AZTEC MEDICINE

by

FRANCISCO GUERRA
THE discovery of America placed the European nations in contact with three major
civilizations, the Aztec in the Mexican plateau, the Maya in the Yucatan peninsula,
and the Inca in the Peruvian Andes. The Mayas had been settled for centuries in the
same area and developed a civilization with high cultural manifestations, whereas the
Aztecs and Incas, in spite of their political power and strong resistance to the Spanish
conquest, were actually cultural parvenues among pre-Columbian people.
The Aztecs were the most powerful among Mexican nations at the time of Cortes's
arrival, and after a long migration from the north, they had settled in Chapultepec-
on the shores of the Lake of Texcoco-around A.D. 1267. Historical sources make it
possible to trace the evolution of the Aztecs before the European arrival; nevertheless
the field of Mexican archaeology is expanding considerably and many ideas are still
sufficiently fluid to be subject to correction, as Krickeberg (1961) has pointed out. On
the other hand, there is at present a much more critical attitude in the study of
American archaeology and its medical aspects.
AZTEC ARCHAEOLOGY
The earliest Mexican civilization to leave traces in the central plateau around
955 B.C. was the Olmec. However, most of the Aztec cultural achievements were
inherited from the Toltecs who arrived at Colhuacan in A.D. 908 and founded their
capital Tula in 977. The Toltecs left a deep impression not only on other Nahuatl-
speaking tribes but even on the Maya territories which they invaded around 999.
The Toltecs were remarkable for city planning, a solid architecture with use of
caryatids; the introduction of bow and arrow for hunting and combat; the adaptation
of nets for individual transport of goods in the absence of beasts of burden; the be-
ginning of copper metallurgy and a variety of other contributions, from the ring used
in the Mexican ball game to the warriors' fraternities. The Toltecs were overrun in
the Valley of Mexico about A.D. 1172 by the more nomadic and aggressive Chichimecs,
and it was after that date that a number of Mexican tribes around the Texcoco Lake,
each representing the original migrating stocks, increased their cultural intercourse.
The Aztec legends assert that their people came from a mythical place, Aztlan, or,
like other Nahuatl-speaking tribes, from the seven caves in the north, Chicomoztoc.
Only after a migration lasting ninety-nine years were the Aztecs able to reach, in
1267, the Lake of Texcoco; however, it was not until 1325 that their capital Tenochtitlan
was built, known after the Spanish conquest as Mexico City. The Aztecs remained
all those years subject to the Atzcapozalco tribe until their city Tenochtitlan joined in
a league with the nearby cities of Texcoco of Chichimec and Tlacopan of Acolhuac
stock, obtaining their independence under the leadership of Iztcoatl in 1427. After
the death of their leader in 1440, the Aztecs elected King Moctezuma I, a monarch
315
 F. Guerra
who should not be confused with Emperor Moctezuma II, elected in 1503, and who
died during the Spanish conquest of Mexico in 1519. Excellent monographs on the
Aztecs have been published by Caso (1959) Vaillant (1947) and Soustelle (1961).
The Aztec area in the Valley of Mexico combined the semi-arid lands of the high
plateau surrounded by volcanoes and exposed to extreme variations in temperature,
with the agricultural lowlands of the lake shores. Their land was divided in hereditary
tribal lots calpulli, and the cultivation surface was enlarged by floating in the lake
artificial plots or chinampas. Beasts of burden and the plough were unknown, a long
wooden stick coa was used instead for breaking the ground and planting; burning
the brush was also used to clear the ground for the milpa. Their economy was based
on the agriculture of temperate climates supplemented by the produce of tropical
lowlands such as cotton cloth, feather, gold, cocoa beans-used not only as food but
as currency as well-obtained in market exchange or as taxation revenue from sub-
jugated nations. The problem of nutrition among the Aztecs has been discussed
thoroughly by Davalos (1956) in an attempt to disclaim the belief that they were
undernourished. The Mexican staple diet was based on maize, beans and chili,
therefore being of low protein intake; however, contrary to expectations, the reports
of the chronicles did not indicate the existence of any disease due to malnutrition
among the Aztecs at the time of the conquest. Although several sources of animal
protein were present, turkey huaxoloti, hairless dog itzcuintli, fish and game, Davalos
(1956) shows that aminoacid analysis of maize and beans when supplemented by
tryptophane and tyrosine from pulque, a drink obtained after fermentation from
agave syrup, could give a balanced though limited diet. However, anthropophagia-
around 20,000 captives were sacrificed every year according to most sources-and
vermiphagia, maguey worms, still eaten today as a Mexican delicacy, have given
Aztec nutrition a poor reputation. But Carcer (1953) in an interesting study on the
cultural transfer between Spain and Mexico, has pointed out the important con-
tributions of the Mexican cuisine to our diet.
The Aztecs had an astronomical calendar extending over the solar year of three
hundred and sixty-five days divided into eighteen months of twenty days each, plus
five complementary unlucky days nemontemi. In addition there was the astrological
or religious calendar Tonalamati of two hundred and sixty days, divided into thirteen
months of twenty days, each under a god. The role of the Tonalamatl in medical
matters cannot be overemphasized, as the fate of the individual, health, disease, its
prognosis, length of life, besides profession, trade or plain luck was determined by
it. The Aztecs were usually named after their birth day, and their horoscopes estab-
lished according to astrological predictions. The names of days and months were
represented by ideograms. Although the Aztecs did not possess hieroglyphic writing,
their pictographic characters or rebus writing reached great perfection and they
recorded events, taxation and ideas in beautiful codices made of vegetable paper or
deer skin folded like a screen. Writing was also extended to represent mathematical
symbols according to a vigesimal system, the units represented by points, twenty by a
flag, four hundred by a pine, and eight thousand by a bag. An oral literature of great
beauty and sophistication is known to have existed among the Aztecs and other
Nahuatl groups. In architecture the civic centres had among the Aztecs the design and
316
 1w~.2m .
}ts'2.iI:tl[\.

va5i1#-Sfs*>~.
Al ,
t ii:;
}v 2!".:

4.4
*_Rd.c44 . .
..........

o4144VX. '. 1t t4\ 1.,4?i|*v*

545
#
AA

(; l V5s 45 ttiv1444 '*4U#

454 *
tZs:L§
. 4~~~~~~~~~~~~~~.

4.. 1545 .TSSIVIS(

\.4........

.44

. ...Y...X N,.

ffij34

fri \ t t 2b. 4 < ,@ ~ t u. a i s v on

.7m7 °-
..\ : ud + sllX X v ~ 62M _ *

.141g Vs s R;&.

44944; : 7 : 44J 4.j

.S._..

- ------ ----------

:S..::
-~~~~
- S sc - . ......... .. -

...... ....... ...

Mv . g W p *;Foki.eB6..i --i

; iX

4424*4 44" 1' 1 '24.>?'k' .W' "."A D ...............

sS.
.....
S*st . W-p PR ... .S
sirS p:r, 44.4%
44.4.444 44
4 44.%
N sl .4444 . . A
* : * ,~ ,.. . 5 8

Figure 1. Codex Sahagun, f. 4. Ritual extraction of the heart.

 sEv>w~"^10)g},l-zrtf;>#S*-4~ e -*S8.t:P4.a'leRS*
V.en I? A8
.

:X F

I AS3'
f 3 BA
.rS
½;
.. .. o. o .ng s. e

7%

7¾,)

44'~ ~ ~~~N

tt
_1m
)t~~~~
~ 4s
i

04---
Ag
-4 *4

1* U4 al6 mia 4(co%

a*7'),
~r mne~
is.uuhnw$ #.:'keSe4VMi4s
Vora"lflhn* v

1''D

>14t wt ISi
wl fA W d I'm
1, W j

~~~p. 'F~~~~~~~~*M-4.X
t;tJt*#.4sWA
4w4tfjod40s_f§8-"
wt f }SF

t
, w'f " I&**y{ * F¢+X i b^^{ : C Sf.S + ^Z* "~ ^Q,^

Figure 2. Codex Vaticanus lat. 3738, f. 54. Medical astrology

 Figure 3. Codex Magliabecchi, f. 77(65). Temazcal, steam bath.

Figure 4. Codex Magliabecchi, f. 78(66). Ticitl, medical diagnosis.

 I
____
___________________________________________________~~~~~~~~~~~~~~~~~~~~wo
t;re tc
a:
Qj1716 A;pia; c

ccctlzi,iur
iR zgrre4~~irt
tcrSyiVumndjtC ia//Ant~~~~~~~~~~~~ p.6:r.qt...t.o.4
ft
c nntnttet ~rw nrc f~/flJ~fl 4VS~%'r7
CW
~ ~ ~ ~ ~ ~. Ct/ap.tt.la/f
,nartAII* carAYe 5~ ~ ~ ~ ~ ~ihr.
,nnnafcnlj~~~AcALd ,nAcfruezii ttcnd
/241~~~~~~nrn 1~~~~~~ikt-- F/;#nrp-6-co-------4---t---ror--P

..i.t .. n rj:5rf4
in MCto ' 4jY n ttdIrT)Y
ycnt.irrs pc1e19....e ..r..,,.n%f.b..
jg5 Jg*¼ q"~~k'~frn.w.f.ia
,tn*vkj#c~~~~~~~.r ......4..
can.
l4 s
ntim. n 44, ~8t/rZtVna.
/4;ic....... . Fft c
a
,aS' ,.nnnsAnj w: nr
#rz1w
rnrttr ~v4 rap~,Szrfncsaa/
~~~~~~~~o
tfn 4~~~~~~n4ePir 0~~~~~~~~v-t hInnf fAc
ILf~~~~~~~~~~~~~~

Figure 5. Codex Badianus, f. 57v. Drugs used in parturition.

 Aztec Medicine
character they so much admired in the Toltecs, and at the time of the European arrival
their capital Tenochtitlan was the largest and most beautiful in America, with pyra-
midal temples, streets, water supply and gardens.
MEDICAL SOURCES
Among the historical sources of pre-Columbian civilizations, those pertaining to
the Aztecs are probably the most numerous, and some of them provide medical
information; but there are two documents, the Badianus codex and the Sahagzin
codices, so outstanding in this respect that, up to a point, every study of Aztec medicine
must rely on them.
The Badianus codex was the work of Martfn de la Cruz, an Indian physician, who
was a student at the Franciscan Convent of Tlatelolco. The codex has been wrongly
named after Juan Badiano, the Mexican scribe and Latin teacher at Tlatelolco who
in 1552 prepared the Latin version of the medical information given in Nahuatl by
de la Cruz under the title Libellus de medicinalibus Indorum Herbis. The original of
this manuscript, with beautiful pictographic reproductions of medicinal herbs, was
unearthed in the Vatican Library by Clark (1929) and Thorndike (1929); a later copy
of the seventeenth century, probably by Cassiano dal Pozzo, exists at the Royal
Library, Windsor. Gates (1932) published an English translation soon afterwards
superseded by the facsimile edition and study by Emmart (1940); another edition,
with a Spanish version and ethnobotanical analysis by Guerra was published in
1952. Unfortunately, the other four illuminated manuscripts on medicinal herbs of
the Indies in Philip II's library, described by Le6n Pinelo (1629), are not extant.
The Sahag4in codices are the group of manuscripts on the Mexicans written by the
Franciscan friar, Bernardino de Sahaguin 0. F. M. (1499-1590), who arrived in
Mexico just eight years after the conquest (1529) and devoted the greater part of his
long life to writing an exhaustive anthropological study of the Aztecs. His General
History of the things of New Spain was prepared by obtaining data direct from Indian
informants and stands even today as an accurate and reliable work; in point of fact,
most of our information on the Aztecs stems from Sahagun's writings. Three manu-
script texts have survived of the original study-known by the locality they were
written in-which texts complement each other. These were preceded by Sahag in's
draft of 1541 at Tehuacan published by Kingsborough (1848) which until now has
been ascribed to an anonymous hand. Sahaguin wrote at Tepepulco between 1558
and 1560 a first draft of his own work known as Primeros Memoriales or Tepepulco
MS. Its chapter IV Tlacayotl (Earthly Things), has an outline of Aztec medical matters
in Nahuatl with three sections: No. 5 The extemal organs of man; No. 6 The interior
organs of the body; and No. 9 A list of ailments and their remedies. These sections
were recently translated into German and published by von Gall (1940). After Sahaguin
was transferred to Tlatelolco between 1560 and 1565 a more extended version in
Spanish was prepared, a copy of which constitutes the Codices Matritenses or
Tlatelolco MS.; here the medical section was considerably enlarged and takes up
Book X, chapters xxvii and xxviii. Curiously enough, Sahagun inserted a religious
tract under the anatomical heading of chapter xxvii, omitting the anatomical text,
but in chapter xviii he gave an enlarged Spanish version of ailments and remedies.
317
 F. Guerra
When Sahagutn moved to Tenochtitlan or Mexico City between 1565 and 1568
another extended Nahuatl version was prepared which is known as the Florentine
Codex or Tenochtitlan MS., in which the anatomical section takes up chapter xxviii.
Translations of both sections into German were also published by von Gall (1940)
and in English by Dibble and Anderson (1961) with certain variants. It is most
important to mention that there are considerable differences in the text of Book XI,
chapter vii on medicinal herbs between the Tiatelokco and Tenochtitlan Mss. because
the informants and their material were entirely different. Notable differences also
occur in the text of these MSS. for Book X chapter xxviii.
It becomes clear that the Tici-amati or 'Doctrine for Physicians' mentioned by
Torquemada (1615) as an independent work of Sahaguin on Aztec medicine is the
medical section of chapter iv, No. 5, No. 6, No. 9 in the first draft or Tepepulco MS.
which became Book X chapters xxvii and xxviii in the much enlarged later versions
of the Tlatelolco and Tenochtitlan MSS. The information gathered by Sahaguin differed
in certain details according to the localities, but the underlying ideas are the same.
At Tepepulco the informants relied on pictographic codices still extant at that time,
and in the Tlatelolco MS. the scribe recorded the given names of the Indians: Gaspar
Mathias, Pedro de Santiago, Francisco Sim6n, Miguel Damian, Felipe Hernandez,
Pedro de Requena, Miguel Garcia and Miguel Motolinia . . . 'old physicians of
Tlatelolco much experienced in medical matters'. As for the Tenochtitlan MS.,
Sahagdin's medical data [X No. 28] 'was examined by the [Tenochtitlan] Mexican
physicians whose names follow': Juan Perez, Pedro Perez, Pedro Hernindez, Jose
Hernandez, Miguel Garcia, Francisco de la Cruz, Baltasar Juarez and Antonio
Martinez. A partial knowledge of Sahagdin's medical material had been available
since early in the nineteenth century, in the publications by Bustamente (1829-1830)
and Lord Kingsborough (1831) of the Spanish version of the Tlatelolco MS. There
were several editions in Spanish (1890-1895), one facsimile by Francisco del Paso y
Troncoso (1905-1908) of great importance; others in Spanish have been published
recently (1938 and 1956) besides editions in French (1880), English (1932) and German
-this by Seler (1927); but it would seem that the English version from the Nahuatl
made by Dibble and Anderson (1950-1963) from the Florentine codex or Tenochtitlan
MS. is the most valuable for medical research, though it contains a number of errors
in the transcription and translation.
The Badianus and Sahagiin codices are direct sources from Mexican informants
gathered within the framework of the late medieval culture in Europe and deep
Catholic indoctrination, as represented by Sahagdin's background. The Renaissance
interpretation of Mexican biological and medical knowledge was crystallised during
Francisco Hernandez's expedition (1570-1577), exhaustive for the Mexican area in
respect of natural history as applied to medicine but less profound than Sahaguin on
anthropological matters. The influence of religious beliefs upon medicine may be
studied in the 1629 report by Ruiz de Alarc6n published in 1892, and to a lesser degree
in La Serna's work of 1656. There is another primary course of great importance,
unfortunately dispersed among several institutions, namely the historical studies
on Aztec science prepared by A. Le6n y Gama (1735-1802) from original pictographic
documents and ancient materials.
318
 Aztec Medicine
Research on semantics, as pointed out elsewhere (1964), may enlarge the avenues
of research in pre-Columbian cultures; the recent use of Molina's large Mexican
vocabulary (1571) for anatomical terms is just one example. Molina even had in mind
its possible use by physicians when he wrote in the prologue, ' . . . it will be difficult
for a physician to cure a sore or hidden ailment if he does not know what the patient
is saying'. Alonso de Molina O.F.M. (1513-1585), due to his arrival in Mexico (1524)
as a child immediately after the conquest and to his upbringing and education with
Aztec children, mastered Nahuatl like a native, and when he eventually became a
Franciscan friar he published (1555 and 1571) the best contemporary dictionaries
ever made. Although in the case of the Badianus and Sahagzin codices it is easy to
make an appraisal of the information and the medical tenets of the Aztecs, most of
the historical studies so far have relied too heavily on the Nahuatl lexicon, taking
for granted that the interpretation by the European mind of a particular Mexican
term expressed the same cultural idea. An example of this is Ocaranza's (1936)
statement of the Aztec idea of the circulation of the blood, based exclusively on the
Nahuatl terms for pulse and heart beat. Mexican literature, furthermore, is extremely
rich in ancient chronicles, some of them referring to the medical practices of the
Aztecs; in some cases their sources were actual pre-Columbian documents. That
apparently was the case with Clavigero's Ancient History of Mexico (1780), containing
several chapters on medicine, surgery, medical botany and hydrotherapy among the
Mexicans which may be read with benefit, and no doubt influenced Le6n y Gama's
studies.
Modem studies on Aztec medicine began with Francisco A. Flores (1852-1931)
who devoted to this subject the first of his three folio volumes on the History of
Medicine in Mexico (1886-1888). This colossal doctoral thesis presented, in a well-
planned study, most of the material collected by Molina and Sahagun during the
sixteenth century, and still retains considerable merit notwithstanding the fact that
neither medicine nor historical studies offered in Flores's day the critical techniques
of today. Francisco del Paso y Troncoso (1842-1916) published almost simultaneously
(1886) a first part of a mature work on medicine among the Nahuatls covering medical
botany, but no subsequent parts of this work ever appeared. Other studies published
after that date have been condensed versions of the previous works by Flores and
del Paso y Troncoso; such is the case of Raffour (1900), Gerste (1909), the excellent
synthesis by Ocaranza (1934), and the monograph by Martinez (1934). A bibliography
of these and other publications appeared in 1949. Finally, Martinez Cortes (1965)
has recently reviewed magic and religious ideas in Aztec medicine, relying heavily
upon Sahagu'n.
MEDICAL HAGIOLOGY
The medical doctrines and practices of the Aztecs were permeated by profound
religious elements. The Aztecs believed in the hereafter, with a heaven Tonatiuh in
the sun reserved for the heroes, another heaven Tlalocan on the earth, and the abode
of rest, the underworld Mictlan, reached by the dead after a dangerous journey.
Other religious tenets were the creation of the universe by a god under a dual principle,
[Ome or] Tonacatecutli male and [Ome or] Tonacacihuatl female, and the rule of
319
 F. Guerra
major gods Huitzilopochtli for war, Tialoc for agriculture, Quetzalcoatl for wisdom,
Mictlantecutli for death, besides many others connected directly with medical matters.
The mother of the gods, Teteoinam or Toci, was, according to Sahagu'n [I No. 8], 'the
goddess of medicine and medicinal herbs, worshipped by physicians, surgeons,
phlebotomists, midwives and those women using herbs for abortions'. The owners of
bathing houses, temazealli, always kept her image in view. The medicinal goddess
was Tzapotlatena [I No. 9], credited with the discovery of uxiti or a pine resin used in
rituals. The religious and psychological factors involved in Aztec medicine have been
thoroughly discussed by Aguirre (1947) who emphasizes that many characteristics
arise from the social structure of the Mexican civilization, their stern discipline, and
the ultimate dependence of children upon parents, particularly well depicted in the
Mendoza codex. The Aztec personality developed, furthermore, according to a com-
plex obedience-reward and disobedience-punishment which created a dependence
of the individual on the parents, the tribal leaders and, in particular, on the gods, a
fact of great importance in the understanding of their anxieties, netepalhuiliztli
sickness due to dependence, and their idea of disease. Dietschy (1937) has also ex-
pounded the complex sin-disease, because the Aztecs considered sickness the punish-
ment infficted by their gods for their sins. A close relationship existed between a god
and a specific type of disease as far as cause and treatment were concerned. Tialoc,
the god of waters, was responsible for rheumatic ailments, the gout and syndromes
related to dampness and cold. The same god punished those abusing the drinking
ofpulque, by sending them generalized tremor, delirium, fluxion of the eyes and twisted
mouths-a fair description of the final stages and sequels of alcoholism. The Tlalocs
inhabited mountains and rivers, and presents were offered there by patients to please
these gods and obtain relief. Xipe Totec, the flayed god [I No. 8], so-called because
he was covered by the skin of one of his victims, was responsible for exanthematic
diseases, boils, scabies and eye ailments. Patients with exanthema and skin infections
used to march in the front of the processions during the god's festivities tlacaxipehua-
liztli in the second Aztec month, also covered with skins from human sacrifices, to
appease the god and obtain a cure. Titlacahuan [III No. 2] or Tezeatlipoca, when
displeased by a breach of fasting, vows or sexual behaviour, induced contagious and
incurable diseases and buboes. In this respect it may be mentioned that though bitter
arguments have been exchanged on the American origin of syphilis, no proper ap-
praisal of the Aztec gods related to that disease has been made. Many were the gods
connected with venereal diseases and their number and significance cannot be over-
looked because the syndromes given by Sahagdin's informants clearly leads to the
belief that syphilis-like lesions existed in pre-Columbian America. Macuilxochitl, god
of pleasures, sent the breakers of his rules diseases of their hidden parts, not only
haemorrhoids but boils and buboes and corruption of the penis. Xochiquetzal,
goddess of love, also sent incurable buboes, scabies and skin exanthemata and other
infections.
MEDICAL EDUCATION AND PRACTICE
Aztec medicine enjoyed considerable prestige among Middle American civilizations
because it had absorbed many positive contributions from neighbouring areas and
320
 Aztec Medicine
conquered peoples. However, the medical profession-practised by both men and
women alike-did not have the social standing that could be expected as a result of
their special training and their religious and astrological associations. Ticitl is trans-
lated by Molina (1570) not only as the medical practitioner but also as the witch
doctor dealing with horoscopes and fortune tellers. Sahaguin [X No. 8 and No. 4]
placed the male physician on a par with the carpenter, mason and scribe, and classed
the female physician with the cook, the seamstress and the spinner, though above the
whore. The explanation is quite subtle and from his description of the medical pro-
fession for women the reader may infer the reasons for its bad reputation.
Medical art ticiotl was believed by the Aztecs to have been developed among the
Toltecs by four wise men, Oxomoco, Cipactonal, Tlatetecui and Xochicaoaca.
Sahaguin also recorded [X No. 39] that these scholars knew the nature and qualities
of herbs, which were good, bad, harmful, deadly or medicinal; in addition these
Toltec men of science had developed the astronomical calendar Tonalamatl, were
familiar with the influence of the stars upon the body and were able to interpret dreams.
These two elements, one attached to medical botany and the other supernatural,
shaped Aztec medicine.
There were among the Aztecs the tepatiani or ticitl, physicians experienced in
diseases occurring in a particular locality, who examined the patient and applied
remedies or administered medicinal herbs in the treatment; others were nahualli,
physicians who used horoscopes, predictions and religious ceremonies, in addition
to secret ingredients for a cure. Most historians have mentioned that a degree of
specialization existed in the Aztec medical profession, the surgeon tetecqui or texoxotla
ticitl, the phlebotomist tezoc or teximani, the midwife tlamatqui or temixintiani
ticiti, and the apothecary papiani or panamacani; omitted until now has been a
practitioner mentioned by Molina (1571) who was devoted to the curing of turkeys
totolpixqui.
The Aztec concept of the scientist overlaps in Sahagutn's MSS. [X No. 8] with that
of a physician, therefore the education and professional practice in both cases must
have been extremely close. The loftiness of the ethical values expressed by the Mexican
informants indeed deserves to be quoted; due to literary variants between Sahagu'n's
Castilian and Nahuatl versions an amalgamation of their concept is advisable. For
the Aztecs,
... the wise man or scholar tlamatini is exemplary, like a beacon, a shining mirror, learned,
well-read, keeper of books, bearer of tradition and responsibility, a guide. A good scientist is
like a good physician, who takes good care of things, he is a counsellor, a teacher of the true
doctrine, worthy of confidence, a confessor, reliable. He shows the way, establishes order, he
knows about the land of the dead, he is dignified, unreviled, confided in and trusted, he is very
congenial, reassures, calms, helps, satisfies, gives hope, favours with his knowledge, he makes
one whole. A bad scientist is a stupid physician, silly and vain, pretending to be trustworthy and
wise, he is a sorcerer, soothsayer, a deluder, a deceiver, a public robber, he confounds, causes
ills, leads into evil, destroys people and kills.
The physician ticitl is a curer of people, a restorer and provider of health. A good physician is a
diagnostician, experienced and well versed in the virtues of herbs, stones, trees and roots. He
is moderate in his acts, cures people by setting bones, providing splints, knows how to purge
and to give emetics and potions, he knows how to bleed, he stitches wounds, makes incisions
and revives the sick. A bad physician is a fraud, a half-hearted worker, unskilled, a killer with
his medicines because of overdosage, he worsens the condition of the sick, endangers others'
321
 F. Guerra
lives, he pretends to be a counsellor, adviser and chaste. He bewitches, is a sorcerer, a soothsayer,
a caster of lots, he seduces women and bewitches them.

Sahagu'n's texts [X No. 14] on the women physicians differ in the Castilian and
Nahuatl versions, the latter being more extensive:
A woman physician is knowledgeable in herbs, roots, trees and stones; she has experience in
them. She can make prognoses and can be trusted because of her professional skill. The good
woman physician restores and provides health, revives and relaxes, makes people feel well,
covers one with ashes. She can cure people, she lances them, bleeds them in various places with
the lancet. She gives potions, purges and medicines. She cures disorders of the anus. She anoints
them, rubs, massages, provides splints, sets their bones, makes incisions, she treats festerings,
gout, and cuts the growth from the eye. A bad woman physician pretends to have professional
knowledge. She has a friction-loving vulva. She does evil, bewitches, makes drink potions,
kills people with drugs, endangers the sick. She deceives people, seduces them, perverts them,
blows evil upon them, removes objects from them, sees their fate in water, reads their fate with
cords, casts lots with grains of maize, draws worms from their teeth. She draws paper, stones,
worms from them.

It is difficult to understand how this ethical doctrine has escaped being quoted by
Flores (1886), Ocaranza (1943) and Vargas Castelazo (1956) in their eulogies on
Aztec medicine when the Sahaguin records were already printed and widely known;
only Leon Portilla (1963) has expounded these concepts with philosophical insight.
Flores (1886), followed by Ocaranza (1934), has quoted Alva Ixtlixochitl chronicles
asserting that the Chichimecs at Texcoco, like the Aztecs at Tenochtitlan, required
the medical practitioner to pass an examination and obtain permission to practice
from one of the four Councils of Government. However, no statement of this nature
can be found, and Alva Ixtlixochitl [chapters xxxvi and xxxviii], writingin the sixteenth
century, mentions only that during the reign ofhis ancestor, Emperor Netzahualcoyotl,
a Council of wise men watched over witchcraft. On the other hand Sahag6hn [X No.
39], though crediting the Chichimecs with a broad knowledge of medicinal herbs,
mentions that when one of them was sick and showed no sign of recovery after three
days they would kill him by shooting an arrow through the throat.
The internal evidence in Aztec primary sources points to a medical training by
apprenticeship, mainly within the family tradition, and whole families were devoted
to this art; the roles of the scholar tlamatini and the teacher temachtiani must have
been similar. The specialized knowledge of the astronomical calendar and prog-
nostication in some cases, or the identification of medicinal herbs, their use and
application, and the training in some surgical interventions was passed on to the
student momachti, usually by his father who was the scholar and the teacher. Accord-
ing to Clavigero (1780) training began very early in life and men started to practise
much younger than women; the latter engaged in medicine only after the menopause
when they were not subject to menstruation or parturition, these being considered
as bodily impurities.
ANATOMY AND PHYSIOLOGY
Flores (1886) was the first historian to deal with the anatomical lexicon of the
Aztecs, and his text has been followed by Ocaranza (1934) and Vargas Castelazo
(1956). Martin del Campo (1956) has been critical of the preceding works and of the
322
 Aztec Medicine
Spanish chronicles which gathered the Mexican information after the conquest, but
he himself, ignoring Sahagun's anatomical lexicon in the Tepepulco MS. and the more
extended version in the Florentine codex, turned to another Spanish source, the Mexi-
can-Spanish dictionary by Molina (1571). However, it should be remembered that
Molina compiled only a fraction of the anatomical terminology collected by Sahaguin.
The anatomical terminology of the Aztecs, showing a detailed nomenclature and
knowledge of the exterior and much less of the interior parts of the human body,
seems to have been the result of the extensive practice of human sacrifice by the
priests teopixquis. The extraction of the heart and flaying of the victim with the
distribution of parts of the body after cutting in pieces and carving for the ritual
banquet, made the priest and communicants familiar with muscles, joints, bones,
arteries, and veins, and the main viscera. As a reminder of this it could be mentioned
that at the coronation of Moctezuma II, shortly before the Spanish conquest, five
thousand Otomi captives were sacrificed. The number of human bones piled up in
the Huetzompan or skull depository of the great temple at Tenochtitlan was con-
siderable. Tezozomoc (c. 1598) mentioning over sixty-two thousand skulls.
A collation of the three main original sources, Sahagun's Tepepulco and Tenochtitlan
MSS. as studied by von Gall (1940) and Dibble and Anderson (1961), and the terms
in Molina's large vocabulary (1571) selected by Martin del Campo (1956), shows that
there is an abundance of Nahuatl names for the external parts of the body, but the
nomenclature for internal parts is poor. In referring to the human body, the term-
wrote Molina (1571)-was preceded by the possessive pronoun to meaning our, and
when this prefix was omitted it indicated the same term for an animal. The Tepepulco
MS. by Sahagun contains fifty-four main terms for the exterior parts of man and
only seventeen for interior organs, a figure similar to Molina's; however, in the
Tenochtitlan MS. the anatomical lexicon of Sahaguin, as collated by von Gall (1940)
and Dibble and Anderson (1961) with indications of variable characters in the ap-
pearance and texture of the organs, the colossal number of almost four thousand is
reached; this makes Martin del Campo's statement groundless. It is also pertinent to
correct an error common to all writers dealing with this subject, that is, claiming
on occasion the existence of several Nahuatl names for the same Castilian synonym.
This is the result of the variants given by the different infornants at Tepepulco,
Tlatelolco and Tenochtitlan for Sahaguin, and practically the same localities for Molina;
Chichimec Nahuatl was spoken in Tepepulco whereas in Tenochtitlan the language
was Aztec Nahuatl, and Molina (1571) makes a point of it. There are appreciable
differences in the Nahuatl terms for anatomical parts depending on the source
utilized, Molina or Sahagun, and even between the manuscript versions of the latter.
Discrepancies in Nahuatl spelling between von Gall (1940) and Dibble and Anderson
(1961) are also noticeable. Examples of the anatomical lexicon in Nahuatl are as
follows: skin coatl, flesh nacati, fat suchiotl, hair tzontli, bone yaoquizque, joint
toniltecca. The parts of the body were, head tzontecomatl, neck toquechtla, thorax
elpantli, abdomen ititl or xilantli, leg icxitl. In the head, the occiput tocuezco, fore-
head ixquatl, face ixtli, eyelid ixquatolli, eyebrow ixquamolli, orbit ixcallocantli,
eye ixtelolotli, pupil tixtotouh, nose iacatl, nostrils iatomolli, mouth camati, lip tentli,
palate copactli, tongue nenepilli, tooth tlantli, molar tlancochtli, chin tenchaii, ear
323
 F. Guerra
nacaztli. In the neck, oesophagus cocotl, windpipe cocoti, gullet tlatolhoaztli. In the
arm, shoulder aculli, armpit ciacatl, forearm matzotzopaztli, elbow molicpiti, wrist
maquechtlantli, hand macpalli, maitl, finger mapilli. In the chest, torso tlactli, breast
chichioallic, rib omicicuilli, sternum eltepicicitl, lungs tomimiaoaio. In the abdomen,
waist topitzaoaia, loins tomimiluihca, spine cuitlatetepontli, hip tocuitlaxaiac, navel
xictli, buttocks tzintli, anus tzincamactli, penis tepolli, vulva tepilli. In the leg, crotch
maxactli, groin quexilli, thigh metztli, knee tlanquaitl, calf cotztetl, shank tlanitztli,
ankle xoquechtlantli, foot xocpalli, heel quequetzolli, toe xepilli. Other parts of our
anatomy were, skull quaxicalli, brain quatextli, heart yoyollotli, liver eltapachtli,
testis cuitlapanateti, stomach totlatlaliaia, intestine cuitlaxcufii, womb conexiquipilli,
uterus cioatl, bladder axixtecomati, blood eztli, blood vessel ezcocotli, nerve toaloatl.
INTERNAL MEDICINE
The repeated observation of disease among the Aztecs led to a pathology made up
of a collection of symptoms and regional syndromes. The primary sources do not
offer any all-embracing theory nor a mechanism of disease such as the humoral
pathology so prevalent among the Europeans of those days. Disease, particularly
those of a serious nature, were thought to be sent by the gods as a punishment for
sin, occasionally it was believed that they had been induced by enemies, and only in
certain instances were natural causes given as the true origin of a disease.
The description of ailments in the Sahagzin and Badianus codices follows the
characteristic medieval order, de capite ad pedem, which groups under the same
heading pathological entities of the most opposite etiology. For instance, dandruff
appears next to fractures of the skull among head ailments, the anatomical arrange-
ment indicating that there was no clear idea about the cause and mechanism of
disease, at least in the case of the compilers, which has led Aguirre Beltran (1963) to
believe that both sources show traces of European influence. There is a definite idea
of the pathological nature of some excretions, ' . . . the rottenness, the filth, which
issues from the body' in the Tiatelokco MS. [No. 27 (14)] which includes not just
the excrement cuitlati, but diarrheic evacuation apitzalli, flux tlahelli. bloody flux
eztlahelli, purulent flux iztac tiaheii, rheum of the eye ixcuitlatI, mucus of the throat
tozcaiacacuitlatl, dental tartar tlancuitlatl, coated tongue nenepiltextli, smegma
teoplquatexti, urethral secretion tepoltemalacati, pyuria temalaxixtli, hematuria
eztlaxixtli, phlegm alaoac, pus temaii, humour tzonqualactli. Nahuatl terms for
pathological secretions are formed by joining the organ word to that denoting their
aspect or nature, i.e. temaii for purulent or eztli for bloody.
The process of diagnosis among the Aztecs included the professional gift in identi-
fying the pathological syndrome of the patient together with the supernatural in-
fluences affecting his case. The latter was the result of the religious concept of disease,
and therefore involved practices related to horoscopy as much as religious ceremonies
alongside sound medical exploration. Pre-Columbian codices portray a human figure
showing the influence of certain signs upon specific parts of the body. This idea of
supernatural influences upon the human being was not exclusive to the Mexican
Indians, but was such a common element in medieval medical literature that astrologi-
cal influences, as depicted in the Zodiac signs and their relation to phlebotomy and
324
 Aztec Medicine
prognosis, are still currently favoured by a considerable public. The glyph for cipactli
alligator, earth symbol, is related to the liver, ehecati wind to the lungs, calli house to
the right eye, cuetzpailin lizard to the buttock, coatl serpent to the reproductive
organs, miquiztli death to the head, mazati deer to the right leg, tochtli rabbit to the
left ear, atl water to the hair, itzcuintli dog to the nose, ozomatli monkey to the left
arm, malinalli a twisted herb to the intestine, acatl reed to the heart, ocelotl jaguar
to the left leg, cuauhtli eagle to the right arm, cozcacuauhtli vulture to the right ear,
ollin sign of movement to the tongue, tecpatl flintstone to the teeth, quiahuitl rain to
the left eye, and xochitl flower to the breasts.
The magic element in diagnosis has been clearly described by Sahaguin [X No. 14]
and La Serna, and even the Magliabecchi codex depicts the procedure carried out by
the nahualli. Certain female physicians used shells ticicaxil for this purpose, others
threw grains of maize into a pot filled with water and gave a bad prognosis if the corn
dispersed in the water, a good one if they remained grouped together. La Serna
(1656) mentioned a variant of the ceremony by using nineteen or twenty-five grains-
always an odd number-and watching the way in which the grains fell when thrown
on a solid surface. The prognosis was favourable if they were grouped in lines or if
they stood on end. Sahagutn also mentioned a trial by knot in which a knotted rope
was stretched tight, if the knot became undone of its own accord the patient would
recover. As in other cultures the hoot of the owl tecoloti was a bad omen. Furthermore
Ruiz Alarcon (1629), among others, described in detail the use of hallucinogenic
plants such as ololiuhqui and peyotl in order to ascertain the cause of the disease and
its prognosis, or to point out the person or evil influence responsible for the ailment,
a practice which has lasted until the present day.
Both the Sahaguin MSS. and Molina's lexicon offer several instances of medical
practice, including the initial question in a case history: Where are you having pain?
Campa ymmitz cocoa? to the point of prognosis. Fatal prognosis-quoted by Molina
(1571) nite ixnauatia, a patient beyond recovery-constitutes one of the finest pages
in the Badianus codex [13], very much in the best Hippocratic tradition, as pointed
out elsewhere (1952).
The wise physician foretells from the eyes and nostrils of the sick man whether he is going to
live or die. According to his prognosis, if the eyes are bloodshot it is doubtless an indication of
life, if they are pale and bloodless recovery is uncertain. The signs of death are a certain sooty
colour found in the middle of the eyes, the top of the head becoming cold or contracting and
depressing, the eyes darkening and losing their brightness, the nose appearing thin and pointed
like a rod, the jaws becoming rigid, the tongue cold, the teeth dusty with tartar and incapable
of movement or of opening. The clenching of the teeth and the flowing of dark or very pale
blood after incision are the warnings of approaching death. In addition, the face turning livid
or ashen or its expression changing constantly. Finally if he should roll about and unintelligible
words pour from him, such as a parrot would utter.
SURGERY
Surgical practice among the Aztecs has been highly praised by Flores (1886),
through Ocaranza (1934), after using Flores's material freely, has shown the con-
siderable limitations of a practice without proper pathological basis, or adequate
control of haemorrhage or infection. Flores's main evidence seems to have been the
Nahuatl lexicon taken from Molina (1571) which indicated at least a certain degree
325
 F. Guerra
of surgical specialization: texoxotla ticitl general surgeon, tezoc or tezoani phleboto-
mist, texiuhqui or teximani barber surgeon, tezalo or teomiquetzani bone surgeon,
tlacopinaliztli dentist, and teixpati eye surgeon. In a short monograph on Aztec
surgery prior to the Spanish conquest, Ocaranza (1936) has offered chapters on
hagiology and some surgical treatments, but a survey of the sources shows the
Aztecs to have had a rational approach only in respect of dental ailments, wounds,
luxations and fractures. Their technical ability resided in a fair knowledge of external
anatomy, little internal anatomy, practically no physiopathology, and a few flint
and obsidian instruments, knives iztli, lancets tecouani, suture materials made of
human hair tzontli or vegetable fibres from metl, and needles made of human or
animal bone.
The Aztecs appear closer to our ideas in dental techniques, described by both the
Sahagtin [X No. 28] and the Badianus codices in similar contexts, and studied at length
by Fastlicht (1950). Rinsing the teeth with water was recommended after every repast
and also the removal of food particles or foreig substances between the teeth by
means of thorns or small toothpicks netlancuicuiuani. The cleaning and brushing
of the teeth was done with a dentifrice made of ashes, acting as a gentle abrasive,
and white honey which was applied with a root tlatlauhcapatli serving as a brush.
The tartar was removed by the use of charcoal in salted water, or a mixture of salt,
alum, chili and cochineal. Swollen and abscessed gums were pierced with thorns
and scarified, cleansing them of pus; a magic element was somehow introduced into
this rational procedure by the use of a dead man's tooth for that purpose. Decayed
teeth were treated locally by certain vegetable juices but there is no record of cavity
drilling in dental caries, though the Aztecs made excellent use of dental drills and
cements for ornamental inlays of gold and semi-precious stones. In odontalgia with
caries extraction was recommended and salt applied to the bleeding gum afterwards.
In the treatment of burns the affected surface was treated with a poultice made of
nopal, teamoxtli, texiyotl and other plants, their sap blended with honey and the
yolk of egg which gave a binding texture to the plaster and protected natural healing.
A similar idea existed in the treatment of wounds; the wound lips were first sewn with
hair by interrupted suture and the stitches covered by a dressing made of warm metl
sap and other ingredients which was repeatedly changed if inflammation occurred,
but no change was made in the dressing if healing proceeded satisfactorily. In the
case of nasal wounds, when the organ was cut off and suture failed, Sahagu'n's text
recommended the application of a prosthesis made of convenient materials, to cover
the fault. No record of other prosthesis is mentioned. This source also leaves the
impression that a vague idea existed among the Aztecs in respect of primary and
secondary wound healings and of the advantages of their occlusive treatment by
application of latex ulli to form an adhesive dressing, ' . . . quickly wrapped in order
that the air will not enter [the wound after suture] and healing may proceed in that
way'. Ulli was used with similar purpose in the treatment of keloids by previous
scarification and burning of the deformed scars. The type of stitch used by the
Mexicans was the interrupted suture, examples of it may still be seen in the Xipe
totec sculptures and drawings, depicting how a flayed human skin was sewn over
another person to cover and cure skin diseases.
326
 Aztec Medicine
In the treatment- of pterygium the Aztecs show understanding of conjunctival
growth, and dissected with a long thorn from metl the fleshy part from the eyeball
and, once isolated, the growth was cut off; some drops of woman's milk with the
juice of chichicaquilitl or an infusion of iztalquiltic were applied to the eye to prevent
further conjunctival growth. However, in the treatment of corneal opacities, cataracts
and other ocular complaints the Aztecs resorted to scatological procedures which were
bound to produce violent infections and accounted for a considerable amount of
blindness.
Tumours, independently of their nature, were treated in a similar manner. A knee
swelling, probably due to synovial fluid, was sectioned, unfortunately, with a lancet
and a poultice of toloa was applied to the joint. A similar procedure was followed
in purulent abscesses of the breast and the enlargement of lymphatic glands either in
the neck or in the groin, and poultices made of the herbs chichicquahuitl, yapaxihuitl
and itzcuinpatli were applied to the wound after sanies had been removed.
The Sahagfin codex [X No. 28] deals twice with fractures and luxations and offers
a separate section on 'the setting of broken bones', but the Badianus codex [No. 1]
refers only to the fractures of the skull and the drugs used in their wounds. The
mechanical cause of luxations and fractures and the aesthetic, functional, and patho-
logical changes brought about in the joints and the bones were readily apparent to
the Aztec surgeons who followed a logical treatment aimed at the restoration of the
limb shape and function. In dislocated joints the part affected was first pressed, then
stretched, and afterwards a poultice made of the herb cococpatli and fine charcoal
was applied. If the limb became too inflamed, bleeding was advised to avoid excessive
swelling. In the case of a wrenched neck, as in torticollis, the neck muscles were
massaged, relaxed and straightened; a drink made of coaxihuitl was prescribed 'to
cool the blood', and the patient was bled in the veins of the neck.
Whatever the location of a fracture the outline in treatment was to press the area,
stretch the bone to its original length and position, and join its broken ends; then a
poultice made of pulverized cacacili root was applied to the surface of the fracture.
Indeed a certain degree of sound observation existed in the Aztec treatment of
fractures because immobilization was recommended, using wooden splints pressed
and bound tightly around the fracture with cords; the Sahagu'n Florentine codex even
carries some colour drawings of how to perform this technique. The immobilization
period recommended was only twenty days, an Aztec month, which probably nowa-
days would be considered too short to promote a solid callus and bone healing for
certain leg fractures. However, some scatological compounds when applied to open
fractures, bleeding a closed fracture, or certain surgical manipulation of the affected
area could not improve the fracture prognosis. There is mention of the powder of the
herb xipetziuh mixed with the root iztac zazatic applied locally in fractures of the spine
and ribs, or hot baths, but more important was the use of obsidian knives to perform
periosteotomies in the exposed fractures or the heroic measure of foreign grafting
in the bone by the application of a very resinous stick to be inserted within the bone,
bound inside the incision and covered after suture with the vegetable remedies
mentioned. Farill (1952) has touched slightly on this technique of intramedullary
fixation and reproduced some cases of club-foot deformities portrayed in frescoes in
327
 F. Guerra
Teotihuacan. Freeman (1924) and others (1961) have reported evidence of cranial
trepanation among the Aztecs but occurring with less frequency than among the
Incas.
Closely related to surgical practice were the human mutilations performed among
the Aztecs as a result of religious ceremonials or military and social standing. Their
type and extent have been surveyed by Davalos and Romano (1956), who find cranial
deformation by progressive flattening from childhood, pressing the forehead and
occiput of the infant between two pieces of wood, more frequent than the cylindrical
deformation obtained by bandaging the same area in the child. Fastlicht and Romero
(1951) have published a detailed study of dental mutilation among the Mexicans
which developed precisely in the Aztec area and spread among other groups. The
upper incisors were usually filed to offer a sawing edge, or drilled and inlaid by jade,
turquoise or gold. The ear lobe, the septum and nose wall, and the lower lip were also
frequently perforated and jade, turquoise or gold pieces inserted. For these purposes,
and ritual sacrifice, a certain degree of vascular control was necessary.
OBSTETRlCS
Mexican obstetrics have been the subject of an excellent study by Leon (1910) who
surveyed in detail the available sources of information known in his day, particularly
the Sahagiin codices. In them can be found quotations pertaining to the folklore of
Aztec marriage and childbirth [VI Nos. 24 to 38] which have also been used by Flores
(1886) and Ocaranza (1934). Le6n (1910) mentions that women of quality were married
between fourteen and sixteen years of age, and among the common people even
earlier; other writers give twenty as the usual age for the woman's marriage. The mid-
wife tlamatqui ticitl seems to have been one of the four old wives who carried the bride
in the marriage ceremony. As soon as the pregnancy was announced there was an
exchange of long-winded and elaborate speeches between the family, midwife and
the expectant mother-ichpuchpihua if it were her first pregnancy-expressing the
joy and reverence her condition demanded. It was customary for the pregnant woman
to have, besides the usual cleansing baths, two ritual bathing sessions at the temazcalli
or steam house, one around four months after conception and the other two months
prior to her delivery. The Sahagtin codex asserts that in the latter the midwife ascer-
tained the position of the foetus by abdominal exploration, and if necessary she carried
out an abdominal version by external manipulation aimed at securing a normal de-
livery.
Pregnancy, as in other civilizations, was a topic of curious beliefs, and the women
were advised not to warm the abdomen to excess by getting near the fire or by exposure
to the sun because that could 'toast' the child; napping during the day could deform the
child's face, and chewing tzictli or chewing-gum would induce in the child hardening
of the palate and gums with consequent suckling difficulties. The midwife also advised
sexual moderation in the early months of pregnancy to avoid miscarriage, and
abstinence at the final stages, but at the same time they believed that lack of sexual
activity with the husband would produce sickly and weak children. To look at some-
thing red would induce an abnormal podalic or shoulder presentation of the foetus,
to look at a man who had been hanged would induce intrauterine strangulation of
328
 Aztec Medicine
the foetus by the umbilical cord, and to deny the pregnant woman her whims would
mean damaging the child. Sound commonsense advice about good food, gentle
exercise and work is found in the primary sources, also avoidance of food taste
perversion because it is hinted that whatever the future mother eats becomes part of
the child; but the fact remains that the Mexican expectant mother continued her
pregnancy under considerable hardships with regard to work and food. It was part
of the midwife's duty to stay with the pregnant woman during the days immediately
preceding parturition, to start the fire which lasted four days after, cleanse and bathe
the patient and be in attendance as soon as the pains started. Le6n (1920) holds the
opinion, based on the archaeological evidence of some sculptures and the scenes
depicted in Codex Nuttall and Codex Borbonicus, that the Aztec woman adopted a
squatting position during parturition. The Sahagtin [VI Nos. 27 and 30, and XI No. 5]
and Badianus [XI] codices recommended the stimulation of labour by several drugs;
some, such as a potion made of opossum tail tlacuatzin, were magic elements, but
others such as the cihuapatli infusion have been confirmed experimentally to possess
oxytocic action. After parturition a number of ceremonies were carried out by the
midwife. She first cut the umbilical cord and, if the child were a boy, gave the placenta
to a soldier to be buried on the battlefield, or, if a girl, she buried the placenta near
the fireplace. Afterwards she bathed mother and child and attended to the baptism
of the child, a ritual very similar to the Christian ceremony. Within four days the
child was given a name, usually that of his birthday, but for the unlucky days of the
Aztec calendar and on certain occasions the name of an outstanding event occurring
on his birthday, for example a comet, was selected. The horoscope of the child was of
great importance and also certain beliefs about twins coati and triple childbirth
tenamnatzin, which announced the imminent death of one of the parents. Visitors to
the new-born child used to rub its bones and joints with ashes with the idea of pro-
moting strong bone structure.
But underneath all these folk practices the primary sources indicate the keen
clinical observations of the Aztec midwife. She recognized the great value of pre-
serving the amnion intact during labour in order to obtain smooth and progressive
dilation of the cervix and delivery with the minimum of trauma. As Sahaguin points
out, only a clumsy midwife allowed a premature breaking of the amnion. The same
author [VI Nos. 27 and 28] mentions that embriotomy of the dead foetus was per-
formed by Mexican midwives: 'The midwife well experienced and knowledgeable in
her craft, as soon as she realized the foetus was dead in the mother's womb because
there was no movement and the mother was in great distress, readily inserted her
hand through the channel of generation and with an obsidian knife cut the body of
the creature and took it out in pieces'. For this operation the consent of the patient's
parents was required, otherwise the suffering woman was left alone to die and was
regarded very highly as a goddess ciaopipiltin in the hereafter. There is a section
[VI No. 27] in which certain gynaecological diseases are clearly described. The
secretion of a purulent exudate of the vagina, ' . . . like white atoli . . .', after sexual
intercourse late in the pregnancy is given as the cause of uterine infections and
puerperal fever leading to the death of the mother.
Women's sterility, as in other civilizations where agricultural labour was supplied
329
 F. Guerra
by the children of the family, was regarded with aversion and barren wives tetzacotl
were easily divorced; Juan Bautista (1600) mentions a medicine tianechicolli used to
promote pregnancy. However, this author, as well as Sahaguin (1565), Lopez de
Gomara (1551) and several others indicate that induced abortions were quite common
and carried out by some women with special knowledge of herbs and manipulation
for that purpose. Nursing of the child went on for over three years, the codices
Fejervary-Mayer and Mendoza [58] portraying interesting examples of it and of
pediatric practices, but it should be borne in mind that the Aztecs lacked domestic
animals, providers of milk.
EPIDEMIOLOGY
Pre-Columbian records suggest that the early Mexican migration from the north
in the year ce acatl (A.D. 583) was not entirely due to famine but to epidemics; further-
more, Leon (1919) has pointed out Toltec chronicles indicating that the fall of the
Tula kingdom in the year ce tecpatl (A.D. 1116) immediately preceding the Aztec
hegemony, was also due to epidemic disease. Notwithstanding the slow progress in
pre-Columbian hieroglyphic interpretation, any identification of diseases in the
American codices, however, fragmentary has momentous consequences in the history
of epidemiology. It was pointed out (1964) that evidence of Aztec pre-Columbian
epidemics are found in three Mixtec and Cholultec codices. The Selden codex (Roll A2)
depicts two years of disease with blood vomit and death in section 18, the Borgia
codex depicts another cycle of one with blood vomit, diarrhoea and melaena in
section 13, and the Vatican codex B3773 also includes bad omens with blood vomit
in section 18; all three, therefore, give data in favour of yellow fever epidemics in the
Aztec area. Jarcho (1964) has surveyed other sources complementing this data,
describing excavations with gummatous and proliferative periostitis which are
sufficient proof of syphilis in pre-Columbian times, and American fossils of certain
anthropods supporting the existence of vectors for certain Rickettsia, although he is
in doubt about evidence for vectors of malaria and yellow fever. On the other hand,
Bruce-Chwatt (1965) has discussed in detail the arguments favouring the existence of
malaria in America prior to European arrivals, including Molina's (1570) word
uiptlatica atonauiztli fever with shivering which Flores (1886) previously identified
with tertian fever.
Aztec epidemiology revolves around two aboriginal entities of considerable im-
portance in population movements: the matlazahuatl and the cocolitztli. Documentary
analysis leaves no doubt they were the great killers of the Aztec in pre-Columbian
times, though after the Spanish arrival exposure to new diseases, smallpox, influenza,
measles and, much later, cholera, overshadowed the persistent Indian mortality by
these endemic infectious diseases. The identification of both terms matlazahuatl and
cocolitztli has baffled historians so far and marred many otherwise important works.
In Nahuatl language matlazahuati may be derived from matlati net or matlali
bluish, and zahuatl exanthema or boil. Cocolitztli however, seems to be a much more
generic name and has been translated by Molina (1571) and others as pestilence
or a severe widespread disease. Shortly after the Spanish conquest of Mexico in
1519 the descriptions of a pyrexia lasting from one to two weeks, with nose bleeding,
330
 Aztec Medicine
severe prostration, headache, rash, sphacelus and mental disturbances, characteristic
of matlazahuati epidemics, were identified by the arriving Spaniards with the synonym
of tabardillo or tabardete, the traditional Castilian name for exanthematic typhus.
The confusion existing until now in historical literature has been in great part due to
the similarity between the incubation period of exanthematic typhus and typhoid
fevers, and the comparatively recent identification of Rickettsia and Salmonella as
the corresponding pathogenic agents. The semantic analysis of matlazahuatl could be
stretched to favour typhoid fever by rendering matlati into Spanish not as net red but
redanio, used by Cabrera Quintero (1746), which means not only net but was also the
Spanish archaic anatomical name for omentum; this elaborated translation of
matlazahuatl, as omentum or viscera with boils, comes close to describing the morbid
anatomy observed in typhoid fever autopsies. But additional arguments favouring
matlazahuatl as typhus and cocoliztli as a general term for pestilence may be obtained
from early clinical accounts and several epidemiological factors. Both matlazahuatl
and cocoliztli, whatever their nature, existed before the European arrival, the terms
and the records speak for themselves. These epidemic diseases spread over Mocte-
zuma's empire, which nowadays corresponds roughly with the geographical distri-
bution of the American spotted fevers, including the exanthematic louse-borne typhus
and their vectors. The contemporary accounts always agreed on the high mortality
of the epidemics which, if they had been typhus and other Rickettsia infections, could
reach up to 70% of the cases, but could never have gone beyond 20% in enteric
fevers. The strongest argument in the identification of matlazahuatl as exanthematic
typhus can be found in the celebrated Mexican book by Bravo (1570), one fourth of
the text being devoted to 'The Universal doctrine of the cruel disease (commonly
known as tabardete) which ravages the oboriginals of this Mexican province'.
Rodriguez Mendez (1902) in his discussion on the similarities between the plague of
Athens and matlazahuati also supported the idea of it being typhus, though he was
unaware of the existence of Bravo's work.
Cocoliztli could be the Nahuatl generic term for pestilence, embracing even the
matlazahuatl, were it not used in sixteenth century Mexico as a separate entity.
The holograph report on the spot by Hernandez first described by Guerra (1956)
refers to an epidemic of 'continuous high fever, black and dry tongue, epistaxis,
parotiditis, sometimes diarrhoea, weak and accelerated pulse, the eyes and skin tainted
yellow, delirium and convulsions, greenish urine, gangrene and sphacelus of the
buttocks and extremities. It attacked mostly young people, older people showing
greater resistance. In the autopsies the liver was found to be enlarged and pale'.
Hernandez's clinical description of cocoliztli in 1576 could be one of typhus, but for
the icterus ' . . . oculi universumque corpus lutea'. In his painstaking account of the
1736 epidemic Cabrera Quintero (1746) used both terms matlazahuatl and cocoliztli,
and mentioned that it was thought by some to be v6mito prieto or yellow fever, not
influenza as had been mentioned. The description by Escobar he quoted, ' . . . sudden
illness, intense headache, suffused eyes, deep jaundice, nausea, epistaxis, pain in the
abdomen and in the joints, parotiditis, delirium on the fourth day followed by death',
reads, indeed, like yellow fever, as Thomas (1885) suggested. The identification of the
1736 and earlier epidemics of cocoliztli in the Mexican plateau with yellow fever would
331
 F. Guerra
make necessary a reappraisal of American epidemiology in pre-Columbian times.
THERAPEUTICS
The basic ideas in the treatment of disease among the Aztecs are conveyed in
Mendieta's statement (c. 1590) that, ' . . . when called to cure a patient the [Aztec]
physician used herbs and applied some remedies if the ailment was of minor impor-
tance, but if the disease was acute and dangerous he would tell the patient, "you
have committed a sin" '. Psychotherapy and religious rituals, therefore, supplemented
the use of indigenous materia medica.
In the Sahagiin and Badianus codices treatments are arranged from head to toe;
the first has Book X, chapter xxviii devoted to 'Diseases of the human body and
medicines against them'; the second, so oustanding for its beautiful representations
of medicinal plants, offers thirteen chapters of receipts for ailments of the head, eyes,
ears, nose, teeth, throat, lungs, heart, stomach, intestines, urinary tract, limbs, and
for remedies to be used for idiocy, and in obstetrics and pediatrics. Some sections refer
to unusual syndromes: fear, maleficent airs, the fatigue of civil servants, and perils of
travel. Both primary sources make use of vegetable, mineral and animal substances,
including scatological material, such as urine and excrement, and certain procedures
with distinctly supernatural implications, a cadaver's tooth on the head of the patient,
the coyotl's eye tied to the arm, flowers round the neck, and the like. As a whole the
receipts in these codices resemble the medieval pharmacopoeia, particularly in their
generous use of botanical remedies. The treatment of syndromes in the Sahagufn
codices is followed by Book XI, chapter vii, sections 4 and 5 respectively on 'Medicinal
herbs' and 'Medicinal stones'. Animal products of medicinal use are also mentioned
throughout the text, praising, among others, the virtues of the tlacuatl's tail, a marsu-
pial recommended to ease parturition. An example of such a receipt in the Badianus
and Sahagzin codices reads as follows: 'The head with scabies should be washed with
urine; then covered with a poultice made of huitzquilitl, tezonpahtli, tequammaitl,
and tetzmixochitl roots mixed with ground copalquahuitl and atoyaxocotl bark'. There
is no indication of the mode of action of drugs in the receipts, nor any apparent
connection between the cause of disease and the virtues, if any, of the ingredients.
The Badianus codex mentions 251 plants, 185 of these being portrayed in colour;
Sahagutn mentions only 123; Hernandez's survey (1570-1577) is usually quoted as
covering 1,200 medicinal plants, in fact the index of the plant names he recorded
includes 4,043 items. Nahuatl botanical nomenclature was sound, the name of the
plant always referring to some of their characteristics, properties or attributes (for
instance yoloxochitl the heart flower) the suffix xihuitl in the name meant annual
herbaceous, quahuiti tree, xochitl flower, and pahtli drug, with the actual Greek double
meaning of poison and medicine. This consistent nomenclature, the sheer number of
plants utilized-Hernandez described almost seven times more drugs among the
Aztecs than Dioscorides knew of in the ancient world-and their tradition in thera-
peutics, has bestowed upon the Mexican materia medica considerable prestige, to a
point where over 5,000 references can be found (1950) to books or pharmacological
studies in this field. The botanical gardens of Netzahualcoyotl and Moctezuma, and
the fact that a special market existed in the ancient Tenochtitlan just for medicinal
332
 Aztec Medicine
herbs were deeply admired by the conquistadores. These became acquainted with
new diets of maize, potatoes, beans, cocoa, chili and a great variety of fruit, besides
ichcatl cotton, ulli rubber and picietl tobacco, and with their domestic and medical
uses. Mexican materia medica included some great drugs of the past such as guiac,
jalap, castor oil, sarsaparilla, balm and others now in disuse. However, a whole group
of hallucinogenic drugs (1954) has recently been rediscovered, including teonanacatl
mushrooms, peyotl a cactus, ololiuhqui a creeper, and toluah related to the daturas.
In certain cases it has been possible to confirm certain pharmacological activity,
the cihuapatli woman's medicine, from cihuatl woman and patli drug, has oxytocic
action. More often a potent drug was used for magical effects, the yoyotli nuts, a
powerful cardiotonic, were carried against haemorrhoids. The apparent wealth of the
Aztec materia medica must not be allowed to disguise the fact that few of its natural
drugs are still in use. On the other hand, it is a great repository of valuable raw
materials, such as diosgenin, which have undergone many processes in pharmaceutical
chemistry.
The temazcalli or steam bath house, was a therapeutic procedure among the
Aztecs, combining the idea of bodily cleanliness with spiritual purification. They
were chambers of about six by six feet square and four feet high, made of adobe
brick, with a very narrow entrance and a wall section of tetzontli, a porous volcanic
stone. Next to this section a fire was made and water sprayed over the hot stones
from within the chamber which produced steam. The action of the steam and the
sweat induced had a strong effect on the patients for at least thirty minutes; after
that time the patient was taken out and received a shower of tepid or cold water with
invigorating results. The missionaries strongly disapproved of temazcallis on the
grounds that they were used for sexual orgies by people of the same or opposite sex.
Due to the use of sulphurous springs and the location of some temazcallis, there is
reason to believe the beneficial effects they produced upon so-called leprosies, and
certain dermatoses may have been due to the high sulphur content of the waters used
in the bath.
The psychotherapeutic procedures used in Aztec medicine have so far been ap-
proached under a religious bias. Their proper value in the treatment of disease in
that society at large can only be analysed within the context of dynamic psychology.
Glimpses of the underlying elements affecting mental health among the Aztecs,
family interdependence, aggressiveness towards neighbouring groups, sexual be-
haviour or religious beliefs may be found in some primary sources such as Sahagu'n.
but the outstanding document is Ruiz de Alarc6n's report (1626) written after years
of intimate ethnographic and sociological study in closed Indian communities where
Aztec culture and behaviour had survived. Ruiz de Alarcon's sixth treatise is 'On
the superstitious physicians and their tricks' and contains 32 chapters transcribing the
magic formulae, a sort of medical liturgy enunciated by the ticitl physician for each
disease, from head to toe: 'Treatise on the superstitious cure of the head', ibid 'of the
eyes', ibid 'of the ear-ache', and so on. In the first treatise Ruiz de Alarcon dealt with
the use of hallucinogenic drugs, ololiuhqui, picietl or tobacco, and peyotl, in the treat-
ment of ill-health attributed to sorcery (1966). The Fourth treatise, chapter iii, 'On
evils and diseases arising from illicit love affairs', and chapter iii of the Sixth treatise,
333
 F. Guerra
'On the remedy they use to so-call reconcile', deserve a much more detailed analysis.
The sex urge, sodomy, psychosomatic transfer and many ideas of contemporary
psychology can all be found in that important, though neglected study.
COROLLARY
On the eve of the American conquest Aztec medicine enjoyed considerable prestige
among pre-Columbian cultures and in the eyes of the European arrivals. The gist of
this consensus appears in Cort6s's request to Charles V not to allow physicians to
come into Mexico because the dexterity and knowledge of the Aztec doctors made it
unnecessary. The extent of anatomical and botanical nomenclature, professional
ethics, some sound clinical observations, and the importance given to psychological
factors in the genesis and treatment of disease were outstanding in the Aztec culture.
Some of these elements of dynamic psychology, appreciable only through the study
of its medical history, are of considerable importance in the interpretation of con-
temporary sociological phenomena.

REFERENCES
AGuILAR, GILBERTO F., La medicina, M6xico, M6xico prehispanico, 1946, pp. 725-36.
AouIRR BELTRAN, G., 'La medicina indigena', America indigena, 1947, 7(2), 107-127.
Aounuu BELTRAN, GONZALO, Medicina y magia. El proceso de aculturacion en la estructura
colonial, M6xico, Instituto nacional indigenista, 1963,
ALATRISTE DE LoPE, JOAQuIN, Algwias observaciones sobre la historia natural mndica antes
de la conquista, M6xico, XI Congreso de Americanistas, 1895, pp. 356-60.
ALCOCER, IGNACIO, 'Consideraciones sobre la medicina azteca', in Sahagin, 3, 375-382, 1938.
ALVA IXLxoCHIL, FERNANDO DE, Obras historicas, M6xico, Secretarfa de Fomento, 1891-
1892, 2 vols.
ALVARADO TEZOZOMOC, HERNANDO. Cr6nica mexicana escrita hacia el afno MDXCVIII,
M6xico, I. Paz, 1878.
BARRERA, A. and BAssoLs, I., 'Un ensayo sobre los conocimientos entomol6gicos en el
Mexico antiguo', Memoria del Congreso Cientifico mexicano, 1953, 7, 85-98.
BELTRAN, E., 'Plantas usadas en la alimentaci6n por los antiguos mexicanos', America
indigena, 1949, 9, 195-204.
BRAvo, FRANCIsco, Opera medicinalia. Mexico, P. Ocharte, 1570.
BRUCE CHwATT, L. J., 'Paleogenesis and Paleo-Epidemiology of Primate Malaria', Bulletin
of the World Health Organization, 1965, 32, 363-87.
CABRERA Y QuINTERo, CAYETANO, Escudo de armas de Mexico . . . en la angustia que ocasionoc
la pestilencia, Mexico, J. B. de Hogal, 1746.
CAPITAN, L., 'Les sacrifices humains et l'anthropophagie rituelle chez les anciens mexicains',
Journal de la Societe des Americanistes, 1920, 12, 211-17.
CARCER Y DIsDIER, MARIANo DE., Apuntes para la historia de la Transculturacion Indo-
espaifola,;M6xico, Instituto de Historia, 1953.
CASO, ALFONSO, Contribuci6n de las culturas indigenas de Mcxico a la cultura mundial, Mexico,
M6xico y la Cultura, 1946.
CAso, ALFONSO, The Aztecs: people of the sun, Trans. by L. Dunham. Norman, University
of Oklahoma Press, 1959.
CEBALLOS NovELo, R. H., 'El temazcal o bafno mexicano de vapor,' Ethnos, 1920, 1, 28-36.
CHAVEZ, IGNACIO, Mexico en la cultura mUdica, Mexico, M6xico y la Cultura, 1946.
CLAVIGERO, FRANCISCO XAVIER, Storia antica del Messico, Cesena, G. Biasini, 1780-1781.
4 vols.
334
 Aztec Medicine
COINDET, L. 'La m6decine au Mexique,' Archives de la Comission scientifique du Mixique,
1865, 1, 351-65.
ConDET, L., 'Histoire de la m6decine ancienne au Mexique', L'Echo du MWxique, Paris,
1924, 4, (34), 2-4.
COMAS, JUAN, 'Influencia indigena en la medicina hipocritica en la Nueva Espafia del siglo
XVI', Am6rica indigena, 1954, 14: 327-61.
COOK, S. F., 'The incidence and significance of disease among the Aztecs and related tribes',
Hispanic American Historical Review, 1946, 26, 320-35.
CRAVIorO, R. O., 'Nutritive value of the Mexican tortilla', Science, 1945, 102, 91-93.
CRAVIOTO, R. O., 'Valor nutritivo de los alimentos mexicanos', America indigena, 1951,
11, (4), 297-309.
CREsSON, F. M., 'Maya and Mexican sweat houses', American Anthropologist, n.s., 1938,
40, 88-104.
DkAvios HURTADO, E., 'Investigaciones osteopatol6gicas pre-hispinicas en Mexico,'
Memoria del Congreso Cientifico Mexicano, 1953, 12, 78-81.
DAvALos HURTADO, E., 'La alimentaci6n entre los m6xicas,' Revista mexicana de estudios
antropol6gicos, 1956, 14, 103-18.
DAvALos HURTADO, E. and ROMANO, A., 'Las deformaciones corporales entre los mexicas',
Revista mexicana de estudios antropol6gicos, 1956,14, 79-101.
DIBBLE, C. E., 'Nahuatl names for body parts', Estudios de cultura Nahuatl, 1959, 1, 27-29.
DIETScHY, H., 'Die medizin der Azteken', Ciba Zeitschrift, 1937, 4(42), 1438-1469.
DoMiNGuEz, J. A., 'Los afrodisiacos, en la America pre- y post-colombiana y en la medicina
popular actual', La medicina Germano-Hispano-Americana, 1925, 6, 1-7.
DOMnNGUEZ, JUAN A., La medicina en la America precolombina y en la epoca de la conquista.
La terapeutica; sus nuevas orientaciones, Buenos Aires, J. Peuser, 1926.
DoMINGuEz, JUAN A., La opo y organoterapia en la America pre y post colombiana, y en la
medicina popular de nuestros dias. Buenos Aires, [J. Peuser], 1930.
DOMiNGUEZ, JUAN A., La medicina americana prehispanica, Buenos Aires, T. Graficos
Argentinos, 1933.
[EDITOR] 'II y a 4.000 ans, les AztQques pratiquaient la trepanation', Sem. H6p. Paris, suppi.,
1961, 37, 8-9.
EMMART, EMILY W., The Badianus manuscript (Codex Barberini Latin 241) Vatican Library.
An Aztec herbal of 1552. Baltimore, Johns Hopkins Press, 1940.
FANCHAMPS, A., 'Des drogues magiques des Azt6ques a la th6rapie psicholytique', Acta
psychotherapeutica, et psychosomatica, 1962, 10, 372-74.
FARS GALINDO, Jose, El simbolismo mUdico indigena, M6xico, Ed. Vargas Rea, 1956.
FARILL, J., 'Orthopaedics in Mexico', J. Bone Jt. Surg., 1952, 34-A(3), 506-12.
FASTLICHT, S., 'Tooth mutilations in pre-Columbian Mexico', J. Amer. dent. Ass., 1948,
36, 315-24.
FASTLICHT, S., 'La odontologia en el M6xico prehispanico', Rev. Asoc. dent. Mex., 1950,
7(2), 1-23.
FERNANDEz DEL CASTILLO, F., 'Historia de la materia m6dica mexicana. Los primeros
investigadores', Sugestiones, Mexico, 1943, 91, 17-31.
FERNANDEZ DEL CASTILO, F., 'Historia de la medicina. La cronologia y la medicina nahuatl',
El Medico, Mgxico, 1958, 7(12), 54-59; 8(1), 50-58.
FERNANDEZ DEL CAsTILLo, F., 'La medicina de Tlaltelolco y Fray Bernardino de Sahagoin,
Gaceta mOdica de Me6xico, 1964, 94, 217-229.
FLORES, FRANCISCO A., Historia de la medicina en Mexico, desde la epoca de los indios hasta
la presente, Mexico, Secretarfa de Fomento, 1886-1888, 3 vols.
FOSTERMANN, ERNSr W., La medicina entre los indios mexicanos antes de la Conquista, Mexico,
XVII Congrbs international des Americanistes, 1910, pp. 214-24.
FREEMAN, L., 'Surgery of the ancient inhabitants of the Americas', Art and Archaeology,
1924, 18: 21-35.
335
 F. Guerra
GALL, AUGUST FREHERR VON, 'Medizinische bucher der alten Azteken in vorspanischer
Zeit', Forschungen und Fortschrifte, 1936, 12(17), 222-24.
GALL, AuGusr FREsIERR VON, 'Medicinische bucher (tici-amatl) der alten Azteken aus der
ersten Zeit der Conquista', Quell. Gesch. Naturw., 1940, 7(4-5), 81-299.
GERSE, ACHILLE, Notes sur la mddecine et la botanique des anciens mexicains, Roma, Imp.
Polyglotte, 1909.
GONZALEZ ULLOA, MARo, La medicina en Mexico; sintesis hist6rica, Mexico, Cyanamid de
M6xico, [1959].
GONZALEZ [ULLOA], M., 'ltlet 6s halil a prekolumbianus idokben', Orvosi hetilap, 1961,
102, 2189-91.
GuERRA, F., 'La bibliograffa de la historia de la medicina mexicana', Prensa medica mexicana,
1949, 14, 87-93.
GuERuA, F., La materia midica mexicana, Mexico, Prensa m6dica mexicana, 1950.
GuERR, F., Libellus de medicinalibus Indorum herbis. El manuscrito pict6rico mexicano latino
de Martin de la Cruz y Juan Badiano de 1552. Estudio, texto y version, Mexico, Vargas
Rea y Diario Espafiol, 1952.
GUERRA, F., 'La investigacion de las drogas mexicanas', Memoria del Congreso Cientifico
mexicano, 1953, 10, 106-109.
GuERRA, F., 'Maya Medicine', Med. Hist., 1964, 8, 31-43.
GUERRA, F., 'Mexican phantastica. A study of the early ethno-botanical sources on hallucin-
ogenic drugs', Brit. J. Addiction, 1966, 62 (in press).
GuERRA, F. and OLVERA, HECTOR, Las plantas fantdsticas de Mexico, Mexico, Diario Espanol,
1954.
Gu nrEz COLOMER, L., 'Los baios medicinales entre los indios de Nueva Espa-na', Farmacia
nueva, 1953, 18, 143-46, 213-17.
HERNANDEZ, FRANCIScO, Rerum medicarum Novae Hispaniae thesaurus, Roma, V. Mascardi,
1628.
IZQUERDO, J. J., 'La botanique azteque et la botanique mexicaine moderne', Arch. int. Hist.
Sci., 1955, 8(32), 227-40.
JARCHO, SAUL, 'Some observations on disease in prehistoric North America', Bull. Hist. Med.,
1964, 28, 1-19.
KRICKEBERG, W., 'Das Schwitzbad der Indianer', Ciba Zeitschrift, 1934, 1(10), 335-41.
KRICKEBERG, WALTER, Las antiguas culturas mexicanas, Mexico, Fondo de Cultura Eco-
nomica, 1961.
LAPIER, J., 'La m6decine au temps des AztQques et des Incas', Montreal medical, 1962,
13, 37-43.
LEON, NicoLAs, La obstetricia en Mexico, Mexico, Vda. de F. Diaz de LeOn, 1910.
LEON, NIcOLAs, Que era el matlazahuatl y que el cocoliztli en los tiempos precolombinos y en
la epoca hispana? Mexico, Imprenta Franco-Mexicana, 1919.
LEON PINLO, ANTONIo DE, Epitome de la biblioteca oriental, occidental, nautica, geografica,
Madrid, J. Gonzalez, 1629.
LEON PORTILLA, MIGUEL, Aztec thought and culture: a study of the ancient Nahuatl mind,
Trans. by J. E. Davis, Norman, University of Oklahoma Press, 1963.
Lnrd#, S., 'Dental decoration in aboriginal America', Ethnos, 1940. 5, 2-28.
LIZARDI R&Amos, C., 'La medicina entre los indigenas', Universidad de Mexico, 1949, 3(3 1),
19-20.
LLAMAS, R., 'La alimentaci6n de los antiguos mexicanos', An. Inst. Biol. Univ. Mix., 1935,
6(3-4), 245-58.
MALDONADO KOERDELL, MANUEL, La botdnica, Mexico, Mexico Pre-hispknico, 1946.
MARTIN DEL CAMPo, R., 'La anatomia entre los m6xicas', Rev. Soc. Mix. Hist. Nat., 1956,
17, 145-67.
MARTINEZ, JAVIER, La mJdecine precolombienne au Mexique [These], Paris, Jouv6, 1934.
MARTINEZ CORTES, FERNANDO, Las ideas en la medicina nahuatl, Mexico, Prensa m6dica
mexicana, 1965.
336
 Aztec Medicine
MENDETA, GER6Imo DE, Historia eclesidstica indiana. Obra escrita a fines del siglo XVI,
Mexico, F. Dfaz de Le6n y S. White, 1870.
MOLiNA, ALoNSO, Vocabulario en lengua castellana y mexicana, Mexico, A. de Spinosa, 1571.
NOGUERA, E., 'El uso de anest6sicos entre los aztecas', Rev. mex. Est. antropol., 1928, 2, 162-69.
NOGUERA, M. G., 'Aportacion al conocnimento de la medicina del M6xico precortesiano',
Arch. iberoamer. Hist. Med., 1957, 9, 363-72.
[NUTrALL, ZEUA], 'Sorcery, medicine and surgery in ancient Mexico', Brit. med. J., 1902,
i, 1161-62.
OBERMAYE, MAXIMILAN E., 'Mexico, A study of its contributions to dermatology', Arch.
Derm., 1956, 73, 533-52.
OCARANZA, FERNANDo, Historia de la medicina en Mexico, Mexico, Laboratorios Midy, 1934.
OCARANZA, FERNANDO, La cirugia en el An4huac durante la ipoca precortesiaa, Mexico,
[Laboratorios Midy], 1936.
OCHOTERENA, IsAAc, La biologia. Mexico, Mexico y la Cultura, 1946.
PARDAL, RAM6N, Medicina aborigen Americana, Buenos Aires, J. Anesi, 1937.
PASO Y TRoNcoso, F. DEL, 'Estudio sobre la historia de la medicina en M6xico. La botAnica
entre los nahoas', An. Mus. nac. Mex., 1886, 3, 137-235.
PERI TREo, GUSTAVO A., 'La medicina', Esplendor del Mexico Antiguo, 1959, 1, 211-20.
P[owER] D'A[Rcy], 'Aztec medicine', Brit. med. J. 1940, li, 567.
RAFFOUR, LouLs, La medecine chez les Mexicains precolombienes, Paris, Jouv6 et Boyer, 1900.
RAULIN, L., 'La pathologie et la m6decine pre-colombiennes chez les anciens M6xicains',
Gaz. hebd. Sci. me'd., 1922, 43, 437-40, 458-60.
REGNAULT, F., 'L'art mexicain devant la m6decine', L' Univers mcfdical, 1914, 10 (6), 5-8.
REKO, B. P., 'De los nombres botanicos aztecas', El Mexico antiguo, 1919, 1(5): 113-57.
ROBINSON, F., 'Textos de medicina nahuat', America indigena, Mexico, 1961, 21, 345-53.
RODRIGuEZ, LUIs ANGEL., La ciencia medica de los Aztecas, Mexico, Ed. Hispano-Mexicana,
1944.
RODRIGUEZ ARBELOA, A., 'La medicina entre los Aztecas', Bol. Soc. esp. Hist. Farm., 1960,
11, 157-67; 1961, 12, 13-23.
RODRIGUEZ MENDEZ, R., 'La peste atica y el matlazahuatl', Rev. iberoamer. cienc. med.,
1902, 8, 464-88.
RUIZ DE ALARcON, HERNANDO, 'Tratado de las supersticiones y costumbres gentilicas que
hoy viven entre los indios, naturales de esta Nueva Espaiia', An. Mus. nac. Mix., 1892,
6, 123-224.
SAHAGJN, BERNARDINO DE, Historia general de las cosas de Nueva Espafna, M6xico, Ed. P.
Robredo, 1938, 5 vols.
SAHAGON, BERNARDINO DE, Florentine codex. General history of the things of New Spain,
trans. by C. E. Dibble and A. J. 0. Anderson, Santa F6, University of Utah, 1950-
1963, 13 vols.
SCAFFER, GLORI, 'Aztec herb therapy', El Palacio, 1955, 62, 357-366.
SCHADEWALDT, H., 'Altmexikanische heilkunde', Med. Welt, 1962, 26, 1455-64.
SERNA, JACINTO DE LA, 'Manual de ministros de indios para el conocimiento de sus idolatrias,
y extirpaci6n de ellas', An. Mus. nac. Mex., 1892, 6, 261-480.
SIMONS, BENm B., 'Lidt om den gamle Mexikanske laegekunst', Medicinsk Forum, 1963,
16(1), 1-11,
SOuSrELLE, JACQUES, The daily life of the Aztecs on the eve of the Spanish conquest, trans. by
P. O'Brien, London, Weidenfeld & Nicolson, [1961].
THOMAS, L., Lectures sur l'histoire de la medecine. Une epidemie mexicaine au XVIII siecle. Le
cocolisti ou matlazahualt des Indies. Paris, A. Delahaye et E. Lecrosnier, 1885.
TORQUEMADA, JUAN DE, Los veynte y un libros rituales y monarchia yndiana, Sevilla, M.
Clavijo, 1615, 3 vols.
TRENS, MANUEL B., 'Arte curativo de las enfermedades. Farmacia y hechiceria. La brujerfa
y el nahualismo en la Nueva Espanfa,' Boletin del Archivo general de la naci6n, 1952,
23(4): 494-559.
337
 F. Guerra
URBINA, M., 'Plantas comestibles de los antiguos mexicanos', An. Mus. nac. MEx. 2' Ep.
1904, 1, 503-91.
URBINA, M., 'Rakces comestibles entre los antiguos mexicanos', An. Mus. nac. Mecx., 2'
Ep., 1906, 3, 117-90.
VAILLANT, GEORGE C., Aztecs of Mexico. Origin, rise and fall of the Aztec nation, 2nd ed.,
New York, Garden City, 1947.
VAtSs, F., 'La medicina entre los aztecas', Cultura venezolana, 1919, 3, 258-60.
VARGAS CASmLA, M., 'La patologia y la medicina entre los m6xica', Rev. mex. est.
antropol., 1956, 14(1), 119-43.
VEGA ARELLANO, CORDEIA, Datos para la historia de la farnacia precortesiana, Mexico, Ed.
Vargas Rea, 1953. O
WASSEN, S. H., 'Glimtar av Aztekisk medicin', Stockholm, Medicin historisk Arsbok, 1960.
WASEN, S. H., 'Medicinen och medicinaryrkets utovande i', Nytt och nyttigt, Gdteborg,
1960, 2: 15-21.
WOLTR, M. A., 'La situation de la m6decine chez les Azteques avant la conquete', Scalpel,
Bruxelles, 1959, 112: 768-73.

338