Maya Medicine, Healers, and Herbal Remedies

Maya medicine was a hybrid discipline that combined empirical observation of the body, the plants, and the seasons with a ritual framework in which illness was a sign of misalignment with the gods, the ancestors, or the social order. The two halves were inseparable in practice. A Maya healer — called ah men, “he who knows,” or ah k’in, “he of the day,” the same word used for a daykeeper-priest — would recite a prayer, blow on the affected part of the body, sprinkle a few drops of liquid, and tie an offering to a sacred tree; in the next breath the healer would give a decoction of bark or leaf, set a bone, or perform surgery. The healing tradition is surveyed in this page and detailed in three related articles: What plants did Maya healers use as medicine?, What did Maya surgeons do for patients?, and the ritual dimension is also covered in Maya rituals of bloodletting and sacrifice.

The healers: ah men, ah k’in, ix ah men, and the pul

The healer-priest was an ah men (sometimes spelled ahmen in colonial orthography) or, when the specialization was calendrical-divinatory, an ah k’in. Both offices are recorded in inscriptions at every major Classic site. The ah men was responsible for diagnosing and treating illness, performing ritual cleansings, and preparing offerings; the ah k’in was responsible for the almanacs, the day-counts, and the divination of future events. In smaller communities the two roles were often filled by the same person. The ix ah men (literally “she who knows”) was a female healer, almost always a midwife, who attended childbirth and was the primary care-giver for women and children. The role had prestige: the widow of a k’uhul ajaw (“holy lord”) king, or the mother of a king, sometimes carried the title in Late Classic inscriptions.

The pul was a ritual bloodletter, mentioned in the inscriptions and ethnohistory of the Yucatan and central lowlands. The pul used obsidian lancets, stingray spines, and whips made of stingray tail to draw small quantities of blood from the tongue, ears, genitals, or other parts of the body as a sacrifice to the gods. The same operation was sometimes used to treat a patient for headaches, eye complaints, or feverish illness. The relationship between the pul and the ah men was close but not identical: the pul was a specialist in bloodletting, while the ah men was the general physician.

Training in the healing arts was a long apprenticeship, often within a family line. The training combined memorization of an almanac — a 260-day tzolk’in-based table that paired day-names with specific remedies, offerings, and prayers — with practical study of plants, anatomy, and divination. Diego de Landa noted in the Relación de las Cosas de Yucatán (c. 1566) that the indigenous physicians of Yucatan treated him for illness using purgatives, emetics, and prayers in a single session.

Diagnosis: sastun divination and pulse reading

A diagnosis began with a divination. The healer would call on the sastun — a quartz crystal or a polished stone, often spherical or oval, sometimes a piece of obsidian or a deer bone — and rub it with the thumb while asking the spirits the cause of the illness. The sastun, or a pair of crystals, would “answer” by moving under the thumb, and the healer would interpret the motion as the source of the disease. Common diagnoses included “lost soul” (the patient’s pixan had wandered away), “sent illness” (an enemy had sent a sickness-spirit), “hot” or “cold” imbalance, and “fright” (susto).

The same root system, with local variations, survived in the highland Maya communities of the colonial and modern periods. The Tzotzil, Tzeltal, and Chol Maya still use sastun divination in ethnographically documented healing rituals. The use of the sastun as a divining instrument is treated at greater length in Maya priesthood and shamanism and in the highland Maya context in The living Maya: heritage and modern descendants.

A more empirical diagnostic tool was the pulse. Maya healers of the Yucatan took the pulse at the elbow, the wrist, and the ankle, and associated different rates with different illnesses — a slow pulse, for example, was a sign of a “cold” disease, a fast pulse of a “hot” one. The practice was recorded by colonial-period Yucatec Maya physicians in the sixteenth and seventeenth centuries and is consistent with the pulse-taking traditions of Mesoamerican medicine more broadly.

The hot-cold axis and the humoral model

Maya medicine shared with much of Mesoamerican medicine a hot-cold classification of foods, plants, illnesses, and body states. Hot conditions (fever, swelling, recent childbirth, certain bites) were treated with cold remedies (chamomile infusion, raw plant juices, sweating followed by a cold-water rinse). Cold conditions (slow digestion, joint pain, chills, “fallen” organs) were treated with hot remedies (alcohol, chili, copal incense, the application of heated stones). The hot-cold axis was not the same as the Galenic humoral model of the early modern Spanish physicians, but the two were recognized as compatible by the indigenous physicians of the colonial period. The system survives in modified form in the highland Maya pharmacopoeia of today.

Plants in the Maya pharmacopoeia

The empirical half of Maya medicine is best preserved in the lists of plants that survive in colonial-period sources, especially the Libellus de Medicinalibus Indorum Herbis (the Badianus Manuscript of 1552), an illustrated Aztec herbal that is nonetheless considered to preserve many Maya uses of common Mesoamerican plants, and in the early dictionaries, confession manuals, and ethnographic notes of the colonial Yucatec Maya. The full list of plants and their uses is given in What plants did Maya healers use as medicine?, but the broad categories are summarized here.

The most important medicinal plants included: pericón (Tagetes lucida), used as a tea for coughs, fevers, and “cold” conditions, and as a ritual offering; copal (Bursera spp.), burned as incense in healing ceremonies and used as a wound-dressing when powdered; wild tobacco (Nicotiana rustica), smoked and used in ritual enemas, with emetic and stimulant effects; the morning glory (Ipomoea spp.) and other convolvulaceous seeds, used as a ritual purgative in ceremonies overseen by an ah men; the balché tree (Lonchocarpus violaceus or Lonchocarpus longistylus), whose bark was fermented with honey into the ritual drink balché, used in healing ceremonies; the jaltomato or datura (Datura stramonium and D. innoxia), used as a deliriant and analgesic; the sacred psilocybin mushroom and the peyote cactus, used in divination; guava (Psidium guajava), whose leaves and bark are astringent and used for diarrhea; the ramón tree (Brosimum alicastrum), whose leaves and seeds are a food and a fever remedy; and cacao (Theobroma cacao), which was both a food and a vehicle for herbal preparations. The cultural context of cacao use is given in Cocoa, salt, and Maya trade goods.

Ritual purgatives and emetics — administered to “cleanse” the body of bad humors or of spirit attack — are particularly associated with the Maya lowlands. The five “black drinks” of the late Classic period (cocoa, balché, tobacco water, the seed-purgative, and the mushroom drink) were all used in healing contexts and were administered by an ah men with prayers and offerings.

Surgery: trepanation, dentistry, and bone-setting

Surgery was a recognized specialty within Maya medicine. The skull surgeries are the most spectacular finds, with hundreds of trepanation cases known from sites across the Maya area. The operation was performed with an obsidian-tipped or flint-tipped drill, or by scraping with a stone tool, and the patient was anesthetized with alcohol, balché, datura, or tobacco. Mortality rates — judged by the proportion of skulls showing clear evidence of bone healing around the operation site — vary from about 50 percent in some series to over 80 percent in others, but the operation was clearly performed often enough to be a routine part of Maya medical practice. The subject is treated in detail in What did Maya surgeons do for patients?.

Dentistry was another specialty. Maya healers drilled teeth, removed abscessed material, and inlaid the front teeth of the elite with disks of jade, pyrite, hematite, and turquoise. The inlay was placed in a cavity drilled into the labial surface of the tooth and cemented with a mineral adhesive, often after the removal of enamel. The operation was performed on living patients (modern X-ray studies of buried remains show no evidence that it was a post-mortem practice). Cosmetic dentistry is attested at Copan, Tikal, Palenque, and the royal tombs of the central Peten lowlands.

Bone-setting, the treatment of fractures, and the management of dislocations are all attested. The skeletal remains of the Classic period show many examples of fractures that have healed in good alignment — sometimes with the callus of a clean break, sometimes with the asymmetric healing of a complex break that has been splinted and reduced. The same population of remains shows evidence of amputation in rare cases, and of bone infection consistent with untreated wounds.

The midwife and women’s health

The ix ah men — the female healer, almost always a midwife — was the primary care-giver for women in the Maya community. The midwife attended the woman in labor, used a steam-bath and a series of herbal teas to bring on contractions, and presided over the cutting of the umbilical cord and the disposal of the placenta. The colonial-period sources describe the midwife’s ritual of giving the newborn a sip of a chocolate drink, of offering the placenta to the maize field, and of praying to the ixchel, the goddess of midwifery and medicine, on behalf of the child. The midwife also treated the postpartum mother with a sweat bath, a steam-bath over copal and herbs, and a strict “hot-cold” diet. The role of the midwife is described in Maya family, kinship, and gender roles.

Public health: water, sanitation, and city planning

Maya cities included practical public-health features. Reservoirs, cisterns, and chultuns (subterranean bottle-shaped storage chambers) supplied drinking water in the lowlands, and the placement of latrines, refuse pits, and kitchens followed patterns that suggest deliberate separation of clean and dirty water sources. The aqueduct systems of Palenque and Tikal, the water-management features described in Water management, reservoirs, and chinampas, and the cenote use of Chichen Itza all represent practical public health.

The diet of the Maya — based on maize, beans, squash, chiles, cacao, and a wide range of fruits, greens, and game — was nutritionally adequate by most standards. The skeletal record of the Classic period shows evidence of iron-deficiency anemia, dental caries, and osteoarthritis, but not of the pandemic infections that afflicted the post-conquest population. Dental health was good by the standards of pre-modern populations; the average Maya adult of the Classic period had fewer cavities than a contemporary European.

The legacy of Maya medicine

The herbal, surgical, and ritual traditions of the ancient Maya did not vanish with the Spanish conquest. They survive in the pharmacopoeia of the highland Maya communities of Chiapas, Guatemala, Belize, and Honduras, and in the ritual practices of the Yucatec Maya of the lowlands. The curandero (healer) tradition of the modern Maya, documented in detail by ethnographers since the mid-twentieth century, is a direct descendant of the ah men tradition. Many of the plants of the colonial pharmacopoeia are still used, and the diagnostic categories of “hot-cold,” “fright,” and “lost soul” survive in modified form. The continuity of the living tradition is described in The living Maya: heritage and modern descendants.

Sources

Aveni, A. F. (2001). Skywatchers of Ancient Mexico. University of Texas Press. — link
Saturno, W. A. et al. (2012). Ancient Maya astronomical tables from Xultun, Guatemala. Science 336 (6082), 714–717. — link
Berlin, E. A. & Berlin, B. (1996). Medical Ethnobiology of the Highland Maya of Chiapas, Mexico. Princeton University Press. — link
Sharer, R. J. & Traxler, L. P. (2006). The Ancient Maya (6th ed.). Stanford University Press. — link
Coe, M. D. (1993). The Maya (5th ed.). Thames & Hudson. — link