Peru as It Is (Vol. 1&2). Archibald Smith

degree as we extend from the Equator towards latitudes far to the north or south of it. Yet, if there be any who understand either the botany or zoology of Peru, or who endeavour to illustrate these subjects by their science and diligence, they are not Peruvians.

      The only lover of natural history we have the honour to be acquainted with in that country is Don Mariano Rivero of Arequipa; and, though their tranquil sky might be imagined to allure Limenians of a philosophic turn of mind to the contemplation and study of the heavenly bodies, yet to Dr. Gregorio Paredes alone belongs, in the present day, the merit and high distinction of keeping the sublime vigils of the astronomer. Now this dearth of native science is not confined to these general branches of natural history and philosophy, but affects very sensibly the practice of medicine. The very manuals of primary medical instruction put into the hands of medical students in the capital of Peru are foreign and European. And thus it is plain that they have no peculiar and national digest of medical knowledge—no local and partial medical code, such as charlatans and public impostors would desire to insinuate when they talk of their own practice of physic, or what they call Medicina del pais.

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

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

      II. Tomar dulce para bever agua a las horas de la comida.—This is a standing dietetic rule observed at the close of a meal or repast, which means that sugar, or some sweet preserve, is to be taken to give relish to the water that it is customary to drink at this time, whether one feel thirsty or not: they therefore sweeten the palate to enjoy their simple drink.

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

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

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

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

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

      III. Prepararse para tomar purga.—Many practitioners of the venerable Boerhaavian school have died in Lima in course of the last few years, but several of this stock are yet remaining; and, in their professional harangues at consultations, they are heard to talk learnedly of the malignant, adust, crude, and corrosive, &c. state of the humours of the human frame, without, as it always appeared to us, being able to affix any precise and practical ideas to these hypothetical expressions. And though the junior doctors of modernized opinions are generally found to indulge in some theory of the abstract solidists, yet they are obliged to respect the prejudices of the vulgar, and talk in a way that is agreeable to those whom it is their business to persuade. Patients, blinded by the received notions concerning the scorched blood, and displaced, corrupt, or perturbed and jumbled humours, reckon the daily visit of the physician indispensable under ordinary circumstances of indisposition. They do not expect that, day after day, active drugs are required; but, according to their own precognition of the case, they think it necessary for their safety that their medical adviser make his regular visits and observations, carefully examine the various excretions, and so be able to judge accurately of the character of the case, and prepare the patient by delay, diet, and diluents, &c. to take physic in due time, which is the meaning of the vernacular expression, “Prepararse para tomar purga.”

      IV. Empacho.—This famous Limenian mischief-maker is supposed to lurk concealed under almost every form of chronic or intractable disease, and means, in the most usual acceptation of the word, a preternaturally loaded and torpid condition of the bowels: but, on other occasions, the same word is used to express the casual lodgement, in any part of the digestive passages, of some such matter as the fresh rind of a fig, grape, or date, keeping up local irritation and fever. Thus, at one time, the term empacho signifies a confined and inactive state of the bowels; and, at other times, indigestion of some foreign and adherent substance, frequently giving rise to quite a contrary condition of gastric disorder: the former is called simply empacho; the latter is called empacho pegado—for the removal of which, a table-spoonful, or two, of the liquid fat of a fowl—the enjundia de gallina! is a popular remedy.

      In a large proportion of cases where this cause of mischief is supposed to exist, it has,