Aztec Medicine, Health, and Nutrition (review)

David Tancredi

Perspectives in Biology and Medicine, Volume 35, Number 2, Winter 1992,

pp. 307-309 (Review)

Published by Johns Hopkins University Press

DOI: https://doi.org/10.1353/pbm.1992.0003

For additional information about this article

https://muse.jhu.edu/article/402667/summary

Access provided at 2 Mar 2020 21:43 GMT from Drew University Library
BOOK REVIEWS

Aztec Medicine, Health, and Nutrition. By Bernard R. Ortiz de Montellano.

New Brunswick, N.J.: Rutgers University Press. 1990. Pp. 308. $40.00 (cloth);
$15.00 (paper).
Like other New World peoples, the Aztecs suffered tremendously from crowd
diseases carried by European explorers and conquerors. Some researchers have
sought to explain the catastrophic effects of disease among the Aztecs in terms
of a chronic underlying compromised health status that rendered them particu-
larly susceptible to disease. Bernard Ortiz de Montellano argues to the contrary:
on the whole, the Aztecs were a healthy people in nutritional status and underly-
ing pathology, and further they could rely on a sophisticated and surprisingly
effective medical system in times of illness. While admirable for its holistic per-
spective on health, eclecticism of argument, and breadth of scholarship, this
work raises a number of problems.
The Aztec diet, Ortiz de Montellano claims, was both ample and nutritious,
fulfilling a necessary precondition of immunological competence and good
health. The caloric adequacy of the diet, however, is not established beyond the
level of possibility; his argument depends on controversial population estimates
for the Valley of Mexico in the sixteenth century. While Ortiz de Montellano
appears justified in rejecting previous population estimates that significantly
transcend the projected carrying capacity, little can be said about how much
food was actually available to the people. Needed also is information concerning
distribution—not merely the logistics of allocation, but the differential access to
resources that arises along social class lines. Perhaps the case for the health
status of the Aztecs, concerning diet and even underlying pathology, could be
strengthened by examining the archaeological record? More convincing here is
the interesting discussion about the diversity of the Aztec diet. Supplemented
by a variety of plant and animal products, including algae and insects, the Aztecs'
corn-based diet appears to have provided adequate and well-balanced nutrition.
Here Ortiz de Montellano pauses to dispense with a little meritorious but oddly
recalcitrant argument to the effect that the practice of cannibalism among the
Aztecs had adaptive significance as a means of increasing dietary protein. Not
only was the Aztec diet sufficient in protein, Ortiz de Montellano argues, but the
amount of protein available through cannibalism, even under the most generous
estimates, turns out to be insignificant, even if the estimates are confined strictly
to the Aztec nobility—who alone engaged in this practice. Aztec cannibalism

Permission to reprint a book review printed in this section may be obtained only from
the author.

Perspectives in Biology and Medicine, 35, 2 ¦ Winter 1992 307

had its roots in religion and ritual, as does cannibalism everywhere else it has
been discovered.
Surely the most important contribution of this book, but also its most problem-
atic aspect, is the discussion of Aztec medicine. By interpreting critically the
available sources on Aztec culture written soon after the Conquest, Ortiz de
Montellano portrays a comprehensive system of medicine among the Aztecs.
He provides a concise account of Aztec cosmology, Weltanschauung, and social
structure, drawing out the symbolic connections of the body and the cosmos in
Aztec thought and tying together notions of health and complex cultural and
religious beliefs. He demonstrates the priority of the Aztec value of moderation,
believed necessary to maintain order amid the tendency toward chaos in body
and universe alike. His accounts of Aztec beliefs and practices relating to health
are fascinating, from divinatory diagnosis, to the use of pharmacologically active
herbal remedies, to obsidian scalpel surgery.
There are problems with this account, however. The assumption that Aztec
medicine is a coherent and unified set of beliefs allows Ortiz de Montellano
to extract a systematic account from often contradictory sources and to make
important logical inferences concerning the relation of disease etiology and
treatment that figure into his evaluation of Aztec medicine's effectiveness. This
assumption warrants scrutiny in light of the author's claims regarding the social
configuration of Aztec medical practice. To the extent that Aztec medicine was
the domain of shamans, the individualistic and little-organized social structure
of medical practice does not provide for a standardization of medical knowledge
and practice. Are the contradictions in the historical sources evidence of differ-
ent coexisting "systems" of Aztec medicine?
Another source of difficulty is the link between Aztec medicine and health.
The link seems clear enough in those treatments that can be shown to be effica-
cious by biomedical standards. Ortiz de Montellano goes further to evaluate the
ernie effectiveness of Aztec medicines, that is, the effectiveness of these medi-
cines to induce physiological changes that would be prescribed under the Aztec
ethnotheory of pathophysiology. For example, an emically effective treatment
for a disease resulting from an excess of phlegm would involve removal of the
excess through emesis, diaphoresis, diuresis, etc. Such a treatment contributed
to health ultimately through the placebo effect. Patients, understanding the
etiology and perceiving the physiological changes brought on by the medication,
would believe themselves to be on the mend and therefore often were. One
difficulty with this provocative but highly speculative line of argument is that
the documentation on Aztec conceptions of disease etiologies is incomplete,
requiring often tenuous inferences about a system whose logic is not readily
obvious. In addition, the special case status of the placebo effect is attenuated
to the extent that, as most often found elsewhere, patients and healers did not
share the same explanatory model of disease. Finally, while the list of pharmaco-
logically active agents discovered in Aztec herbal remedies is impressive, further
investigation on the bioavailability and pharmacological activity of these agents
as administered, in vivo, is required to show that the remedies would have the
effects postulated. In the end, one might ask why Ortiz de Montellano has
chosen to emphasize the health effects of Aztec curative practices over public

308 Book Reviews

health and sanitation measures, given the tremendous effect of the latter on
health.
Where this account demands that we take Aztec medicine seriously, it does
succeed in providing a basis for understanding some of the approaches to health
found among Mesoamerican peoples today. In a discussion of syncretism in the
medical domain, Ortiz de Montellano offers insight into the origin and temporal
transformation of many regional folk medical beliefs. By opening up an in-
triguing area of history while addressing issues relevant in contemporary health
care contexts, Aztec Medkine, Health, and Nutrition proves a solid contribution to
the literature on health and medicine in Mesoamerica.
David Tancredi
Department of Anthropology
University of Chkago

TL· H^ory of Yellow Fever. An Essay on the Birth of Tropical Medicine. By François
Delaporte. Cambridge: MIT Press, 1991. Pp. 181. $19.95.
The reconciliation and solution of the contradictory accounts concerning the
1900 discovery of a cure for yellow fever are tackled by an epistemological
approach to the history of science by Delaporte. He traces the roots of this
medical 'who-dunnit' and "shows both pictures to be false because they neglect
important historical antecedents and connectives." His perspective on the con-
quest of yellow fever "emphasizes that the significance of the event should not
be centered on the nationalistic claim to a medical discovery, but rather the
eptáemological shift which allowed scientists to conceive of the mosquito as the
vector for the transmission of disease. This conclusion elucidates the political
uses to which the story has been put, in both Cuba and the United States."
The author has "attempted to lay the groundwork for the history of science
in the true sense: namely, the analysis of theoretical structures and scientific
propositions, of conceptual building blocks and their field of application." He
has clarified and sanitized the relationships between Manson, Finlay, Durham,
Myers, Ross and Reed. His analysis indicates that the merit of individuals is not
at issue.
The solution of the mystery surrounding the cure for yellow fever portrays
and heralds the birth of tropical medicine.
Ronald Singer
Department of Anatomy
University of Chicago

Understanding Medical Terminology, 8th ed. By Sr. Agnes Clare Frenay and Sr.
Rose Maureen Mahoney. Catholic Health Assoc, of the United States, 1989.
This is more than just an abbreviated and simplified medical dictionary. It is
a current and authoritative introduction and explanation of medical terms. It

Perspectives in Biology and Medicine, 35, 2 ¦ Winter 1992 309