Aztec Medicine, Health, and Nutrition (review)

BOOK REVIEWS Aztec Medicine, Health, and Nutrition. By Bernard R. Ortiz de Montellano. New Brunswick, N.J.: Rutgers University Press. 1990. Pp. 308. $40.00 (cloth); $15.00 (paper). Like other New World peoples, the Aztecs suffered tremendously from crowd diseases carried by European explorers and conquerors. Some researchers have sought to explain the catastrophic effects of disease among the Aztecs in terms of a chronic underlying compromised health status that rendered them particularly susceptible to disease. Bernard Ortiz de Montellano argues to the contrary: on the whole, the Aztecs were a healthy people in nutritional status and underlying pathology, and further they could rely on a sophisticated and surprisingly effective medical system in times of illness. While admirable for its holistic perspective on health, eclecticism of argument, and breadth of scholarship, this work raises a number of problems. The Aztec diet, Ortiz de Montellano claims, was both ample and nutritious, fulfilling a necessary precondition of immunological competence and good health. The caloric adequacy of the diet, however, is not established beyond the level of possibility; his argument depends on controversial population estimates for the Valley of Mexico in the sixteenth century. While Ortiz de Montellano appears justified in rejecting previous population estimates that significantly transcend the projected carrying capacity, little can be said about how much food was actually available to the people. Needed also is information concerning distribution—not merely the logistics of allocation, but the differential access to resources that arises along social class lines. Perhaps the case for the health status of the Aztecs, concerning diet and even underlying pathology, could be strengthened by examining the archaeological record? More convincing here is the interesting discussion about the diversity of the Aztec diet. Supplemented by a variety of plant and animal products, including algae and insects, the Aztecs' corn-based diet appears to have provided adequate and well-balanced nutrition. Here Ortiz de Montellano pauses to dispense with a little meritorious but oddly recalcitrant argument to the effect that the practice of cannibalism among the Aztecs had adaptive significance as a means of increasing dietary protein. Not only was the Aztec diet sufficient in protein, Ortiz de Montellano argues, but the amount of protein available through cannibalism, even under the most generous estimates, turns out to be insignificant, even if the estimates are confined strictly to the Aztec nobility—who alone engaged in this practice. Aztec cannibalism Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 35, 2 ¦ Winter 1992 307 had its roots in religion and ritual, as does cannibalism everywhere else it has been discovered. Surely the most important contribution of this book, but also its most problematic aspect, is the discussion of Aztec medicine. By interpreting critically the available sources on Aztec culture written soon after the Conquest, Ortiz de Montellano portrays a comprehensive system of medicine among the Aztecs. He provides a concise account of Aztec cosmology, Weltanschauung, and social structure, drawing out the symbolic connections of the body and the cosmos in Aztec thought and tying together notions of health and complex cultural and religious beliefs. He demonstrates the priority of the Aztec value of moderation, believed necessary to maintain order amid the tendency toward chaos in body and universe alike. His accounts of Aztec beliefs and practices relating to health are fascinating, from divinatory diagnosis, to the use of pharmacologically active herbal remedies, to obsidian scalpel surgery. There are problems with this account, however. The assumption that Aztec medicine is a coherent and unified set of beliefs allows Ortiz de Montellano to extract a systematic account from often contradictory sources and to make important logical inferences concerning the relation of disease etiology and treatment that figure into his evaluation of Aztec medicine's effectiveness. This assumption warrants scrutiny in light of the author's claims regarding the social configuration of Aztec medical practice. To the extent that Aztec medicine was the domain of shamans, the individualistic and little-organized social structure of medical practice does not provide for a standardization of medical knowledge and practice. Are the contradictions in the historical sources evidence of different coexisting "systems" of...