Empacho

Curanderismo and its practices are used to treat an illness of the gastrointestinal tract called empacho. It is considered to be a blockage or an infection in the intestines that can result from either physical or emotional/mental causes. Empacho can be indicated by any number of gastrointestinal symptoms such as stomach cramping, intestinal gas, loss of appetite, vomiting, diarrhoea and/or constipation.
This illness can impact anyone from babies up to our elder community, but it’s considered much more aggressive when we talk about children, especially when children first become mobile and start to eat things that they find when crawling around. This can include material such as plastic, paper, cardboard or other foreign material and it can also occur when they start eating solid foods and they don’t really chew correctly and swallow whole pieces of food. This is considered to provoke a blockage inside their intestines.

There are two types of empacho, a loose and a dry empacho (1).
With a dry empacho, there may be an inflamed abdomen and a lot of pain, potentially a fever, but also, their eyes could be watery, a lot of gas and constipation, and the baby or child may be crying.
Loose empacho is when something contaminated is consumed such as dirty water or a child eats something off the floor that may be contaminated which provokes diarrhoea.
Tana Flores Sanchez a sobadora and curandera from CEDEHC (2) describes the indication of empacho thusly, “When a person has empacho they have a superficial pulse, and it’s very strong. I begin to put pressure on the abdomen, and in some points, if you hear like water has been running, then there is empacho. I’m going to continue to do palpitations, and if I begin to hear like a hollow drum, then there’s a lot of inflammation, and we would call that empacho.”

  1. although one author (Lozoya-Gloria 2003) separates empacho into the following categories; Empacho seco (dry indigestion), empacho pegado (stick indigestion)(sic)[my Spanish dictionary translates pegado as “glued”], trazo de empacho (outline’s indigestion)(sic) [my Spanish dictionary translate trazo as “stroke”], empacho ligero (light indigestion), empacho fuerte (strong indigestion)
  2. Centro de Desarrollo hacia la Comunidad, a school of holistic medicine in the city of Cuernavaca in Morelos, Mexico

In accordance with ancient concepts of balance held by the healing traditions of México empacho may also be classified by its association with either “coldness” or “hotness”. These concepts also fall within the classifications of loose and dry empacho as described above.
Cold empacho is associated with mucous or drool. When a baby is breastfeeding and has a productive cough the mucous mixes with the mothers milk and when enough is swallowed it affects the baby’s digestion. This may also happen when a child is teething. The drool produced when teething is more viscous and sticky than normal saliva and if the baby swallows too much of it it too can affect digestion. Both can cause stomach ache, lack of appetite, colic, general weakness, nausea and a loose and sticky stool. The treatment for this may be massage or herbal teas.

Cempasuchil (1) can be used for a tea. The flowers and stems herb can be made into a tea and can be used to treat diarrhoea, intestinal parasites, to relieve intestinal gas, general griping pains and also as a remedy for bronchitis

  1. Tagetes erecta
Cempasuchil

Empacho that is associated with heat can be caused by eating when emotionally upset. This can occur in fussy children or in adults if eating while subject to strong emotion and can involve what is known as “comfort eating” or binge eating when upset. It can also occur when indigestible items are eaten (by crawling children) or by the over consumption of highly processed foods (particularly involving wheat flour). It is also linked to the eating of unripe fruit.

Symptoms may involve (in children) indigestion, stomach pain, diarrhoea, flatulence, cramping, inflammation of the stomach, loss of appetite, a discoloration of the skin (green-yellow)(1) and (in adults) pain in the stomach (around the belly button area) disrupted bowel movements (either constipation or diarrhoea), intestinal gas and it may give the person the feeling that they are full or heavy.

  1. yellow skin may also be caused by an excess of bilirubin. Bilirubin is a yellow pigment that is created by the breakdown of dead red blood cells in the liver and although not an illness itself it may be indicative of several fairly serious illnesses. If someone presents with yellowed skin and the whites of the eyes are yellow then immediately seek medical advice as it may indicate hepatitis. The yellowing of skin can be fairly common in newborn babies and it often goes away on its own as a baby’s liver develops and as the baby begins to feed, which helps bilirubin pass through the body. It can also happen with breastfed babies and typically occurs one week after birth. This usually resolves quickly.

The treatments for this involve massage and various herbal infusions. Plants that can help:

Children :

  • Mint/Hierbabuena (Mentha sativa) infusion
  • Baby Sage/Mirto (Salvia microphylla) infusion
  • Chamomile/Manzanilla (Matricaria recutita) infusion
  • Lemon Beebrush (Lemon scented verbena)/ Prodigiosa (Lippia citriodora syn Aloysia citrodora) infusion
  • Bricklebush (Brickellia cavanillesii) infusion
  • Wormwood/Ajenjo (Artemisia absinthium) infusion
  • Mugwort/Estafiate (Artemisia mexicana) infusion
  • Mallow/Malva (Malva parviflora) infusion
  • Geranium/ Malvón (Pelargonium inquinans) compress
  • Castor Oil Plant/ Higuerilla (Ricinus communis)  fresh leaves used as a compress  (with lard and baking soda) wrap it around the abdomen and hold in place with a piece of cloth.
The Castor Oil plant leaves. The leaves may be quite large, 40 – 50 cm (15 – 19 inches) wide.
Photo by James Anderson

WARNING

The Castor Oil plant (Ricinus communis) should not be taken internally. All parts of this plant are poisonous if taken internally. The hull of the seed contains a deadly poison called ricin which has been used by Russian KGB assassins and even by everyone’s favourite bad boy Walter White in the Breaking Bad T.V. series.

The consumption of only one seed may be lethal if eaten by a child. Ingestion of seeds may cause a burning sensation in the mouth or throat, severe gastrointestinal irritation with vomiting, diarrhoea and bleeding. Symptoms may be delayed hours to days after ingestion. Seek urgent medical attention if the seeds have been eaten.

There is however one exception. The oil expressed from the seed is edible (if somewhat unpleasant tasting) and has been used medicinally as a laxative and purgative (1) for over 2000 years (2) and seeds have been found in egyptian tombs dating back to 4000 BC. There are references (3)(4) to the use of a decoction of the leaves and roots of the plant being used internally as an antitussive, discutient (5) and expectorant but this is hardcore medical herbalism and should ABSOLUTELY NOT BE ATTEMPTED BY ANYONE except trained experts. Stick to using the whole leaf as a poultice (6).

  1. purging or cleansing, especially by causing evacuation of the bowels; cathartic. Cathartics are severe in action and deal with evacuation of colon
  2. Foster. S. & Duke. J. A. A Field Guide to Medicinal Plants. Eastern and Central N. America. Houghton Mifflin Co. 1990 ISBN 0395467225
  3. Duke. J. A. and Ayensu. E. S. Medicinal Plants of China Reference Publications, Inc. 1985 ISBN 0-917256-20-4
  4. Azadmard-Damirchi, Sodeif & fathi achachlouei, Bahram & Alirezalu, Kazem & Alirezalu, Abolfazl & Hesari, Javad & Emami, Shiva. (2011). Physiological and Medicinal Properties of Castor Oil.
  5. An agent that serves to disperse morbid matter.
  6. the leaf poultice can also be used to treat headaches and boils.
A topical anti-inflammatory application made from pork fat used for empacho. May also contain other ingredients such as ginger, chamomile root, myrrh, clove oil or jalapa root. This product is massaged into the belly and lower back.

Adults :

  • Bricklebush/Prodigiosa (Brickellia canavillesii) infusion (indicated for intestinal infection or fever).
  • Chamomile/ Manzanilla (Matricaria recutita) infusion (antiflatulent- helps relieve intestinal gas).
  • Mint/ Hierbabuena (Mentha piperita) infusion (helps reduce gas).
  • Wormseed/Epazote (Chenopodium ambrosioides syn Teloxys ambrosioides) infusion (anthelmintic – helps reduce parasites). See Post on Epazote for further information on the use of this herb.
  • Mugwort (Artemisia ludoviciana subsp. mexicana) infusion (helps reduce parasites)
  • Guava/Guayaba (Psidium guajava) infusion
  • Cinnamon/Canela (Cinnamomum zeylanicum) infusion
  • Castor Oil Plant/ Higuerilla (Ricinus communis) fresh leaves used as a compress  (with lard and baking soda) wrap it around the abdomen and hold in place with a piece of cloth.


There are two main forms of treating empacho that persist in descriptions of this illness.
The first is massage. In a manner similar to the type of Swedish Massage I was trained in the abdomen is gently massaged in the direction of natural peristalsis (1). From the ascending then to the transverse and descending colon the belly is gently massaged to encourage faecal blockages to continue to move and be evacuated from the body.

  1. peristalsis is the muscular contractions that occur in the gastrointestinal tract that moves food through the intestines. It starts with swallowing and ends with pooping.

A sobadora will then turn the patient over and physically manipulate energetic channels on either side of the spinal column and perform a type of massage that pulls up folds of skin on the patients back and releasing them. A distinctive “popping” sound is said to indicate that the blockage is being released. The daughter of a Mexican friend (jokingly?) says she still suffers PTSD from the memories of her abuela giving her this massage.


The second form of treatment is dietary and herbal. Mild laxatives are used (1) to encourage bowel movement or herbal medicine is used. Herbal medicine can entail the use of anti-parasitics (2) or herbs normally used for griping (3)(also see herbs listed above).

  1. olive oil mixed with freshly squeezed orange juice
  2. Chenopodium ambrosiodes – wormseed, Artemisa vulgaris – mugwort
  3. Tagetes lucida – pericón, chamomile, and peppermint


Intestinal pain can come from any number of sources, some of which can be chronic (1), dangerous (2) or potentially deadly (3). Any symptoms of strong abdominal pain accompanied by vomiting, fever or blood in the faeces may require medical intervention and a doctor should immediately be consulted.

  1. diverticulitis, inflammatory bowel conditions
  2. hernias, impacted faeces
  3. tumours, cancer, appendicitis, gastrointestinal fistulas (4)
  4. a fistula is an abnormal (or surgically made) passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs. Fistulas can occur in the GIT as a result of Crohn’s disease (a chronic inflammatory bowel disease that can affect any part of the GIT from the mouth to the anus but is most common in the lower part of the small intestine called the ileum which opens into the ascending colon)

The treatment of empacho is looked upon somewhat disparagingly by modern medical systems. In an article that quotes both the Mayo Clinic and Rice University the traditional causes of empacho are discounted entirely and treatments mentioned above are briefly glossed over while a particularly dangerous treatment option is described in sharp focus.
The article states “One of the most popular cultural cures for empacho is the administration of lead-based powders such as azarconor greta.” (4) This is partially incorrect as although lead based powders exist there is no such thing as azarconor greta rather it is either azarcon (1) or greta (2). Both are colourful powders that have been used to glaze ceramics and may contain up to 90% pure lead and are known to have caused lead poisoning when used to glaze ceramics that have been used for cooking or eating containers/dishes. Greta has also incorrectly been identified as mercury (3).

  1. Azarcon – lead tetroxide (also possibly called alarcon, coral luiga, liga Maria Luisa or rueda – a red/orange powder). It has been posited (Torres 1983) that Azarcons popularity arose as a result of trying to copy another remedy used by curanderos that is similar in colour; that remedy being the herb/spice azafrán (saffron).
  2. Greta lead oxide (a yellow powder). Another lead based product called Albayalde (or albayaidle – a white powder) might be used. All three powders (Greta, Azarcon and Albayalde) are listed by the Los Angeles County Department of Public health Childhood Lead Poisoning Prevention Program as traditional remedies from Mexico, Central America and Latin America that are reported to contain lead.
  3. (elemental) mercury may be called asoque (or azogue) and has been noted as a remedy for empacho or used in Santeria to help protect the stomach from any dano (evil or damage) directed toward the stomach. The use of it in this manner is considered more a spiritual practice than a medicinal one.
  4. Admittedly this is probably a typo on behalf of the writer but other articles have been written (including by medical service journals) with exactly the same typo. This is probably a case of referencing an original source of flawed (and inaccurate) information without any follow up research being done.

These powders are mentioned in studies (1)(2) and the proclivity of their use is expounded upon. The two studies noted mention its use primarily in the border towns on the U.S side of the border and that its use was prolific and rampant. Another study (3) conducted on the Mexican side of the border in Baja California (3) mentions that “While empacho, a folk illness, was widely recognized as an intestinal disorder, there was almost universal unfamiliarity with the use and knowledge of azarcon and greta for its treatment.” (see table below). The community was composed mostly of peoples with an indigenous background from the State of Oaxaca. This survey goes someway to demonstrate that the use of these powders is likely the result of exposure to “modern” medicinal practices and that indigenous peoples are more likely to use herbs and other remedies that are less accepted by mainstream practitioners.

  1. Baer, R.D., & Ackerman, A. (1988). Toxic Mexican folk remedies for the treatment of empacho: the case of azarcon, greta, and albayalde. Journal of ethnopharmacology, 24 1, 31-9 .
  2. Trotter, RT . Greta and Azarcon: a survey of episodic lead poisoning from a folk remedy. Hum Organ. 1985; 44: 64–72.
  3. Welton, M., Rodriguez-Lainz, A., Loza, O., Brodine, S., & Fraga, M. (2018). Use of lead-glazed ceramic ware and lead-based folk remedies in a rural community of Baja California, Mexico. Global Health Promotion, 25(1), 6–14.

This does not mean that the use of these powders in Mexico is rare (or even uncommon). In a book released in 1977 (Latorre “Cooking and Curing with Mexican Herbs”) regarding the use of folk medicine in Muzquiz, Coahuila (1) it is advised that a child may be given “a pinch of lead monoxide mixed with a bit of sweet and powdered chocolate, or a decoction of chamomile”. The lead monoxide of course should never be given however the decoction of chamomile is a recommended remedy for soothing digestive issues (in both children and adults).

  1. a northern state sharing a border with Texas.

The use of lead is ABSOLUTELY NOT RECOMMENDED for internal (or even topical) use as it is very toxic and is incredibly dangerous to consume. The use of lead as medicine harks back to a time when “modern medicine” considered mercury a panacea and its use killed many of the patients it was purported to save.
Signs and symptoms of acute lead poisoning include:
• abdominal pain and vomiting
• jaundice
• lethargy
• black diarrhoea
• encephalopathy, which affects the brain and can lead to seizures, coma, and death
Symptoms are more likely to appear when there is low grade exposure over a period of time. This is known as chronic poisoning and may occur if the lead based glazes are used for ceramic products that are used to cook food in or serve it on.
These symptoms include:
• slowed body growth
• reduced IQ
• loss of appetite and weight loss
• constipation and mild abdominal pain
• irritability
• general fatigue
• blue tinge around the gums
• anaemia
• hearing loss and reduction in other senses
• neurological weakness, in the later stages
Young children absorb lead 4 to 5 times more readily than adults and, because their bodies are still developing, the risks are further increased.
In 2007 in the country town of Esperance in Western Australia there was a lead poisoning scare after hundreds of birds began dying and elevated lead levels were found in children after environmental contamination by lead occurred after pollution by lead dust escaping from shipments of lead to the port was discovered. Lead is dangerous. DO NOT USE IT.

References

  • Azadmard-Damirchi, Sodeif & fathi achachlouei, Bahram & Alirezalu, Kazem & Alirezalu, Abolfazl & Hesari, Javad & Emami, Shiva. (2011). Physiological and Medicinal Properties of Castor Oil.
  • Baer, R.D., & Ackerman, A. (1988). Toxic Mexican folk remedies for the treatment of empacho: the case of azarcon, greta, and albayalde. Journal of ethnopharmacology, 24 1, 31-9 .e JA. 2009.
  • Duke’s handbook of medicinal plants of Latin America. Boca Raton (FL): CRC Press
  • Duke. J. A. and Ayensu. E. S. Medicinal Plants of China Reference Publications, Inc. 1985 ISBN 0-917256-20-4
  • Foster. S. & Duke. J. A. A Field Guide to Medicinal Plants. Eastern and Central N. America. Houghton Mifflin Co. 1990 ISBN 0395467225
  • Gates, W : An Aztec Herbal, “The Classic Codex of 1552” :  2000 : ISBN  13:978-0-486-41130-9
  • Glueck, R and Morales, N. (2020) The Native Mexican Kitchen : A Journey Into Cuisine, Culture, and Mezcal : Skyhorse Publishing : ISBN10 1510745246
  • LATORRE, Dolores L. (1977) Cooking and curing with Mexican herbs: Recipes and remedies gathered in Muzquiz, Coahuila. ; The Encino Press, Austin, Texas 78703.
  • Linares, E + Bye, R +  Flores, B : Plantas Medicinales de Mexico : 1995 : ISBN 968-7365-08-0
  • López Sandoval, Dr. José Antonio : 2016 : Herbolaria Apuntes (Herbalism Notes) : Unidad de Aprendizaje: Herbolaria (Optativa) (Learning Unit: Herbalism (Optional) : Facultad de Ciencias Agrícolas Ingeniero Agrónomo Industrial : Universidad Autonoma del Estado de México
  • Lozoya-Gloria, Edmundo (2003). [Recent Advances in Phytochemistry] Integrative Phytochemistry: from Ethnobotany to Molecular Ecology Volume 37 || Chapter twelve Xochipilli updated, terpenes from Mexican plants. , (), 285–311. doi:10.1016/S0079-9920(03)80027-8
  • Messer, E : The Hot and Cold in Mesoamerican Indigenous and Hispanicized Thought : International Food Nutrition Planning Program MIT : Soc Sci Med Vol 25 No 4 : 1987
  • Pérez Ochoa, Monica Lilian & Chavez-Servia, Jose Luis & Vera, Araceli & Aquino-Bolaños, Elia & Cruz Carrillo-Rodríguez, José. (2019). Medicinal Plants Used by Indigenous Communities of Oaxaca, Mexico, to Treat Gastrointestinal Disorders. 10.5772/intechopen.82182.
  • Torres, Eliseo : Curanderismo : The Art of Traditional Medicine Without Borders : ISBN 978-1-5249-3665-5
  • Torres, Eliseo : Green Medicine “Traditional Mexican-American Herbal Remedies” : 1983 : ISBN 9612008-0-4
  • Torres, Eliseo : Curandero, “A Life in Mexican Folk Healing” : 2005 : ISBN 978-0-8263-3640-8
  • Trotter, RT . Greta and Azarcon: a survey of episodic lead poisoning from a folk remedy. Hum Organ. 1985; 44: 64–72.
  • Welton, M., Rodriguez-Lainz, A., Loza, O., Brodine, S., & Fraga, M. (2018). Use of lead-glazed ceramic ware and lead-based folk remedies in a rural community of Baja California, Mexico. Global Health Promotion, 25(1), 6–14.




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