The midday sun scorched everything it touched one January afternoon at the height of the dry season in Teli, a village of the Dogon tribe in Mali. I was en route to Kani Kombole and passed the heat of the day napping on a wooden platform bed covered with reed mats beneath a thatched roof. I had eaten my fill of chicken and rice with peanuts and chilies, I had consumed endless calabashes of cool, clear water, and I had only sipped politely from the calabash of kojo, the bubbling millet beer proffered by the headman. While I slept the children and women kept a watchful distance, but the men had long before retreated to their toguna, an open-sided shelter with a thick roof of millet straw insulating it from the strong rays of the sun.
Even though Teli lies only seventy miles from the nearest town with electricity, the lack of roads cuts it off from the world.
The path to the closest market town in the Dogon headquarters of Bandiagara leads across a dry plain to Kani Kombole, up a thousand-foot escarpment to the village of Djuigibombo, and then over a mud track, for a total walk of eighteen hard miles. The Dogon living in Teli value few market goods enough to transport them that long way by foot. The villagers grow their own millet, peppers, peanuts, and onions and raise their own goats, pigeons, and chickens. They bring in a little rice and tobacco from the market as well as brightly printed cotton cloth imported from China, and the village headman owned a transistor radio capable of pulling in garbled voices from Bamako.
When I awoke, I noticed the women and children waiting quietly and watching me from a respectful distance. I could tell from the cautious yet persistent way that they stared at me that they wanted something, but I was unsure what. After putting on my shoes and jacket, I rose from the platform bed to leave. Only then did a woman approach me with her baby slung over her hip. The child’s right eye was swollen shut beneath a crust of secretions. The child stared distracted into space, not seeming to notice the mother, the flies, or me. The mother pointed to the child’s deformed face and chanted: “Chloroquine, chloroquine, chioroquine.” She wanted the tablets used to fight malaria and assumed by so many of the natives in the area to be effective against any type of malady. I had left all my chioroquine tablets in another village to which I was soon returning and would not have wanted to give them to a baby anyway. I reached in my pack and fished up two aspirin for her. With exaggerated thanks, the woman popped the two pills into her own mouth and swallowed them dry while the baby remained motionless, staring through the flies. I left the woman and headed across the village toward the men in the toguna, not knowing why the woman had taken the pills herself.
Teli, like so many areas of the world, relies almost exclusively on native cures heavily dependent on ritual and religion. The inhabitants supplement these local herbs and plants with a few imported medicines such as aspirin or chloroquine when they can get them and when they have enough extra millet to afford them. Of all the drugs, it puzzled me that the woman would ask for chloroquine in as remote a place as Teli, since most Africans have a natural immunity to malaria, but the drug has an important reputation as a general febrifuge.
Malaria ravages more people than probably any other disease in many of the backwater areas of the world. For most of human history, no effective cure or preventive existed for this Old World disease. For as long as we have had medical records it appears that malaria struck every part of Africa, Europe, and Asia where mosquitoes thrived, but there was none in the Americas. When the Europeans took malaria to America in the hulls of the trade ships, the Indians quickly found that one of their traditional medicines, Peruvian bark, offered relief from the symptoms. This bark produced quinine, the active ingredient in chloroquine.
The introduction of quinine marks the beginning of modern pharmacology. Prior to that time, Old World doctors had various potions, plasters, odd forms of surgery, and leeches with which to treat diseases and control a few of the symptoms. Essentially, however, they had no cures for smallpox, leprosy, tuberculosis, the plague, malaria, or any of the other dreadful diseases that haunted the Old World and killed hundreds of thousands of people in periodic epidemics. Known also as ague or the shakes, malaria, physicians claimed, originated in the bad air of swamps and other lowland areas. Malaria probably killed Alexander the Great and Oliver Cromwell. Prior to the dissemination of quinine, researchers estimate that malaria killed approximately two million people a year throughout the world and infected tens of millions of others [Taylor, p.75]. But even today in many tropical zones such as West Africa, malaria tortures millions of people too poor to afford the miracle drugs made from quinine.
The Quechua-speaking Incas of the Andes understood well the medicinal properties of many plants growing not only in the Andes but in the Amazon jungle as well.
One of these plants was a tree that grew at elevations of three to nine thousand feet and produced the very bitter-tasting Peruvian bark that could cure many ailments, including cramps, chills, and heart-rhythm disorders. The Quechua word quina means “bark,” but this particular bark with such miraculous powers deserved the name quina-quina, “bark of barks,” and from this came the name “quinine” [Taylor, p.78].
Europeans did not use the word “quinine” until 1820, when Parisian scientists Joseph Pelletier and Joseph Caventou finally extracted the active ingredient from the bark and named the substance after the original Quechua word. Until that time the bark was known as cinchona, a corruption of the name of the Countess of Chinchona, Francisca Henrique de Ribera, who married a viceroy of Peru and during the early seventeenth century lived with him in Lima, where Indians supposedly cured her malaria with their miracle bark. When the time came to give the plant a scientific name, Carolus Linnaeus assigned it cinchona after the countess who had “discovered” it. Even today in some parts of the world people refer to quinine as chinchonine, preferring the French rather than the Quechua name.
The bark seems to have been introduced to Europe about 1630 and had already gained mention in a Belgian medical text, Discours et Avis sur les Flus de Ventre Doloureux by Herman van der Heyden, by 1643. The new medicine made extensive European settlement of America possible. For example, the 1671 records of Governor Berkley of Virginia show that before the introduction of quinine into Virginia one colonist of every five died within the first year from malaria. After the incorporation of quinine, no one died from malaria [Hallowell, p .328]. The change was dramatic and simple.
Not until the twentieth-century work of the British physician Sir Ronald Ross was the etiology of the disease unraveled. He discovered that Anopheles mosquitoes carry microscopic Plasmodium in their bodies that they acquire while drinking the blood of a malaria patient, and they then pass these into the blood of the next victim they bite. The French physician Charles Laveran had already discovered that Plasmodium was the source of the disease, but until the researches of Ross, no one knew that the mosquito transmitted it into the human bloodstream.
This discovery led to a Nobel Prize in medicine for Ross in 1902, three hundred years after the unknown Quechua Indians had given the cure for the disease to the world, a gift for which they received no recognition.
Until chemists extracted the active ingredient from the bark in the nineteenth century and could then manufacture it in the laboratory, the medicine remained the exclusive domain of the very rich or of those supported by colonizing governments and companies. Once it became readily available, doctors realized that quinine not only cured malaria but also prevented it when taken before infection. Synthetic forms of quinine sold in recent decades as chloroquine and primaquine serve both as prophylaxis and treatment for malaria.
Colonial officials serving throughout the tropics in the nineteenth century took small but regular doses of quinine to ward off malaria. Because of the extreme bitterness of the drug, they mixed it with sugared water before drinking. This daily concoction became the tonic water that continues today as a popular mixer for making alcoholic drinks even where malaria has long been eradicated.
In some parts of the world, tonic water still serves as a medicine, as I found after leaving Teli for Timbuktu, about three hundred miles north of Teli in the Sahara. Today Timbuktu survives as merely a small town of little importance on the edge of the known world. From King Mansa Munsa’s fabled Golden City of great wealth connecting the trade routes of the Sahara with those of black Africa, Timbuktu has shrunk to a mud town of fewer than twenty thousand people. Many of the windowless family compounds of mud brick lie abandoned, and each day a little more sand from the desert creeps into the once bustling streets. The sand has already risen about two feet above the old street level, forcing people to step down to pass between the decorated doorposts and enter their houses or into one of the three ancient mosques.
In many regards, Timbuktu lies more isolated today than in the past. It once stood proudly as the most northern city on the mighty Niger River, hut through the centuries even the river turned its back on the dying city and withdrew from the Sahara.
When I visited Timbuktu I approached it from Mopti, its closest neighboring city, 250 miles to the south. The trip required five days and nights on the river to reach the village of Niafunke and then two days over a desert trail marked only by the bones and mummified skins of camels and donkeys. Traveling east from Timbuktu the next town is Gao, also about 250 miles away. I made the trip on an ancient open truck named the Green Elephant, which reached Gao after a drive of two full days over a marked road that is little more than a series of ruts through the desert.
During the wet season in Guinea and lower Mali, rains cause the Niger to flood this modest road for most of the year and thus prevent travel between the two cities.
Life in Timbuktu centers on the market much more than on the mosque or the Koranic school. Caravans still bring salt cut into slabs five feet long and eighteen inches wide in the mines of Taudeni, seven hundred kilometers north of Timbuktu in the middle of the Sahara. Although a few small camel caravans still make the trek, today most of the 3.5 million kilograms of salt mined there annually arrives on caravans of dilapidated desert trucks, which have replaced the trains of up to twenty thousand camels that used to carry the trade.
On the western edge of Timbuktu adjacent to the graveyard, townspeople cut series of neatly terraced gardens circling a small but deep well, protected from people and animals by a fence of dried thorn bushes. Here they hand-water rows of lettuce, tomatoes, chilies, onions, okra, corn, beans, and melons for sale in the market. Tuaregs bring in goats and dates from other oases, fishermen cart in piles of smoked fish from the Niger, and from the south come sacks of rice, wheat, millet, and sun-dried peanuts.
Only a few goods are imported from far away. Tea arrives in wooden chests shipped from Hong Kong, and instant coffee comes in small cans from the Ivory Goast. In the market women sell calabashes filled with beef fat to flavor the cooking, chopped and dried okra, freshly baked pita bread, small bundles of charcoal, and assorted fresh vegetables. Men sell the salt, dates, hacked pieces of goat and sheep, sandals, and brightly embroidered galabias that the men sew in their stalls along the edge of the market. Young boys hawk piles of deep-fried dough balls, and girls balance on their heads large trays stacked with patties of peanut butter rolled in hot chilies.
Timbuktu remains one of the few places in the world where it is impossible to buy cola drinks, chewing gum, or the chocolate candies that always seem to constitute the first assault of contemporary western influence. With this conspicuous absence of modernization, it surprised me to find that in the midst of all this traditional culture the Arab shopkeepers sold soda bottles with a clear drink called Indian Tonic, featuring the emblem of an American Plains Indian dressed in a full war bonnet. Both the image and the drink seem incongruous in Timbuktu, one of the most traditional places in the world. The drink turned out to be essentially quinine water sold not as a refreshment but as a medical tonic to restore vitality and cure virtually any ailment.
The Indian Tonic of Timbuktu survives as a relic of a long line of now mostly forgotten tonics sold in the nineteenth and early twentieth century as cures for every known or imagined ailment. The medicine show of the last century frequently featured an Indian healer or claimed that the product being sold originated with an Indian medicine man. These medicine men often added ingredients such as distilled alcohol, opium, kola nuts, sugar, or caffeine, which were not Indian in origin but gave an added kick to the medication.
The evolution of quinine from an important medicine into a soft drink was a pattern repeated numerous times by many of the patent medicines made from Indian drugs. Sassafras and sarsaparilla teas used by the Indians, for example, were also mixed with sugar and other spices to which carbonated water was added to make one of the “Indian root beers” that were hawked as cures for numerous pains. Like the quinine tonic, root beer soon became a drink used primarily for refreshment without a medicinal pretext.
Another American relative of the tree that provided quinine also helped cure amoebic dysentery, a lethal intestinal infection, caused by the ingestion of certain amoebas, that produces high fever and bloody diarrhea. Even today it still ranks as one of the world’s major killers of young children and if not treated can kill adults as well. The Indians of the Amazon cured this disease with medicine made from roots of three-to-four-year-old Cephalaelis ipecacuanha and C. acuminaja plants. The Indians made a medicine that they called ipecac. One of the properties of this medicine was that in certain doses it caused the patient to vomit.
In this capacity as an emetic, the Indians used it both to expel unwanted substances such as poisons and as a way of ritually purifying the body. Poison clinics throughout the world still use ipecac for the same purposes when children or adults have ingested too much of a toxic substance and need to expel it.
Its most important use, however, came as a cure for the much more common amoebic dysentery. Ipecac killed and expelled the harmful amoebas and allowed the patient to recover. It was introduced to France in 1888 by a Dutch doctor named, inappropriately enough, Schweitzer, which means “the Swiss” in German. He changed his name to Jean Adrien Helvetius, which means “the Swiss” in Latin, and with this Latin name sounded much more professional and credible. His new medicine became the rage of France when it supposedly cured the dysentery of the dauphin, son of Louis XIV. This made the quack Helvetius into a respected pharmacist, and he sired a prosperous family that included his grandson Claude Arien Helvetius (1715-1771), who became a famous philosopher of the Enlightenment and the author of De I’Espirit (1758), in which he expounds on the themes of sensualism or sensationalism. The prosperity and education of this family, however, derived directly from the introduction of the Amazonian cure ipecac to the world.
The Indian discovery of drug cures for a wide range of diseases did not spring merely from the fortuitous circumstance that.
America was blessed by nature with more drugs to be discovered.
Quinine and ipecac happen to come from plants that grew only in America, but the cure of scurvy illustrates the general superiority of Indian medical knowledge and pharmacology. The Old World abounded in plants which could easily have cured this disease, but western science ignored them until the Indians demonstrated their utility.
The cure for scurvy first came to European attention in a dramatic incident during the second of three voyages to Canada made by the French explorer Jacques Cartier (1491-1557) for Francis 1. In November 1535, after visiting the Huron town of Hochelaga, which later became the site of Montreal, Cartier’s ships, the Grande Hermyne, the Petite Hermyne, and the Emerillon, became frozen in the St. Lawrence River. Cartier ordered his men ashore to build a small fortification in which to await the spring thaw. He traded provisions with local Indians, but he soon forbade the Indians to enter the fort because they showed signs of scurvy, and he did not want his men to catch this disease.
Even then the Indians knew scurvy was not communicable. As the winter months slowly passed, scurvy soon began to stalk his men. They grew listless and weak. Their gums grew spongy and began to bleed, ugly splotches erupted on their skin, and they emitted a wretched stink. Of the 110 men, only ten showed no signs of the disease by February, and one by one the men died until twenty-five of his men were gone.
Cartier busily concealed the disease from the Indians for fear that they might attack the weakened men. Gradually, however, Cartier realized that the Indians who developed scurvy did not die but recovered their full health. He inquired cautiously about a cure, and the Indians readily showed him how to make a tonic from the bark and needles of an evergreen tree that the Hurons called annedda and was probably a hemlock or pine.
This distasteful concoction carried a massive dose of vitamin C, the only cure for scurvy, and every man who took it recovered within eight days. Cartier dutifully recorded in his log that no amount of drugs from Europe or Africa could have done what the Huron drugs did in a week. In appreciation Cartier kidnapped the Indian chief Donnaconna and the other Indians in hopes that they could lead him to mountains of gold [Bakeless, pp.115-16].
The world ignored this discovery of the cure for scurvy, but a fanciful legend did develop that the annedda tree of that area could cure syphilis. Sailors did sometimes pick up supplies of dried cranberries from the Indians of New England and use them to prevent scurvy, but sailors continued dying for the next two centuries. Not until James Lind (1716-1794), a Scottish naval officer, read of the incident with Cartier did European medicine take official notice that the Indians had found the cure for the disease. Based on Lind’s research, the British Admiralty issued an order in 1795 to supply all naval ships with lime juice to prevent the disease. Lind then walked into hisiory as the discoverer of the cause and cure of scurvy. His work finally led to the discovery of vitamins and to a fuller understanding of human nutrition [Driver, p .399].
The Incas apparently knew how to prevent goiter problems as effectively as scurvy. The Incas harvested tons of Pacific Ocean kelp, Macrocystis, annually. They dried the seaweed and then transported it throughout the Andes for use as a food additive.
The high iodine content effectively prevented most forms of goiter problems in the population. Today, all along the Pacific coast from California to Peru, large commercial ships harvest the underwater forests of kelp for a variety of foods, pharmaceuticals, and toiletries.
From the very first contacts between the Old and the New World, European doctors recognized that the Indians held the key to the world’s most sophisticated pharmacy. Medicine in most of the world at that time had not yet risen far above witchcraft and alchemy. In Europe, physicians talked about the balance of body humors as they attached living leeches to the patient in order to suck out the “bad blood.” Moslem doctors burned their patients with hot charcoals, and physicians in the Orient prescribed elaborate potions of dragon bones mixed with all types of flavorings.
By contrast the Indians of America had refined a complex set of active drugs that produced physiological and not merely psychological effects in the patient. This cornucopia of new pharmaceutical agents became the basis for modern medicine and pharmacology.
The Indians of northern California and Oregon gave modern medicine the most commonly used laxative or cathartic. They used the bark of the Rhamnus purshiana shrub as a cure for constipation. The Old World’ already had a number of such medical cures, but the Indian remedy, as advertisers still stress today, acts in an exceptionally mild manner. It evacuates the bowels completely within eight hours but with almost no discomfort to the patient. When the Spanish arrived in California and found this bark, they named it cascara sagrada, “sacred bark,” because of its unique qualities. Because of its bitter taste, it had to be mixed with sugar or in some cases with chocolate to persuade people to use it. Even though scientists have failed to synthesize it in the laboratory and vast amounts of bark must be gathered annually for its manufacture, it has spread to become the world’s most commonly used laxative since its first introduction by the American pharmaceutical industry in 1878.
When Francisco de Orellana made his river voyages down the Napo through what is now Ecuador and discovered the Amazon River, Indians along the way frequently attacked his heavily armed band. The simple wooden weapons of the lndians seemed to offer little threat against the sophisticated European arsenal of metal. The confidence of the Spanish suffered a serious challenge, however, when one of Orellana’s men died from a minute Indian arrow that barely pierced the skin. This unknown soldier of Orellana’s became the first European victim of the arrow tipped with the powerful poison that became famous as curare.
Not until 1807 did the German naturalist Baron Alexander von Humboldt discover that the source of curare originated in a group of plants growing in the Amazon jungle. The most important of these was the woody vines of the genus Chondodendron, which the Indians cooked into a gum and then painted onto their arrows and darts.
Even after the discovery of the plants, medical research took a long time to figure out how the poison worked. Unlike the poisons of the Old World, which invariably produced violent spasms and almost epilepsy-like seizures in the victim, curare produced a quiet, gentle, and quick death; Persistent research revealed that the patient died from asphyxiation. Further research finally unraveled the complicated process whereby the curare blocked nerve transmission to the muscles, leading to paralysis and death when the muscles no longer enabled the victim to breathe.
Initially, no one could imagine any practical application for such a powerful drug other than for illegal or unethical uses, but doctors soon found that small doses of curare acted as a muscle relaxant. In this way it served as the first treatment of tetanus or lockjaw, which caused a severe cramping of the muscles of the throat and jaw; curare relieved the cramping by relaxing the muscle. Doctors soon gave it to patients going into abdominal surgery to relax the strong muscles that could make surgery quite difficult. Doctors also found that curare relaxed a patient enough to permit insertion of a tube into the windpipe to facilitate breathing during operations. In due time curare was synthesized into a number of different muscle-relaxant drugs fulfilling a variety of medicinal purposes. In the 1980s, Dutch doctors introduced curare as a means of euthanasia for terminally ill patients (Ferrieri, p .51).
Indians in the northeastern United States treated intestinal worms with the vermifuge pinkroot, Spigelia marilandica, a plant with red and yellow flowers. Trees of the genus Cornus of North America, known as dogwoods, were used by the Indians as a febrifuge, or fever reducer. They had a number of emetics in addition to ipecac; these included bloodroot Sanguinaria canadensis, also called puccoon and lobelia. The Indians made an astringent called alumroot from the wild geranium, Heuchera americana, and a stimulant from boneset, Eupatorium perfoliatum [Driver, pp.557-58].
The Indians of North America used the bark of the poplar or willow tree to make a liquid capable of curing headaches and other minor pains. Only centuries later with the discovery of aspirin as a coal-tar derivative was it found that the active ingredient salicin closely resembled what we now know as aspirin or acetylsalicylic acid. Such a simple medication remains as a good example of the many American Indian gifts that western medical science failed to recognize and then had to invent independently through a laborious and expensive process of research.
Indian healers developed many drugs especially to treat the problems of women.
They used a parasitic plant that grew on the roots of oak trees blue cohosh or squawroot, Caulophyllum thalictroides as an antispasmodic that helped induce menstrual discharge.
They also used the bitter root of Trillium erectum to ease pain during childbirth, a practice that subsequently led the pioneers to name the plant “birthroot.”
Indians of America developed a large number of ointments and salves to promote the healing of flesh wounds, and the pioneers usually called these medicines “balsams.” In the western United States the Indians gave the pioneers a balsam root from plants of the genus Balsamorhiza, especially B. sagittata, which produces yellow flowers and an aromatic root. Tolu, or balsam of Tolu, the aromatic resin of the tropical tree Myroxylon toluiferum, became widely used in toiletries and pharmaceuticals. The North American tree tacamahac or balsam poplar, Populus balsamifera, produced fragrant resin-coated buds that Indians also made into a variety of ointments. An evergreen from northeastern North America, the balsam fir, Abies balsamea, produced very small needles and cones and was used to make Canada balsam. One of the best-known of all was the balsam of Peru made from the resin of the tree Myroxylon pereirae, which has an aroma prized in the manufacture of perfumes and some toiletries.
The Indians also developed the astringent that became known as witch hazel, made from the bark and leaves of the shrub Hamamelis virginiana and used to soothe tired or strained muscles.
The Indians knew how to dry the flowers of plants in the genus Arnica to make a tincture of arnica that they applied to sprains and bruises to relieve the pain and swelling.
The Indians gave the colonists the oil of wintergreen, which could be used in a similar way but has since become much better known as a flavoring for candies and medicines.
One of the most widely used skin ointments in the world today is known in English as “Indian petrolatum” or “petroleum jelly,” a scientific name derived from Greek and thus obscuring the Indian invention of the ointment. In making this nearly colorless gelatinous material of olefin hydrocarbons and methane, the Indians found one of the first practical uses for petroleum. Indians applied it to human and animal skin to protect wounds, stimulate healing, and keep the skin moist. They also used it to lubricate the moving parts of tools.
Petroleum jelly is another of the American Indian products readily available for sale in Timbuktu and areas throughout the Sahara. Traditionally the nomads of the Sahara smear beef fat on their skin and hair as prdtection from the relentless sun, dry wind, and pounding sand. Today, many of them have replaced beef fat with petroleum jelly, which has proven to be a superior skin ointment. Petroleum jelly dffers the same protective properties as fat, but since it uses an inorganic material, it does not attract insects as much as do animal fats. Petroleum jelly, like quinine water, meets such an important need in the Sahara that Tuareg traders transport it over thousands of kilometers to every corner of the desert.
In addition to employing the sophisticated medicine chest of the Indians, native doctors also understood and practiced many medical arts, some of which were still unknown in the Old World.
One of the most unusual of these was the brain surgery or trephining performed by surgeons in varied Indian civilizations, particularly in the Andes. The surgeon drilled a hole in the skull, usually in the right parietal, and thereby relieved the compression that built up from some forms of concussion, particularly those resulting from severe blows to the head during combat.
Archaeologists have excavated skulls showing that patients survived as many as five trephinations [Wissler, pp.11-12].
The Aztecs developed a particularly sophisticated medical organization with different kinds of specialists for the diagnosis of a disease, for its treatment, and for the making of drugs.
Tlamatepatlcitl applied medicines to the skin and prescribed drugs somewhat like contemporary internists while texoxotlaticitl acted as surgeons. On a lower level of prestige and importance came the temixiuitiani, who performed as midwives, and tezoctezoani, who acted as bloodletters. Papiani served as herbal pharmacists and panamacani as the dealers who distributed the drugs [Guzman, p.13]. In this medical system, the Aztecs paralleled in many regards the European organization of medicine at that time, and in some ways they surpassed it. Even today no steel scalpel has ever been made that cuts sharper than the obsidian implements of the Aztec surgeons. Only the laser beam can cut a finer incision with less bleeding and less scarification than the Aztec surgeons.
The fine Aztec scalpels allowed the doctors to cut with minimum blood loss, and the wound healed with fewer scars.
Indian surgeons sewed facial lacerations by using bone needles threaded with human hair. They set bones in plasters made of downy feathers, gum, resin, and rubber.
They gave enemas with rubber hoses, and they invented the bulbed syringe for use in a variety of medical treatments as well as simple tasks such as cleaning the ears. In Amazonia, where rubber originated, they made syringes with rubber, but in the north, they made them from animal bladders. European doctors quickly adopted both the rubber hose and rubber syringe and continue to use them today.
Indian healers lanced boils and removed tumors by surgery.
Surgeons amputated limbs, prescribed artificial legs, removed teeth, and castrated men and animals. They also understood the principles of sucking out the venom to treat snake bite, and they mastered the application and use of tourniquets and cauterization.
Papiani concocted emetics, purges, febrifuges, and skin ointments as well as underarm deodorants, toothpaste, and breath fresheners.
The Aztecs may have had the most thorough understanding of human anatomy of any society in the world of the sixteenth century. In part this knowledge derived from the peculiar and varied nature of the human sacrifices they performed. They understood the role of the heart and blood circulation long before the Englishman William Harvey (1578-1657) proposed his theory of blood circulation. The Nahuatl-speaking doctors developed an extensive vocabulary that identified virtually all of the organs that the science of anatomy recognizes today.
One medical practice employed extensively by the Aztecs but abhorred by the Spanish was bathing. This included daily washing in a river, lake, stream, or pond as well as more elaborate medicinal baths, The Aztecs built temazcalli, steamrooms similar to ancient Roman hypocausts. These beehive-shaped structures of stone or brick were heated, and the patient rested inside while various combinations of drugs were burned in the smoke or added directly to the steam to treat the patient. Sometimes this was accompanied by body massage with various types of leaves and ointments. Every village had one or more temazcalli, and they were used to treat everything from fevers and boils to insect allergies and snakebites. They were also used to treat exhaustion and aching muscles as well as to speed the recovery of women following childbirth.
Apparently this practice extended over virtually all of the Americas in various forms. When Francisco Pizarro arrived in the land of the Incas, the emperor Atahualpa was in the mountains enjoying the thermal baths around Cajamarca and recovering from a long military campaign against his half brother Huascar.
Throughout the Andes, hot springs; were tried as sacred huaca by the Quechua speakers and used to promote good health.
The extensive use of baths by the Indians was viewed with great consternation by the Spanish, who thought that such frequent bathing was debilitating to the body and could lead to terrible diseases. Colonial officials repeatedly tried to outlaw such practices as harmful to the Indians, and the temazcalli disappeared in Mexico, but persisted in the remote areas.
Virtually all of the Indians of North America used steambaths similar to the Aztec temazcalli. Groups as widely separated as the natives of California and Delaware built semisubterranean earthen structures entered by a tunnel. The Alaskan natives built similar baths covered with logs, while the Creeks covered theirs with hides and mats. Many of the natives in the southeastern United States slept all night in the sweat lodges during the winter months and each morning upon awaking ran from the lodge to jump into the cold water of the river. The Plains Indians used a temporary structure made of branches and leaves covered in blankets [Driver, p.132]. Still today, Indians throughout the United States and Canada use the sweat bath as a ritual part of religious ceremonies and powwows and for general physical and mental hygiene.
The widespread and persistent use of the steambaths and of water baths by the Indians paralleled the practices of ancient Mediterranean cultures, but stood in sharp contrast to the practices of the Europeans who arrived in the New World. The bathing probably served to reduce diseases among the Indians prior to the European arrival and thereby partly accounted for the general freedom from epidemic diseases. The destruction of the lodges by the Europeans and their denunciation of frequent bathing quite probably contributed to the rapid spread of Old World epidemics among the nahves of the Americas.
The same Indians who gave the world quinine also gave it coca, which Indian farmers cultivated in approximately the same area at the foot of the Andes. One of the traditional uses of coca was as a ritual cleanser applied to the body of the patient by a healer. More commonly, the leaves of the coca bush are chewed or made into a tea that soothes the body and alleviates pain as well as the discomfort of thirst, hunger, itching, and fatigue.
Even though it cured no diseases the way quinine did, it seemed to refresh the mind and spirit as much as quinine refreshed the aching body.
Coca arrived in Europe by 1565, when Nicolas Monardes of Seville made the first scientific descriptions and drawings of it.
Not until the late 1850s did German chemists manage to isolate the active ingredient, which became known as cocaine. The first major medical use for it came in the 1880s as an anesthesia for painful eye surgery and later for dental surgery and other kinds of operations. Eventually chemists synthesized cocaine to make procaine. Under the trademark Novocain, it continues today as one of the most important anesthetics in the world. Even though cocaine cured nothing, it launched the medical use of local anesthesias that replaced the more common use of ether.
At the same time that medicine was exploring the surgical possibilities of cocaine, the young chemist Angelo Mariani introduced Mariani’s Coca wine, a concoction for which the pope gave him a special medal. This wine made cocaine the fad of Europe not merely because of its medicinal properties but because of its recreational and refreshing qualities as well. In addition to Pope Leo XIII and Queen Victoria, customers included such celebrities as William McKinley, Thomas Edison, and Sarah Bernhardt.
During the same time in the United States, pharmacist and Confederate war veteran John Styth Pemberton of Atlanta devised a series of medicines using both native American ingredients and some foreign ingredients. He invented medications with names such as Flower Cough Syrup, Triplex Liver Pills, and French Wine Coca, advertised as the “Ideal Nerve and Tonic Stimulant” and an obvious imitation of Mariani’s Coca wine.
Realizing that the public most enjoyed the stimulant property of the drink and that they could buy mere alcohol anywhere, he dropped the wine and added some caffeine and the flavorings of the African kola nut. The result was Coca-Cola, which was released to the public in 1886 as a flavoring for water drinks. Soon the water of choice for mixing with the syrup became fizzy carbonated water, and thus was born the modern drink that has captured a world market.
Pemberton marketed the syrup through drugstores and soon attracted the interest of another pharmacist, Asa Griggs Candler, who bought up the Coca-Cola business to add to his small array of products that included De-lecta-lave dentifrice, Everlasting Cologne, and Botanic Blood Balm. Although he manufactured the products together and advertised them together, sales of the new drink soon surpassed those of all the other products, and Candler built a whole soft-drink empire around it [Kahn, pp.55-59].
The connection between cocaine and Coca-Cola continued so closely even after the manufacturers removed cocaine from it that the nickname for Coca-Cola quickly became Coke, the same nickname used for cocaine. In the early part of the twentieth century in the south, where Coca-Cola was so popular, people often called the drink simply “dope” or more obliquely “a shot in the arm.” Still today, hearing-impaired users of sign language express the same connotation in their slang sign for a cola drink, They make the gesture of inserting a hypodermic needle into the upper forearm.
Many of the roots and barks used to make Indian medicines tasted quite bitter or spicy. Because of this, many of the plants became known as peppers, and the drinks made from them bore such trademarks as Dr Pepper, emphasizing both the spicy taste and the medical origin. Of course, the emotional or physiological kick from these drinks originally came not from the misnamed “peppers” in them but from the alcohol, opium, caffeine, cola, and cocaine.
In common speech, however, the word “pepper” became closely associated with the notion of excitement, hyperactivity, and the amphetamine like high produced from these supposedly Indian tonics. Young people soon shortened the word “pepper” to “pep” to signify the state produced by these drinks; and thus the English language acquired a new word. One of the first recorded uses of the new word appeared in the Literary Digest of August 21, 1915, when “pep” was written in quotes to refer to the power of a motor.
“Pep” became one of the buzzwords of the twentieth century and was closely associated with the 1920s; in time it appeared in phrases such as “pep talk,” “pep rally,” and “pep pill.” The popular word was also used as the basis for yet another cola drink, Pepsi.
The soft-drink industry in America grew directly out of the traveling medical salesmen who hawked various kinds of Indian tonics. Because of the association of the Indians with the medical knowledge in the nineteenth century, the sellers of every medicine tried to connect it as closely as possible with Indians.
Advertisements proclaimed their medicines as Indian tonics or Indian cures. The traveling medicine hawkers often carried a living Indian with them as proof that their medicine sprang from genuine Indian medicine. The most famous of these included the Kiowa Indian Medicine and Vaudeville Company and the Kickapoo Indian Medicine Company, which sold for $250,000 in 1911 after over; thirty years of performances.
Documents show that at least 150 medicine shows featured one or more Kickapoo Indians, compared with 180 stock companies playing Broadway shows around the country in 1911 [Green and Laurie, p.69].
In the nineteenth century, medical publishers brought out a series of books on Indian medicine. These started in 1813 with The Indian Doctor’s Dispensatory, followed by The Indian Guide to Health in 1836 and The North American Indian Doctor, or Nature’s Method of Curing and Preventing Disease According to the Indians in 1836 [Hallowell, p.329]. The United States Pharmacopeia, which first appeared in 1820, listed over two hundred drugs supplied by the Indians; of these about twenty-five are of South American origin [Driver, p.557].
As American medicine became established and regulated by universities, hospitals, and medical associations, the Indian healer was pushed ever farther aside. The medicine shows became more vaudeville than medicine as they combined humor, tricks of daring, and a little sex to stimulate flagging sales of their Indian nostrums, which often contained more alcohol, opium, or cocaine than they did Indian medicines. Increasingly, Indian medicine became associated with shams and quackery.
At the same time these shows helped to build a new image of the Indian as a daring and savage fighter. Particularly in the show started by William E “Buffalo Bill” Cody (1846-1917 in 1883, the Indians were presented not as healers but as expert horsemen and fierce warriors who performed feats to thrill the American and European masses. The wild west shows coincided with the development of the film industry, and Cody starred in one of the first such films depicting the action and drama of his traveling troupe. This gave birth to a whole new genre of entertainment as the cowboys-and-Indians movie was born.
The Plains Indian in full warpaint became the symbol of the Indian that was then diffused around the world. The Indian as warrior replaced the Indian as healer.
By this time the Indian cures and medicines had circled the world and become fully integrated into cultures on every continent.
The medicines became so taken for granted that it was easy to forget that they had not always been there and that they had not been discovered or invented by Old World doctors, pharmacists, and chemists. The Indian as healer lives on in only a few places such as Timbuktu, where the great Indian drugs arrived but the wild west show and the cowboy western films never came to change the image of the Indian from healer to warrior.
The accumulation of archaeological and medical evidence has slowly led to the conclusion that in addition to all the medicines that America gave the world, it contributed at least one dreaded disease syphilis. The Old World had no knowledge of syphilis prior to 1493, and contemporary observers claimed that Columbus brought it back from Hispaniola, a claim given added weight with the publication in Spanish of Treatise Called Fruit of All the Saints Against the Serpentine Malady of Hispaniola by Ruiz Diaz de Isla in Seville in 1539. Each country it infected, however, named it for the country from which it received it. Thus the Italians and English called it the French disease, Poles called it the German disease, Russians called it the Polish disease, and so forth until the name “syphilis” was established in the early sixteenth century.
The first documented outbreak came in Italy in 1494 or 1495 during a French invasion led by King Charles VIU, who wanted to make himself king of Naples. In 1497, Gaspar Torrella published his Treatise with Advice Against Pudendagrain or the Gallic Malady, giving one of the first medical accounts of this disease that struck so suddenly and so viciously. By 1495 the disease moved to Germany, and it followed to Britain in the next year. Carried by Portuguese sailors, it reached the Middle East and India in 1498, and it arrived in Russia and eastern Europe by 1499. By 1505, only a dozen years after Columbus’s return to Spain from America, syphilis erupted in China on the farthest side of the Eurasian continent.
The disease in its early years acted much more virulently and rapidly than today. It killed fast and frequently. Its impact on the Old World was much like that of Acquired Immune Deficiency Syndrome, AIDS, in the twentieth century. There was no known cure, it spread easily, it attacked young, active individuals, and it usually proved lethal. Once again the Old World inhabitants turned to the pharmacy of the Americas for a cure, and they thought they had found it in the wood of trees of the Guaiacum genus. The oil guaiacol acted as an expectorant. According to European medical logic of the era, a patient would easily spit out the noxious infection in the pints of saliva which he expelled from his body after taking guaiacol.
Doctors claimed to have cured many people by this method only to have the patient infect others. In the meantime, merchant families such as the Fuggers made fortunes importing the wood from America and selling it in the form of various drugs. At the same time, British merchants claimed that they too had found the cure for syphilis in the sassafras plant, which made a very popular tea sold at high prices. Whether or not syphilis actually came from America and no matter what its early history, it proved to be one disease for which the Indians had no cure to offer.
Despite the sophistication of American medicine when the Europeans arrived, the healers succumbed to the onslaught of Old World diseases. Never in human history have so many new and virulent diseases hit any one people all at the same time.
Smallpox, bubonic plague, tuberculosis, malaria, yellow fever, influenza, and the other major killers of the Old World had been totally unknown in America until the arrival of Columbus. These diseases swept rapidly through the people, who lacked all immunities against them. The Indians also lacked immunities to what are often called the childhood diseases of the Old World.
Diseases such as measles, mumps, and whooping cough that provoked only a minor illness among Europeans and Africans proved deadly to whole villages of Indians who had never before encountered any of those germs.
In a few cases the Indian doctors could apply their old cures, such as quinine that proved to be a cure for malaria, but for most of the Old World diseases they had no protection at all.
Even the medicine of quinine quickly became too precious to the Europeans for them to allow the Indians to use it. The whites monopolized it to eradicate malaria in Europe while leaving the Indians to die from this disease that soon found a new permanent home in the American tropics. The Indians died by the millions.
Probably 90 percent of the American Indian population died within the first century after the European arrival in America.
Both continents were left decimated again and again by wave after wave of the new diseases.
In this agonizing and slow genocide, the Indian doctors found most of their cures impotent and were thrown back increasingly on the meager resources remaining to them, prayer and magic.
They chanted, danced, mumbled, and searched for magical solutions to ailments that they had never before encountered.
The great accomplishments of Indian medicine have been forgotten. In a few remote spots in North America, however, a small memorial still exists to the great power of Indian medicine in the English place-names. The faint memory of Indian medicine lingers in such seemingly quaint and obscure names as Medicine Lake, Montana, Medicine Bow Forest, Wyoming, and Medicine Hat, Alberta.