Illness, Healing and Care in the Inca World

In the Inca realm of the central Andes, centered on Cusco in present-day Peru, illness brought together household assistance, specialist treatment and ritual. The imperial period expanded mainly between the fifteenth century and the Spanish conquest of 1532. Catholic writer Bernabé Cobo completed his Historia del Nuevo Mundo in 1653, more than a century after the conquest; anthropologist John Howland Rowe’s later account summarizes Cobo and other chroniclers. Household work and care were part of daily life in the Inca world.

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Household care and specialist roles

A healer’s treatment could take place where the patient lived. Cobo’s account describes a person too ill to walk to a place where two rivers met receiving the water-and-white-maize-flour washing at home, within the patient’s household.

Rowe records hampi-kamayoq, meaning “medicine specialist” in Quechua, an Andean language. Such a healer used plant remedies and could also divine the cause of illness. Cobo’s examples include diviners, medicine specialists and professional midwives. Rowe reports that midwives massaged pregnant women to reposition the fetus, a distinct form of bodily care from treatments for illness or injury.

Treatment, ritual and bodily practice

Cobo describes a healer beginning with a sacrifice to the spiritual source of the practitioner’s power, then using divination to identify a cause. In one account of illness attributed to neglected worship, the patient blew colored maize flour mixed with ground shells toward huacas, sacred beings or places, while praying. The patient also offered coca leaves, from an Andean shrub, to the Sun and gold or silver to the deity Viracocha. When ancestors were considered angry, Cobo says food was placed at their tomb or in a designated part of the house, and chicha, a fermented maize drink, was poured on the ground.

Cobo also records physical actions used by healers. When a practitioner attributed pain to a displaced organ or an object within the body, the healer rubbed the patient with guinea-pig fat, massaged the painful area or sucked at it. Cobo says the healer then displayed material such as a small stone, plant matter or straw as the cause. He also reports that a healer made repeated sacrifices at the place of an accident when treating a broken bone or dislocation, linking the injury to the spirit of that location.

Cranial procedures and healing

Trepanation is the deliberate opening of the skull, practiced in the Andes before and during Inca rule. Archaeologists distinguish several techniques: scraping used repeated strokes of a sharp-edged tool to thin a small area; grooving cut around a circular or oval section; and drilling made a ring of holes, with the bridges between them cut to release a disk of bone. Rowe’s 1946 account describes specimens he considered probably Inca-period from the Cusco region: one had an oval opening outlined by overlapping drilled holes, while another showed two pairs of cut grooves crossing each other.

Modern researchers Valerie Andrushko and John Verano examined trepanations from eleven Cuzco-region burial sites, identifying 109 openings on 66 people. Circular cutting and scraping were common in their sample, and the authors identify cranial trauma as a possible reason for some procedures. Bone growth around an opening shows that a person survived long enough for healing, though it cannot show that the original condition was cured; some skulls preserve more than one healed procedure.

A larger study by David Kushner, John Verano and Anne Titelbaum examined more than 800 trepanned skulls from Peru over a long period beginning around 400 BC. For their Inca-period segment, dated to the 1400s–1500, they estimated long-term survival at 75–83 percent.

A colonial hospital in Cusco

After the conquest, Spanish municipal government introduced another setting for care. Historian Gabriela Ramos dates the founding of Cusco’s hospital for Indigenous residents to 1556, by order of the town council. The institution joined assistance to the poor with colonial charity and government, establishing a new urban setting alongside household and specialist care.