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by Batchelder, Tim
Some years ago I was shocked to read that the Navajo are often dissatisfied with hospital based treatment for cancer because it "does not reveal a cause" and instead attribute many illnesses to acts such as "killing a sacred animal" or "exposure to lightning" (Csordas and Kleinman 1990). Indeed, the more I looked into it, the more it seemed that the medical traditions of the native people of North America offered much by way of useful therapies for the modern disease of cancer, from herbs to spiritual techniques. Indeed anthropologists in recent years have found that Navajos with colon cancer show improved outcomes when they supplement conventional treatment with peyote ceremonies (Csordas and Garrity 1994) and other traditional methods of healing. In this column, I will examine in detail Native American Medicine (NAM) with special consideration given to how these methods can be adapted to modern health problems such as cancer.
Native American Medicines
In an excellent article by Ken Cohen entitled "Native American Medicine" appearing in Alternative Therapies in Health and Medicine (Nov. 1998) the author emphasizes the importance of intuition, spiritual awareness, and community in Native American healing, helping to alleviate the alienation caused by disease. However he notes that the term Native American medicine is actually a bit of a misnomer since the indigenous people of North America identified themselves by Nation (commonly called tribe) of which there were 500 or so, band or community, clan, and family. It was invented as a way for all of these nations to come together to resist encroachment by Europeans. The healing methods of all of these indigenous groups have been practiced in North America for a minimum of 12,000 years and probably more than 40,000 depending on whose theory you ascribe to as to the first appearance of people on this continent. Also, many indigenous people are rightly hesitant to share their medicinal knowledge with white people after the terrible history of genocide whites have inflicted on them. And since native medicine was transmitted orally until quite recently it is difficult to obtain useful information on this healing form. A medicine man or woman caught telling a white man about his medicine risks being ostracized from his or her community. Fortunately many native people are starting to realize the importance of sharing their knowledge with whites to preserve it in the face of ever-encroaching white man's medicine as long as they are treated with respect.
Maker of All Things Above
Native American medicine places great emphasis on spirituality and maintaining the integrity of the person in medicine and the higher force which is the source referred to by numerous names, including Kitchi Manitou ("the Great Mystery," Ojibway), Wakan Tanka ("the Great Sacred" or "Great Spirit," Lakota), Acbadadea ("Maker of All Things Above," Crow), Shongwayadihs:on ("the Creator," Iroquois), or simply God. In living things this divine spirit is made flesh in the form of divine breath. A healthy purpose follows the path imprinted in the heart by the Great spirit and walking a path of harmony, balance, and beauty, keeping a "good mind" and "good thoughts" of respect, generosity and gratefulness. To restore health means restoring ethical behavior and the harmonious relations with one s community. Native American medicine is based on a spiritual and social "mechanism" rather than a materialistic one.
Becoming a Native American Healer: The Calling
In contrast to hospital medicine's heroic methods, Native American medicine considers some conditions to be untreatable and to have important messages for the patient. These include inherited conditions such as birth defects and retardation (including fetal alcohol syndrome) caused by parent's immoral behavior. Healers refuse to impose their treatments on people who don't seek them out, in contrast to hospital medicine's heroic "missionary" style approach. Finally, and most importantly, Native American medicine, like other traditional systems of medicine, has the category of the calling: a disease of initiation necessary for the creation of future medical practitioners or carriers of guardian-spirit power. These can involve a feeling of dying, or near death experiences, from drowning, Western diseases such as polio, accident, injury, possession by a spirit power, or even actual death. The initiate is then healed by a native healer to teach him the techniques of healing. Native healers feel that people learn t o heal best the conditions they have experienced. Becoming a medicine man is considered a curse for some because one only becomes one by being quite ill.
Wandering Sickness, Staying Sickness, Cruel Words, and the Giveaway Feast
In Native American Medicine a distinction is made between internal and external sources of illness. In Piman medicine 'wandering sickness' is caused by noxious substances (like germs, heat, pus) that wander through the body and cause fever, hemorrhoids, and sores and is treated with herbs. 'Staying sickness ' is caused by improper behavior towards powerful objects (like using wood from a lightning struck tree or hunting a sacred animal). Ka:cim stays in the body causing weakness and tiredness and can only be cured by a shaman who sings to the object or animal and sucks out the pathogen while blowing in spirit power.
Internally caused diseases, according to Cohen, are linked to negative thinking including shame, worry, depression and despair as well as anger, jealousy and blame. A person who does not use their own internal gifts causing self-doubt, rots inside. Healing involves allowing the person to express themselves and be appreciated. This can involve dream interpretations to help patients discover hidden feelings and unfulfilled needs. Iroquois dream interpretation is especially respected. People are seen to get too caught up in their past, a self-centered form of negative thinking which causes obsessive thoughts, and leads to greed, wastefulness, stinginess and hoarding of possessions. A chief cause of disease in Native American medicine is not giving enough away and people have higher status if they give more. Important events such as a birth, naming, or healing are honored by a giveaway feast in which possessions are redistributed in the community. Healers traditionally have the fewest possessions and live the mos t simple, frugal life.
Externally, germs, which are also spirits in NAM, can invade the body, and take hold if the person is weakened by negative thinking. A supportive, loving family is seen as crucial in helping people recover from disease and loving thoughts and prayers have healing power while negative thoughts, expressed or unexpressed, can cause disease. The hex is a powerful source of harm and sorcerers remove life energy from victims using stones, herbs, charms, pieces of hair, nails or clothing. Storms and places that radiate evil can cause disease and are called utgon in Seneca. White man's food which is rich in refined carbohydrates and fat and is processed and contaminated and is not grown locally, have caused many health problems among Native Americans since government food rations were implemented and traditional hunting, fishing and gathering grounds were taken away due to the different genetic predispositions of Native Americans versus Europeans (see my Thrifty Genotype article in a previous issue of TLfDP on my web site at http://anthrocode.coml thriftygenotype.htm).
Soul loss is a common problem among native people. Head injury patients suffer from confusion and disorientation because their spirit is no longer whole and soul fragments are lost in the lower world where ancestors and spiritual beings dwell, which is why psychotherapy or talk therapy as is used in hospital medicine is ineffective and why laying on of hands and other physical methods are needed to re-integrate the patient. Native American medicine is very concerned with avoiding shocking experiences since they can cause a sudden loss of spiritual power. By avoiding negative thinking one surrounds oneself with guardian spirits that prevent injury and accidents and improve decision making.
Finally, breaching taboos can cause disease. For Native Hawaiians entering heiaus or power places are kapu or forbidden to non-Hawaiians and are guarded by spirits that cause disease or misfortune. I experienced this directly during my ethnobotany field research on Kauai (be sure to see my TL[DP article at http://anthrocode.com/kauaitrip.htm). Also, powerful animals such as bears must be addressed, using special names or their spirits will be offended. Cruel words and violence are taboo and can cause disease in a person, community and even whole Nations and married people who don't love each other or abandon each other, causes sickness.
Shaking Tents, Freshly Cut Sticks and the Night Chant
NAM practitioners spend a great deal of time talking to patients about their illness but also rely heavily on hands-on methods in which they enter an altered state of consciousness using wild tobacco, drinking clear acorn water and singing sacred songs while moving their fingers over the patient's body with the help of spirit helpers to sense any unseen internal injuries and "feel the patient's pain" in their own bodies. Medical divination relies on patterns in flowing water, crackling of a fire, and dream interpretation. Sometimes practitioners must sit in a "shaking tent" (as is used among the Cree) in which diagnostic spirits speak to the healer in darkness. Before sleep, healers cleanse themselves with the smoke of a sacred plant such as sage or cedar and pray that the dream spirits inform them of the patient's problem. In Cherokee divination a freshly cut stick is immersed in a stream and the healer then interprets the clarity of the water and omens such as passing fish. Cohen emphasizes that these techniques can't be imitated or taught and can only be learned by participating in Native tradition.
After diagnosis, according to Cohen, the first step in any healing ritual is prayer which serves the vital purpose of focusing the patient's and practitioner 's minds on the task at hand and invoking the spiritual powers. All prayers end with the phrase "All My Relations" which is far more than Christianity's Amen, a method of invoking the help and dedication to all relations of our species: stones, plants, animals, earth, sky, sun, moon, ancestors, spirit helpers and the Great Spirit. Chants can be formalized such as The Night Chant of the Navajo and the Remaking Chants of the Cherokee and may include special breathing techniques to drive poisons out of the body or attract healing power. Music is a vital part of the prayer and helps to empty the mind of worries (especially the Indian flute) and entrain the mind (using a steady drum beat or rattle) allowing it to focus purely on the power of nature to heal. To experience the shamanic state of consciousness I highly recommend Michael Harner's innovative worksho ps at http://www.shamanism.org which I have tried and enjoyed thoroughly. Prayers are usually sung and there are prayers to willow trees, thunder spirits, snow flakes, bear, salmon, winds, fire, water and for gathering and preparing herbal medicines. Songs can enter the patient and destroy pathogenic forces and are learned from dreams or visions or from elders.
Quinine, Peyote, Lightning Flash Gathering and Spiritual Intrusion Sweeping
Herbs are employed extensively in NAM, beginning with the smudge which is the ritual cleansing of place using smoke of a sacred plant such as sage (Salvia species or Artemisia species), cedar (usually Juniperus species), or sweetgrass (Hierochloe). Smudging increases sensitivity, induces an altered state of consciousness, and heightens emotions, which increases sensitivity to energetic or spiritual imbalances. In the past NAM practitioners say that there was a local plant cure for every disease but now due to environmental degradation there are fewer plants and they are not as effective. NAM medicines in North America alone saved the lives of many early colonists and provided the basis for 170 drugs in the US Pharmacopeia or the National Formulary according to Vogel. The most famous case was the curing of Jacques Cartier of scurvy, by a Huron decoction of pine needles, high in vitamin C, but Native people also gave Europeans quinine to- cure malaria, ipecac to expel toxins and Cascara sagrada to treat constip ation. Peyote is much more than just a recreational drug of abuse as it has become in modern White society, but is considered a medicine for the body and soul and is used in a spiritually intense atmosphere of drumming, singing, prayer, and cedar smoke, to cure leukemia, tuberculosis, pneumonia, stroke, and other disorders.
Similarly, Cohen notes that in contrast to European's abuse of tobacco as a recreational drug, NAIVI uses this herb to carry thoughts and prayers to the Great Spirit. It is also used in ritual to induce heightened awareness, alertness, and intuition due to the structural similarity of nicotine to acetylcholine and nicotine's ability to bond to cholinergic receptor sites. Nicotine also triggers the release of norepinephrine, epinephrine, serotonin, dopamine, and other compounds (see Wilbert).
NAM practitioners draw on over 300 herbs but trying to identify pharmacological qualities in them is difficult since in many cases it is the ritual context that provides the therapeutic effect rather than the herb itself. For example, there are 200 ways of gathering plant medicines among the Mohawk and in the Navajo Night Chant some plants are gathered only when lightning flashes.
Native American medicine is placebo driven healthcare and as such almost impossible to test using a Western scientific methodology, according to Cohen. Doses can't be standardized since they vary between healers and cases. Methods and outcomes are not recorded on paper. Native Americans are suspicious of Western scientists in general since their findings are often used against the Indian nations (such as to dam up their rivers for electricity and dig up their burial grounds for condo complexes).
Massage and healing touch is equally important in NAM but its use is quite different than in hospital medicine which is only now even acknowledging that touch can have beneficial effects. In NAM laying on of hands serves to sweep away spiritual intrusions or collect healing powers. Cherokees warm their hands over coals before circling them on the body or above it while others place their hands on either side of the body to create an electrical current. Muscles may be rubbed to relieve tension or pain using buffalo fat, bear grease or sea algae and herbs maybe burned on affected areas (similar to TCM's moxibustion) while rose thorns may be used like acupuncture needles and burned down to the body.
Certain behavioral approaches are used as well and some clinicians have adapted traditional approaches to treat Native health problems in a hospital setting (for example Duran and Duran's treatment of Native American alcoholism that allows the patient to "speak to the spirit in the bottle.")
NAM healers work in sweat lodges, hogans or other ceremonial lodges. Sweat lodges are domes of willow branches covered by blankets and heated by pouring water on red hot stones. It is very dark inside and the sacred pipe is smoked to help enter an altered state of consciousness while the intense heat helps to purge toxins.
A Bit of Cloth, an Ounce of Tobacco, and Cigarette Papers
The process of therapy and training for practitioners in NAM is intense. Healing power can be inherited or transmitted but healers usually need to go through a long period of fasting and preparation and are often asked to "carry on" the tradition when they are cured of a serious condition which increasingly, is cancer. Vision quests, periods of seclusion in nature, can begin at an early age (age 6 in some cases according to Cohen) but usually occur at puberty. NAM practitioners can specialize in snake bite curing, bone setting, countering sorcery, divining, and herbalism. In Ojibway Medicine training the candidate is instructed every week for years in herbalism, songs and prayers while in Navajo Medicine training candidates must memorize exactly, complex chants, sand paintings and rituals and can begin at any age from teenage years to their fifties. The National Institutes of Mental Health began funding a program in Arizona in the 1970's to train Navajo medicine men to teach apprentices. The average age of th e students was 50, and the average age of the faculty was 85.
All payment for NAM is on a sliding scale and NAM practitioners view the fees of hospital based health professionals as exorbitant and unethical since all medicine comes from the Great Spirit. Sometimes the only gift required is a pouch of tobacco which stands as a seal of contract between patient and healer and a sign of respect for the medicine. In the past deer skins or moccasins were common gifts while today, cloth, groceries, and money are often more needed. A typical initial "fee" is a bit of cloth, an ounce of tobacco, and cigarette papers. A practitioner might treat between 20-30 patients a year. The patient also must often provide food and accommodations for the medicine person and his or her helpers as well as community members who are assisting for several days. Finally, the patient may make a "sacrifice" of money or goods to show respect to the healing powers. This can include an important possession such as a printing press in one case.
Cohen notes that there is renewed interest among Native people in NAM as well as among Europeans. However he adds that many non-Natives pursue a romanticized version of NAM as a way of rebelling against the dominant society without learning the wisdom of their own cultural heritage. These "New Agers" actually represent a threat to Indian culture since they stereotype their behavior and misrepresent their teachings. The passing of the Indian Religious Freedom Act in 1978 was a big step towards allowing Native people to practice their traditional medicine. However Cohen expresses concern that the rapid loss of biodiversity and traditional lands may destroy Native herbal medicines and healing traditions by eliminating their traditional means of subsistence.
Medicine Men, Lakota Medicine, Bull Durham, and Buffalo Meat
According to an online article entitled "Native American Traditional Medicine" by Subhuti Dharmananda at the Institute for Traditional Medicine, in Portland, Oregon, medicine men were actively pursued and imprisoned as leaders of traditional Native culture during colonial days yet the Lakota who recently helped lead the American Indian Movement (MM), have been very resistant to encroachment by Europeans and as a result their traditional medicine has been the most studied of all the Native Americans. Lakota Deer Medicine for example comes from watching deer and the greens they eat and the water they drink. But it also involves praying to the deer because they are able to communicate with the Creator and so there is a spiritual element as well. NAM healers consider themselves "hollow bones" through which the power flows.
In addition, Navajo herbalism is increasingly studied. The author adds that even though tobacco has been heavily adopted by whites from Native people and then was re-borrowed back by natives (who currently favor Bull Durham in their healing rituals), red willow bark was the preferred herb used in healing ceremonies such as the sacred pipe ceremony among many nations such as the Sioux.
Despite the renewed interest in NAM herbalism Dharmananda adds that herbalists that "fix symptoms" were considered less important in NAM and hospital doctors were considered a type of these remedial practitioners. Yet some herbalists who use herbs ceremonially are highly valued. For example, among the Lakotas burning and inhaling sage smoke is used for exorcising evil influences, while sweetgrass is used to induce the presence of benevolent influences. White men use NAM herbs without their ceremonial context (such as infusing the plant material in water while singing a prayer and blowing into the infusion) which is considered to make them "useless. The dislocation of tribes in the 19th century divorced native people from herbs that grew only in their home range which caused a decline in use of herbs in current NAM.
Dharmananda notes that divorcing native people from their medicinal plants was only one of the root causes of the increase in disease affecting native people. He adds that the white man forced the Lakotas and other native people to live without migration which had brought clean surroundings and spiritual renewal compared to the evolving contamination and relative emptiness of the owned land. They also forced them to rely on nutritionally inferior food sources such as cattle meat which is considered inferior to buffalo meat and government rations of starch and cheese. Finally, they confined these people to square houses rather than their circular tipis which interrupted their whole cosmology based on circularity (especially among Plains Indians) in all their ceremonies which also led to disease.
Further, Dharmananda notes that many native people consider the white man's word "medicine man" an insulting term like "squaw" since there are so many types of healers under this category including herbalists (pejuta wicasa in Lakota), conjurers (wapiya) and others.
Moon Women and Snakebite Remedies
Women are very powerful during menstruation and must be allowed to retreat and meditate in separate moon lodges during their "moon time," to engage in their own cyclic ceremonies of purification as preparation for childbirth. Menstruating women in traditional cultures were considered to be so powerful they could "kill a rattlesnake by spitting on it" (a Lakota belief). During the Sundance dancers would feel exhausted if there was a woman "in her moon" around since her intense energy overwhelmed them. In addition, women were seen as less susceptible to death than men and had time-consuming roles in childbearing according to some Lakota authors, which limited their role in NAM since becoming a healer takes years of training beginning at age 20. Today, however, more and more women are becoming NAM practitioners and are focusing especially on herbalism and childbirth treatments that don't require as much of an emphasis on ceremony according to Dharmananda.
Dharmananda adds that renewed interest in native American herbs such as echinacea (Echinacea angustifolia), black cohosh (Cimicifuga racemosa), cascara sagrada (Rhamnus purshiana), and goldenseal (Hydrastis canadensis) among "Western herbalists" is often a misapplication of NAM. For example, Echinacea, used to boost immunity in the natural products industry, due to European backed research on anti-infection properties of the root, was used by the Sioux as a leaf for treating toothache and other pains by topical application and for snakebite.
Drought Apparitions, The Gulf War, and Peyote Healing Finally, I'll turn to Thomas Csordas who has written an arresting article entitled "Ritual healing and the politics of identity in contemporary Navajo society" in Ameri can Ethnologist (Feb. 1999) based in part on a presentation he made to the Seminar in Clinically Relevant Medical Anthropology at Harvard University. In this article he points out that medical imperialism continues on the reservations as modern health professionals blame the Navajo for their susceptibility to various diseases such as the Hanta virus as a result of their lifestyle (in this case living in dirt floored hogans which are considered unsanitary by industrial standards and shelter mice which are labeled as the vectors of this disease.)
Csordas notes that many native Americans consider that their illnesses are the result of white man's environmental pollution and they may indeed be correct, as extensive military testing has been recently revealed on the reservations while uranium mining has long contaminated the water supplies. Indeed the mice were seen by Navajos as messengers bearing a warning against the white man's disease rather than carriers of disease, revealing the fundamental difference between the two group's world views. In addition he notes the growing tension among the Navajo about preserving traditional medicinal rituals. Some feel that chanters "aren't chanting enough" which is leading to droughts and apparitions while others are concerned that peyote is being abused.
Csordas provides a series of intriguing case studies of patients undertaking NAM for various health problems and shows how one 30 year-old woman used it to cure her shoulder pain. Another woman used a Blessingway ceremony to help her treat breast cancer.
The chanter told her to "forget about her past" which included an ex-husband who left her when she got sick and to just focus on herself. She felt it helped her immensely. She also tried a peyote ceremony for her illness and became involved with a Christian church which had prayer meetings on the reservation which also helped her.
Another man in Csordas' article who was raised as a member of the Native American Church and as a sheep herder on the reservation, by an alcoholic father who became a Marine and traveled throughout the Far East and Middle East, where he fought in the Gulf War, using peyote ceremonies before and after the fighting for protection. He suffered from respiratory problems and general fatigue that began in the Gulf War and used to run regularly, as is prescribed in traditional spiritual discipline but became too fatigued. He asked for help, along with his mother, from his family road man (healer) and participated in a fullscale all-night peyote meeting that restored his sense of identity, allowed him to release emotional baggage, and say things out loud to his girlfriend who was there that he couldn't say before. Three months later he felt much more energy, began to excel in school and his relationship with his girlfriend improved and she became pregnant. He felt "new Navajos" were blind and materialistic and were d enying their language and culture.
Csordas brilliantly sees NAM as a form of cultural power following similar work by Arthur Kleinman (1980, 1986) who studied traditional healing in the aftermath of the Chinese Cultural Revolution and Thomas Ots (1994) who examined qigong in relation to democracy movements in China. Many other writers have described similar politically empowering effects of traditional medicine for the individual such as Marina Roseman (1996) on the Malaysian state of Kelantan, David Gellner (1994) on Nepal, Jean Comaroff(1985) on Zionist healing in Africa who points to this method as a means of healing a body tormented by political oppression, and Lesley Sharp (1990, 1993) on Madagascar who finds that traditional medicine allows women to work as healers, liberating them from harsh industrial agricultural labor. Michael Taussig (1980, 1987) notes that shamanism in southwest Colombia serves to heal the aftermath of colonialism. Libbett Crandon (1989) writing on Bolivia, suggests that traditional healing served to protect indivi duals during the transition from a colonial society to a class-based agricultural society.
Csordas notes that cultural representations of the "mystery illness" (hanta virus) and the drought apparitions are part of what Scheper-Hughes and Lock (1987) term the "body politic" of Navajo society as it interacts with the dominant white society, while the case studies he provides constitute the "individual body" as a person with a contemporary Navajo identity in the politically charged space between tradition and postmodernity.
Cohen also mentions additional useful references including Beck and Walters' work on witchcraft, Eliade on shamanism, Kalweit, and Krippner and Welch (who provide great information for health professionals such as nurses interested in incorporating Native American medicine into their practice.) Irwin, Bahr et al, Hines, Jilek, Lewis, Miller, Mooney, Powers, and Sander all provide additional resources in this vein. I also covered some of the work of Moerman, Herrick and Snow in previous columns on ethnobotany but should also mention Croom and Moore (very clinically relevant), Gunther, Cochran, Gilinore, Hamel, Curtin, Densmore, and Tantaquidgeon.
Please see my website or email me for additional resources or previous articles.
IAC-CREATE-DATE: June 30, 2003
Daniela Bagozzi
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Copyright 2003 The Townsend Letter Group
Townsend Letter for Doctors and Patients
SECTION: Pg. 61; ISSN: 1525-4283 IAC-ACC-NO: 102372150
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