Non-Elite Healing
Summary
Non-elite healing is the layer of medical practice that operated outside the elite, learned, or institutional medical structure: domestic carers, neighbourhood midwives, herbalists, ritual specialists, country surgeons, and the everyday practitioners that learned medicine often ignored, sometimes appropriated, occasionally persecuted, and could not function without. The term is an analytical convenience, not a name the practitioners themselves used. What it picks out is a relational position, being on the other side of a credentialing line, rather than a single tradition. The page surveys how the encyclopaedia handles non-elite healing as a category, with particular attention to the early-modern Spanish Caribbean, the antebellum U.S. plantation South, and the historiographical project of recovering these practitioners as historical subjects.
The Framing Problem: Whose Practice Counted as Medicine
The most basic question the historiography of non-elite healing has to answer is also the most contested: whose practice counted as “medicine” at any given time, and whose did not. Pablo Gómez’s methodological argument is the encyclopaedia’s lead statement on this question. In the European scholastic-humanistic epistemic hierarchy, empiricism was viewed with disdain as a vulgar form of knowledge inferior to the Aristotelian scientia of learned physicians and theologians.(Gómez, Pablo F., 2017) So-called empirics and superstitious people did not concern themselves with the first principles or final causality that lay at the core of social hierarchies of knowledge production linking philosophy, religion, and bodies. The hierarchy was not just intellectual; it was a guild structure with legal teeth.
Gómez’s solution is to refuse the labels their persecutors used. He declines to call the practitioners he studies brujas, witches, sorcerers, warlocks, or shamans, on the grounds that those terms reflect contemporaries’ efforts to isolate Black ways of knowing from “rational” knowledge production.(Gómez, Pablo F., 2017) He uses the term Mohán, an Amerindian-origin word that the Inquisition scribes themselves applied, and that Inquisition records gloss as “a master of sorcerers.”(Gómez, Pablo F., 2017) The choice is methodological. Reading non-elite healers through the categories of the courts that prosecuted them embeds the prosecutors’ framing in subsequent scholarship.(Gómez, Pablo F., 2017)
The same problem appears on the U.S. plantation. Sharla Fett’s framing rejects a methodology that posits some African American healing beliefs as “superstition” and others as “medicine,” in favour of a meaning-centred analysis rooted in the social, cultural, and political significance of healing.(Fett, Sharla M., 2002) She shows that white slaveholders used the concept of “superstition” as a racial ideology to discredit Black healers, conflating race, religion, and medical competence in a single dismissal.(Fett, Sharla M., 2002) In the antebellum medical profession, regular doctors sought professional legitimacy partly by denigrating enslaved and domestic healers as “old women, root doctors, and quacks of all sorts.”(Fett, Sharla M., 2002) Refusing to repeat that denigration in scholarly form is the historiographical entry point.
The framing matters because it inverts the question. Rather than asking how non-elite healing fared against learned medicine, the historians ask how learned medicine handled the persistent fact that the population it claimed jurisdiction over was largely cared for by someone else.
The Colonial Caribbean: A Permeable Hierarchy
The seventeenth-century Spanish Caribbean offers the encyclopaedia’s most fully documented case of non-elite healing operating alongside and through a learned medical apparatus. The archival picture from Gómez’s The Experiential Caribbean shows a system whose formal hierarchy was real but whose practical permeability was greater.
The formal hierarchy was Galenic. According to the ancient tripartite division of medicine, only physicians could prescribe interventions on the internal body via the six “non-naturals,” apothecaries merely prepared medicines, and surgeons cared for the external body, a division that produced lucrative monopolies for licensed practitioners.(Gómez, Pablo F., 2017) Even in the most sophisticated medicinal treatises of the seventeenth century, explanations concerning the effectiveness of substances with bodily effects remained wedded to notions of divine Christian design and hidden, “occult” qualities. Management of the workings of the internal body was strictly the domain of licensed physicians per legal regulations across Europe and the New World.
The Caribbean was not, however, a plantation economy in the period these practitioners are best documented. Plantation-based economies did not serve as the cornerstones of seventeenth-century Caribbean society; large-scale plantation slave societies arose only in the last decades of the seventeenth century and reached completion in the second decade of the eighteenth.(Gómez, Pablo F., 2017) This matters for understanding why the healing landscape looked as it did: the non-elite practitioners who appear in the archive were not operating in a context defined by cotton-plantation logic but in an earlier, more demographically fluid period of Spanish Caribbean life.
Practical Caribbean healing did not honour those distinctions. The protomedicato in the Caribbean functioned less as a public-health body than as “a mere instrument of occupational control” in a marketplace where “learned humoral medicine offered no more cures than alternative healing practices.”(Gómez, Pablo F., 2017) Black women and men in Caribbean cities served as innkeepers, healers, food providers, surgeons, sex workers, sailors, dockworkers, blacksmiths, and other tradespeople; some enslaved practitioners earned and kept fees that could fund manumission.(Gómez, Pablo F., 2017) Because demographics meant a large segment of the African and Afro-descendant population had been born free or manumitted, African ritual practitioners in the Caribbean did not face the same pressures to conform to European cultural norms as their counterparts in New Spain or Peru.(Gómez, Pablo F., 2017)
Hospitals and the medical economy show the permeability directly. In Caribbean hospitals Black slaves were tasked with washing patients, cleaning wounds, administering medicines, preparing food, and in many cases providing health care themselves; in 1663 the slave Lázaro at Cartagena’s San Sebastián hospital was recorded absent because he had traveled to a nearby village “to cure.”(Gómez, Pablo F., 2017) Diego López, born a slave in Cartagena around 1593, became a renowned mulato barber-surgeon and, by the 1620s, undertook the journey to Santa Fé de Bogotá to be officially licensed; he claimed in 1640 to be “curing fifty people at the time.”(Gómez, Pablo F., 2017) His career, slave, hospital orderly, barber-surgeon, licensed surgeon, illustrates that the boundary between learned medicine and non-elite practice was traversable in both directions for individuals, even as it remained ideologically firm for the system.
Inquisition cases show the inversion at the level of patients as well as practitioners. In 1627 the Portuguese physician Juan Méndez Nieto recorded that the archbishop of the New Kingdom of Granada, having been treated “without much benefit” by Francisco Díaz and other physicians, turned to Mohanes and female healers, who placed his arm “all day long” inside a freshly killed bull until it cooled.(Gómez, Pablo F., 2017) Domingo Congo told Inquisitors in 1658 that the reason for his imprisonment was his cures: “The doctors of Caracas are my enemies because I heal the sick people they leave as incurable.”(Gómez, Pablo F., 2017) When learned medicine ran out of options the elite went to the non-elite practitioner. Black ritual practitioners commonly traced their healing skills to other practitioners, including those of different ethnic origin, against European epistemologies that framed their praxis as “identifiable, secretive, occult knowledge of singular (diabolic or barbarous) origins.”(Gómez, Pablo F., 2017)
The reach of non-elite healing crossed ethnic lines. The black ritual specialist Alonso Venero, born in Vayques, Cuba, told the Holy Office in 1677 that he had learned to cure “numb stomachs” with leaves of a tree called tuatua from country folk and “a Spaniard from Jamaica who had taught him”; he also spoke of encounters with maroons and dead ancestors he called babulares.(Gómez, Pablo F., 2017) Domingo de La Ascensión, deposed in 1665, had learned in eastern Cuba that “rodo de alacrán” was good for wounds, that the water of guayacanes (Guaiacum) cured buboes and colds, and that manzanilla (chamomile) was good for colds and other calentures — a plant lexicon assembled from rural neighbors rather than from any single transmitted tradition.(Gómez, Pablo F., 2017) For these practitioners, knowledge moved through encounter and testimony, not through institutional texts.
The numbers are not negligible. Gómez identifies 102 ritual practitioners of African descent in Spanish Caribbean documents; more than half were criollos born in the New World, with the next-largest groups born in Upper Guinea and West Central Africa.(Gómez, Pablo F., 2017) These are the practitioners who happened to come into the orbit of the Holy Office. The unprosecuted remainder, the practitioners doing routine work that did not summon legal attention, is necessarily larger and harder to count.
Training and Transmission Outside the Academy
One challenge in writing the history of non-elite healing is recovering how practitioners learned. The licensed Galenic system had a legible curriculum: university faculties, required texts, examinations, and formal apprenticeship. Non-elite knowledge moved differently. The Capuchin missionaries who documented Amerindian piaches in seventeenth-century Cumaná described training that was rigorous in its own terms: neophytes studied under designated masters who shaved students’ heads and shut them for months in small shacks only high enough to sit in; many pupils died before completing the schooling, while even more abandoned the training.(Gómez, Pablo F., 2017) These were not practitioners improvising from folk memory but specialists who had passed through a demanding preparation. The missionaries called them “physicians, astrologers, and necromancers” and noted that they were greatly esteemed by communities who “venerated them” and “called them for all matters of curing.”
The piaches also maintained a shared professional culture when facing epidemics: Capuchin accounts describe eight to ten piaches gathering in a hut overnight, singing, imitating dogs, cats, and birds, and at dawn declaring the disease vanquished — a pre-existing collaborative practice for sharing health knowledge during community crises.(Gómez, Pablo F., 2017) The gathering was not superstition in place of expertise; it was a consultation, a mode of collective diagnostic work.
Paula de Eguiluz’s wardrobe, carefully inventoried by the Inquisition in 1623, tells a related story from the other direction. The inventory listed a “dark green wool skirt embroidered with gold,” a “yellow satin skirt with eleven edgings of fine silver,” multiple silk and damask dresses, and shirts from Holland and Rouen — possessions that, as Gómez observes, “do not conform to prevailing beliefs concerning the lives of black slaves in the early modern Atlantic world.”(Gómez, Pablo F., 2017) De Eguiluz was, at the time, a life-sentenced Inquisition penitent, yet she had acquired a material level of comfort through her practice as a ritual healer that exceeded what most contemporary observers expected of any Caribbean Black woman, enslaved or free. Her wardrobe is indirect evidence of demand: patients across the social spectrum were paying, and paying well.
Mateo Arará, an Allada-trained ritual practitioner, expressed perhaps the clearest account of non-elite knowledge production on record. When Inquisitors repeatedly asked him how he knew which “herbs were good to cure diseases,” Mateo answered that he knew this “from his own head” and that, through his own intellectual explorations, he had discovered “the truths of the different herbs.”(Gómez, Pablo F., 2017) This was not a modest man declining credit. It was a practitioner articulating, in his own words, an empirical account of knowledge: trial, observation, and individual discovery, with no institutional affiliation and no transmitted text.
The account that Ambassador Bans brought to the encounter between West Africa and Spain fits the same pattern at a diplomatic scale. In 1657, Ambassador Bans of the West African kingdom of Ardra arrived in Cartagena de Indias on an official trip to Madrid for his ruler King Capoo, who had sent him to discover the secrets behind European monarchs’ reputed longevity.(Gómez, Pablo F., 2017) That a West African king would dispatch a diplomatic mission specifically to investigate European medical practices illustrates a premise the historiography of non-elite healing is still working through: the traffic in health knowledge was not one-directional, and the parties who sent envoys to find out what others knew were not necessarily the weaker ones.
The Antebellum South: Plantation Healing as Non-Elite Practice
In the antebellum U.S. plantation South, the structural position of non-elite healing was different. The enslaved practitioners Sharla Fett documents in Working Cures were not competing for licensure within a permeable Galenic hierarchy; they were healing in a society whose medical system was actively trying to deny them the category of practitioner at all, while structurally depending on their labour.
Enslaved African Americans, Fett argues, were not passive victims of medicine but cultivated a rich health culture with their own practitioners, therapies, and botanical expertise.(Fett, Sharla M., 2002) African American healers grounded their authority in spiritual calling, divine revelation, ancestral wisdom, and dreams, a legitimate knowledge system opposed to white professional credentials.(Fett, Sharla M., 2002) The persistent practice of African American doctoring on southern plantations was a constant reminder that slaveholder power over Black bodies was only partial; conjuring narratives repeatedly affirmed an alternative realm outside white medical and slaveholder control.(Fett, Sharla M., 2002)
The point connects back to the framing problem. Plantation medicine was itself a project of denying the category “healer” to enslaved practitioners while requiring their work. The “old women, root doctors, and quacks of all sorts” rhetoric of antebellum medical journals was not innocent description. It was an attempt to consolidate professional authority by drawing a category line in a place where, on the ground, the line did not hold.
The Ephemeral Materiality of Non-Elite Practice
A persistent challenge in studying non-elite healing is that its evidence does not behave like the evidence of learned medicine. Learned medicine leaves treatises, pharmacopoeias, license registers, and institutional records. Non-elite healing leaves court records of its persecution, planters’ notebooks of its appropriation, and the rare directly recorded testimony of the practitioners themselves.
Gómez argues that the substances used by Caribbean ritual specialists are misread when historians treat them like ingredients on a learned pharmacopeia. The power of these substances “resided in the tactics these practitioners used to claim privileged access to nature’s secrets,” not in pharmacological properties or exoticism.(Gómez, Pablo F., 2017) Histories of materia medica that emphasise “integration” miss what is essential: the inventories speak as much of impenetrability and enclosure as of integration, and the power of these substances depended on local social and experiential authority that “did not travel in lists of materia medica or Jesuit recipe books.”(Gómez, Pablo F., 2017)
Part of what makes this argument possible is a feature of Galenic medicine itself. According to Galenic doctrine, the therapeutic power of medicinal substances was related to specific materials’ qualities and tota substantia — the occult, inexplicable, teleological reason why substances worked in the humoral medicinal system; even in sophisticated seventeenth-century treatises, explanations for how substances worked remained wedded to notions of divine Christian design and hidden “occult” qualities.(Gómez, Pablo F., 2017) The same licensed pharmacopoeia that dismissed non-elite remedies as fraudulent was itself populated with dragon scales, bezoar stones, and theriac — the famous universal antidote made with viper’s flesh — whose efficacy “depended on social and performative factors much more than on their biological, pharmacological properties,” yet which “worked” and were continuously used over centuries.(Gómez, Pablo F., 2017) The distinction between licensed and unlicensed practice was not, on this view, a distinction between pharmacologically grounded and pharmacologically ungrounded medicine. It was a distinction in who held the authority to claim the mystery. The efficacy of the vast majority of substances with bodily effect circulating in the early-modern Atlantic depended on social and performative factors much more than on their biological, pharmacological properties.(Gómez, Pablo F., 2017)
The Mateo Arará case illustrates the trap. Arará, an Allada-trained ritual practitioner brought to Cartagena in the 1640s, used a self-made esterita (palm-leaf “little mat”) and a congolón gourd activated by chicken blood to test “all types of herbs and counterherbs” for whether they were “good to cure Christians,” iteratively repeating the divinatory test three times to confirm a diagnosis.(Gómez, Pablo F., 2017) This is empirical work in any reasonable sense of the term, repeated trials, identification of consistent results, refinement of practice through experience. But it does not show up in the licensed European pharmacopoeia under Arará’s name. It shows up under different names entirely. Some of the plants “discovered” and “classified” by the eighteenth-century Mutis botanical expedition were the same botanicals that seventeenth-century Black ritual practitioners like Arará had experientially tested decades before; the Mutis inventory reveals the procedures by which European natural historians and philosophers subsumed and obscured the intellectual endeavors and techne created by early Caribbean communities under their own scientific rubrics.(Gómez, Pablo F., 2017)
The methodological consequence is that the historian of non-elite healing has to recover practice through reconstructing context, not just by reading lists.
Historiographical Recovery
The category “non-elite healing” is itself a product of recent historiography. For most of the twentieth century, the institutional history of medicine was the history of medical institutions: hospitals, faculties, professional bodies, learned texts. The recovery of non-elite practitioners as historical subjects is a distinct project tied to the social history of medicine that opened up from the 1970s onward and was extended in the early twenty-first century by historians of slavery, colonialism, and gender.
The encyclopaedia treats Gómez and Fett as the lead authorities on this recovery for the early-modern Caribbean and antebellum South respectively. Gómez’s argument that Caribbean ritual practitioners “led an epistemological revolution” in which the experiential replaced first principles as the basis for Caribbean ways of knowing truths about the natural world(Gómez, Pablo F., 2017)(Gómez, Pablo F., 2017) is a strong version of the broader claim. Empiricism, in his framing, “was not necessarily Enlightened; neither was it uniquely modern, exclusively European, or intrinsically connected to the hard sciences”, and matters of experience and new ways of thinking about truth proved central to the creation of authority over bodies and the substances that acted upon them across the sixteenth- and seventeenth-century Caribbean and Atlantic.(Gómez, Pablo F., 2017) Fett’s parallel claim is that enslaved African Americans were not passive victims of medicine but cultivated a rich health culture, and that the historian’s task is to take that culture seriously on its own analytic terms.(Fett, Sharla M., 2002)
The question is whether non-elite healing is a stable enough analytical category to do real work. The encyclopaedia’s working position is yes, with caveats. The category usefully gathers together practitioners and practices that share a structural position vis-à-vis a learned medical class, even when their specific traditions, cosmologies, and patient populations differ widely. It is also useful because it forces the historian to ask, in any given setting, what counts as “elite” and who is doing the counting. In Caribbean Cartagena, Diego López the licensed mulato barber-surgeon occupies a different position than the unlicensed Domingo Congo; on the antebellum Lowcountry plantation, Elsey the named “Doctress” of Thorn Island operates differently from the unnamed neighbouring midwife. The category covers both, and the differences are themselves the object of inquiry.
What the category resists is the residual implication that “non-elite” means second-rate. The evidence Gómez and Fett assemble is consistent on one point. Patients across the social spectrum used non-elite practitioners because non-elite practitioners often delivered better outcomes than the licensed alternative, and because the conditions they treated did not fit neatly into the licensed alternative’s diagnostic frame. The non-elite was not a residual category. For most patients in most places, it was the primary one.
See Also
- ritual-healing
- african-diaspora-healing
- caribbean-creole-medicine
- colonial-medicine
- domestic-medicine
- folk-medicine
- empiricism
- inquisition-records
- pablo-f-gomez
- sharla-fett