iiRDLicKA] PHYSIOLOGICAL AND MEDICAL OBSERVATIONS 223 



for the disease; his second, to determine the particidar objective 

 agent employed thereby. The proce(kire with the patient differs 

 much with the various practitioners. If the cause of the ilhiess is 

 not manifest, the medicine-man iiKpiires into the dreams, symptoms, 

 transgressions, especially of tabus, of the ])atient, and examines him 

 visually and even \>y touch to tletermine to what category of influ- 

 ences the ailment should be attributed. When he decides this, he 

 is expected to make known the cause, and usually he tells also w^hat 

 tabus have been broken, and occasionally even points out a sorcerer. 

 The medicine-man sometimes calls in or refers the patient to other 

 practitioners, specialists in the particular line of affections under 

 treatment, this course being adopted probably as a means of avoid- 

 ing the responsibility of a hopeless case. 



The treatment varies according to the supposed necessities of the 

 case, consisting of propitiation for broken tabus, repeated prayers 

 to the elements or deities, the deposit of prayer sticks or counter- 

 charms in shrines, appeal to the patient's personal protector or totem, 

 the use of especially eft'ectual songs, rubbing or kneading (sometimes 

 quite violent, though employed more commonly for supposed magic 

 effects), rubbing liquid medicine into the skin, extraction of the 

 objective cause of the disease, blowing air or tobacco smoke on the 

 patient, passes with fingers moistened with saliva, ceremonial observ- 

 ances and rites, including painting of the body of the patient as well 

 as that of the medicine-man, and making sand paintings, noises (made 

 with voices, rattle, or drum), commands and exhortations to drive 

 away bad spirits, assurances given the patient, various symbolic rep- 

 resentations, purification of the body by sweat baths, purging and 

 emesis, strong sucking, cauterizing, scarifying, bleeding, external 

 applications, the administration, externally or internally, of secret, 

 magic, or other medicine, and various regulations of the behavior of 

 the patient. In the larger curative ceremonies several medicine- 

 men act conjointly, or, if but one is present, he may have from one 

 to several assistants. 



The extraction of the material agent of the disease, by means of 

 the hand or by strong sucking with the mouth, is sometimes per- 

 formed symbolically, but more frequently the object is assumed to 

 be actually removed. It may be a thorn, a piece of coal, a hair, an 

 insect, a worm, or other substance suggesting by its appearance or 

 nature the symptoms of the disease. It is usually exultingly shown, 

 and then destroyed. 



The Indian medicine-men of to-day are chiefly men of advanced 

 years, shrewd, and knowing (see pi. xxvii, a). Their dress and 

 daily life are in no way distinctive. Many are undoubtedly sincere 

 in all they do, and among them are most impressive figures, but the 

 majority to a greater or less extent are charlatans. Most of the lat- 



