The Origins of Dis-Ease: What Curanderos Knew Before There Was a ‘Diagnosis’

From the first thread of Adriana Ayales' new book, The Rainforest Herbal Apothecary, published by Hay House on September 22.

Western medicine opens with a question: what are your symptoms?

A curandero opens with a different one: what happened to you?

The first question looks at the body as it is right now and asks what has gone wrong there. The second looks at a life and asks what the body is still carrying. Not what is broken, but what occurred in your family, your spirit, your relationships, your land, that never got put down.

Two questions. Two completely different maps of illness.

I grew up inside the second map, in Costa Rica, learning from my grandmother and the curanderas my grandmother worked alongside. My new book, The Rainforest Herbal Apothecary, is my attempt to carry that map forward before the knowledge, like the forests that hold it, is lost. This is the first thread I follow. I invite you to sit with it before anything else.

Illness Was Never Random: The Four Roots

Across the curanderismo traditions of Latin America, from Mexico to the Andes to the Amazon, illness was never understood as arbitrary. It came from somewhere. In this framework, dis-ease could be traced to one of four roots.

The first is the natural world: cold, heat, poor food, or physical injury. The second is the emotional and energetic field: grief, fright, rage, or envy. The third is a broken relationship, with spirit, with the ancestors, or with the land. The fourth is harm sent by another person, through envy, intention, or sorcery. Modern medicine kept the first category. It set the other three aside and called what was left the whole story.

This is not an argument against a lab result. I'm merely questioning whether a lab result was ever the whole picture. A healer working in this tradition would want the bloodwork too (if it was available to her). But she would also want to know who died that year, what was said at the table and what was swallowed instead, and whether the person coming to her to ask about physical symptoms had been back to the place where the fear began.

What follows are five of the conditions curanderos named. Anthropologists have documented each one, and a few have found their way (in name or in spirit) into the vocabulary of modern medicine and psychology.

Susto: When Fright Separates You From Yourself

Susto, or “fright,” is the most widely documented folk illness in the Americas. Anthropologist Arthur Rubel published a formal epidemiology of it in 1964, and researchers have been studying it ever since.

The belief is this: a severe fright, a fall, an accident, witnessing violence, a sudden shock, can cause part of the spirit to separate from the body. The body keeps walking. Something essential stays behind at the site of the fright. The person is present, but not fully present in their own life. What Western medicine might describe through states of nervousness, sleeplessness, loss of appetite, and low mood, this framework reads as a single event with a single meaning. And the resolution was never a pill, but rather a ceremony to call the soul fragment back.

Susto appears in the DSM-5 Glossary of Cultural Concepts of Distress as an illness attributed to a frightening event that causes the soul to leave the body. In a 2008 study of adults in Guadalajara, Mexico, researchers found that people who reported having had susto also reported significantly higher levels of stress and depressive symptoms. That is an association, not a mechanism, and yet it still tells you the healers were looking at something real.

Modern psychology has its own name for a version of this experience: dissociation, the nervous system's response to overwhelming fear, the sense of watching your own life from somewhere outside your body. It is one of the better-documented effects of deep stress and shock. Curanderos did not have fMRI machines. They had generations of watching what happens to a person after the worst day of their life, and they recognized this protective state long before formal terminology entered any textbook.

Empacho: The Gut Was Never Just the Gut

Empacho, literally something “stuck,” is traditionally understood as food lodged in the stomach or intestines, and it is addressed that way, with massage, cleansing practices, and specific traditional plants. A 1993 study across four Latino communities found the core belief remarkably consistent from Guatemala to Puerto Rico.

But in the tradition I learned, the physical diagnosis was rarely the end of the conversation. The deeper question was always: what else is this person holding onto that they cannot yet process? Grief. A swallowed argument. A truth never spoken. The gut was where unprocessed life went to wait.

Gastroenterology now has a name for the gut as an emotional organ: the gut-brain axis, with the vagus nerve running the line between them. Roughly 90 percent of the body’s serotonin is estimated to be made in the digestive tract, not the brain. The science is young, and the details are still being worked out. The observation that the belly keeps score is not young at all.

Mal de Ojo & Envidia: Attention Is Not Neutral

Mal de ojo, or “the evil eye,” is a diagnosis about attention and vulnerability. The belief, found across Latin America and in many other parts of the world, is that a person, often a child, or someone unusually admired, beautiful, or successful, can be harmed by another person's intense gaze or unspoken envy, even when no harm was intended. Reported signs include a sudden, unexplained heat in the body; inconsolable crying with no apparent cause; restless nights; and, in infants in some regional traditions, disinterest in feeding.

It is easy to file this under superstition. Strip away the supernatural framing, though, and there is a precise observation underneath: attention is not neutral. Being watched, judged, and envied changes how we inhabit our bodies. The danger was never envy itself. It was an imbalance in the exchange of attention.

Envidia, “envy,” is the most misunderstood concept in curanderismo, and perhaps the most sophisticated. It is not folklore about jealous neighbors. It is a framework for something real: living inside a community where your well-being is watched, resented, and sometimes actively undermined by the people closest to you. A curandera diagnosing envidia was often doing something modern medicine still has no vocabulary for. She named the cost of being surrounded by people who don't want you to thrive.

Bilis: The Illness That Lived Where the Rage Couldn’t

Bilis, “bile,” is illness from swallowed anger. The belief is that intense anger or resentment, felt but never released, turns inward and disrupts the body, and the tradition locates it in the liver and the bile. The signs recorded across generations of curanderas include tension in the head, sluggish digestion, shaky nerves, deep exhaustion, and in some accounts more serious episodes, following a period of prolonged rage, humiliation, or injustice the person could not act on. The DSM-IV's appendix of culture-bound syndromes listed it as “bilis and colera.”

This is not folklore about temper. It is a diagnosis about power. Bilis was most often recorded in the people with the least social room to express anger safely: women, the poor, the colonized. The illness lived where the rage couldn't.

From My Book: Everything Is Alive

Chapter 1 of The Rainforest Herbal Apothecary closes with five precepts, a synthesis of the way of seeing that produced every diagnosis above. I encourage you to read them slowly.

Healing is relational. 

Wellness does not occur in isolation. It arises from the quality of our relationships to self, to spirit, to community, and to the land. Every illness echoes disconnection, and every true healing restores that connection.

Plants are alive, sentient beings. 

In Indigenous medicine, plants are living intelligences we must respect and listen to. They are teachers, guardians, and allies, each with their own voice and purpose. Healing with plants begins and ends in relationship, not extraction.

Spirit and matter are one. 

Though our perception might lead us to believe otherwise, there is no division between the physical and the spiritual. The body holds the soul's story, and the soul is shaped by its earthly vessel. Ritual, prayer, and energy work are essential tools for restoring wholeness.

Knowledge is ancestral and embodied. 

Wisdom is passed down through words, presence, and the honoring of a living tradition. Healers are shaped by lineage, initiation, and lived experience. Learning comes through dreams, plants, silence, and years of direct communion with the sacred.

Healing is a collective responsibility. 

The well-being of one is intertwined with the well-being of all. The family, the community, and the larger field all hold illness together. Healing ceremonies are often communal not only because they are effective, but because they reflect the truth of our interconnectedness.

Read those five again and notice what they have in common. None of them describe fixing something that’s broken. In this tradition, healing restores a power that was always there, even when it was lost or forgotten for a while.

Dis-ease Is Not a Malfunction

The curanderos did not treat illness as an enemy to defeat. They treated it as information. Illness contains a message: what happened, what broke, what was never said aloud, what relationship in your life has gone unattended.

That’s the map this book is drawn on. It does not ask you to abandon the first question. It asks you to remember there was always a second one.

What’s your body trying to tell you that you haven’t asked it yet?

* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.