Thursday, June 5, 2008

Empacho and Folk Healers


As a boy growing up in a colonia, a rural and unincorporated settlement near the US-Mexico border, I would often suffer stomach-aches from eating too much junk food or swallowing chewing gum. After I started complaining to Mother about my aches, she would tell me that I was suffering from “Empacho.” As soon as I heard the words, I began to relive memories of my previous visits to la sobadora. Even though la sobadora would cure me, I loathed going to la sobadora. Her folk treatments were so harsh, I thought.

As a kid, I never quite understood the definition of empacho. To me it was simple - whenever I suffered from empacho, I would feel four symptoms: stomach aches, bloating and constipation and general malaise. As a medical student I am prone to see empacho as a form of indigestion or constipation that can be relieved with conventional medicines like a stool softener (e.g. mineral oil or docusate) or an antacid. However, an interesting aspect of illness across the world is that sickness can be understood through different cultural paradigms. According to the western medical model, I was suffering from some form of indigestion, but in my culture I was suffering from a potentially deadly sickness. My empacho was not going to disappear on its own. I needed special treatment.

La sobadera would begin by making me drink chamomile tee, followed by a teaspoon of olive oil. Then I would have to strip down to my underwear so that she could massage my body. Specifically, she would grab a towel, which she used to grab my skin, and rigidly pull it until it made a cracking sound… This practice was not very painful when she would apply it to my legs, but when she got to my lower back and abdomen, I would squirm a bit. It seemed so cruel. The skin stretching session would go on for a very long hour… Suffice to say, after several empacho incidents, I perceived treatments as negative reinforcement. Still today, I don’t chew gum anymore. Go figure.

Here is a picture that shows the technique

I am sure there are other folk remedies practiced in other Latin American countries for curing empacho. I’ve heard of curanderas performing healing rituals to alleviate the symptoms. Other practices involve rubbing the abdomen softly (not like my childhood sobadera…) with various oils. Sometimes a good old enema can do the job. However, its important to acknowledge the unique cultural paradigms used to understand illness and the approaches used to treat them. Here is where cultural competence in the health care setting becomes critical. If I ever encounter a patient in the Emergency Dept. and the mother says, “Mi hijo tiene Empacho.” I’ll look at the kid with sincere empathy…

You can do a pubmed search on Empacho and learn much more about this interesting culture-bound phenomenon. Additionally, you can read a very interesting case study of Empacho de Hombre here

2 comments:

Anonymous said...

Restless Doc, I feel your pain however, I believe it works! I dont know how to do it but have seen it done on my oldest son when he was about 1 yrs old. Please do some more research and let us know!

Anonymous said...

my dad is the almight empacho healer in our family. it works, although my husband thinks it is some sort of argentinean voodoo cure. my daughter is currently suffering with an "empacho" my dad came over today, pulled her back skin, she has already broke her fever and was hungry for a bit. no solids for 24 hours once the fever has broke....