Hallucinogenic drugs in pre-Columbian Mesoamerican cultures.

INTRODUCTION: The American continent is very rich in psychoactive plants and fungi, and many pre-Columbian Mesoamerican cultures used them for magical, therapeutic and religious purposes. OBJECTIVES: The archaeological, ethno-historical and ethnographic evidence of the use of hallucinogenic substances in Mesoamerica is reviewed. RESULTS: Hallucinogenic cactus, plants and mushrooms were used to induce altered states of consciousness in healing rituals and religious ceremonies. The Maya drank balché (a mixture of honey and extracts of Lonchocarpus) in group ceremonies to achieve intoxication. Ritual enemas and other psychoactive substances were also used to induce states of trance. Olmec, Zapotec, Maya and Aztec used peyote, hallucinogenic mushrooms (teonanacatl: Psilocybe spp) and the seeds of ololiuhqui (Turbina corymbosa), that contain mescaline, psilocybin and lysergic acid amide, respectively. The skin of the toad Bufo spp contains bufotoxins with hallucinogenic properties, and was used since the Olmec period. Jimson weed (Datura stramonium), wild tobacco (Nicotiana rustica), water lily (Nymphaea ampla) and Salvia divinorum were used for their psychoactive effects. Mushroom stones dating from 3000 BC have been found in ritual contexts in Mesoamerica. Archaeological evidence of peyote use dates back to over 5000 years. Several chroniclers, mainly Fray Bernardino de Sahagún, described their effects in the sixteenth century. CONCLUSIONS: The use of psychoactive substances was common in pre-Columbian Mesoamerican societies. Today, local shamans and healers still use them in ritual ceremonies in Mesoamerica.

Curares y timbós, venenos del Amazonas / Curares and timbós, poisons used in the Amazon

Introducción. Los indígenas que habitaban los ríos Orinoco y Amazonas emplearon durante siglos diversos venenos de origen vegetal. Se revisan los aspectos históricos y etnográficos del uso de curares y timbós en la región amazónica. Desarrollo. El curare se prepara hirviendo las raíces, corteza y tallos de diversas plantas de las familias Loganiaceae (Strychnos) y Menispermaceae (Chondrodendron, Curarea y Abuta). Los curares de la Amazonía oriental proceden de diferentes especies de Strychnos que contienen alcaloides cuaternarios, que actúan como bloqueadores de la unión neuromuscular. Se emplean para cazar animales salvajes y la muerte se produce por parálisis de los músculos esqueléticos. Los primeros músculos que se paralizan son los oculares, cuello y nuca, y después los miembros; el diafragma es el músculo que más tarda en paralizarse. Las primeras crónicas que relataron su uso proceden de Fernández de Oviedo, Cristoval de Acuña, Antonio de Ulloa y José Gumilla. La Condamine, Humboldt, Waterton y Schomburgk, entre otros, llevaron a cabo diversos estudios etnobotánicos sobre el curare. Los venenos ictiotóxicos de origen vegetal, llamados timbós o barbascos, se caracterizan por una gran solubilidad, rápida difusión y elevada actividad. Al menos 70 especies vegetales se emplean para intoxicar los peces en los afluentes del Amazonas y facilitar su pesca. Sapindáceas, papilionáceas, euforbiáceas y teofrastáceas contienen sustancias ictiotóxicas, como rotenona o saponinas. Conclusión. Los relatos etnohistóricos y etnográficos muestran un gran conocimiento de las propiedades tóxicas de los curares y timbós por parte de las culturas amazónicas (AU)

Introduction. The natives that dwell along the banks of the Orinoco and Amazon rivers have used different poisons from plants for centuries. The study reviews the historical and ethnographic aspects of the use of curares and timbós in the Amazonian region. Development. Curare is prepared by boiling the roots, bark and stalks of different plants belonging to the Loganiaceae (Strychnos) and Menispermaceae families (Chondrodendron, Curarea and Abuta). The curares of the eastern Amazon are extracted from different species of Strychnos that contain quaternary alkaloids, which act by blocking the neuromuscular junction. They are used to hunt wild animals and death comes about due to paralysis of the skeletal muscles. The first muscles to be paralysed are those of the eyes, nose and neck, and then those in the limbs; the diaphragm is the muscle that takes the longest to become paralysed. The earliest chronicles reporting their use were written by Fernández de Oviedo, Cristoval de Acuña, Antonio de Ulloa and José Gumilla. La Condamine, Humbolt, Waterton and Schomburgk, among others, carried out a number of different ethnobotanical studies on curare. The ichthyotoxic poisons from plants, which are known as timbós or barbascos, are characterised by their high level of solubility, their fast diffusion and their high rate of activity. At least 70 plant species are used to poison the fish in the tributaries of the Amazon with the aim of make fishing easier. Sapindaceae, Papilionaceae, Euphorbiaceae and Theophrastaceae contain ichthyotoxic substances, such as rotenone or saponins. Conclusions. Ethnohistorical and ethnographic accounts show that the Amazonian cultures have a deep understanding of the toxic properties of curares and timbós (AU)

[Skull cult. Trophy heads and tzantzas in pre-Columbian America]. / El culto a los craneos. Cabezas trofeo y tzantzas en la America precolombina.

INTRODUCTION: The skull cult is a cultural tradition that dates back to at least Neolithic times. Its main manifestations are trophy heads, skull masks, moulded skulls and shrunken heads. The article reviews the skull cult in both pre-Columbian America and the ethnographic present from a neuro-anthropological perspective. DEVELOPMENT: The tradition of shaping and painting the skulls of ancestors goes back to the Indo-European Neolithic period (Natufian culture and Gobekli Tepe). In Mesoamerica, post-mortem decapitation was the first step of a mortuary treatment that resulted in a trophy head, a skull for the tzompantli or a skull mask. The lithic technology utilised by the Mesoamerican cultures meant that disarticulation had to be performed in several stages. Tzompantli is a term that refers both to a construction where the heads of victims were kept and to the actual skulls themselves. Skull masks are skulls that have been artificially modified in order to separate and decorate the facial part; they have been found in the Templo Mayor of Tenochtitlan. The existence of trophy heads is well documented by means of iconographic representations on ceramic ware and textiles belonging to the Paraca, Nazca and Huari cultures of Peru. The Mundurucu Indians of Brazil and the Shuar or Jivaroan peoples of Amazonian Ecuador have maintained this custom down to the present day. The Shuar also shrink heads (tzantzas) in a ritual process. Spanish chroniclers such as Fray Toribio de Benavente 'Motolinia' and Gaspar de Carvajal spoke of these practices. CONCLUSIONS: In pre-Columbian America, the tradition of decapitating warriors in order to obtain trophy heads was a wide-spread and highly developed practice.

Causas tropicales de epilepsia / Tropical causes of epilepsy

Introduction. Eighty-five percent of all epileptics live in tropical regions. Prenatal risk factors, traumatic braininjuries and different parasitic infestations of the central nervous system (CNS) are the reasons behind the high prevalence ofepilepsy. This work reviews the main parasitic infestations causing epilepsy in the tropics. Development. Neurocysticercosis isthe main cause of focal epilepsy in early adulthood in endemic areas (30-50%). All the phases of cysticerci (viable, transitionaland calcified) are associated with epileptic seizures. Anti-cysticercus treatment helps get rid of cysticerci faster and reducesthe risk of recurrence of seizures in patients with viable cysts. Symptomatic epilepsy can be the first manifestation of neuroschistosomiasisin patients without any systemic symptoms. The pseudotumoral form can trigger seizures secondary to thepresence of granulomas and oedemas in the cerebral cortex. The eggs of Schistosoma japonicum are smaller, reach the CNSmore easily and trigger epileptic seizures more frequently. Toxocariasis and sparganosis are other parasitic infestations thatcan give rise to symptomatic seizures. The risk factors for suffering chronic epilepsy after cerebral malaria are a positivefamilial history of epilepsy and a history of episodes of fever and cerebral malaria that began with coma or which progressedwith multiple, prolonged epileptic seizures. About 20% of patients with cerebral infarction secondary to Chagas diseasepresent late vascular epilepsy as a complication. Conclusions. Very few studies have been conducted to examine the prognosis,risk of recurrence and modification of the natural course of seizures associated with tropical parasitic infestations, except forthe case of neurocysticercosis (AU)

Introducción. El 85% de las personas epilépticas vive en regiones tropicales. Factores de riesgo prenatales, traumatismoscraneoencefálicos y diversas parasitosis del sistema nervioso central (SNC) explican la elevada prevalencia de epilepsia.Se revisan las principales parasitosis tropicales causantes de epilepsia. Desarrollo. La neurocisticercosis es la principalcausa de epilepsia focal de inicio en la vida adulta en áreas endémicas (30-50%). Todas las fases de los cisticercos (viables,transicionales y calcificados) se asocian con crisis epilépticas. El tratamiento cisticida favorece la desaparición más rápidade los cisticercos y reduce el riesgo de recurrencia de crisis en pacientes con quistes viables. La epilepsia sintomáticapuede ser la primera manifestación de la neuroesquistosomiasis en pacientes sin síntomas sistémicos. La forma pseudotumoralpuede provocar crisis secundarias a la presencia de granulomas y edema en la corteza cerebral. Los huevos de Schistosomajaponicum son más pequeños, alcanzan más fácilmente el SNC y provocan crisis epilépticas más frecuentemente. Toxocariasisy esparganosis son otras helmintiasis que pueden provocar crisis sintomáticas. Los factores de riesgo de padecer epilepsiacrónica después de malaria cerebral son una historia familiar positiva para epilepsia, y antecedentes de crisis febrilesy de malaria cerebral que comenzó con coma o que cursó con crisis epilépticas múltiples y prolongadas. Alrededor del 20%de los pacientes con infarto cerebral secundario a enfermedad de Chagas presenta como complicación una epilepsia vasculartardía. Conclusiones. Los estudios sobre el pronóstico, riesgo de recurrencia y modificación del curso natural de las crisisasociadas a las parasitosis tropicales son escasos, a excepción de la neurocisticercosis (AU)

[Neurological aspects described in The treasure of medicines for all illnesses by Gregorio López]. / Aspectos neurológicos descritos en El tesoro de medicinas para todas enfermedades, de Gregorio López.

INTRODUCTION: Latin American medicine in the 16th century produced the first collections of herbs with native plants from the New World. Treatises on popular therapies appeared, which included gallenic remedies as well as incorporating autochthonous plants. We review the main neurological diseases and their treatments described in The Treasure of Medicines for All Illnesses by Gregorio Lopez (1542-1596). DEVELOPMENT: Some critics claim that his work was an enumeration of empirical prescriptions, sometimes with a magico-religious influence, which was extended in successive reprints. Yet, this manuscript is probably the first treatise on therapeutics written by a European in the New World to describe the native remedies employed in the treatment of diseases. In the section entitled Remedies in alphabetical order the following neurological ailments and appropriate remedies to treat them are described: abscess, apoplexy, brain, chilling, cramp, gota coral or epilepsy, headache, melancholy, memory, migraine, nerves, palsy, paralysis, sciatica, stupor and vertigo. The list of diseases is very complete and includes syndromes ranging from fevers, colics and bruises to phthisis, scabs or burns. The copy of the manuscript in the Vatican contains a final section on Indian medicines, which includes a list of medicinal plants used at that time, with the names given in Nahuatl language. CONCLUSIONS: Headaches, epilepsy and conditions affecting the peripheral nerves were the neurological pathologies that were described at greatest length in The Treasure of Medicines for All Illnesses, and for which a greater number of natural prescriptions were compiled.

[Immunopathogenesis and treatment of the myelopathy associated to the HTLV-I virus]. / Inmunopatogenesis y tratamiento de la mielopatia asociada al virus linfotropico humano de celulas T (HTLV-I).

INTRODUCTION: Human T-cell lymphotropic virus type-I (HTLV-I) causes tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM). Immunopathogenesis and available treatments for TSP/HAM are reviewed. DEVELOPMENT: At least 20 million people are infected worldwide and 0.3-4% will develop TSP/HAM. Incidence in endemic areas is around 2 cases/ 100,000 inhabitants and year. The 50% of TSP/HAM patients suffer from clinical progression during their first ten years. Progression is associated with high proviral load and ager than 50 years at onset. HTLV-I proviral DNA and m-RNA load are significantly raised in TSP/HAM patients compared to asymptomatic carriers. This antigenic load activates T cells CD8+ specific for Tax-protein, which up-regulate pro-inflammatory cytokines. Corticoids, plasma-exchange, intravenous immunoglobulins, danazol, pentoxifilline, green-tea polyphenols, lactobacillus fermented milk, zidovudine, lamivudine, monoclonal antibodies (daclizumab), interferon, and valproic acid have been used in open trials in a small number of patients. Nevertheless, their clinical efficacy is limited. Interferon alpha and beta-1a have cytostatic properties and may cause a reduction in HTLV-I proviral load. CONCLUSIONS: High HTLV-I proviral load and an exaggerated pro-inflammatory cellular response are involved in the pathogenesis of TSP/HAM. No therapy has been conclusively shown to alter long-term disability associated with TSP/HAM. Multicentric clinical trials are necessary to assess long-term efficacy of interferon in TSP/HAM.

Inmunopatogénesis y tratamiento de la mielopatía asociada al virus linfotrópico humano de células T (HTLV-I) / Immunopathogenesis and treatment of the myelopathy associated to the HTLV-I virus

Introducción. El virus linfotrópico humano de células T (HTLV-I) es un virus neurotropo causante de la paraparesia espástica tropical/mielopatía asociada al HTLV-I (PET/MAH). Se revisan la patogénesis y los principales tratamientos empleados para tratar esta mielopatía. Desarrollo. Se estima que al menos 20 millones de personas en el mundo son portadoras delHTLV-I. La incidencia de PET/MAH en áreas endémicas es de 2 casos/100.000 habitantes y año; el riesgo de padecer PET/MAH oscila entre el 0,3 y el 4%. Un 50% padece una progresión clínica en los primeros 10 años, que se asocia con una carga proviral elevada e inicio de los síntomas a partir de los 50 años. El ADN proviral y el ARN mensajero del HTLV-I están significativamenteelevados en pacientes con PET/MAH, comparados con sujetos asintomáticos. Esta carga antigénica activa linfocitos T citotóxicos CD8+ específicos de la proteína Tax, los cuales producen citocinas inflamatorias. Se han empleado fármacos antiinflamatorios, antivirales e inmunomoduladores, con eficacia muy limitada: corticoides, plasmaféresis, inmunoglobulinas, vitaminaC, leche fermentada con lactobacilos, polifenoles del té verde, danazol, pentoxifilina, análogos de nucleósidos (cidovudina + lamivudina), anticuerpos monoclonales, interferón y ácido valproico. Los interferones alfa y beta-1a tienen propiedades citostáticas y antivirales, y provocan una disminución de la carga del ADN proviral. Conclusiones. Tanto la carga proviral elevada comouna respuesta inmune celular proinflamatoria exagerada están implicadas en la patogénesis de la PET/MAH. La efectividad de los tratamientos inmunomoduladores a largo plazo para reducir la incapacidad es escasa. Son necesarios ensayos clínicos multicéntricos que evalúen la eficacia de los interferones en la PET/MAH

Introduction. Human T-cell lymphotropic virus type-I (HTLV-I) causes tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM). Inmunopathogenesis and available treatments for TSP/HAM are reviewed. Development. At least 20 million people are infected worldwide and 0.3-4% will develop TSP/HAM. Incidence in endemic areas is around 2 cases/ 100,000 inhabitants and year. The 50% of TSP/HAM patients suffer from clinical progression during their first ten years. Progression is associated with high proviral load and ager than 50 years at onset. HTLV-I proviral DNA and m-RNA load aresignificantly raised in TSP/HAM patients compared to asymptomatic carriers. This antigenic load activates T cells CD8+ specific for Tax-protein, which up-regulate pro-inflammatory cytokines. Corticoids, plasma-exchange, intravenous immunoglobulins, danazol, pentoxifilline, green-tea polyphenols, lactobacilus fermented milk, zidovudine, lamivudine, monoclonal antibodies (daclizumab), interferon, and valproic acid have been used in open trials in a small number of patients. Nevertheless, their clinical efficacy is limited. Interferon alpha and beta-1a have citostatic properties and may cause a reduction in HTLV-I proviral load. Conclusions. High HTLV-I proviral load and an exaggerated pro-inflammatory cellular response areinvolved in the pathogenesis of TSP/HAM. No therapy has been conclusively shown to alter long-term disability associated with TSP/HAM. Multicentric clinical trials are necessary to assess long-term efficacy of interferon in TSP/HAM

[Treatment of headaches among the Aborigines of Tierra de Fuego. A comparison with other anthropological studies]. / Tratamiento de las cefaleas entre los Aborígenes de Tierra de Fuego. Comparación con otros estudios antropológicos.

SUMMARY INTRODUCTION: Several different indigenous groups (Yamana, Selk'nam, Alacaluf, Haush) used to inhabit the Patagonian region of Tierra de Fuego, but are now extinct. AIM: To analyse the healing practices that these prehistoric aborigines used to treat headaches and to compare them with those observed in other anthropological studies. DEVELOPMENT: The article reviews the most important manuscripts from the end of the 19th century written by anthropologists and missionaries who were in contact with these peoples (Bridges, Hyades, Gusinde). The Yamana, or 'canoero' Indians, lived in the coastal areas and ate mostly seals and shellfish. The Selk'nam were nomadic hunter-gatherers who lived in the northern part of the Isla Grande. The Yekamush were the Yamana healers. The chief palliative treatments for pain were fasting, drinking cold water and the application of localised heat and massages. Headaches were one of the most prevalent conditions among the Yamana. Treatment for headaches consisted in hitting the patient's head with prickly chaura (Pernettya mucronata) leaves, which produces a small amount of bleeding, or the use of fresh nettle leaves, which were held in place with a headband. The Selk'nam used the term kwaketan to refer to the feeling of sadness with pain, while the term kwake meant 'illness'. Other common ways of treating headaches included ritual ceremonies with chanting, the detection of painful points, and the absorption and expulsion of the kwake. CONCLUSIONS: Headaches were one of the most frequent neurological pathologies among these prehistoric Fuegian aborigines, in line with the observations made in other transcultural studies conducted on present-day native cultures.

[Ritual use of Anadenanthera seeds among South America natives]. / Usos rituales de la semilla de Anadenanthera sp entre los indígenas sudamericanos.

INTRODUCTION: Several South-American native societies snuff psychoactive seeds in magic-religious rituals since ancient times. OBJECTIVES: To describe archeological, historical and ethnographical evidences regarding the ritual use of vilca or yopo (Anadenanthera sp). DEVELOPMENT: Anadenanthera seeds were used in South America 3,000 years ago. Archeological studies found vilca seeds in funerary tombs from 1,000 BC in the north of Chile and Argentina; ceramics and snuff tubes were found in San Pedro de Atacama archeological sites from the same data, and in Tiwanaku ceremonial center in Bolivian Altiplano. Today, Anadenanthera sp is used by several native groups in Orinoco basin, where is known as yopo, and in the Brazilian and Colombian Amazon. Hallucinogenic effect is due to the presence of methyl-tryptamine derivatives. Most snuff is prepared from the roasted and powdered seeds, vegetable ash and/or lime obtained from shells. CONCLUSIONS: Archeological and ethnographical data suggest that vilca was used and is still used by native shamans as a sacred seed in South America, due to its hallucinogenic effects.

[Evidence of facial palsy and facial malformations in pottery from Peruvian Moche and Lambayeque pre-Columbian cultures]. / Malformaciones y parálisis faciales en la cerámica de las culturas precolombinas Moche y Lambayeque.

INTRODUCTION: Moche (100-700 AD) and Lambayeque-Sicán (750-1100 AD) are pre-Columbian cultures from Regional States Period, developed in Northern Peru. Information about daily life, religion and medicine has been obtained through the study of Moche ceramics found in lords and priests tombs, pyramids and temples. OBJECTIVE: To analyze archeological evidences of Moche Medicine and neurological diseases through ceramics. MATERIAL AND METHODS: Representations of diseases in Moche and Lambayeque iconography and Moche pottery collections exposed in Casinelli museum from Trujillo, and Brüning National Archeological museum from Lambayeque, Peru, were studied. The most representative cases were analyzed and photographed, previous authorization from authorities and curators of the museums. RESULTS: The following pathologies were observed in ceramic collections: peripheral facial palsy, facial malformations such as cleft lip, hemifacial spasm, legs and arm amputations, scoliosis and Siamese patients. Male and females Moche doctors were also observed in the ceramics in ritual ceremonies treating patients. CONCLUSIONS: The main pathologies observed in Moche and Lambayeque pottery are facial palsy and cleft lip. These are one of the earliest registries of these pathologies in pre-Columbian cultures in South-America.

[Mescaline and the San Pedro cactus ritual: archaeological and ethnographic evidence in northern Peru]. / Mescalina y ritual del cactus de san Pedro: evidencias arqueológicas y etnográficas en el norte de Perú.

INTRODUCTION: The San Pedro cactus contains the alkaloid mescaline and other derivates of phenethylamine with hallucinogenic properties. This cactus was used throughout history by a number of different pre-Columbine cultures and civilisations that settled in northern Peru. In this article we review the ethno-archaeological and ethno-historical evidence of the ritual use of the San Pedro cactus in the pre-Columbine cultures, and these findings are compared with the information provided by current ethnographical studies. DEVELOPMENT: The longer a cactus has been stored, the stronger and the higher its content in mescaline-derived alkaloids will be. Archaeological evidence has been found of the use of San Pedro for magical-religious purposes in the following pre-Columbine cultures: Cupisnique (1500 BC), Chavin (1000 BC), Moche (100-750 AD) and Lambayeque (750-1350 AD). Today's master shamans use San Pedro on altars ('mesas') erected for healing rites in order to treat enchantment and bad luck. The mesa follows a sophisticated ritual: 'levantar' (raise) or sniff tobacco with alcohol, ingest San Pedro, pinpoint the diseases, cleanse the evil and 'florecer' (flourish) the sick person. The mesa rite is performed in the early hours of Tuesdays and Fridays, which are sacred days in the Andean religions. San Pedro is sometimes replaced by an infusion of plants and seeds that contain hallucinogenic components, such as ayahuasca and the 'mishas' (Brugmansia sp.). CONCLUSIONS: The ancient tradition of using the San Pedro cactus for healing and hallucinogenic purposes has remained part of the culture in Andean shamanism up to the present day.

[Ethnographic study of neurological and mental diseases among the Uru-Chipaya peoples of the Andean Altiplano]. / Estudio etnográfico sobre las enfermedades neurológicas y mentales entre los urus-chipayas del altiplano andino.

INTRODUCTION: The Uru-Chipaya people are an ethnic group of about 2,500 people, descendants of primitive Andean cultures. Their isolation (they live at an altitude of 4,000 metres in southern Bolivia), their non-written language (Chipaya-Puquina) and their traditional way of life, clothing and customs, which are similar to those used for thousands of years, make this an unusual culture. The aim of our work was to carry out an ethnographic study of the neurological diseases experienced by these people, the way they conceive such disorders and their therapeutic approaches to them. DEVELOPMENT: An ethnographic field study was conducted in June 2004. A structured interview was held with a yatiri, or Chipaya healer, to allow classification of the neurological or mental diseases. Epilepsy (tukuri) is interpreted as being a consequence of an evil spirit entering through the nose. Treatment consists in drinking an infusion containing dried powdered butterfly (jesko), birds or curupancho. Achamixi (headache) is common and is treated by drinking the yatiri's fermented urine, herb tea made from the chachacoma plant and by blowing, which is done by the yatiri over the patient's head. Fright, the symptoms of which are similar to those of a post-traumatic stress disorder, is treated by a wilancha, that is, the ritual sacrifice of a llama offered to the Pachamama. Sadness, the cultural equivalent to depression, is treated with infusions made from ayrampo, a plant found in the Andean Altiplano. Psychosis (sumsu), which is treated by means of a wilancha, and mental retardation/static encephalopathy (pustkis), which are considered to be a result of a fright suffered by the mother during pregnancy, also exist. No mention was made of the existence of extrapyramidal or vascular pathologies. CONCLUSION: The cultural equivalents of certain neurological pathologies (headache, epilepsy, mental retardation, anxiety and depression) are present in this ancestral culture.

[Neurological paleopathology in the pre-Columbian cultures of the coast and the Andean plateau (I). Artificial cranial deformation]. / Paleopatologia neurologica en las culturas precolombinas de la costa y altiplano andino (I). Deformaciones craneales intencionales.

AIMS: The aim of this work was to study the cranial trepanations and deformations carried out by the ancient Paraca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. DEVELOPMENT: Cranial deformation was more common in the Andean regions and was performed by putting little pieces of wood or compressive bandages on newborn infants' heads in order to modify the growth axis of the cranial cavity. Cranial deformations were performed for aesthetic and magic religious reasons, but were also used as a means of ethnic or social identification, as a symbol of nobility or to distinguish the ruling classes. The immediate consequence of such deformation was the modification of the normal process by which the cranial sutures close. There is a significant correlation between the presence of posterior and lateral wormian bones, according to the degree of artificial deformation. The persistence of metopic suture and exostosis of the outer ear canal have been found in 5% of the skulls belonging to pre Columbine mummies. Other paleopathological findings include cranial fractures (7%), porotic hyperostosis (25% of children's skulls), spina bifida occulta, signs of spinal disk arthrosis and Pott's disease. CONCLUSIONS: Artificial cranial deformation was a very widespread practice in the Andean regions in pre Columbine times.

[Neurological paleopathology in the pre-Columbine cultures of the coast and the Andean plateau (II). The history of cranial trepanations]. / Paleopatología neurológica en las culturas precolombinas de la costa y el altiplano andino (II). Historia de las trepanaciones craneales.

INTRODUCTION AND AIMS: Trepanation is one of the earliest examples of a surgical procedure being carried out by human beings and was performed from the Neolithic period onwards in a large number of primitive cultures throughout the five continents. Trepanation and cranial deformation were both common in the pre-Columbine cultures. The aim of this work was to study the trepanations carried out by the ancient Paraca, Nazca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. DEVELOPMENT: In the pre-Columbine cultures, trepanation was performed on both men and women for therapeutic purposes (depressed fractures, epilepsy, vascular headaches and those associated to artificial cranial deformations) and as a ritual. Signs of trepanation have been found in 5% of skulls and 80% of these show evidence of the 'patient' having survived such an intervention. Some of them have several holes in different stages of healing. The trephining procedure involved the use of obsidian knives with wooden handles and tumis, which were ceremonial knives that were used to cut the scalp. Gold and silver cranioplasty plates have also been found in some skulls. CONCLUSIONS: Cranial trepanation was very successful despite the rudimentary methods and instruments employed to perform it.

[Neurological syndromes associated with the ingestion of plants and fungi with a toxic component (II). Hallucinogenic fungi and plants, mycotoxins and medicinal herbs]. / Sindromes neurológicos asociados con el consumo de plantas y hongos con componente tóxico (II). Hongos y plantas alucinógenos, micotoxinas y hierbas medicinales.

INTRODUCTION: A wide range of fungi and medicinal herbs, rich in hallucinogenic substances and widely used for mystic and medicinal purposes, can give rise to neurotoxic symptoms. DEVELOPMENT: We review the toxic syndromes that can arise from the ingestion of hallucinogenic fungi, cacti and plants, together with descriptions of cases of acute poisoning resulting from the use of medicinal herbs and from foodstuffs that are contaminated by mycotoxins. A series of different psychedelic fungi belonging to the Psilocybe, Panaeolus and Stropharia genera contain hallucinogenic alkaloids such as psilocybin. Some of the most notable plants displaying hallucinogenic and sedative properties are Papaver somniferum, Erytroxylum sp. and Cannabis sativa. Infusions of ayahuasca are obtained from the lianas and roots of different plants with psychoactive properties, such as Banisteriopsis caapi and Psychotria viridis, which contain alkaloids derived from tryptamine and from the beta carboline harmala. Peyote, a cactus rich in mescaline, and Claviceps purpurea (a fungus rich in LSD) are strong hallucinogens. We also examine ergotism and mycotoxicosis from Arthrinium sp. Poisoning from mycotoxin containing moulds on sugar cane can give rise to encephalopathy and late dystonia. Some of the more noteworthy medicinal plants for which neurological toxicity has been reported are Hypericum perforatum, kava kava (Piper methysticum), Aconitum sp. and Callilepis laureola. CONCLUSIONS: Because of the increasingly more widespread consumption of herbs and fungi and their potentially neurotoxic effects, in clinical practice there is a need to be aware of the neurological syndromes deriving from their use.

Síndromes neurológicos asociados con el consumo de plantas y hongos con componente tóxico (II). Hongos y plantas alucinógenos, micotoxinas y hierbas medicinales / Neurological syndromes associated with the ingestion of plants and fungi with a toxic component (II). Hallucinogenic fungi and plants, mycotoxins and medicinal herbs

Introducción. Existe una amplia gama de hongos y hierbas medicinales, ricos en sustancias alucinógenas, empleados con propósitos místicos y medicinales, que pueden provocar síntomas neurotóxicos. Desarrollo. Se revisan los síndromes tóxicos por ingestión de hongos, cactus y otras plantas con propiedades alucinógenas, así como los casos de intoxicación aguda descritos por el uso de hierbas medicinales y por alimentos contaminados por micotoxinas. Diversos hongos psicodélicos de los géneros Psilocybe, Panaeolus y Stropharia contienen alcaloides alucinógenos como la psilocibina. Entre las plantas con propiedades alucinógenas y sedantes destacan Papaver somniferum, Erytroxylum sp. y Cannabis sativa. La infusión de ayahuasca se obtiene de las lianas y las raíces de diversas plantas con propiedades psicoactivas, entre ellas Banisteriopsis caapi y Psychotria viridis, que contienen alcaloides derivados de la triptamina y de la Beta -carbolina harmala. El peyote, cactus rico en mescalina, y el Claviceps purpurea (hongo rico en LSD) son potentes alucinógenos. Se revisa el ergotismo y las micotoxicosis por Arthrinium sp. La intoxicación por azúcar de caña enmohecida con micotoxinas puede provocar una encefalopatía y distonía tardía. Entre las plantas medicinales en las que se han descrito casos de toxicidad neurológica destacan Hypericum perforatum, kava-kava(Piper methysticum), Aconitum sp. y Callilepis laureola. Conclusiones. El consumo cada vez más extendido de hierbas y hongos y sus potenciales efectos neurotóxicos hace que sea necesario conocer los síndromes neurológicos derivados de su uso en la práctica clínica (AU)

[Neurological syndromes linked with the intake of plants and fungi containing a toxic component (I). Neurotoxic syndromes caused by the ingestion of plants, seeds and fruits]. / Síndromes neurológicos asociados con el consumo de plantas y hongos con componente tóxico (I). Síndromes neurotóxicos por ingesta de plantas, semillas y frutos.

INTRODUCTION: A wide range of plants, seeds and fruits used for nutritional and medicinal purposes can give rise to neurotoxic symptoms. DEVELOPMENT: We review the neurological pathology associated with the acute or chronic consumption of plants, seeds and fruits in human beings and in animals. Of the plants that can trigger acute neurotoxic syndromes in humans, some of the most notable include Mandragora officinalis, Datura stramonium, Conium maculatum (hemlock), Coriaria myrtifolia (redoul), Ricinus communis, Gloriosa superba, Catharanthus roseus, Karwinskia humboldtiana and Podophyllum pelatum. We also survey different neurological syndromes linked with the ingestion of vegetable foodstuffs that are rich in cyanogenic glycosides, Jamaican vomiting sickness caused by Blighia sapida, Parkinson dementia ALS of Guam island and exposition to Cycas circinalis, Guadeloupean parkinsonism and exposition to Annonaceae, konzo caused by ingestion of wild manioc and neurolathyrism from ingestion of Lathyrus sativus, the last two being models of motor neurone disease. Locoism is a chronic disease that develops in livestock feeding on plants belonging to Astragalus and Oxytropis sp., Sida carpinifolia and Ipomea carnea, which are rich in swainsonine, a toxin that inhibits the enzyme alpha mannosidase and induces a cerebellar syndrome. CONCLUSIONS: The ingestion of neurotoxic seeds, fruits and plants included in the diet and acute poisoning by certain plants can give rise to different neurological syndromes, some of which are irreversible.

[Neurological anthropology among the Kamayura Indians of the Alto Xingu]. / Antropología neurológica entre los indios Kamayurá del Alto Xingú.

INTRODUCTION: The Kamayura tribe is made up of 300 persons living in the Alto Xingu in Mato Grosso, Brazil. Their traditional system of health care is based on the pajé, a witch doctor who uses plants and prayers for treatment. MATERIAL AND METHODS: Field work was done in the Kamayura village holding successive interviews with the chief and the pajé Takumá to obtain information regarding the neurological disorders found there, the indigenous beliefs regarding illness (natural or based on witch-craft), their classification and traditional treatment based on plants. The terms employed were translated from Kamayura into Portuguese. RESULTS: Illness in Indians is caused by the revenge of the spirit (mama'e) of the animal killed by the huntsman. Epilepsy (Teawurup) or armadillo disease is caused when a huntsman kills an armadillo. It is treated with two roots, tsimó and wewuru, kneaded, diluted in water and applied to the eyes. An infusion of enamum root is also used. Migraine or monkey disease causes a pulsatile headache and vertigo. Mental retardation and infantile cerebral palsy are included in the ant-bear disease. Depression is treated with the plant 'iputunú'; which is applied diluted in water to the face of the patient so that he no longer sees his dead relations and may be cured. Schizophrenia or apuayat (owl disease) also occurs, but not parkinsonism or stroke. CONCLUSION: The Kamayura pajes have established a system of health-care based on magic folklore, transmitted orally and making use of traditional plants.