Common Folk Diseases and Their Treatment
Table 12–4 lists a number of folk diseases and the usual source and type of treatment as reported to me by several Puerto Ricans. Many of these diseases or disharmonies were mentioned in the section on Mexican approaches. None- theless, there are subtle differences in the ways folk diseases are perceived by Mexicans and Puerto Ricans. For example, although diseases are classified as hot and cold, treatments—that is, food and medications—are categorized as hot (caliente), cold (frio), and cool (fresco). Cold illnesses are treated with hot remedies; hot diseases are treated with cold or cool remedies. Table 12–5 lists the major illnesses, foods, and medicines and herbs associated with the hot-cold system as it is applied among Puerto Ricans in the United States.
A number of activities are carried out to maintain the proper hot-cold bal- ance in the body. Examples are as follows:
1. Pasmo, a form of paralysis, usually is caused by an upset in the hot- cold balance. For example, if a woman is ironing (hot) and then steps out into the rain (cold), she may get facial or other paralysis.
Table 12–4 Folk Diseases Among Puerto Rican and Other Hispanic People
Name Description Treatment Source of Treatment
Susto Sudden fright, causing shock
Relaxation Relative or friend
Fatigue Asthma-like symptoms Oxygen; medications Western health care system
Pasmo Paralysis-like symptoms, face or limbs
Prevention; massage Folk
Empacho Food forms into a ball and clings to the stomach, causing pain and cramps
Strong massage of the stomach; medication; gentle pinching and rubbing of the spine
Folk
Mal ojo Sudden, unexplained illness in a usually well child or person
Prevention; babies wear a special charm
Depends on the severity of the symptoms: usually home or folk
Ataque
Screaming; falling to the ground; wildly moving arms and legs; hysterical crying
None—ends spontaneously
310 ■ Chapter 12
Table 12–5 The Hot-Cold Classification Among Puerto Ricans and Other Hispanic People
Frio (Cold) Fresco (Cool) Caliente (Hot)
Illness or bodily condition
Arthritis Menstrual period
Colds Constipation Diarrhea
Joint pain Pregnancy Rashes Ulcers
Medicines and herbs
Bicarbonate of soda Linden flowers
Anise Aspirin
Milk of magnesia Castor oil Nightshade Cinnamon Orange flower water Cod-liver oil Sage Iron tablets Tobacco Penicillin
Vitamins Foods Avocado Barley water Alcoholic beverages
Banana Whole milk Chili peppers Coconut Chicken Chocolate Lima beans Fruits Coffee Sugar cane Honey Corn meal White beans Raisins Evaporated milk
Salt cod Garlic Watercress Kidney beans Onions Peas
Source: Schilling, B., & Brannon, E. (1986, September). Health-related dietary practices. In Cross-cultural counseling— a guide for nutrition and health counselors, p. 5. Alexandra, VA: U.S. Department of Health and Human Services. Nutrition and Technical Services Division. Reprinted with permission.
2. A person who is hot cannot sit under a mango tree (cold) because he or she can get a kidney infection or “back problems.”
3. A baby should not be fed a formula (hot), as it may cause rashes; whole milk (cold) is acceptable.
4. A man who has been working (hot) must not go into the coffee fields (cold), or he could contract a respiratory illness.
5. A hot person must not drink cold water, as it could cause colic.
There is often a considerable time lag between disregarding these precau- tions and the occurrence of illness. A patient who had injured himself while lifting heavy cartons in a factory revealed that the “true” reason he was now experienc- ing prolonged back problems was because as a child he often sat under a mango tree when he was “hot” after running. This childhood habit had significantly damaged his back, so that, as an adult, he was unable to lift heavy objects without causing injury. Table 12–5 provides additional examples of this phenomenon.
HEALTH and ILLNESS in the Hispanic Populations ■ 311
The following are examples of selected behaviors a patient may manifest with an illness thought to be caused by an imbalance of hot and cold:
■ During pregnancy a woman may avoid hot-classified foods and medi- cines and take cool-classified medicines.
■ During the postpartum period or during menstruation a woman may avoid cool-classified foods and medicines.
■ Infant formulas containing evaporated milk, which are hot-classified, may be avoided as the baby is fed cold-classified whole milk.
■ Penicillin, a hot-classified prescription, may not be taken for diarrhea, constipation, or a rash, as these are hot-classified symptoms.
■ When a diuretic is prescribed that needs to be supplemented with cold- classified bananas or raisins, the bananas or raisins may not be eaten when the disease is a cold-classified condition.
These examples illustrate the use of foods or medicines to restore a sense of bal- ance (Harwood, 1971).
Puerto Ricans also share with others of Hispanic origin a number of beliefs in spirits and spiritualism. They believe that mental illness is caused primarily by evil spirits and forces. People with such disorders are preferably treated by a “spiritualist medium” (Cohen, 1972). The psychiatric clinic is known as the place where locos, mentally ill people, go. This attitude is exemplified in the Puerto Rican approach to visions and the like. The social and cultural environment en- courages the acceptance of having visions and hearing voices. In the dominant culture of the continental United States, when one has visions or hears voices, one is encouraged to see a psychiatrist. When a Puerto Rican regards this experi- ence as a problem, he or she may seek help through Santeria (Mumford, 1973).
Santeria is the form of Latin American magic that had its birth in Nigeria, the country of origin of the Yoruba people, who were brought to the New World as slaves over 400 years ago. The Santeria, or santero, may use storytelling as a way of helping people cope with day-to-day difficulties (Flores-Peña, 1991). They brought with them their traditional religion, which was in time synthesized with Catholic images. The believers continue to worship in the traditional way, especially in Puerto Rico, Cuba, and Brazil. The Yorubas identified their gods—Orishas— with the Christian saints and invested in these saints the same supernatural powers of gods. The orishas/saints related to health situations are listed in Table 12–6.
Santeria is a structured system consisting of espiritismo (spiritualism), which is practiced by gypsies and mediums who claim to have facultades (sacred abilities). These special facultades provide them with the “license” to practice. The status or positions of the practitioners form a hierarchy: The head is the babalow, a male; second is the presidente, the head medium; and third are the santeros. Novices are the “believers.” The facultades are given to the healer from protective Catholic saints, who have African names and are known as protecciones. Santeria can be practiced in storefronts, basements, homes, and even college dormitories. Santeros dress in white robes for ceremonies and wear special beaded bracelets as a sign of their identity.