protomedicato, introduced in Spain under Ferdinand and Isabel (late 15th century), regulated the practice of medicine and its assistant disciplines and combatted intrusions such as quackery. Due to historic ambiguities in this system, certain types of folk medicine were occa-
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sionally incorporated into the regulations, for example the practices of ensalmadores, spice and herb merchants.19 And over the centuries other practices typical from charlatanes have become legitimate specializations within the official medical system; thus the exercise of the old sacamuelas (molar puller) now belongs to the domain of odontology and must be considered its historical antecedent, and traditional midwives have now disappeared in favor of a new profile of matrons with university education. The justice system continues to prosecute those who encroach upon official medicine, from swindlers and quacks to doctors who carry out unconventional therapies. There have also been transfers of knowledge between academic and folk medicine. Eduardo L. Mene´ndez argues that although biomedicine is characterized by a continuous process of expansion, popular knowledge changes through a continuous process of modification whereby concepts and practices of diverse sorts of knowledge, including biomedical knowledge, are synthesized and incorporated.20 For instance, sanitary education and its attendant concepts relating to “self care” are now popular practices which used to be exclusive to professional sanitary workers. Even many medicines which were formerly subject to prescription are now freely available over the counter. Meanwhile, and in light of new holistic and ecological perspectives, many professionals are looking back to traditional procedures and incorporating some of them in new medical specializations. As their efficacy is demonstrated such practices find their place in the academic context.
Skin and Its Care from the Perspective of Folk Medicine As in orthodox medicine, a classificatory system of disease determines which ailments are important and treatable in folk medicine. This system pays relatively special attention to factors such as the timing of illness, the intensity of malaise (especially that of pain), and the likelihood that the ailment portends disease. For this last reason, everything pertaining to human skin (cuero or pellejo in archaic terms) is worthy of special attention: not only do such afflictions alter people’s appearance, being more evident than interior ones, but some color or skin texture changes are viewed as signs of a general imbalance of the organism which will cause disease. Accordingly, there is an enormous variety of popular practices concerning dermatology, and in some parts of the Iberian Peninsula there are many specialists in this field.21 Becon˜a has even surveyed the advices of different popular specialists on skin disease, recording the distribution of different classes of remedies around Spain.22 Certain skin ailments, such as warts, culebrillas (herpes zoster), isipula or disipula (jaundice), and certain
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inner conditions which manifest symptoms in the skin, such as tericia have been relegated almost exclusively to folk medicine. Most skin diseases are treated at home with a wide knowledge of household remedies and a set of beliefs which mix magic formulae and popular religious symbols. Popular dermatology employs the entire realm of therapeutic folk knowledge, as Erkoreca demonstrates in his classification of remedies common in the Basque country23: Y The fluids and substances of the patient’s organism, such as saliva for cutting hemorrhages or for treating hemorrhoids; urine for cleaning wounds or for treating bites; menstrual discharge for warts, etc. Y Foods, such as hot and cold water used for chilblains; salted water for corns; oil for burns; the lamp oil of a special church for dermatitis; fresh cream used as a cosmetic and for treating cutis diseases; bread with vinager for warts, etc. Y Domestic products, such as soap is used for corns, bleach for hemorrhoids; snow with oil for burns; gas-oil for crab louses, etc. Y Animals and their derivatives, such as snails are used for varicose veins; louses for jaundice; slung, fresh meat or bacon skin for warts; leeches for hematomas; cobwebs for hemorrhages; or ointment made with lard and cow kidney fat. Y Plants and medical fruit, perhaps the most studied and called upon such as garlic for dog bites, childblains or warts; onions for boils; figs, potatoes, or apples for warts; lettuce, elder, or lemon for wounds; verbena for inflammations and childblains, etc. Y Saints and sanctuaries, such as San Juan de Gaztelogatx, who is called upon to heal corns; or Santa Eufemia and the Albo´nbiga churches in the Basque Country, for skin diseases. Y Magic processes mostly made by healers who know the cabalistic language of numbers; astrology or many symbolic rituals used for several diseases.
Representative Contributions to Iberian Folk Medicine Applied to Skin Diseases Alcantara Montiel, a folklorist doctor active today, carries out extensive fieldwork in the province of Ma´laga where he interviews healers and other connoisseurs of folk medicine. A chapter of his recent book is devoted to dermatology, and he tackles pathologies such as warts, furuncles and spots, corns, labial herpes, ahorre, impetigoes, alopecia, whitlows, freckles, herpes zoster, and burns, in addition to other nondermatological conditions which are manifested through the skin, such as eritema pernio (eyrisipelas).24 Amezcua describes the case of Lucia, a scholar from an Andalusian village who specialized in the cure of culebrillas (herpes zoster) and eyrisipelas. She also gives the gracia (magic power) in a rural context.25
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Barandiara´n (1889 –1991), in his monumental work on Basque folk medicine, collected numerous remedies for skin diseases and alterations such as warts, corns, chilblain, inflammations, eczemas, whitlows, burns, thorns, wounds, any kind of bites, jaundice, frenckles, scabies, baldness, etc.26 Although the author does not give a detailed account of ailments and their remedies, he makes useful descriptions of the context where the curative phenomenon happens. In the case of a boy affected by commun impetigo, we can appreciate how the social meanings are necessary to understand the remedy effectiviness: Viene a mi casa hoy -2.I.1950- Luisa de Kapetenia a pedirme limosna para estipendio de misa. Se trata de curar a un nin˜o de Jomildegiko-borda que sufre saindu-mina. Para curarla, una viuda tiene que recoger de limosna una cantidad en dinero suficiente para un estipendio de misa. Con este fin Luisa recorre las casas de la vecindad. Cada vecino contribuye con una pequen˜a cantidad que con las que aporten los dema´s vecinos formara´ el estipendio de misa que se pide. Es creencia que siendo muchas las casas que tomen parte en una operacio´n de esta clase, el estipendio que representa el sacrificio de muchos tiene mayor importancia. El estipendio ası´ formado sera´ enviado a Zugarramurdi con encargo de que algu´n sacerdote de aquella localidad celebre una misa a la intencio´n de la donante.26 [Today (2 January 1950) Luisa de Kapetenia came to my house seeking alms for a fee of mass in an effort to cure a boy from Jomildegiko-borda who suffers from saindumina. To cure this ailment, a widow must collect alms in a quantity sufficient for this stipend. Each neighbor contributes a small quantity which, together with those sums donated by others, will provide for the stipend requested. It is believed that the more households which take part in an operation of this type, the better, for stipend which represents the sacrifice of many has greater importance [power]. The stipend thus constituted will be sent to Zugarramurdi, charging some priest of that locality with the task of celebrating a mass in honor of the intentions of the woman who sent it].26
Folklorist Ignacio Marı´a Barriola describes, among other ailments, arrosa, el mal de la rosa and gives a magic and religious recipe and a curative ritual for inflamed wounds in fingers. This introduces the symbolism of number three.27 Juan Francisco Blanco carried out an opinion poll in the region of Salamanca. He obtained a “recipes book” of traditional remedies with a religious, magic, or natural origin presented according to diseases classification. Skin diseases are baldness, corns, culebro´n, eczemas, eyrisipelas, sores, fistulas, furuncules, spots, chaps, hemorrhages, wounds, herpes, jaundice, ulcers, skin and nails spots, bites, whitlow, stings, chilblain, scabies, hives, and warts.28 Cantero Cerezo and colleagues describe not only the use of plants for problems such as skin diseases, burns, and eruptions, but also some healing recipes and hairgrowth stimulants. They distinguish between plants used directly on the skin surface, such as boiled poul-
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tices, ointments, plasters or rubbings, and those plants which are used as curative ritual elements. For example, in order to cure warts, one should beat a juniper with berries before dawn saying, Buenos dı´as enebro enebroso, aquı´ esta´ (el nombre del enfermo) el verrugoso.29 [Good morning junipery juniper/Here we have warty (name of the patient)].29
Consiglieri collects several Portuguese beliefs and superstitions. Some of them must take place on the Night of San Juan, when water is used to improve women’s cutis, to cure diseases such as tin˜a (ringworm), and for skin ailments in general. Among other curiosities, he presents this odd remedy for warts, collected in Meas, Coimbra: Se cuentan las verrugas y se cuentan despue´s tanto granos de sal como aquellas sean: a media noche se meten estos granos en un pedazo de pan que se da a comer a un perro, quedando ası´ la persona libre de las verrugas: o de otro modo, se envuelven los granos de sal en un papel y se le dan a un pobre, que al cogerlo, hereda tambie´n las verrugas.30 [First the warts are counted and then the same number of grains of salt. At midnight these grains of salt are put into a piece of bread which is given to a dog, and thus the person is freed of warts. Alternatively, the grains of salt can be wrapped in a piece of paper which is given to a poor man who, the minute he seizes it, inherits the warts as well].30
The folklorist Angel Carril describes household remedies used in Castilla-Leo´n, classifying them by organs affected and by curing methods. Thus he refers to buccal affections (lip sores, fever blisters, and ulcers); to vascular troubles (gangrene, varixes, hemorrhoids, hemorrhages); and to some topical uses such as mustard plaster and poultices.31 In a previous article, he provides remedies collected in Salamanca for swellings and hard skin patches, for whitlow, hives, styes, hemorrhoids, and so on.32 In both works, he includes rich folkloric material such as conjuros (spells), magic charms, and even coplas (popular songs). From the region of Salamanca comes the following song about the medical use of the leech: En la calle de Santa Ana hay un rato´n con viruelas y a la cabecera un gato ponie´ndole “sangrijuelas.”32 [In Santa Ana Street/ there is a mouse with warts/ and at his head a cat applying leeches] (Note that the Spanish word for leech, sangrijuela, contains that of blood, sangre, reflecting the history of its use for medicinal purposes).32
Angel Carril also often cites historic materials such as in this song sung for hemorrhoids, recounted in 1545 by Fray Luis Escobar in Las Quatrocientas Respuestas: Echado quatro o cinco ranas en olla que no sea nueva porque el olio no se enbeva para vuestras almorranas.
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Y de azeyte de comer ave´ys allı´ de poner medio azumbre bien tasado y en fuego que sea templado las dexare´ys descozer. Y allı´ conviene mecellas hasta ser desechas ellas y untad con aquel liquor las almorranas, sen˜or, y ası´ podreys sanar dellas.31 [Throw four or five frogs/ in an old pot/ so that the oil may not be absorbed/ for your hemorrhoids./ And from olive oil/ you must put there,/ half a azumbre (liquid measure) carefully measured,/ and over a mild fire/ leave the rats to cook./ Now, let them simmer/ and it is as well to keep there/ until they fall apart./ Anoint your hemorrhoids/ with this liquid, senor,/ and you will be cured of them].31
In a similar vein, Luis L. Corte´s y Va´zquez collects this spell written in nine verses and used for eyrisipelas in Hinojosa (Salamanca): -¿De do´nde vienes, Pedro? -Vengo de Barcelona. -¿De que´? -De curar el mal de la ampolla. -¿Con que´ lo curas? -Con soga de esparto Y aceite de oliva. Yo te curo, Dios te sane.33 [- Where are you coming from, Pedro?/ - From Barcelona./ - What were you doing there?/ - From healing my blister(s)./ - And how do you heal them?/ - With olive oil and rope made of esparto./ I cure you; God heals you].33
The doctor Anto´n Erkoreka focuses on dermatology in a large chapter in his book on Basque folk medicine, based on his own fieldwork in the region and analyzed from an academic medicine perspective.23 He begins with anatomical annotations and procedes to common pathologies such as warts, arrosa, scurf, herpes, pellagra, eyrisipelas, eruptions, furuncules, corns, and so on. Elsewhere, he highlights the popular religious practices invoked for skin problems, describing how these involve rituals and pilgrimages to remote churches and sanctuaries, etc.34 Paloma Falque Rey and Francisco M. Ferrero study the features of healers and folk medical specialists in part of Andalusia, viewing their practice as an alternative and complementary medical service. In describing some of the diseases treated by these specialists, they detail curative processes and record the incantations or conjuros used by healers for culebrina (forked lighting) and eyrisipelas.35 Emilio Gavilanes deepens the study of numeric symbolism and analyzes the variety of forms assumed by the number nine in both the symbolism of natural orifices (he provides anatomical notes) and in the remedies for various illnesses including dermatological conditions such as gumboils, scabies, styes, alpecia, spots,
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buccal aphtas, hemorrhoids, finger wounds, jaundice, etc.36 Angel Goicoetxea publishes the only study we could find which specifically deals with skin diseases from the popular point of view for the Basque country. He describes the development of different ailments and their remedies.37 The anthropologist Pedro Go´mez Garcı´a collects a wide repertoire of remedies currently employed in the treatment of culebrilla by healers in the provinces of Granada, Jae´n, and Ma´laga. Culebrilla, or herpes zoster, is an example of a disease which could be standardized because the rituals performed by healers are consistently more successful than the antiviral therapy of conventional medicine. The author develops a theoretical explanation for this success based on symbolic efficiency.38 The folklorist Alejandro Guichot y Sierra (1859 –1941) gathered an extensive collection of Andalusian beliefs and superstitions, comparing it with his contemporary Consiglieri’s Portuguese collection. He also collected remedies of a magical nature used by folk healers for afflictions such as warts, hangnails, eyrisipelas, and rijas, and for nail and hair care. He recounted a traditional Andalusian copla which reveals a cultural interpretation of skin problems: Mujer de lunares, Mujer de pesares; Hombre de verrugas, Hombre de fortuna.39 [Woman with moles/ Woman of sorrows;/ Man with warts/ Man with a fortune].39
Victor Lis Quiben dedicates a chapter of his study on Galicia to the description of many practices known in this region and in neighboring Portugal. The locals treat eyrisipela with the following copla recited by the Portuguese to cure rosa maldita: Quando o Senhor pelo mundo ando´u, Pedro Paulo encontro´u. E o Senhor ihe pregunto´u: -Pedro Paulo, que vai por la´? -Muita erisipela, erisipela, E muita gente morre dela. -Pedro Paulo, torna atra´s e talhara´s Con agua da fonte, Esparto do monte, E tres vezes dira´s: Sai-te daquı´, rosa maldita, Pro´ mais alto pinheiral. Que esteja a´ beira do mar.21 [When the Lord walked the world,/ he encountered Peter Paul./ And the Lord asked him:/ - Peter Paul, where are you going?/ - erisipela, erisipela is here/ And many people die from this./ - Peter Paul, turn back and wash yourself/ with water from the fountain,/ and esparto from the mountain./ And thrice you must say:/ - Leave immediately, cursed rose,/ for the highest pine-tree/ Which is near the sea].21
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The “grandfather” of folklore in Spain and the scholar who translated William George Black’s seminal work in the late 19th century, Antonio Machado y Alvarez, also conducted some important research of his own. He collected diverse ideas, feelings, and popular knowledge regarding colors, noting for instance that white and black spots on teeth and nails were considered signs of disease or indications of love. He also noted some curative remedies based on color symbolism, such as the custom of rubbing the excrement of a black cat or stew froth on one’s face to stimulate the beard growth; or blood from the cut ear of a black cat to cure eyrisipelas.40 The anthropologists Danielle Provansal and Pedro Molina study therapeutic resources from their users’ perspective along the coast of Almeria, pointing out as well the presence of healers in industrial areas. They contrast techniques applied from afar (e.g., magical means for skin ailments like warts, eyrisipelas, and cuts) with those performed in the presence of the patient (e.g., suggestion techniques for jaundice). Forms of prayers for cuts and eyrisipelas are collected in an appendix.41 Francisco G. Seijo Alonso, in his book on Valencia, describes information relating to skin and recounts some incantations for ailments such as herpes or the mal de la rosa punxonosa identified as eyrisipelas. He provides, for instance, the following conjuro: La rosa punxon˜osa por el mundo andaba, y mi sen˜or Jesucristo, por allı´ pasaba. Y le dijo, ¿tu, mujer, quie´n eres que tan colorada vas y tan colorada vistes el caballar que tu andas? Pues soy la rosa punxon˜osa, que me pincho las manos y me deshare´ como la sal en el agua, ¿quie´n te corta? ¡la maldita!.42 [The punxon˜osa rose was/ wandering about the world,/ and my Lord Jesus Christ happened upon her./ And he said to her,/ - You, fair lady, who are you/ who goes about in such colored finery,/ who dresses her horse in such bright colors?/ - Well, I am la rosa punxon˜osa,/ which attacks my hands/ and will eat away at me/ as salt dissolves in water./ Who is able to cut you from the stem,/ oh cursed rose?].42
In the course of their investigation into beliefs regarding the mal de ojo (evil eye) and its unfortunate consequences in a rural parish of La Mancha, Ana M. Verde Casanova and Jose M. Pe´rez Baroja Mendoza collected information regarding diverse ailments and cures which are part of traditional local medical knowledge. They describe, for instance, popular interventions
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for things like swollen glands, warts, eyrisipelas, and herpes zoster or culebrilla.43
Conclusions Folk medicine is a complicated concept, in that it refers both to an ancient praxis and an incipient discipline which seeks to situate itself between medicine and anthropology. Those who practice and benefit from it tend to use it as an alternative medical system complementary to the official health system. In contrast, those who study it, at least at first, viewed it as a system in conflict with academic medicine. As a professional or lay practice in the Iberian Peninsula, folk medicine has given rise to a propagative genre of literature based on medieval tradition and is still very much in force. Nowadays, not only “recipe books” and other descriptive texts written by amateurs and medical professionals, but also combative writings from more intransigent sectors, constitute important ethnographic sources for understanding the historic evolution of folk medicine. The first attempts to systematize the concept of folk medicine appeared in the Iberian Peninsula in the late 19th and early 20th centuries, following the lead of other European (especially Italian and British) folklorists. Until the middle of this century, it remained the exclusive investigative domain of medical folklorists, whose interest in popular knowledge of health and illness constitutes an interesting trend within official medicine. However it never became a university discipline. Since the late 1970s some anthropologists and sociologists have succeeded in implanting folk medicine in an academic context by developing the anthropology of medicine as a discipline, thereby also establishing the basis of ethnomedicine. The relation between folk and academic medicine has always been tense, because the practice of the latter has been regulated since the beginning of modernity. Conflict is due, not only to the ambiguous delimitation of official medical specializations, but also to the intransigence of other social sectors such as the Church. Despite this overt conflict, it is evident that there has been a continuous transfer of knowledge between both types of medicine; that they mutually influence yet are simultaneously used to delimit and define one another. Somehow they have managed to adopt parallel itineraries, as both types of medicine have amply demonstrated their ability to expand and adapt themselves to the changing needs of society. In the specific case of popular dermatology, it is clear that the entire spectrum of folk medicinal therapies is employed. These range from empirically based remedies made of food, animals, plants, and other domestic products to a wide range of therapies based on faith and magic. The important development and diffusion
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of this branch of folk medicine is due to the aesthetic and pathological consequences of most skin diseases and of other internal conditions manifested through the skin; thus, there are many skin specialists and healers who continue to practice in the Iberian Peninsula, in rural and even urban contexts. Such cases are crying out for investigation for, apart from rare works which approach skin problems under the general rubric of folk medicine, they have attracted relatively little attention. Because a number of skin conditions and their remedies are already well documented, providing striking evidence that folk and orthodox medicine continue to be applied alternately and simultaneously by those who suffer from them, monographic studies on the contents and effectiveness of traditional methods of popular dermatology are needed to explain their survival in a developed society like ours.
References 1. Kuschick I. Medicina popular en Espan˜a. Madrid: Siglo XXI de Espan˜a Editores SA, 1995. 2. Martı´nez Herna´ez A, Comelles JM. La medicina popular. ¿Los lı´mites culturales del modelo me´dico? Revista de Dialectologı´a y Tradiciones Populares (Madrid) 1994; 49(2):109 –36. 3. De Miguel JM. Introduccio´n al campo de la antropologı´a me´dica. In: Kenny M, De Miguel JM, editors. La antropologı´a me´dica en Espan˜a. Barcelona: Editorial Anagrama, 1980:11– 40. 4. Comelles JM, Martı´nez Herna´ez A. Enfermedad, Cultura y Sociedad. Madrid: Eudema, 1993:85– 6. 5. Granjel LS. La medicina espan˜ola antigua y medieval. Salamanca: Universidad, 1981:150 – 60. 6. Granjel LS. La medicina espan˜ola del siglo XVII. Salamanca: Universidad, 1978:113–25. 7. Prat Ll. Aportaciones de las topografı´as me´dicas al conocimiento etnogra´fico de los Paı´ses Catalanes. Boletı´n de Historia de la Antropologı´a 1990;2:3–7. 8. Pujadas JJ, Comelles JM, Prat J. Una bibliografı´a comentada sobre antropologı´a me´dica. In: Kenny M, De Miguel JM, editors. La antropologı´a me´dica en Espan˜a. Barcelona: Editorial Anagrama, 1980:323–53. 9. Caballero Venzala´ M. Diccionario Bio-bibliogra´fico del Santo Reino de Jae´n, vol. 2. Jae´n: Instituto de Estudios Giennenses, 1986:170. 10. Pablo J. La medicina popular de Black un siglo despue´s. Presentacio´n de la edicio´n facsı´mil de la edicio´n de 1889 de la Medicina Popular de W. George Black. Barcelona: Alta Fulla, 1982:7–17. 11. Kenny M, De Miguel JM, editors. La antropologı´a me´dica en Espan˜a. Barcelona: Editorial Anagrama, 1980. 12. VV AA. I Jornades d’antropologı´a de la medicina. II Col.oqui de l’I.C.A. Arxiu d’etnografı´a de Catalunya, 1982, 3 vols. 13. Gonza´lez Alcantud JA, Rodrı´guez Becerra S, editors. Creer y Curar: La medicina popular. Granada: Diputacio´n, 1996. 14. VV AA. Enfermedad y muerte en la cultura andaluza. Demo´filo (Sevilla) 1994;13.
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15. Go´mez Garcı´a P. La interpretacio´n del curanderismo. Dos coloquios contrastantes. Demo´filo 1994;12:111–22. 16. Amezcua M. Pra´cticas y creencias de los “santos” y curanderos en la Sierra Sur (Jae´n). Gazeta de Antropologı´a (Granada) 1992;9:99 –109. 17. McLane MF. Curanderos en Andalucı´a Oriental. In: Kenny M, De Miguel JM, editors. La antropologı´a me´dica en Espan˜a. Barcelona: Editorial Anagrama, 1980:167– 81. 18. Liso´n Tolosana C. Racionalidad e Inquisicio´n en el Siglo de Oro. Historia y Fuente Oral 1993;9:53– 67. 19. Amezcua M. Conflicto y norma en la relacio´n me´dicocurandero. In Go´mez P editor. El Curanderismo entre nosotros. Granada: Universidad, 1997:175–92. 20. Mene´ndez EL. El saber popular como proceso de transformacio´n. Tipos de articulacio´n entre la biomedicina y la medicina popular. In: Gonza´lez Alcantud JA, Rodrı´guez Becerra S, editors. Creer y Curar: La medicina popular. Granada: Diputacio´n, 1996:31– 61. 21. Lis Quiben V. La medicina popular en Galicia, Madrid: Akal, 1980:113– 64. 22. Becon˜a Iglesias E. Pervivencia y continuidad de la medicina popular gallega. I Jornades d’antropologı´a de la medicina. II Col.oqui de l’I.C.A. Arxiu d’etnografı´a de Catalunya 1982;2:189 –203. 23. Erkoreka A. Ana´lisis de la medicina popular vasca. Bilbao: Labayru Ikastegia, 1985:204 –228, 305–15. 24. Alca´ntara Montiel JF. La medicina popular en la comarca del Alto Guadalhorce. Ma´laga: Diputacio´n Provincial, 1990:84 –106. 25. Amezcua M. La Ruta de los Milagros. Jae´n: Entreolivos, 1993:104 –107. 26. Barandiara´n JM. Recetas y remedios en la tradicio´n popular vasca, (3rd ed.) San Sebastia´n: editorial Txertoa, 1995: 74 – 6, 84 – 8, 102– 8. 27. Barriola IM. La medicina popular en el Paı´s Vasco. San Sebastia´n: Ediciones Vascas, 1979:88 –9, 118 –9. 28. Blanco JF. Medicina y veterinaria populares en la provincia de Salamanca, 2d ed. Salamanca: Centro de Cultura Tradicional, 1985:28 – 81. 29. Cantero Cerezo A, Gaudens Cros MV, Gonza´lez Molina P. Plantas medicinales en la sierra de Albacete. IV Jornadas de Etnologı´a de Castilla-La Mancha (Toledo) 1987:349 –358.
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30. Consiglieri Z. Elementos para una mitologı´a popular portuguesa. El Folk-Lore Frexnense y Be´tico-Extremen˜o, 1883– 4:224 –39. 31. Carril A. Etnomedicina popular. Valladolid: Castilla Ediciones, 1991:59 –78. 32. Carril A. Veterinaria y Medicina popular en Salamanca. Revista de Folklore 1981;5:27–31. 33. Corte´s y Va´zquez LL. Medicina popular riberana y dos conjuros de San Martı´n de Castan˜eda. Revista de Dialectologı´a y Tradiciones Populares 1952;8:531. 34. Erkoreka A. Patologı´as por las que se recurre a santuarios en el Paı´s Vasco. En Alvarez Santalo´ y cols. La Religiosidad Popular, vol. 3. Barcelona: Anthropos-Fundacio´n Machado, 1989:338 –52. 35. Falque Rey P, Harcı´a Ferrero FM. Algunos aspectos de la medicina popular en la sierra de Ca´diz. I Jornades d’antropologı´a de la medicina. II Col.oqui de l’I.C.A. Arxiu d’etnografı´a de Catalunya 1982;2:269 – 85. 36. Gavilanes E. El nu´mero nueve en la medicina popular. Revista de Dialectologı´a y Tradiciones Populares 1995;50: 243– 62. 37. Goicoetxea A. Las enfermedades cuta´neas en la medicina popular vasca. Bilbao, 1982. 38. Go´mez Garcı´a P. Oficio de curanderı´a: creencias, pra´cticas, relaciones, paradigmas. Demo´filo 1994;13:35– 65. 39. Guichot y Sierra A. Supersticiones populares andaluzas. El Folk-Lore Andaluz, (Sevilla) 1882– 83:21bis– 411. 40. Machado y Alvarez A. Folk-Lore de los colores. El Folk-Lore Frexnense y Be´tico-Extremen˜o 1883–1884: 299 –308. 41. Provansal D, Molina P. Alternativas terape´uticas en la provincia de Almerı´a. I Jornades d’antropologı´a de la medicina. II Col.oqui de l’I.C.A. Arxiu d’etnografı´a de Catalunya 1982;1:240 – 69. 42. Seijo Alonso FG. Curanderismo y medicina popular en el Paı´s Valenciano. Alicante: ediciones Biblioteca Alicantina, 1974:98. 43. Verde Casanova AM, Pe´rez Baroja JM. El ser o no ser de la medicina tradicional en un pueblo de la Mancha. I Jornades d’antropologı´a de la medicina. II Col.oqui de l’I.C.A. Arxiu d’etnografı´a de Catalunya 1982:365– 85.
T
he consideration of folk medicine places us in a hazy domain where meanings are clouded by interests and assumptions which are often at odds with one another. This article on folk medicine in the Iberian Peninsula reveals that while there is no doubt of the vitality of the practice and the relevance of the concept, its content and function depend on the context in which it is used. Folk medicine is at once a body of practice and study. Those who practice and benefit from it in Spain also call it household or domestic medicine. In the past it gave rise to a number of written treatises which were highly diffused among popular sectors, whence its common designation medicina de pobres (of the poor) or medicina vulgar. Folk medicine today continues to be defined in contradistinction to an official system of medical knowledge, as a form which draws on both empirical principles of this official system and on magic and religious knowledge. Those who have approached folk medicine as an object of study did so, at first, with a view toward collecting data on popular practices and beliefs about health and illness (folk medicine), emphasizing the cultural values which shape these (ethnomedicine); later and more recently their investigations have also served to legitimize folk medicine as a distinct branch of medical anthropology. The purpose of this article is to review and summarize the status of research on folk medicine in the Iberian Peninsula. In the first part we suggest some key features of the relationship between folk and academic medicine and trace the history of the study of Iberian folk medicine. In the second section, we focus on skin, a subject of paramount interest and indeed specialization within Iberian folk medicine, and provide a summary of some of the most relevant and representative investigations of this subject for various regions of Spain and Portugal.
Folk Medicine as Object of Investigation The concept of folk medicine has traditionally been opposed to that of academic/professional medicine, From the Laboratory of Cultural Anthropology, University of Granada, Granada, Spain. Address correspondence to Manuel Amezcua, Apartado de Correos, nr. 734, 18080 Granada, Spain. © 1999 by Elsevier Science Inc. All rights reserved. 655 Avenue of the Americas, New York, NY 10010
limiting it to those ideas and medical practices with magical, religious, and natural (empirical) bases.1 According to Martinez-Herna´ez et al., it is a concept developed in the context of Western medicine which was subsequently borrowed by anthropology.2 Thus it was an Italian folklorist, Guiseppe Pitre, who first invented the epistemological concept in the late 19th century; prior to this time popular medical wisdom had generally been considered part of the quack heterodoxy which lay well outside the bounds of science, as superstitious falsehood indistinguishable from quackery itself. Although the concept is some 100 years old, folk medicine is still difficult to define. In Spanish, folkmedicina, folklore me´dico, and medicina tradicional are the terms scholars use to refer to a partial system which is framed between medicine and popular culture, knowledge of which is transmitted orally. Their meaning is distinct from that of medicina primitiva, which refers to non-Western native medical systems, and from that of Etnomedicina, which alludes both to a discipline and its object of research referred to any medical system, be it rural or urban3, folk or official.4
“Tesoro de Pobres” The fact that folk medicine has not been the object of systematic study until recently has precluded neither its use in the community nor its status as a body of knowledge communicated orally and via the written word. In the Iberian Peninsula, abundant texts generated over centuries by practitioners and their detractors constitute a veritable treasure for contemporary scholars. The source for the many descriptive texts about diverse dimensions of health, diseases, and their therapies is a particular type of medieval divulgative literature which provided collections of empirical knowledge for the use of common people who had no access to professional medicine. An early example of such treatises on domestic medicine is Menor dan˜o de la medicina, by Alonso Chirino (1429), one of the doctors of Juan II of Castile. This “regimiento de sanidad” (health regimen), written in the Romance style, pretends to heal diseases without medical care.5 Chirino’s work was followed by other treatises, written by both doctors and laymen, which were widely propagated and which shaped the style of the “medi0738-081X/99/$–see front matter PII S0738-081X(98)00066-2
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cine of the poor.” Tesoro de los pobres (1519) by Pedro Hispano, Tratado breve de medicina y de todas las enfermedades (1579) by Fray Agustin Farfa´n, Tesoro de medicinas (1672) by Gregorio Lo´pez, Medicina y cirugı´a racional y espargı´rica (1674) by the priest Juan Vido´s y Miro´ and the work which responds to it, Medicina dome´stica, necesaria a los pobres y familiar a los ricos (1686) by a Dr. Felipe Borbo´n—these, among others, were books of great popularity. Juan Sorapa´n de Rieros’ Medicina espan˜ola (1616), a compendium of proverbs, is worth special mention for many editions were made of it, proof of the high popular esteem in which it was held. Medicina espan˜ola constitutes a true Treatise of Dietetics.6 At another extreme of folk medicine we can situate the heterodox wisdom which gave birth to some manuals like Libro del aojamiento (evil eye treatment) o fascinologia (in a letter of 1411), by Enrique de Villena. This and other astrological and magic books were viewed as superstitious and were consequently vilified by men of the church like friar Martı´n de Castan˜eda (Tratado de las supersticiones y hechicerias, 1529), Pedro Ciruelo (Reprobacion de las supersticiones y hechicerias, 1529), and Gaspar Navarro (Tribunal de la supersticio´n ladina, 1631). These latter, repressive books gave rise to a new genre of literature which not only shunned “superstition” but also the very people and body of knowledge which gave rise to it. In short, information about popular medicine appears condensed in both prescriptive books and the writings which proscribed them. Due to their clear evolution and diversity, these are indispensable ethnographic sources. Moreover, a further genre of relevant scientific literature, known as topografı´as me´dicas, appeared during the Enlightenment. These belong to the intellectual tradition of hygenism and they provide holistic descriptions of the relationship between environment and illness; of particular interest for our purposes are references to conflict between official and domestic medicine and their practitioners, conflict which hinged on the notion of medical faults.7
Studies and Students The German anthropologist Ingrid Kuschick points out that at the time she began studying Spanish ethnomedicine (in the late 1970s), she was the first foreign scholar to contribute to the subject.1 This situation had already been noted by Padujas and his colleagues when they introduced their bibliography of Spanish Medical Anthropology in 1980. Here, they also regret that the subject had been consistently overlooked by university disciplines.8 Until very recently, then, Spanish folk medicine has received attention only from Spanish folklorists. Their work in Spain dates from the late 19th century translation of William George Black’s Medicina Popular, un capı´tulo en la historia de la cultura (1888 and ´ l1889) by the famous scholar, Antonio Machado y A
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varez (“Demo´filo”), who introduced the British folklore trend to Spain. Among the studies promptly spawned by Machado’s translation are Olavarrı´a Huarte’s article, “Superticiones espan˜olas y medicina popular” (included in the second Spanish edition of Black’s work in 1889), Dr. Manresa Olaguer Miro i Borras’ Aforı´stica me´dica catalana, confrontada ab la de altres llengues (1900) and, for Portugal, Castro Pires de Lima’s remarkable labor, Arquivio de medicina popular. Perhaps the most outstanding work is that of Salillas, who discusses the diffusion of conceptions of disease on a national level in his La fascinacio´n en Espan˜a. Brujas, brujerı´as, amuletos (1905). In the 1940s a new approach to folk medicine— one which is still in vigor today—was introduced by a new breed of scholars known as medical folklorists. With no pretensions but detailed ethnographic documentation, they focused on the collection of household remedies. I describe some of these nuevos recetarios (new prescriptions) in the second part of this article where representative works on dermatological practices are reviewed. Among the early Spanish medical folklore contributions is the immense, but scattered, corpus of Antonio Castillo de Lucas, Assistant Professor of Medical Hidrology at San Carlos University in Madrid. He focused on proverbs and sayings, characterizing them as “condensations of experience and knowledge,” and attempted to link them with certain elements of Hipocratic and Galenic medicine. The validity of these efforts are discussed by Kuschick.1 Pujadas and colleagues made an index of Castillo de Lucas’ work, coming up with more than 100 titles8, which may be further supplemented with titles such as those cited by Caballero Venzala´.9 Other pioneers in medical folklore include Victor Lis Quiben, who describes quack doctors in both rural and urban contexts in his work on Galician folk medicine8, Gallardo de Alvarez for Extremadura, and Barriola for the Basque country.10 The publication of the prominent anthropologist Carmelo Liso´n Tolosana’s Brujeria, estructura social y simbolismo en Galicia (1979) marked the beginning of ethnomedical studies in Spain and turned folk medicine into a topic of interest for anthropologists. A year later Kenny (who, prompted by the American anthropologist George Foster, published one of the first articles on ethnomedicine) and de Miguel summarized the researches to date in ethnomedicine and the sociology of medicine for Spain.11 By this time there was a seminary of folk medicine in the bosom of the Madrid Anthropological Association, but not until 1982 and under the auspices of Catalan medical or anthropological organizations were the significant contributions that anthropologists could bring to the study of practices and systems of representations involving health and illness first formally recognized and explored.12 Recently, the
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Laboratory of Anthropology of the University of Granada has organized a series of works on quackery in Eastern Andalucia. Some of these papers were presented at the international colloquium, “Creer y curar: la medicina popular,” celebrated in Granada in 199413; others appeared in the monographic edition of Demo´filo entitled Enfermedad y muerte en Andalucia.14 Once again it seems worth stressing the quality of Kuschick’s work, as hers was the first general attempt to approach folk medicine in Spain based on abundant and detailed published material. Comparing various regions of Spain and neighboring countries such as Portugal and France, the author emphasizes the diversity of interpretations of concepts and therapies which fall outside the domain of orthodox medicine. She also examines the historic layering of some popular medical practices such as the animism and worship of natural elements characteristic of the Ligurian, Iberian, Celtic, and Germanic peoples; the doctrine of humors promulgated in Iberia by Greek and Arab medicine; and the worship of saints introduced via Christain symbolism.1
The Popular and the Medical The relationship between folk and academic medicine has always been marked by conflicts turning on concepts of competence and complementarity. That doctors and practitioners of folk medicine, mostly specialists and healers, have always been in conflict has been manifested in endless polemics about the rationality of folk practices and debates over competence which often end up in court. It is known that the positivistic attitudes of some theologians and doctors lead them to classify some popular certitudes as superstitions or medical fallacy. Such intransigent attitudes are refuted by the practitioners of folk medicine, who combat them dialectically through continuous debates in the media.15 However the great debate over competence is limited to practitioners: the users of both systems seem little influenced by it, convinced that they are separate and complementary systems. Thus they may turn to them alternately for specific ills, or simultaneously for the same illness.16,17 The intransigence of the establishment against popular healing practices has repeatedly resulted in trials against those who profess to practice them publicly. The repressive attitude of the Inquisition against witches and sorcerers is well known, although in Spain—as opposed to the rest of Europe—these trials involved some consideration of the rational component of such practices, so that punishments here were somewhat less harsh than elsewhere.18 The institution of the Protomedicato, introduced in Spain under Ferdinand and Isabel (late 15th century), regulated the practice of medicine and its assistant disciplines and combatted intrusions such as quackery. Due to historic ambiguities in this system, certain types of folk medicine were occa-
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sionally incorporated into the regulations, for example the practices of ensalmadores, spice and herb merchants.19 And over the centuries other practices typical from charlatanes have become legitimate specializations within the official medical system; thus the exercise of the old sacamuelas (molar puller) now belongs to the domain of odontology and must be considered its historical antecedent, and traditional midwives have now disappeared in favor of a new profile of matrons with university education. The justice system continues to prosecute those who encroach upon official medicine, from swindlers and quacks to doctors who carry out unconventional therapies. There have also been transfers of knowledge between academic and folk medicine. Eduardo L. Mene´ndez argues that although biomedicine is characterized by a continuous process of expansion, popular knowledge changes through a continuous process of modification whereby concepts and practices of diverse sorts of knowledge, including biomedical knowledge, are synthesized and incorporated.20 For instance, sanitary education and its attendant concepts relating to “self care” are now popular practices which used to be exclusive to professional sanitary workers. Even many medicines which were formerly subject to prescription are now freely available over the counter. Meanwhile, and in light of new holistic and ecological perspectives, many professionals are looking back to traditional procedures and incorporating some of them in new medical specializations. As their efficacy is demonstrated such practices find their place in the academic context.
Skin and Its Care from the Perspective of Folk Medicine As in orthodox medicine, a classificatory system of disease determines which ailments are important and treatable in folk medicine. This system pays relatively special attention to factors such as the timing of illness, the intensity of malaise (especially that of pain), and the likelihood that the ailment portends disease. For this last reason, everything pertaining to human skin (cuero or pellejo in archaic terms) is worthy of special attention: not only do such afflictions alter people’s appearance, being more evident than interior ones, but some color or skin texture changes are viewed as signs of a general imbalance of the organism which will cause disease. Accordingly, there is an enormous variety of popular practices concerning dermatology, and in some parts of the Iberian Peninsula there are many specialists in this field.21 Becon˜a has even surveyed the advices of different popular specialists on skin disease, recording the distribution of different classes of remedies around Spain.22 Certain skin ailments, such as warts, culebrillas (herpes zoster), isipula or disipula (jaundice), and certain
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inner conditions which manifest symptoms in the skin, such as tericia have been relegated almost exclusively to folk medicine. Most skin diseases are treated at home with a wide knowledge of household remedies and a set of beliefs which mix magic formulae and popular religious symbols. Popular dermatology employs the entire realm of therapeutic folk knowledge, as Erkoreca demonstrates in his classification of remedies common in the Basque country23: Y The fluids and substances of the patient’s organism, such as saliva for cutting hemorrhages or for treating hemorrhoids; urine for cleaning wounds or for treating bites; menstrual discharge for warts, etc. Y Foods, such as hot and cold water used for chilblains; salted water for corns; oil for burns; the lamp oil of a special church for dermatitis; fresh cream used as a cosmetic and for treating cutis diseases; bread with vinager for warts, etc. Y Domestic products, such as soap is used for corns, bleach for hemorrhoids; snow with oil for burns; gas-oil for crab louses, etc. Y Animals and their derivatives, such as snails are used for varicose veins; louses for jaundice; slung, fresh meat or bacon skin for warts; leeches for hematomas; cobwebs for hemorrhages; or ointment made with lard and cow kidney fat. Y Plants and medical fruit, perhaps the most studied and called upon such as garlic for dog bites, childblains or warts; onions for boils; figs, potatoes, or apples for warts; lettuce, elder, or lemon for wounds; verbena for inflammations and childblains, etc. Y Saints and sanctuaries, such as San Juan de Gaztelogatx, who is called upon to heal corns; or Santa Eufemia and the Albo´nbiga churches in the Basque Country, for skin diseases. Y Magic processes mostly made by healers who know the cabalistic language of numbers; astrology or many symbolic rituals used for several diseases.
Representative Contributions to Iberian Folk Medicine Applied to Skin Diseases Alcantara Montiel, a folklorist doctor active today, carries out extensive fieldwork in the province of Ma´laga where he interviews healers and other connoisseurs of folk medicine. A chapter of his recent book is devoted to dermatology, and he tackles pathologies such as warts, furuncles and spots, corns, labial herpes, ahorre, impetigoes, alopecia, whitlows, freckles, herpes zoster, and burns, in addition to other nondermatological conditions which are manifested through the skin, such as eritema pernio (eyrisipelas).24 Amezcua describes the case of Lucia, a scholar from an Andalusian village who specialized in the cure of culebrillas (herpes zoster) and eyrisipelas. She also gives the gracia (magic power) in a rural context.25
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Barandiara´n (1889 –1991), in his monumental work on Basque folk medicine, collected numerous remedies for skin diseases and alterations such as warts, corns, chilblain, inflammations, eczemas, whitlows, burns, thorns, wounds, any kind of bites, jaundice, frenckles, scabies, baldness, etc.26 Although the author does not give a detailed account of ailments and their remedies, he makes useful descriptions of the context where the curative phenomenon happens. In the case of a boy affected by commun impetigo, we can appreciate how the social meanings are necessary to understand the remedy effectiviness: Viene a mi casa hoy -2.I.1950- Luisa de Kapetenia a pedirme limosna para estipendio de misa. Se trata de curar a un nin˜o de Jomildegiko-borda que sufre saindu-mina. Para curarla, una viuda tiene que recoger de limosna una cantidad en dinero suficiente para un estipendio de misa. Con este fin Luisa recorre las casas de la vecindad. Cada vecino contribuye con una pequen˜a cantidad que con las que aporten los dema´s vecinos formara´ el estipendio de misa que se pide. Es creencia que siendo muchas las casas que tomen parte en una operacio´n de esta clase, el estipendio que representa el sacrificio de muchos tiene mayor importancia. El estipendio ası´ formado sera´ enviado a Zugarramurdi con encargo de que algu´n sacerdote de aquella localidad celebre una misa a la intencio´n de la donante.26 [Today (2 January 1950) Luisa de Kapetenia came to my house seeking alms for a fee of mass in an effort to cure a boy from Jomildegiko-borda who suffers from saindumina. To cure this ailment, a widow must collect alms in a quantity sufficient for this stipend. Each neighbor contributes a small quantity which, together with those sums donated by others, will provide for the stipend requested. It is believed that the more households which take part in an operation of this type, the better, for stipend which represents the sacrifice of many has greater importance [power]. The stipend thus constituted will be sent to Zugarramurdi, charging some priest of that locality with the task of celebrating a mass in honor of the intentions of the woman who sent it].26
Folklorist Ignacio Marı´a Barriola describes, among other ailments, arrosa, el mal de la rosa and gives a magic and religious recipe and a curative ritual for inflamed wounds in fingers. This introduces the symbolism of number three.27 Juan Francisco Blanco carried out an opinion poll in the region of Salamanca. He obtained a “recipes book” of traditional remedies with a religious, magic, or natural origin presented according to diseases classification. Skin diseases are baldness, corns, culebro´n, eczemas, eyrisipelas, sores, fistulas, furuncules, spots, chaps, hemorrhages, wounds, herpes, jaundice, ulcers, skin and nails spots, bites, whitlow, stings, chilblain, scabies, hives, and warts.28 Cantero Cerezo and colleagues describe not only the use of plants for problems such as skin diseases, burns, and eruptions, but also some healing recipes and hairgrowth stimulants. They distinguish between plants used directly on the skin surface, such as boiled poul-
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tices, ointments, plasters or rubbings, and those plants which are used as curative ritual elements. For example, in order to cure warts, one should beat a juniper with berries before dawn saying, Buenos dı´as enebro enebroso, aquı´ esta´ (el nombre del enfermo) el verrugoso.29 [Good morning junipery juniper/Here we have warty (name of the patient)].29
Consiglieri collects several Portuguese beliefs and superstitions. Some of them must take place on the Night of San Juan, when water is used to improve women’s cutis, to cure diseases such as tin˜a (ringworm), and for skin ailments in general. Among other curiosities, he presents this odd remedy for warts, collected in Meas, Coimbra: Se cuentan las verrugas y se cuentan despue´s tanto granos de sal como aquellas sean: a media noche se meten estos granos en un pedazo de pan que se da a comer a un perro, quedando ası´ la persona libre de las verrugas: o de otro modo, se envuelven los granos de sal en un papel y se le dan a un pobre, que al cogerlo, hereda tambie´n las verrugas.30 [First the warts are counted and then the same number of grains of salt. At midnight these grains of salt are put into a piece of bread which is given to a dog, and thus the person is freed of warts. Alternatively, the grains of salt can be wrapped in a piece of paper which is given to a poor man who, the minute he seizes it, inherits the warts as well].30
The folklorist Angel Carril describes household remedies used in Castilla-Leo´n, classifying them by organs affected and by curing methods. Thus he refers to buccal affections (lip sores, fever blisters, and ulcers); to vascular troubles (gangrene, varixes, hemorrhoids, hemorrhages); and to some topical uses such as mustard plaster and poultices.31 In a previous article, he provides remedies collected in Salamanca for swellings and hard skin patches, for whitlow, hives, styes, hemorrhoids, and so on.32 In both works, he includes rich folkloric material such as conjuros (spells), magic charms, and even coplas (popular songs). From the region of Salamanca comes the following song about the medical use of the leech: En la calle de Santa Ana hay un rato´n con viruelas y a la cabecera un gato ponie´ndole “sangrijuelas.”32 [In Santa Ana Street/ there is a mouse with warts/ and at his head a cat applying leeches] (Note that the Spanish word for leech, sangrijuela, contains that of blood, sangre, reflecting the history of its use for medicinal purposes).32
Angel Carril also often cites historic materials such as in this song sung for hemorrhoids, recounted in 1545 by Fray Luis Escobar in Las Quatrocientas Respuestas: Echado quatro o cinco ranas en olla que no sea nueva porque el olio no se enbeva para vuestras almorranas.
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Y de azeyte de comer ave´ys allı´ de poner medio azumbre bien tasado y en fuego que sea templado las dexare´ys descozer. Y allı´ conviene mecellas hasta ser desechas ellas y untad con aquel liquor las almorranas, sen˜or, y ası´ podreys sanar dellas.31 [Throw four or five frogs/ in an old pot/ so that the oil may not be absorbed/ for your hemorrhoids./ And from olive oil/ you must put there,/ half a azumbre (liquid measure) carefully measured,/ and over a mild fire/ leave the rats to cook./ Now, let them simmer/ and it is as well to keep there/ until they fall apart./ Anoint your hemorrhoids/ with this liquid, senor,/ and you will be cured of them].31
In a similar vein, Luis L. Corte´s y Va´zquez collects this spell written in nine verses and used for eyrisipelas in Hinojosa (Salamanca): -¿De do´nde vienes, Pedro? -Vengo de Barcelona. -¿De que´? -De curar el mal de la ampolla. -¿Con que´ lo curas? -Con soga de esparto Y aceite de oliva. Yo te curo, Dios te sane.33 [- Where are you coming from, Pedro?/ - From Barcelona./ - What were you doing there?/ - From healing my blister(s)./ - And how do you heal them?/ - With olive oil and rope made of esparto./ I cure you; God heals you].33
The doctor Anto´n Erkoreka focuses on dermatology in a large chapter in his book on Basque folk medicine, based on his own fieldwork in the region and analyzed from an academic medicine perspective.23 He begins with anatomical annotations and procedes to common pathologies such as warts, arrosa, scurf, herpes, pellagra, eyrisipelas, eruptions, furuncules, corns, and so on. Elsewhere, he highlights the popular religious practices invoked for skin problems, describing how these involve rituals and pilgrimages to remote churches and sanctuaries, etc.34 Paloma Falque Rey and Francisco M. Ferrero study the features of healers and folk medical specialists in part of Andalusia, viewing their practice as an alternative and complementary medical service. In describing some of the diseases treated by these specialists, they detail curative processes and record the incantations or conjuros used by healers for culebrina (forked lighting) and eyrisipelas.35 Emilio Gavilanes deepens the study of numeric symbolism and analyzes the variety of forms assumed by the number nine in both the symbolism of natural orifices (he provides anatomical notes) and in the remedies for various illnesses including dermatological conditions such as gumboils, scabies, styes, alpecia, spots,
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buccal aphtas, hemorrhoids, finger wounds, jaundice, etc.36 Angel Goicoetxea publishes the only study we could find which specifically deals with skin diseases from the popular point of view for the Basque country. He describes the development of different ailments and their remedies.37 The anthropologist Pedro Go´mez Garcı´a collects a wide repertoire of remedies currently employed in the treatment of culebrilla by healers in the provinces of Granada, Jae´n, and Ma´laga. Culebrilla, or herpes zoster, is an example of a disease which could be standardized because the rituals performed by healers are consistently more successful than the antiviral therapy of conventional medicine. The author develops a theoretical explanation for this success based on symbolic efficiency.38 The folklorist Alejandro Guichot y Sierra (1859 –1941) gathered an extensive collection of Andalusian beliefs and superstitions, comparing it with his contemporary Consiglieri’s Portuguese collection. He also collected remedies of a magical nature used by folk healers for afflictions such as warts, hangnails, eyrisipelas, and rijas, and for nail and hair care. He recounted a traditional Andalusian copla which reveals a cultural interpretation of skin problems: Mujer de lunares, Mujer de pesares; Hombre de verrugas, Hombre de fortuna.39 [Woman with moles/ Woman of sorrows;/ Man with warts/ Man with a fortune].39
Victor Lis Quiben dedicates a chapter of his study on Galicia to the description of many practices known in this region and in neighboring Portugal. The locals treat eyrisipela with the following copla recited by the Portuguese to cure rosa maldita: Quando o Senhor pelo mundo ando´u, Pedro Paulo encontro´u. E o Senhor ihe pregunto´u: -Pedro Paulo, que vai por la´? -Muita erisipela, erisipela, E muita gente morre dela. -Pedro Paulo, torna atra´s e talhara´s Con agua da fonte, Esparto do monte, E tres vezes dira´s: Sai-te daquı´, rosa maldita, Pro´ mais alto pinheiral. Que esteja a´ beira do mar.21 [When the Lord walked the world,/ he encountered Peter Paul./ And the Lord asked him:/ - Peter Paul, where are you going?/ - erisipela, erisipela is here/ And many people die from this./ - Peter Paul, turn back and wash yourself/ with water from the fountain,/ and esparto from the mountain./ And thrice you must say:/ - Leave immediately, cursed rose,/ for the highest pine-tree/ Which is near the sea].21
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The “grandfather” of folklore in Spain and the scholar who translated William George Black’s seminal work in the late 19th century, Antonio Machado y Alvarez, also conducted some important research of his own. He collected diverse ideas, feelings, and popular knowledge regarding colors, noting for instance that white and black spots on teeth and nails were considered signs of disease or indications of love. He also noted some curative remedies based on color symbolism, such as the custom of rubbing the excrement of a black cat or stew froth on one’s face to stimulate the beard growth; or blood from the cut ear of a black cat to cure eyrisipelas.40 The anthropologists Danielle Provansal and Pedro Molina study therapeutic resources from their users’ perspective along the coast of Almeria, pointing out as well the presence of healers in industrial areas. They contrast techniques applied from afar (e.g., magical means for skin ailments like warts, eyrisipelas, and cuts) with those performed in the presence of the patient (e.g., suggestion techniques for jaundice). Forms of prayers for cuts and eyrisipelas are collected in an appendix.41 Francisco G. Seijo Alonso, in his book on Valencia, describes information relating to skin and recounts some incantations for ailments such as herpes or the mal de la rosa punxonosa identified as eyrisipelas. He provides, for instance, the following conjuro: La rosa punxon˜osa por el mundo andaba, y mi sen˜or Jesucristo, por allı´ pasaba. Y le dijo, ¿tu, mujer, quie´n eres que tan colorada vas y tan colorada vistes el caballar que tu andas? Pues soy la rosa punxon˜osa, que me pincho las manos y me deshare´ como la sal en el agua, ¿quie´n te corta? ¡la maldita!.42 [The punxon˜osa rose was/ wandering about the world,/ and my Lord Jesus Christ happened upon her./ And he said to her,/ - You, fair lady, who are you/ who goes about in such colored finery,/ who dresses her horse in such bright colors?/ - Well, I am la rosa punxon˜osa,/ which attacks my hands/ and will eat away at me/ as salt dissolves in water./ Who is able to cut you from the stem,/ oh cursed rose?].42
In the course of their investigation into beliefs regarding the mal de ojo (evil eye) and its unfortunate consequences in a rural parish of La Mancha, Ana M. Verde Casanova and Jose M. Pe´rez Baroja Mendoza collected information regarding diverse ailments and cures which are part of traditional local medical knowledge. They describe, for instance, popular interventions
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for things like swollen glands, warts, eyrisipelas, and herpes zoster or culebrilla.43
Conclusions Folk medicine is a complicated concept, in that it refers both to an ancient praxis and an incipient discipline which seeks to situate itself between medicine and anthropology. Those who practice and benefit from it tend to use it as an alternative medical system complementary to the official health system. In contrast, those who study it, at least at first, viewed it as a system in conflict with academic medicine. As a professional or lay practice in the Iberian Peninsula, folk medicine has given rise to a propagative genre of literature based on medieval tradition and is still very much in force. Nowadays, not only “recipe books” and other descriptive texts written by amateurs and medical professionals, but also combative writings from more intransigent sectors, constitute important ethnographic sources for understanding the historic evolution of folk medicine. The first attempts to systematize the concept of folk medicine appeared in the Iberian Peninsula in the late 19th and early 20th centuries, following the lead of other European (especially Italian and British) folklorists. Until the middle of this century, it remained the exclusive investigative domain of medical folklorists, whose interest in popular knowledge of health and illness constitutes an interesting trend within official medicine. However it never became a university discipline. Since the late 1970s some anthropologists and sociologists have succeeded in implanting folk medicine in an academic context by developing the anthropology of medicine as a discipline, thereby also establishing the basis of ethnomedicine. The relation between folk and academic medicine has always been tense, because the practice of the latter has been regulated since the beginning of modernity. Conflict is due, not only to the ambiguous delimitation of official medical specializations, but also to the intransigence of other social sectors such as the Church. Despite this overt conflict, it is evident that there has been a continuous transfer of knowledge between both types of medicine; that they mutually influence yet are simultaneously used to delimit and define one another. Somehow they have managed to adopt parallel itineraries, as both types of medicine have amply demonstrated their ability to expand and adapt themselves to the changing needs of society. In the specific case of popular dermatology, it is clear that the entire spectrum of folk medicinal therapies is employed. These range from empirically based remedies made of food, animals, plants, and other domestic products to a wide range of therapies based on faith and magic. The important development and diffusion
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of this branch of folk medicine is due to the aesthetic and pathological consequences of most skin diseases and of other internal conditions manifested through the skin; thus, there are many skin specialists and healers who continue to practice in the Iberian Peninsula, in rural and even urban contexts. Such cases are crying out for investigation for, apart from rare works which approach skin problems under the general rubric of folk medicine, they have attracted relatively little attention. Because a number of skin conditions and their remedies are already well documented, providing striking evidence that folk and orthodox medicine continue to be applied alternately and simultaneously by those who suffer from them, monographic studies on the contents and effectiveness of traditional methods of popular dermatology are needed to explain their survival in a developed society like ours.
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