Curanderismo of northern Peru

Northern Peru runs from the coastal desert around Trujillo, Chiclayo and Piura through dry forest and mountains into the Amazon. Few regions in the world have such a rich medicinal flora. The Peruvian anthropologist Lupe Camino called the north part of the 'health axis' of the Andes, an area from southern Ecuador to northern Bolivia where healers have long gathered and traded plants.

The tradition is old. Archaeologists have found remains of the San Pedro cactus at sites that are thousands of years old. The Moche, who lived on this coast between about 100 and 800, depicted healers on their pottery, as well as the San Pedro and the seeds of cabalonga and of ishpingo. Remains of such plants have been found in the tomb of the Lord of Sipán, a Moche ruler.

Moche pottery also shows a mysterious, comma-shaped fruit with a large calyx, which researchers call ulluchu. It hangs from the belts of warriors and messengers and floats around priests and sacrificial scenes, and real fruits have been found in graves. Nobody knows for certain which plant it is. Bussmann and Sharon think of a Guarea, an Amazonian tree whose seeds contain poisonous alkaloids, and suspect that the Moche used them in sacrifices and perhaps as a snuff. That is a hypothesis not yet confirmed by chemical analysis. The name is uncertain too: the archaeologist Rafael Larco Hoyle used it in the 1930s, but it does not appear in the dictionaries of Mochica.

After the Spanish conquest, Indigenous medicine blended with Catholicism and with Spanish ideas about illness. In the 1780s Bishop Baltasar Martínez Compañón of Trujillo had everything in his diocese described and painted, including the useful plants. According to the botanist Rainer Bussmann and the anthropologist Douglas Sharon, about 40 per cent of those plants are still sold in the coastal markets. A third is now used only in the Amazon, and the rest fell out of use. At the same time many new plants were added. In their view, healers in Peru could experiment more freely than in Ecuador, where traditional medicine was persecuted for a long time.

Curanderos and curanderas, male and female healers, treat body and soul together. Many complaints that bring people to them are called in Spanish susto or espanto (fright), mal aire or mal viento (bad air), mal ojo (the evil eye), envidia (envy) and daño (harm through sorcery). According to Bussmann and Sharon, more than a quarter of all the plant uses they recorded concern such 'magical' complaints.

Plants have a character of their own: they are hot or cold, and some are strong or even dangerous. Plants from the high mountains, especially from around the sacred lakes, are considered particularly powerful. The best known are Las Huaringas near Huancabamba, where healers and patients travel.

In their work healers use a mesa, an altar laid out on a cloth. On it lie shells, stones, staffs and ancient pottery, next to crosses and images of saints. The old Andean world and Christianity stand side by side: the prayers call on Christ and the saints, but also on the mountains, the apus, and the lakes.

A healing often begins with a limpia, a cleansing: the healer sweeps the patient with plants, an egg or a guinea pig and sprays him with holy water and perfume. From the guinea pig the healer then reads what ails the patient. A ceremony is often followed by a baño de florecimiento, a 'flowering bath' with flowers and fragrant herbs. Patients sometimes take home a seguro: a small bottle with herbs, perfume and personal items that protects them and brings luck.

Healers rarely work with a single plant. Bussmann and Sharon recorded 974 different mixtures, usually of two to seven plants. For ordinary complaints, such as coughs or kidney problems, healers often use the same mixtures. For spiritual complaints each healer has a recipe of his or her own, which is closely guarded. Most remedies are boiled in water. In laboratory tests, extracts in alcohol were often far more toxic than those in water: in many cases the traditional preparation is the safer one. In the same tests, plants that healers use against infections inhibited bacteria far more often than plants without such a use: according to Bussmann and Sharon, about three quarters against one third. Plants used mainly in seguros rarely did.

Many plant names reflect history. About two thirds of the names are Spanish. The rest come from Quechua, such as cuti cuti, or from the extinct Mochica language, such as espingo.

The knowledge is passed on orally, from healer to apprentice and within families. Spanish chroniclers such as Nicolás Monardes, José de Acosta and Bernabé Cobo described the useful plants of Peru. Later came the botanists Hipólito Ruiz and José Pavón and the Italian Antonio Raimondi.

In the 1970s the anthropologist Douglas Sharon worked with the curandero Eduardo Calderón from Trujillo. His book Wizard of the Four Winds (1978) and the film Eduardo the Healer made northern curanderismo known around the world. Later, with Bussmann, he described 510 medicinal plants from the markets of Trujillo and Chiclayo, with about 2,500 uses. In their book Medicinal Plants of the Andes and the Amazon (2015) they stress that the knowledge remains the property of the healers and vendors who shared it.

Peru increasingly recognises traditional medicine. In 1991 a National Institute of Traditional Medicine was set up, with the physician Fernando Cabieses as its first director. Since 1999 the social security system EsSalud has had centres for complementary medicine, including one in Trujillo, where doctors prescribe medicinal plants. In 2022 the Ministry of Culture declared the traditional use of San Pedro in the north to be cultural heritage.

In the markets of Trujillo and Chiclayo, such as the Mercado Mayorista and the Mercado Modelo, dozens of stalls sell medicinal plants. Small stalls mostly carry ordinary herbs such as chamomile, horsetail and eucalyptus. Large stalls specialise in everything healers need, from 'magical' plants to perfumes and amulets. According to Bussmann and Sharon, the trade in these markets brings in some 1.2 million dollars a year.

The tradition changes with the times. Healers take up new plants, such as noni, and some now also use ayahuasca from the Amazon. Many people combine herbs with conventional medicines.

There are also concerns. Plants are often sold as powder, so no one can see which species it is. Different species are sold under one name, and sometimes a completely different plant is sold as 'cat's claw'. Some species are overharvested, such as cat's claw, huamanripa and hercampuri. The land where the plants grow is disappearing through the growth of cities, large sugar and rice plantations and mining in the mountains, including near the sacred lakes.

The markets sell plants from every corner of the country. From the coastal desert and dry forest come palo santo, whose wood is burned as incense, and tara, whose pods are used to gargle for sore throats. Molle (pirul) is a tree used for rheumatism and coughs and in cleansings. The pods of the algarrobo are boiled into a sweet syrup given as a tonic and for coughs.

From the mountains come bitter plants such as hercampuri, corpus way and other gentians, used for liver, gallbladder and blood sugar complaints. They include pasuchaca, one of the best-selling remedies for diabetes, the 'blood-cleansing' canchalagua and the root of rhatany, which is rich in tannins. Huamanripa serves for coughs and asthma, muña for stomach ache and wind, and manayupa for inflammation. The leaves of yacón are drunk for diabetes, and the Peruvian elder (sauco) for fever and coughs. Giant horsetail is among the best-selling remedies for bladder and kidney complaints, as are achiote and chanca piedra, the 'stonebreaker'.

From the Amazon come cat's claw, sangre de grado, guayusa, matico and the fragrant mucura, used in flowering baths. The bark of chuchuhuasi and the parasitic huanarpo are steeped in wine or cane spirit as a strengthening drink, and the fragrant seeds of ishpingo go into baths. Coca, cinchona bark, maca and tobacco also belong to Peruvian herbal knowledge.

Many everyday remedies came with the Spaniards: chamomile (manzanilla), the best-selling herb on the markets, rue (ruda), wormwood (ajenco), lemon balm (toronjil), rosemary (romero), fennel (hinojo), plantain (llantén) and eucalyptus.

Some plants are sacred or dangerous and belong only with experienced healers: the San Pedro cactus, floripondio or misha, and the poisonous cabalonga.

San Pedro and floripondio are at the heart of the night-time ceremonies. The card for San Pedro describes how the tradition prepares the cactus, with the risks and the legal status; for floripondio and cabalonga we deliberately do not, because the effective and the lethal amounts lie close together. Mescaline, the active substance in San Pedro, is banned in many countries; in the Netherlands it is on List I of the Opium Act. Ceremonial tourism puts pressure on the tradition. Curanderos from the north have expressed their concern in a joint statement about foreigners collecting wild San Pedro.

The knowledge in this story was written down by researchers, but it belongs to the healers and vendors who shared it. Peru has a law protecting the collective knowledge of Indigenous peoples, and a commission against biopiracy that challenges unjustified patents, for example on maca.

Preferably buy plants from cultivated or sustainably harvested sources, and be careful with powders of unknown composition.