The Alekchi: The Choctaw Medical System and the Importance of the Medicine Man
Native American healing practices can be thought of as antiquated and of little modern use. But in this day of advanced scientific research methods and quest for more natural remedies for common ailments, there is growing evidence that the medical knowledge of early Native Americans is applicable to pharmacological research being conducted today. In looking at the Choctaw Indian tribe, one can understand the advanced medical knowledge of many Native American tribes, and how during times of early contact with settlers, the Choctaw’s medicinal knowledge was sought by white doctors. Through an understanding of the Choctaw Indians’ beliefs on diseases and the role, techniques, and knowledge of the tribe’s Medicine Man, there lies a depth of knowledge that is only now being fully understood by modern science.
To understand fully the Choctaw medicine, one must first understand the limits of the information available. While the Choctaws as a tribe had slowly developed in the 16th century, they did not develop a written language until the late 19th century.[i] This fact leaves a large gap in the historical knowledge of the tribe that can only be filled by oral history. Although people such as Gideon Lincecum recorded his research in Choctaw medical practices in the 1830s, his interactions is considered one of the first substantial recordings of Choctaw pharmacopoeia and medical practices.[ii] His work provides a starting point of sorts for historical records, allowing historians to understand a culmination of effort and knowledge gained by the Choctaw tribe in regards to medical knowledge. While this fact is important, another issue is the nature of medical knowledge among the Choctaw. It was passed through the use and training of Medicine Men, who safeguarded that information and occasionally felt concerned about spreading the intimate details of that knowledge to outsiders. This is due to mainly the spiritual nature in which Choctaw Medicine was practiced. As these issues will be discussed through this work within their respective sections, it is important to understand the current limitations to providing a full understanding of the development of Choctaw medicine. Instead, records provide a snapshot as to the state of Choctaw medicine when it was first encountered, before it was eventually supplanted by medical practices brought by settlers of the United States and medicine practiced on the Native American reservations within the hospitals there.
Choctaw Indian Understanding of Health and Disease
As with most Native American tribes, Choctaw Indians’ religious beliefs influenced many aspects of their lives and culture. One of these aspects was their understanding of health and wellness. Within the Choctaw tribes, there existed a belief in the need to maintain balance between oneself and the universe. This cosmological balance between a person and those things around him was essential in maintaining a healthy life. An imbalance in the connections between a person and his surroundings could lead to disease, so all ailments and cures carried a degree of religiousness with them.[iii]
Choctaw Indians held that those cosmological imbalances which caused diseases within people originated from two distinct sources. With injuries and diseases that seemed to be caused by natural occurrences, treatment was often sought from the natural world. These health issues included things as obvious as snakebites, wounds, indigestion, fever, etc., and the natural remedies that could be applied to such issues would be those that utilized plants or other natural material to heal. More mysterious ailments, such as those caused by tumors or other invisible particles, were often believed to be of a more religious nature. These mysterious agents and diseases also included those diseases introduced by European contact, such as small-pox and measles. These mysterious ailments required a more spiritual form of treatment.[iv] According to H.B. Cushman, who spent time among the Choctaw as a child and later as a historian, wrote in 1899 that religious treatments tended to center more around “superstitions and incantations.”[v] This mix of natural and religious causes of disease guided the methods, rituals, and beliefs of Choctaw people and their tribes ability to treat diseases.
Once it was determined that a patient was ill, and his treatment could come from the natural world, Choctaw Medicine Men would gather and prepare the appropriate herbal remedies. These remedies could come from a wide variety of plants, but the key healing aspect came from the “spirit” of the plant. For these plants to have full efficacy, plants had to be harvested under certain conditions and following certain rules, mainly focusing on the supernatural or religious properties of the plant. These special, spiritual procedures were an attempt to maintain that spiritual properties of the plant after harvest. [vi] The mixing of religious and natural aspects of Choctaw medical practices starts early in the treatment cycle, with the harvesting of the natural remedies. The various herbal remedies utilized, and the preparation techniques will be discussed later within the paper while discussing the treatments provided by the Choctaw Medicine Men.
With an understanding of the religious nature ingrained in the Choctaw’s understanding of health and healing, the importance of the Medicine Man in Choctaw society becomes evident. Through an understanding of the role, capabilities, and knowledge of the Choctaw Medicine Man, one can better understand the Choctaw medical system, prior to the eventual supplantation of it by western concepts of medicine in the 20th century.
Choctaw Medicine Man
Medicine men played an important role within the society of the Choctaw tribe, serving multiple roles critical to the lives and beliefs of Choctaw Indians. While there was no age or sex restrictions upon who may become a Medicine Man, there was three distinct categories of these powerful people who served as the religious and medical leaders within the tribe. Through a glimpse into the role, customs, and training of Medicine Men, the intricacies of the Choctaw medical system can be seen.
Within the Choctaw tribe, there were three types of Medicine Men: hopayi, aleckchi, and hoshkona. Each of these classes had their own unique set of skills and knowledge. The hopayi were given the power to tell the future, speak with the spirits of the world, and could control the weather. The hoshkona had the power to cast spells to harm another being (much like a witch in today’s lore). The alekchi, however, was a medical specialist who was trained to heal others as well as how to ward off evil spirits and spells cast by the hoshkona.[vii] Regardless of the role of the Medicine Man, their connection to the spirit world is what provided them their power, as well as the respect they commanded from the members of the tribe.
Medicine Men would often select their successors from the young children of the tribe who showed promise in a particular skill set. The Medicine Men, especially the alekchi (which will be used interchangeably with “Medicine Men” throughout the rest of this paper), would look for a child who showed promise in the knowledge of plants, and oftentimes these children would be of the same family as the older Medicine Man. Through a form of apprenticeship, the alekchi-in-training would follow the older Medicine Man and began to learn the plants, their uses, preparations, and the incantations required for the harvest and concocting of remedies. A senior alekchi may take multiple apprentices at any given time, but occasionally would only teach certain types of skills to certain followers.[viii] The division of skills would tend to follow the breaks in practiced skills by doctors that we see today. Some of the apprentices would be trained in wounds and snakebites, while others may be trained in fertility and childbirth, while others still may be given extensive knowledge of pain or seasonal ailments.
This method of training, and the subsequent division of labor among Choctaw Medicine Men, ensured that the medical knowledge of the Choctaw people could be passed down from generation to generation. Alekchi became a type of “living book”, a repository of medical knowledge that must be transmitted orally, in the same fashion as their religious beliefs, creation stories, and much of their culture.[ix] With this “living book” of knowledge, and the religious yet secretive nature of Choctaw healing, only snapshots of the full knowledge can be uncovered. The records of many of the first white settlers such as Gideon Lincecum, H.B. Cushman, and John Swanton focused on their observations of the medical treatments and the preparation and giving of herbal remedies. While that provides historians a glimpse into the ability of the Choctaw Medicine Men, many of the details of “why” and “how” the Choctaw believed certain medicines and treatments work are currently unknown.
Choctaw Medicine Men relied heavily on religious and spiritual powers to assist them with their healing abilities. This mix of physical knowledge and spirituality gave the Medicine Men their ability to heal, but also imbued them with a degree of mystery. This perception as a semi-divine person with healing powers provided the alekchi with the faith of the tribe in their capabilities.[x] This position of reverence did not prevent the alekchi from falling from grace if his skills or spiritual power was too weak to heal the sick. Medicine men were known to refuse to even attempt to heal a patient if their illness was beyond their skill level or their ability to appropriate spirits to heal a sick person.[xi] Part of that refusal would be to prevent a perceived weakening of their spiritual powers, but also to prevent from being considered a hoshkana and potentially being killed for the use of evil spirits to harm someone.[xii]
Through the treatment and healing process, Choctaw Medicine Men also utilized Medicine Sticks and chants to aid in the healing process. These Medicine Sticks would be used to help with the preparation and application of herbal remedies and were an essential part in connecting spiritual power to the healing process. The Medicine Stick would be chosen and created by the individual Medicine Man, and a special process to purify the stick would provide it with its spiritual powers.[xiii] In conjunction with the spiritual power of the Medicine Stick, the other source of spiritual healing power came from chants and incantations. These chants were utilized to unlock the full healing potential of the herbal remedies, to invite the spirits into the healing process, and to help heal the wounds.[xiv]
While Choctaw alekchi practice included a large degree of spirituality, their skills were often of equal efficacy as the white doctors who first observed them. Their healing ability and use of herbal remedies was sought by men who considered themselves doctors, such as Gideon Lincecum, and anthropologists such as John Swanton, who was impressed with their skills as healers.[xv] Granted, medical skills on the frontier of America in the 1830s were not terribly advanced, the collective skill level that was passed down strictly through oral teachings is impressive, however.
The individual skill level of Choctaw Medicine Men would vary from person to person, but they were a very capable group of practitioners. Medicine Men could apply their full knowledge of the herbal pharmacopoeia toward healing of a disease, but often were treating the symptoms of ailment and not the underlying disease.[xvi] While this process is not advised by medical practices today, in the 1830’s it was quite common, and usually the only way to provide relief to a suffering patient. While ailments were often treated with a mix of spiritually powerful herbal remedies, Medicine Men were also capable of treating physical injuries.
Many alekchi possessed the methods and skills needed to treat battle wounds, bone breaks, and other injuries. Most Medicine Men could successfully set broken bones and stitch large wounds to encourage fast and proper healing. More advanced and knowledgeable alekchi could conduct simple amputations and minor surgery. The development and application of these skills was often noted to be on par with those of the white doctors of the 1830s. [xvii]
Although Medicine Men were exceptionally skilled, they often encountered patients who were beyond their capabilities. When this occurred, the alekchi responded in two different manners. One option, as discussed earlier, would be to refuse to treat the patient out of fear of weakening their spiritual power. The other option that some alekchi would pursue would be a form of “mercy killing” or assisted suicide. Often when patients were too ill or were in such great pain with no chance of survival, the Choctaw Medicine Men would begin preparing the patient for death. These preparations would involve the beginning of the families mourning process, or even providing poison to the patient to bring death and release from pain to the patient sooner.[xviii] While there are records within H.B. Cushman’s history of the Choctaws that patients may escape the attempted killing only to return to the village to witness their own funeral, most Medicine Men were trained well enough to recognize accurately when a patient had no chance of recovery.[xix]
Choctaw Medicine Men were the medical system within the Choctaw tribes. Their roles within the tribes ensured they were critical and respected. To ensure the survival of knowledge, they trained new Medicine Men and Women in the medical skills, herbal knowledge, and religious practices that created the basis of the Choctaw medical knowledge and healing process. An understanding of the complexity of the Choctaw pharmacopoeia and the wide variations of medicinal and therapeutic techniques utilized by the alekchi underscores the amount of knowledge they contained and why they were considered the “living book” of medical knowledge for the Choctaw tribes.
Pharmacopeia and Treatments
The Choctaw alekchi’s most useful tool in treating patients was their expansive knowledge of herbal remedies. While the early records of plants utilized by Choctaw Medicine Men compiled by Gideon Lincecum, John Swanton, H.B. Cushman, and others list numerous plants, there are typically between 16–25 plants utilized by Choctaw Medicine Men.[xx] Even with this large number of plants, it is shown that individual pants can be utilized to treat various ailments. An example of the multiple uses of a plant for the alekchi is the Eryngium aquaticum, commonly known as the “bitter snakeroot” or the “rattlesnake master” plant. This plant was used as a diuretic, expectorant, stimulant, anti-poison, and to treat gonorrhea.[xxi] In seeing how many uses a single plant could contain, and the number of plants that the alekchi must be comfortable in identifying and preparing, the criticality of their role as a “living book” and the need to have Medicine Men specialize within certain skill sets becomes apparent.
The way a single plant could be used for various ailments was through the various methods of preparation. These methods included such things as boiling the roots and leaves to create broths and teas, chewing and swallowing the juice from bark or leaves, drying and grounding of leaves and bark, and creating balms from sap. With these various methods, the Choctaw were able to have items that would serve as astringents, cough suppressants, cause lactation, prevent or cause abortions, contraceptives, expectorants, stimulants, painkillers and anti-inflammatory, induce sweating, treat diarrhea, and aid in indigestion.[xxii] The multiple uses of plants indeed increased the size and usefulness of the Choctaw pharmacopeia, comparable to the modern day drug store.
Beyond the knowledge of an effective pharmacopeia, Choctaw Medicine Men were also quite adept at treating injuries and physical wounds. Like modern medical practice, broken bones were set with a splint for stabilization while the bone healed.[xxiii] For injuries such as leg cramps, often developing during the play of the stick-ball game, players were treated with scarification with a sharpened turkey bone in order to prevent and relieve leg cramps.[xxiv] This treatment mixed the physical and the spiritual, due to the spiritual nature of the turkey within Choctaw culture. Alekchi also used techniques such as bloodletting and warm/cold baths in their treatments to help heal the sick.[xxv]
While most of the physical treatments of the Choctaw matched the treatment options provided by white doctors of the 1830s, two techniques they utilized were different than those used by the typical white doctor. One was the use of cupping, often mixed with bloodletting. Choctaws would utilize a buffalo or cow horn that was hollow and put a small hole in the point so that the alekchi could suck through the horn. These horns were used to create a suction to remove foreign objects that may have been lodged in the skin or deeper.[xxvi] Often, small cuts would be made on the skin of the patient, and the horn and suction would be applied to pull blood or fluids from a body. This horn technique was a very useful method for many treatments, but when observed by recorders of Choctaw medicine, the results seemed to come from the spiritual realm instead of the physical.[xxvii]
Another specialized treatment of the Choctaw Medicine Man was the akuna, which is very similar to what most people recognize as a sauna today. The anuka was a low hut, with all cracks within the structure sealed. Medicine Men would heat the hut with a fire until it reached the right temperature and remove the fire, then place their patients inside the air-tight chamber. The goal was to induce a large amount of sweating, which when the patient was released, he then ran to a cool pool of water and submerged his head in the cold water. H.B. Cushman notes that this form of treatment was highly effective for curing unknown fevers.[xxviii]
Modern Reviews of Effectiveness
While Choctaw medical capacity impressed many of the first settlers who encountered and recorded the knowledge, society is just now beginning to understand fully the capacity of the herbal remedies of not only Choctaw medicine, but all Native American herbal medicine. With the rise of consumer interest in herbal remedies, many organizations are conducting scientific research into the effectiveness of Native American herbal remedies, which often form the basis of modern herbal remedies. In studies looking at the effectiveness of herbal painkillers and anti-inflammatories, Native American treatments that claimed to help with fevers and pain have shown surprising efficacy. Oftentimes these treatments, once the proper dosage is determined, are as effective as modern drugs.[xxix] Treatments for things such as rattlesnake bites utilizing a mix of the horn treatment and herbal remedies have also proven equally effective to modern anti-venoms.[xxx] With these modern confirmation of the efficacy of treatments, the power of Choctaw medicine is only recently being fully understood.
Choctaw Medicine Men, alekchi, served as an important part of the Choctaw tribes. Their knowledge and skill were critical to the survival of their tribe, and their knowledge of medical treatments was expansive. By serving as a “living book”, one of their key tasks was to ensure their knowledge was passed down to the next generation. Using oral and religious traditions, these medical experts maintained a large knowledge base that is only today becoming fully understood.
[i] Mississippi Band of Choctaw Indians. Accessed October 21, 2020. https://www.choctaw.org/culture/language.html.
[ii] T. N. Campbell, “Medicinal Plants used by Choctaw, Chickasaw, and Creek Indians in Early Nineteenth Century,” Journal of the Washington Academy of Sciences 41, no. 9 (September 1984): 285. https://www.jstor.org/stable/24531248.
[iii] Jennifer L. Burns, “Sensing The Past: EthnoAesthetics and Memory Within Oklahoma Choctaw Cultural Revitalization Projects.” (Master’s Thesis, Southern Illinois University, 2014), 63.
[iv] H. B. Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, (Greenville, TX: Headlight Printing House, 1899), 228.
[v] Cushman, 228.
[vi] Andrea T. Borchers, Carl L. Keen, Judy S. Stern, and M E. Gershiwn. “Inflammation and Native American medicine: the role of the botanicals,” The American Journal of Clinical Nutrition 72, no. 2 (August 2000): 339. https://doi.org/10.1093/ajcn/72.2.339; David, Lewis, Jr., and Ann T. Jordan, Creek Indian Medicine Ways: The Enduring Power of Mvskoke Religion, (Albuquerque: University of New Mexico Press, 2002), 76, 118.
[vii] Burns, “Sensing The Past”, 43.
[viii] Lewis, Jr. and Jordan, Creek Indian Medicine Ways, 25, 139.
[ix] Lewis and Jordan, 122.; Campbell, “Medicinal Plants used by Choctaw, Chickasaw, and Creek Indians in Early Nineteenth Century,” 286.
[x] Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, 230.
[xi] Burns, “Sensing The Past”, 43.
[xii] John Swanton, Source Material for the Social and Ceremonial Life of the Choctaw Indians, (Alabama: University of Alabama Press, 2001), 228. Accessed October 4, 2020. ProQuest Ebook Central.
[xiii] Lewis, Jr. and Jordan, Creek Indian Medicine Ways, 52–53.
[xiv] Lewis, Jr. and Jordan, 99.
[xv] Burns, “Sensing The Past”, 42.; Campbell, “Medicinal Plants used by Choctaw, Chickasaw, and Creek Indians in Early Nineteenth Century,” 286.
[xvi] Lewis, Jr. and Jordan, Creek Indian Medicine Ways, 93.
[xvii] Burns, “Sensing The Past”, 42.
[xviii] Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, 229.; John R Swanton, “An Early Account of Choctaw Indians” in A Choctaw Source Book, edited by John H. Peterson, Jr., (New York: Garland Publishing, Inc., 1985), 64.
[xix] Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, 229.
[xx] Campbell, “Medicinal Plants used by Choctaw, Chickasaw, and Creek Indians in Early Nineteenth Century,” 285–290.
[xxi] Campbell, 287.
[xxii] Campbell, 286–288.
[xxiii] David I. Bushnell, Jr., “The Choctaw of Bayou Lacomb, St. Tammany Parish, Louisiana” in A Choctaw Source Book, edited by John H. Peterson, Jr., (New York: Garland Publishing, Inc., 1985), 25.
[xxiv] Burns, “Sensing The Past”, 65.
[xxv] Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, 228.
[xxvi] Lewis, Jr. and Jordan, Creek Indian Medicine Ways, 103–104.
[xxvii] Swanton, “An Early Account of Choctaw Indians”, 62.; Cushman, History of the Choctaw, Chickasaw, and Natchez Indians, 259.
[xxviii] Cushman, 259.
[xxix] Andrea T. Borchers, Carl L. Keen, Judy S. Stern, and M E. Gershiwn. “Inflammation and Native American medicine: the role of the botanicals,” The American Journal of Clinical Nutrition 72, no. 2 (August 2000): 340–345. https://doi.org/10.1093/ajcn/72.2.339.
[xxx] Joseph A. Price, III, “An “in vitro” Evaluation of the Native American Ethnomedicinal Plant “Erynbium Yuccifolium” as a Treatment for Snakebite Envenomation,” Journal of Intercultural Ethnopharmacology 5, no. 3 (June 2016): 219–25. https://doi.org/10.5455/jice.20160421070136.