MOCHE; A PLRLVJAN COASTAL COMMUNITY— GILLIN 



131 



ditch, a sudden fall, etc. This is believed to scare 

 the soul out of the body. The difference between 

 the nearby (de cerca) and distant {dc lejos) variety 

 is that the fonner usually tal<es place in or near the 

 house, and the soul of the person which has been 

 jarred loose nevertheless remains near Inm. If the 

 fright has taken place in the field or some distance 

 away, however, the soul stays at the site of the 

 fright and special methods must be used to get it to 

 come back. 



Xo one, even a strong man, is ashamed of being 

 asnstado. It is regarded as something beyond the 

 control of the individual. Men pride themselves 

 on their physical courage when facing other men or 

 dangerous physical situations, but they do not re- 

 gard it as childish to be "frightened" in the technical 

 sense of susto. Several Moche men have served as 

 conscripts in the armed services in the jungle and 

 during the "incident" with Ecuador, but claim they 

 had never been asustado in this sense, although they 

 are willing to admit that on occasion they have been 

 asustado (frightened) in the ordinary sense of plain 

 physical fear. Women do not fall ill of susto during 

 childbirth tior at the monthly crisis. Although in- 

 dividuals are frightened by nightmares, one does not 

 get susto from them. It is thus clear that susto 

 involves special psychological complexes which are 

 not well translated by the English words "fright" 

 or "fear" in their ordinary North American con- 

 texts. 



The symptoms of importance to a curandcra are 

 as follows. The armpit and lobe of the ear are 

 white and the inside skin of the arm does not show 

 any veins and is often wrinkled. There is a low 

 fever and the patient is "nervous" and hypersensi- 

 tive to sudden sounds. Physically he is weak, and 

 he often has diarrhea. A man does not lose potency, 

 but he will do harm to a woman if he tries to have 

 intercourse with her. Urine is yellow; when it 

 turns white, the cure is successful. Aside from 

 hypersensitivity to loud noises or interruptions, the 

 patient seems to be in a depressed state, saying little, 

 often with the eyes closed or cast down to the ground. 

 Some patients have an abstracted or dreamy attitude, 

 gazing off into space. I have personally seen only 

 three adult patients in the first stages. All of them 

 were depressed and quiet but contactable and well 

 oriented in time and space. I was able to obtain 

 some detailed history on seven cases in all. I dis- 

 cussed nine other cases from the experiences of my 

 informants. One man in Moche died, allegedly of 



susto, during my work there, although the immediate 

 cause of death was recognized as tuberculosis. There 

 were no newly developed cases of adult susto 

 handled during my work in Moche, but I had an 

 opportunity to see something of three new cases 

 brought for cure from outside the community and 

 four old cases from the community itself (including 

 the fatal one just mentioned). Full case histories 

 were not obtained from any of these patients, but 

 the following features appeared in all histories : ( 1 ) 

 A debilitating illness, usually malaria, had appeared 

 some time before the susto attack; (2) all patients 

 seemed to be emaciated or wasted physically; (3) all 

 but one case gave a history of some emotional crisis 

 preceding the fright which had precipitated the susto 

 itself. The four women all had a "love" or sex 

 crisis, such as a man leaving them for another ; two 

 of the men had had trouble with their sweethearts, 

 while a third had had a row over inheritance rights. 



Dr. Pedro F. Castillo Diaz, chief of the women's 

 section of the Trujillo general hospital (Hospital de 

 la Beneficiencia Puhlica), has handled a good many 

 cases of alleged susto in his service. He emphasizes 

 that he is not a psychiatrist, but rather an internist. 

 However, his impression is that susto is a hysterical 

 manifestation based on general debility usually 

 caused by malaria or tuberculosis. He says that he 

 has practically never seen an alleged susto patient 

 who is not run down ; the patient usually has a low 

 fever, is poorly nourished, usually has anemia, and 

 is in a "delicate and irritable frame of mind." He 

 does not rule out the possibility of such cases appear- 

 ing in families with a history of psycopathology, but 

 has no records which would show this. In Lima 

 I discussed this matter with two young psychiatrists 

 attached to the Hospital Loyaza, Dr. Arnoldo Cano 

 J. and Dr. Valega. They expressed the opinion 

 based on their experience that so-called susto usually 

 turns out to be either hysteria or tuberculous menin- 

 gitis with an underlying history of malnutrition, 

 malaria, or tuberculosis, or all three. 



Certainly the medical and psychiatric aspects of 

 this condition should be more thoroughly studied, 

 and I await the opportunity to carry out more in- 

 tensive investigations of this interesting problem. 

 The present tendency of the medical profession seems 

 to be to pooh-pooh the business, because it does not 

 fit neatly into the textbook definitions of diagnostic 

 symptoms. 



It is my tentative opinion that susto is somewhat 

 similar to the "nervous break-down" among North 



