Read Ebook: Peru as It Is Volume 1 (of 2) A Residence in Lima and Other Parts of the Peruvian Republic Comprising an Account of the Social and Physical Features of That Country by Smith Archibald

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Their soups, together with a great variety of vegetable dishes, are so heated with agi-pepper, that the coats of the stomach would indeed require to be well greased to protect them against the piquant effects of this popular condiment. Useful and even necessary as this agi is found to be by those Indians of the valleys who cultivate it around their doors, and whose diet is nearly all vegetable, yet in a climate like that of Lima, and in constitutions so delicate as those of its inhabitants confessedly are, it must prove injurious to the organization of the stomach, and to the health in general, when freely and daily taken with a plentiful allowance of animal food, and a general mode of living sober but not temperate; for though the better classes deal sparingly in wine, yet, by partaking more or less of every dish at table, and these not a few, they usually eat more than the powers of digestion can comfortably apply to the support of the frame, not usually exposed by so indolent a people to great waste from athletic exertion.

Of water taken by the writer from the fountain of the great square in Lima, just as the river began to rise in January from the effects of the inland rains, he is happy to be able to furnish the following analysis by Dr. Thomson of Glasgow.

Sp. gr. 1?00028; purer than Clyde water: 1000 grains contained

Grains.

Nature has supplied the Peruvians of the coast with fruits most suitable to their wants; and these, though often injurious when eaten in a state of immaturity, or when the stomach is not in a fit state to receive them, are yet, when used in season, most grateful to the taste, and salutary to the constitution, in the regions where they abound.

We shall, therefore, introduce in this place a list of the fruits produced in the orchards in and about Lima, with a specification of the months when they are in season. This we are happily able to do by presenting our readers with a list, obligingly given to us by Mr. Mathews, an English botanist, now making rich botanical collections in the interior of Peru; but whose occupation, as an horticulturist at Lima, afforded him the best opportunity for exact and practical information on the subject.

Plantains produce all the year, but the greatest abundance is during the hot months. The pepino is also much eaten during December, January, and February. In the months of April and May, the pulp surrounding the seeds in the pod of the pacay are much eaten.

In addition to the above account by Mr. Mathews, we may notice that the melon and sandia, or musk and water-melon, are much cultivated in the neighbourhood of Lima; and are to be seen in large heaps by the bridge, and at the corners of streets, where they are bought up, and consumed with avidity, in the hot month of February. Olives too, and very good ones, grow in the Vale of Rimac, and arrive at maturity in February and March. During the late civil wars, several valuable olive plantations were wantonly cut down. Strawberries, and likewise "tunas," or Indian figs, of inferior quality, grow in Lima; but the market is supplied with these fruits, and of the best quality, from the neighbouring valley of Sta. Ulaya. The pine-apple does not ripen spontaneously in Lima, though attempts are now making near the Callao gate of the city to cultivate it. The pine-apple eaten in Lima is usually brought from the eastern side of Peru, from the Monta?a of Tarma and Guancayo, &c. Sometimes, also, a few pine-apples are carried from about Moro on the coast to the northward; but these often decay before they arrive in Lima.

Remarks explanatory of certain Dietetic maxims, and established notions or prejudices, illustrative of the physical constitution and domestic habits of the Limenians.

In Lima there are certain opinions and rules, relating to the nature and cure of diseases, so very popular and well received among the vulgar, and at the same time so habitually countenanced by many of the native practitioners, that, for any one who proposes to practise in that part of the world, and hopes to be honourably acquitted by the jury of nurses and attendants who are always numerous about the sick, it may be worth while to consider the tenor of the following remarks:

Every one, we think, will admit that the practice of medicine must be modified, or considerably altered, according to the topography of any particular country; for it is observed, that difference of locality affects not only man, but plants and animals, in a striking degree as we extend from the Equator towards latitudes far to the north or south of it. Yet, if there be any who understand either the botany or zoology of Peru, or who endeavour to illustrate these subjects by their science and diligence, they are not Peruvians.

It is indeed to be hoped that no respectable physician in Peru will hereafter indulge in the folly of maintaining that Europeans are neither fit to practise in that country, nor able to comprehend the peculiar influences of the climate of Lima. This climate, like every other on the known face of the globe, is open to the investigations of the meteorological observer, whether he be a native of the Old or New World.

The laws of physiology, we may further observe, like those of gravitation, are the same in Peru as in other parts of the world; and the aphorisms of Hippocrates, generally founded on accurate observations made more than two thousand years ago, are at this day equally true as when first embodied, and applicable to man's physical constitution all over the globe. The medical treatment of diseases, whether conducted at home or abroad, must be conducted in conformity with the common and immutable laws of the animal economy, and with due attention to the constitution and temperament of individuals. The locality of the patient's birth or residence, the influence of climate, diet, and habits, &c. are mere accidental circumstances, secondary and subordinate considerations, which every physician or medical officer of our fleets and armies, to whatever clime he be transported, should be able to survey and to estimate, like the skilful commander who, as he reconnoitres his ground, perceives the local character of a new field of action.

Should a Limenian in perfect health, who thus drinks water at stated periods, feel thirsty shortly after a meal concluded, as usual, with sugar or some sweet-meat and water, he is taught to endure the inconvenience rather than bring on himself indisposition by indulging his thirst. To understand this, it is requisite to know, that, until three hours have elapsed after the taking of the last meal, no one is supposed to drink even water, which is the most common beverage of the natives; for to commit such an irregularity would, it is believed, be to occasion a fit of indigestion or to hazard health.

This may appear a ridiculous prejudice to those who are accustomed to quench their thirst, as often as it naturally arises, without regard to rules; but, on the coast of Peru, the neglect of this prophylactic rule of only drinking at stated periods, when it violates the established habits of an individual trained up in the observance of it, may be allowed to be injurious to the health, as it certainly disturbs the digestive functions. This strict attention to measured periods of drinking water is also countenanced in the hill-land of the interior, where digestion is usually so vigorous as not to require such nice precaution: but it is patronised by custom; and this, no doubt, the majority hold as a sufficient reason for the continuance of the practice.

When a person suffers from acute febrile disease, and is only allowed very spare and tenuous diet, such as chicken soup, panada, tapioca, or arrow-root, &c.; then, from one meal to another, the regular interval is five hours; three hours after each meal, water, or some medicated drink, is given; and, two hours after this drink, the allotted aliment, of whatever simple sort it may be, is again repeated. Thus food and drink are regularly alternated till the patient is considered to be in a state which requires the supply of solid food; and then, as when in ordinary health, the interval from meal to meal is understood to be seven hours. The solid food given to the convalescent generally consists of chicken, which, of all the items in the list of Limenian dietary, is that in most general requisition. Now, for the proper digestion of the chicken, five hours are allowed before any medicated drink is ordered after it; and the principle recognised in this method is, that drink, which too much dilutes and weakens the gastric juice in the stomach, cannot with propriety be taken before chymification is complete.

Nurses, and very kind and obliging friends, usually attend so strictly to the above order in giving food and drink, that, though the poor patient be burning with thirst, he can only have permission to quench it at the fixed and assigned hours; and, through a feeling of pure benevolence towards the sick, they interrupt a salutary sleep rather than fail in punctually giving either drink, nutriment, or medicine at the corresponding hours. Under the influence of an amiable sense of duty, the anxious mother is often heard to assure the doctor that she herself was attentive to give her child its drink or medicine at exact time, as announced from the nearest church spire by the striking of the clock; though it grieved her to interrupt its gentle slumber.

During the exacerbations of intermittent fevers, so prevalent in Peru, the state of the stomach is usually much disturbed; and in such circumstances, instead of alternating food and drink without regard to the condition of the digestive functions, we have taken pains to persuade the sick to deviate from the order established by custom, and allowed our patients the inexpressible comfort of drinking as often as thirst urged them, until there was obtained a solution of the febrile exacerbation.

In a large proportion of cases where this cause of mischief is supposed to exist, it has, in fact, no place or existence except in the mind that conceives the notion of it; and, in itself, the fallacy is harmless so long as it is speculative: but the practice to which it leads is often mischievous, and it is with the latter that the practitioner has most to do.

It would, indeed, be a hopeless task for the regular practitioners in Peru to reason a Limenian doctress out of her reveries on the subject of empacho, which, when viewed by her as the exciting cause of disease, assumes a Protean character, and is visible to her imagination in mostly every case of ailment, which she, true to her favourite opinion, offers to cure in her own way.

The evil effects of a farrago of nostrums, or untimely and inappropriate medicaments applied by the help of the doctress, the educated physician is often called, but sometimes too late, to correct; and the fatal abuses thus arising have, on various occasions, called forth the public and earnest remonstrances of the highest medical tribunal of the country,--but all to no purpose, the practice being rooted in vulgar favour and prejudice.

As a familiar example of the abuse of the jeringa, may be mentioned the vulgar practice of resorting to it in disorders attendant on dentition. Sometimes the increased action of the bowels is indiscreetly stopped by astringents thus adhibited, and a fatal determination of blood to the head ensues; but it more frequently happens that the contrary practice is pursued, and stimulant remedies are administered, which either increase the existing disease, or transmute it into a dysentery. On such occasions the skilful practitioner may endeavour in vain to convince the mother that her child's gastric ailment does not proceed from the presence of the dire empacho. When, as often happens during the progress of teething, children are suffered to eat all sorts of sweets, fruit, and unwholesome diet, or permitted to partake of strong food used by adults, and ill-suited to the more delicate organs of the tender child, then, no doubt, empacho or indigestion may be traced, in many cases, as a co-existing cause of the irritation and disturbance in the bowels, to which the offspring of white parents are more particularly subject in Lima. Complicated cases of this nature demand a prudent modification in treatment. Yet such instances are not so frequent as others, independent of indigestion, and in which a moderate bowel complaint is so far from being injurious that it is most salutary, as a natural protection against affections of the head during the process of teething. It is a peculiarity connected with the religious belief and popular customs of the country, that diseases of infancy and early childhood are too lightly considered by the native physician. The reason assigned for this is the devout one, that little innocents are exempted from the pangs of Purgatory, which must be borne by adults for the purification of their souls; and that therefore, for the child, it is happiness to die.

We have heard the physician offer this consolation to a weeping mother in the higher ranks of society. He softly assured her that her pretty babe would pass through Purgatory to Paradise without as much as scorching a finger in the transit.

In the lower and middle ranks especially, this religious dogma seems to stifle the natural emotions of the heart; for, evidently forgetting that even "Jesus wept," they celebrate with music and dancing the death of the dearest object of a fond parent's affection, who, as her child is consigned to a niche in the Pantheon, bedecks her person, grown thin by previous care and watching, and now she smiles in her robes of white, as if these were indeed no emblems of torn affection!

It will be readily imagined that, in numerous instances coming under the vulgar denomination of empacho, the subtraction of blood will be a necessary measure before purgatives can be properly or safely resorted to, with a view to remove from the bowels the irritating cause lodged there, and affecting the general system.

But to avoid the unjust criticism of uncharitable members of the profession, who are always ready to turn to their private advantage, any popular prejudice which can be called in to humble the name of fellow-practitioners more respectable than themselves, and also as a mean either to acquire or to preserve the confidence of the sick, the prudent physician will not overlook the natural effects of any known prepossession regarding blood-letting. He will so far accommodate his practice to the ideas of those who are most interested in the issue of his treatment, as to order at least one enema, when the empacho is firmly believed to exist, before he proceed to the further discharge of his professional duty, and fulfilment of the indication of the case, by ordering the lancet to be applied.

No time or advantage is lost by such a concession to the preconceived and inflexible opinion, that bleeding is particularly hurtful in those cases of illness connected with undue accumulations in the bowels: but one very important end is gained by it; since, by agreeing with the sick and their friends on an indifferent point of practice, they will more willingly submit to the application of other remedies necessary for the safety of the patient.

When the physician prescribes any particular diet or physic to a patient in Lima, he must be ready to answer many inquiries regarding the qualities of the things prescribed.

Besides professed sick-tenders, zamba housekeepers or head-servants, some women in the middle and humbler ranks, such as manteras, chocolateras, tenderas, cigareras, picanteras, pulperas, changaneras,--that is, female shopkeepers, chocolate and cigar venders, with a subordinate gradation of publicans, &c.--are always ready to talk, with confounding fluency and volubility, without knowledge, concerning qualities and temperaments; and they display a natural acuteness of metaphysical capacity, with a truly peripatetic nicety of discrimination, when, in a moment of oratorical excitement, they assign to certain mixtures and drinks ideal measures and degrees of the elementary qualities. Women skilled in such mysteries, and omniscient charlatans, run over the various combinations of the cold and hot, dry and humid, and all their resulting modifications of temperature and temperament, with apparently unerring precision, and with a graduated exactness which no chemist in Europe, with every advantage of science and apparatus, can pretend to equal in his elaborate investigations into the qualities and elements of bodies either living or inanimate.

The particular temperament of the patient his intimate friends are supposed to know perfectly; and the doctor's reply to any question that may be proposed to him on this subject will be considered, in many instances, as no bad test of his penetration and professional knowledge in other matters with which they do not presume to be themselves so well acquainted.

Colour is looked upon as an indication of constitutional temperament even in the lower animals. Thus, when one in town labours under hectic fever, or consumption, he is recommended to go to the country, and drink warm milk from a black cow, because it is allowed to be more cooling and febrifuge than the milk taken from a cow of any other colour.

In case of a rheumatic swelling of a joint,--the knee, for instance,--or some tumefaction in any of the glands, it is taken for granted, that, whatever other remedy be applied, the envelope for the limb or part affected must be of a medicinal colour, and consist of black wool, or something of a dark woollen texture. In short, so far has this general idea concerning the antiphlogistic nature of black been carried, that few natives dispute its accuracy: nor are we prepared to say that it may not have some foundation in fact and observation ; for it is well known to scientific men, that the free radiation of heat is much influenced by the differences of colour in the radiating surfaces of bodies.

With respect to food and drink, the division into cold and hot is never overlooked.

Various kinds of fruit and vegetable juices, which are considered cool in their qualities, are not rarely most heating in their effects, according to the condition of the system when taken. The melon is in reputation for its cooling nature; but, though the impression made by it on our alimentary organs is at first very refreshing, the muleteer who journeys from the Cordillera to the coast, and has but once in his lifetime been attacked with a gastric tertian, in consequence of cooling his parched fauces by eating of the melon, can give a lively account of the internal heat, agitation, and oppression experienced by him on the occasion. There is no cooling fruit safer than the granadilla, which is most grateful and refreshing to the feverish patient, or thirsty traveller in the scorched and rock-bound ravines and narrow valleys of the interior, where this fruit is often abundant, as it is also on the coast in its proper season.

This chicken-tea, called "agua de pollo," is commonly prepared in the proportions of three cupsfull of water to one half of a little unfledged chicken, with the addition of a mallow leaf or two, and the core of a lettuce, by which latter in particular its cooling properties are said to be exalted. After the ingredients are boiled together for a proper length of time, the clear decoction is poured off for use. The great efficacy of this drink is accredited by the undisputed consent of doctors of all colours, and matrons as well as nurses of all sorts and temperaments.

It is needless to remark that, in general, plain water or toast-water, or a ptisan of barley decocted with some of the subacid fruits of the country, would answer very agreeably the purpose of the agua de pollo; but when the latter is preferred, it should be remembered that in warm weather it decomposes rapidly, and then acquires irritating properties. As a purgative, in gastric disorders, the old physicians in Lima extol almond oil, which is often of inferior quality; and they take some pains to arm the minds of the credulous against the use of the best castor-oil of European preparation, by telling them that it is extracted from the seeds of the "higuerilla," or castor-oil shrub, everywhere indigenous in the warm valleys of the interior; and these seeds are generally known to be excessively drastic when taken as the peasants use them, in the dose of two or three bruised, and then swallowed in substance. Now from the seeds the native apothecaries prepare an impure oil, which is sold in the shops under the name of "oil of higuerilla;" and as it is only used for burning in lamps, when the vulgar learn that castor-oil is but another name for the same, they naturally consider it as essentially hot, and most heating and improper for internal use. The vulgar should be advised by every ingenuous and intelligent member of the profession, that the fault is not in the remedy, but in the way of preparing it: and this remark may be extended to the delicate preparations from the mineral kingdom, which acquire a bad name when badly prepared, as is necessarily the case in Lima, where chemistry is so little cultivated or practised as a science.

This opinion seems to have partly originated from a notion, once entertained by the doctors, that acids coagulate the animal fluids, and so produce obstructions and disease. It is made evident to our senses, that milk secreted from the blood is readily coagulated by acids; and thus they seem to conceive that something of the same process takes place in the circulating fluids of the body when acids are taken into the system.

Not only the vulgar, but some of the professional characters, appear to be impressed with the notion that the blood is thickened or curdled by acids, whether mineral or vegetable; and that the delicate circulation of the lungs is consequently impeded, and the respiratory pores clogged. This opinion appears to be expressed in the very common remark, "El enfermo tomo fresco de lemon, y con el acido se le ha tupido el pecho," which means that the patient drank cold lemonade, and with the acid the breast was stopped up.

We are well persuaded that there are instances, especially among delicate females, where the respiratory organs are so susceptible of impressions, that the immediate refrigerating effects of cool acidulated drinks on the stomach of such persons extend rapidly, by sympathy, from the stomach to the surface of the body and lungs; and there produce a certain degree of constriction on the exhaling vessels, which disturbs their healthy action.

It is only in this manner we can account for the fact, as frequently stated to us by patients, that, as certainly as they did take anything cool and acidulated, they were speedily affected with a tightness about the chest, and felt as if they had actually caught cold. On such occasions their usual observation was, "El acido me ha cerrado el pecho,"--the acid has locked or closely shut the breast.

A complicated ailment which is vulgarly conceived to be seated in the chest, is often met with in Lima during the sultry months of January, February, and March. It is attended with a short and dry cough, a foul tongue, and evening fever, or restlessness, that chases away sleep. The patient becomes low-spirited and anxious; and dreads an approaching attack of consumption, or spitting of blood.

In illustration of the fact here stated, it may be mentioned that we were once called to see a lady in Lima who had been ailing for about a twelvemonth; and, on inquiring why she had delayed her cure so long, her reply was,--

In this instance the error, for which the French physician was blamed, consisted in his having overlooked the popular rule universal in Peru, and probably not unknown in Chile, that "acido sobre la leche es malo," viz. that acid after milk is hurtful.

According to this rule in Peruvian dietetics, it would be considered little short of poisonous to use milk or cream with any sort of fruit, jam, or preserve containing the least quantity of acid. And here it may be noticed, that in their own preserves, they completely destroy the rich and distinguishing flavour of the fruit by an excess of sugar, just as they annihilate, in very bad taste, the peculiar and natural fragrance of their finest flowers by sprinkling upon them foreign and artificial perfumes.

During their confinement ladies are not sufficiently exempted from this friendly intrusion, or neighbourly attention. The only restraint imposed upon those who visit a lady on such an occasion is, that they do not enter her apartment with flowers or perfumes; nor are the attendants permitted to introduce censers with the fumes of burning incense, as is customary at other times. Thus, it is acknowledged that "Los olores son malos para las recien paridas," viz. that perfumes are injurious to women during their confinement; and they certainly are so, for they are frequently observed to give rise to fainting, convulsions, or other bad consequences. These precautions all who visit or wait upon the sick are strict in observing; and so much the more, as it is customary for females in every rank to use perfumes on their dress, and to decorate their heads with flowers for evening visits: a practice in which the woolly-haired negress and mulatta greatly excel, as they love to adorn their stunted curls with flowers of aroma and jessamine.

When there is a feeling of sickness and faintness, with a disconsolate sensation at the epigastrium or scrobiculus cordis, they are allowed on all occasions to apply to the stomach, as a popular remedy with the matrons, a bit of warm toast, or the breast of a fowl sprinkled over with powdered cinnamon and moistened with wine, or, as it is vernacularly expressed, "la pechuga de gallina con vino y canela;" and they agree that this application, which possesses a great deal of their confidence, commonly produces the best effects.

We were once consulted by a curate of an irritable disposition, and an epicure in his taste, on account of an induration and very prominent enlargement of the liver, which some time after ended in a fatal abscess. This gentleman assigned, as the exciting cause of his malady, his having drunk cold water when angry, or on occasion of a quarrel he had with his cook, a Zamba girl, who we may suppose must have spoiled some favourite sauce.

This was the first time we were consulted on an ailment said to arise from drinking cold water when angry. But afterwards, as we had engaged in more general practice, we were called upon to listen to very many statements of the same sort; and, on such multiplied and independent evidence, we are compelled to believe that this is indeed one of the usual causes of hepatic derangement very prevalent in Peru.

During these fits of anger the brain appears to be greatly excited, and the flow of blood to it increased; and the liver, which readily sympathises with the brain in our mental states of angry emotion, seems to be at the same time gorged with blood. Under these circumstances, we think a draught of cold water operates injuriously, by creating a sudden chill within, and inducing, through the channel of sympathy between the stomach and liver, contraction of the biliary excretories, which lays the foundation of more permanent congestion and consequent inflammation, by preventing the natural relief which should arise from a free flow of bile. That the ready flow or free outlet of bile is the natural and proper medium of relief in such cases, every one has an opportunity to judge; for fits of anger are so common in Lima, that a day never passes without witnessing or hearing of their ill consequences; and the most familiar and immediate effect is a bilious disorder of the bowels, or indigestion and subsequent vomiting,--just as the stomach happens to be occupied, or otherwise, during the period of mental perturbation.

We may remark, that ice and iced water are only considered safe when they are given after the violence of the commotion is over, and after the stomach, if it happen to be loaded, has, by drinking warm water or otherwise, been freed of its contents; but in hot weather, when the skin is more relaxed, and the bilious secretion more plentiful and redundant than common, ices are much used, and iced water forms the usual drink at the hour of meals.

We meet with persons who never experience the smallest annoyance or approach to anger, without being affected by some corresponding movement in the bowels; and others are never known to get warm in earnest discussion without feeling some derangement at the stomach, or showing on the following day a white or furred tongue. In truth, the delicacy of the digestive organs, or that mobility by which their functions are so easily affected by mental emotions, is quite extraordinary; and, as the daily repair and due sustenance of the whole frame depends on the regular and healthy discharge of the digestive functions, it is not to be wondered at that, among a people by no means intellectual in their habits, the sword should often be observed to wear out its scabbard,--in other words, that the frequent agitations of passion should induce serious diseases, and easily wear out the frame in a country where the sympathy between the mind and chylopoetic organs is so very marked and influential. Hence the anxiety which experienced natives feel at the hour of awakening repentance, or the return of sober reflection, after a culpable indulgence of anger; and hence, too, the rigid abstinence or tenuous diet attended to after one has been fretful or out of temper, till the pulse is again observed to be natural, and the organs of digestion sufficiently composed: and to show how far these painful states of mind may affect the secretion of milk, we have only to recollect that the Lime?a will hear her babe cry a whole day, rather than harm it by giving the breast till her own agitation, which she knows vitiates her milk, is quieted after one of those choleric movements which it has been either her fault or misfortune to suffer.

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