Hallucinogens in Africa

I have argued here, here, and here that the Upper Amazon is the center of a larger culture area uniquely characterized by the use of psychoactive plants and mushrooms in the practice of shamanism.

A number of people offered the counterexample of iboga (Tabernanthe iboga) in the Bwiti religion as a shamanic use of a hallucinogen outside this extended culture area.

Now, there is no question that psychoactive plants and fungi are widely used in indigenous cultures around the world. The question we are asking, however, is not whether they are used, but whether they are used by shamans for shamanizing. And that raises a number of considerations. Sometimes, of course, psychoactive plants or fungi are used outside any ceremonial context at all, for recreation, say, or to alleviate fatigue; sometimes they are used in a ceremonial context that is nonshamanic, as part of an initiation ritual, for example; and we find, surprisingly often, that they are used, not by shamans, but rather by people who are imitating shamans. We also have to look carefully at the reliability of the reports we have received about a psychoactive plant or fungus claimed to be used by shamans, and at its relevant physical effects, to see whether those effects are consistent with the demands of the shamanic performance.

The Bwiti religion, a revitalization movement in West-Central Africa, uses the hallucinogenic plant iboga in its initiatory rituals, primarily in order to contact the spirits of dead ancestors, and to provide the experience of passing over to the land of the dead. Massive amounts are taken during the initiation ceremony, and smaller amounts at other ceremonies thereafter, to keep awake and relax the body. At these lower doses, iboga does not act as a hallucinogen, but rather as a stimulant. Indeed, the original use of iboga was apparently to relieve fatigue while hunting and as an aphrodisiac. This ability to suppress fatigue is of value at Bwiti ceremonies other than initiation, where participants must dance all night; low doses of iboga lighten the body, they say, so that it can float through the ritual dances.

At initiation, however, the dose is from fifteen to fifty times the normal threshold dose, with the intention to “break open the head.” The purpose of this massive ingestion at the time of initiation is to see the bwiti. The term refers first to a superior deity and, at the same time, the ancestors in the realm of the dead, and the great deities of the Christian pantheon. Thus the plant offers revelations and power to the initiate; upon return to the normal state, the candidate is questioned by the initiated men to see whether the vision was sufficient for admission.

Anthropologist James Fernandez obtained reports from thirty-eight people regarding the content of these visions; eight people told him that they heard many voices, a great tumult, and recognized the voices of ancestors; thirteen said they heard and saw various ancestors, who walked with them and told them about the land of the dead; eight said that they walked or flew over a long, multicolored road, or over many rivers, which led them to the ancestors, who then took them to the great gods.

Two features of these interviews are striking. First, the accounts of the visions are clearly stereotyped; for example, the relatives who serve as guides through the visionary landscape are often white, clothed in white, or change to white, because white is the color of the dead. Second, nine people told Fernandez that they saw and heard nothing. Many members of Bwiti have undergone initiation more than once, presumably because of just such lack of significant visionary experiences. Subsequent initiations may involve larger doses, sometimes with untoward results.

There is no doubt that iboga, at sufficient dosages, acts as a hallucinogen, and that Bwiti initiation candidates seek visions of a specific type by ingesting it in massive quantities. But there seems to be very little about this use that has much to do with shamanizing.

At the same time, sorcerers are said to drink iboga before demanding information from the spirits, and iboga is said to be used in sorcery, like an invisible rifle, to cast spells. In addition, religious leaders reportedly eat iboga for an entire day before asking their ancestors to give them advice. I have no information about the level of such consumption, or whether the dose might be hallucinogenic, or what other ritual acts might be involved. Such uses might well qualify as shamanic.

More Legal Stuff

I have written previously on the legal status of ayahuasca in the United States. In response, I have received claims to the effect that, while possession or sale of DMT may be a felony, it is legal to possess plants containing DMT, such as chacruna. I have struggled to find the source of this contention — which has achieved the status of folklore — and I think I have found it.

In 1980, the United States ratified the United Nations Convention on Psychotropic Substances, in support of an international effort “to prevent and combat abuse of [psychotropic] substances and the illicit traffic to which it gives rise.” The treaty classifies substances according to their degree of safety and medical usefulness, with Schedule I representing substances that are considered particularly unsafe and lacking any medical use. Among these substances is dimethyltryptamine (DMT). Parties to the convention — more than 160 nations in all — must, under Article 7(a), prohibit “all use except for scientific and very limited medical purposes,” with the following provision under Article 32(4):

A State on whose territory plants are growing wild which contain psychotropic substances from among those in Schedule I and which are traditionally used by certain small, clearly determined groups in magical or religious rites may, at the time of signature, ratification, or accession, make reservations concerning these plants, in respect of the provisions of article 7, except for provisions relating to international trade.

Under this provision, the United States made a reservation for religious use of peyote by the Native American Church, and Perú made a reservation for the use of DMT “by certain Amazon ethnic groups in magical and religious rites and in rites of initiation into adulthood.” Neither the United States nor Brazil ever made a reservation for DMT.

International treaties are recognized by the Constitution as being the law of the land. But, where the provisions of a treaty, such as the 1971 United Nations Convention on Psychotropic Substances, conflict with the provisions of a statute passed subsequent to the treaty, such as RFRA, the Supreme Court has held that the statute, to the extent of the conflict, supersedes the treaty.

Now the Convention provides that “a preparation is subject to the same measures of control as the psychotropic substance which it contains,” and defines preparation as “any solution or mixture, in whatever physical state, containing one or more psychotropic substances.” The District Court in New Mexico held that the ayahuasca drink at issue in that case was not, technically, a "preparation" of DMT, and therefore fell outside the treaty. But the Supreme Court, pointing to the plain language of the Convention, held, contrary to the District Court, that boiling constituted preparing, and held that the ayahuasca drink indeed fell within the scope of the Convention.

The Court did not have to further examine the implications of the Convention, however, because, the Court said, the prosecution had failed to show — indeed, even to submit evidence for — a compelling state interest in applying the Controlled Substances Act, which implements the Convention, to the sacramental use of the ayahuasca drink by the UDV. It is unclear what the outcome would be if the prosecution, in the next case, undertook to make such a showing.

But what if you are arrested for possession of the chacruna leaf? Here is where it gets interesting. The official commentary to the Convention notes that natural hallucinogenic materials, such as plants, are not listed in Schedule I, and that “plants as such are not, and it is submitted are also not likely to be, listed in Schedule I, but only some products obtained from plants.” Are you protected by the commentary to the Convention? The Supreme Court provided little guidance on that issue. The commentary, the Court held, was irrelevant to the case before it, since what was at issue was the ayahuasca drink, not the leaves from which it was made.

However, as the Tenth Circuit has pointed out, this commentary to the Convention does not constitute particularly strong evidence one way or the other. It was not written by the negotiators or signatories to the Convention. Rather, it was drafted by a single author, published five years after the Convention was negotiated, and is, at best, ambiguous on the question whether a preparation like the ayahuasca drink, as opposed to the chacruna from which it is made, is covered by the Convention. The commentary is thus just not the sort of "negotiating and drafting history" or "postratification understanding of the contracting parties" that courts have traditionally used as evidence of the signatories' intent.

Still, the interpretation of an international treaty by the United States agency charged with its negotiation and enforcement — that is, in this case, the Drug Enforcement Administration — is usually given great deference by the courts. It is, of course, likely that the DEA would argue against any natural plant exemption to the Controlled Substances Act.

So, the question is not settled. But I would not bet my liberty on the outcome.

NOTE: This blog entry does not constitute a legal opinion or legal advice. Laws change, and situations differ. If you have any questions, consult a lawyer experienced in this field.

Going Fishing

Tambaqui (Colossoma macropomum)

There is an amazing abundance and variety of fish in the Upper Amazon. For both mestizo and indigenous peoples, the lakes and rivers are an endless source of food, with more than two thousand species of freshwater fish. There are catfish of all sorts — the boquichico (Prochilodus nigricans), carachama (Pterygoplichthys multiradiatus), doncella (Pseudoplatystoma tigrinum), and especially the delicious dorado (Brachyplatystoma flavicans), which can grow to a hundred pounds in deep river channels and oxbow lakes. There are carahuasú (Astronotus ocellatus), paña, piranha (Pygocentrus nattereri), tambaqui (Colossoma macropomum), sábalo (Brycon melanopoterus), and paiche (Arapaima gigas), the largest freshwater fish in the world, whose flaky and delicately flavored flesh has been featured in Gourmet Magazine.

Machiguenga greet strangers by asking, "Are there fish in the river where you live?" La Patarashca, a restaurant in Tarapoto, serves doncella stuffed with shrimp in a sauce of cocona fruit (Solanum sessiliflorum), and as a patarashca — stuffed leaves — with tomato, onion, and sweet chili, wrapped in bijao leaves (Calathea lutea). People are not fooling around here.

But first you have to catch the fish.

Paiche (Arapaima gigas)

There are a number of places in the Upper Amazon which are particularly good for finding fish. Large and medium-sized rivers in low areas often form numerous meanders which, when the river changes course, become cochas, oxbow lakes. These cochas often have sediment settled on the bottom, relatively clear water, and high temperatures, and therefore rapid plant growth, which in turn supports quite large fish populations. Sometimes too you can see strips of clear and very slow water in a river. These are quiet places where plankton tends to grow; you can usually find fish downstream. You can also find fish under camalones, places where aquatic vegetation has formed a dense mat on the surface of the water. And fish love to move into the waters covering seasonally flooded forests.

Carachama, sailfin catfish (Pterygoplichthys multiradiatus)

It is possible to take fish just with your hands. It is not as hard as it sounds; I once caught a beautiful trout with my bare hands in a stream in the Esacalante Wilderness. In the Amazon, people wade close to shore in muddy water, gently feeling for fish under rocks and in the mud. In particular, carachama, the armored sailfin catfish (Pterygoplichthys multiradiatus), constructs burrows in the muddy banks of the cochas and rivers in which it lives, each a few feet deep and generally angled downward. You only need to feel around for a burrow, reach in, and very carefully — because carachama have very sharp spines on their dorsal fins — pull a carachama out of its hole and toss it up onto the bank. They are delicious.

Net casting

People in the Amazon often fish with hook and line — an innovation dependent on the availability of steel hooks and high test monofilament fishing line. All you have to do is tie a hook to a length of line on the end of a stick, put a piece of grasshopper on the hook, and toss the hook into the water. Especially in an overpopulated cocha, in just a few minutes you have caught a fish. You can do this over and over again; in half an hour, you have caught enough fish for several days. You can be creative, and tie a piece of wood to the string as a float. If you have a family to feed, you can set out a trotline with baited hooks. Hook-and-line fishing can be done where other methods do not work — at night; during the rainy season, when the water is turbid; in the main current of the river. And it is considered to be — heck, it is — fun.

Fishing nets can be cast from a canoe or by wading out into the water. Casting a fishnet requires skill clearly beyond my own, although, to my chagrin, I have seen numerous young boys do it quite successfully.

Communal fishing with barbasco (Lonchocarpus urucu)

People also fish using fish spears or bows and arrows — usually with barbed two-tined heads — either from a canoe or from shore, sometimes on the river right in frront of the village. Spear and bow-and-arrow fishing is largely limited to the dry season, when rivers tend to be clear rather than silty. A fisher can also put a tabaje, a fish trap, across a cocha outflow. Tabajes are woven from strips of caña brava, giant cane (Gynerium sagittatum) or bombonaje (Carludovica palmata). I have seen two mestizo fishermen work a running stream by anchoring a woven barricade with sticks downstream, driving fish into the trap from upstream, and then gathering them by hand. In a few hours they had caught enough fish, after being dried and salted, to last for a week.

Fish poison is also widely used in the Upper Amazon. The term barbasco can be used to refer to fish poison in general, or more specifically to Lonchocarpus urucu, which is of sufficient importance that some indigenous peoples cultivate it in their gardens. The procedure is simple: the root is is dug up, carried to the fishing place, and pounded with sticks so that the milky sap can be drained into the water. The primary active ingredients are rotenone and deguelin, which affect gill function in fish, inhibiting their ability to breathe. Within fifteen minutes or so fish begin to float on the surface of the water, where they can be collected by hand or in baskets, hit on the head with a machete, speared, or shot with a bow and arrow.

Preparing fish for salting and drying

Fishing with barbasco in a cocha is simple; squeeze the milky sap into the still water, watch it spread, and then collect the fish. It only takes one or two people to fish a cocha in this way. On the other hand, in a flowing stream or river, you have to build a dam at the upper end of the fishing area to slow the flow, and another at the lower end — sometimes with a woven basketry net — to make it easier to capture the stunned fish. Such temporary dam construction may require additional people, which can, of course, turn into a party.

Animated Shamanism

Artist Luc Perez has completed a new eleven-minute animation entitled Shaman, to be released as a French-Danish coproduction from Danske Tegnefilms and 24 Images.

The story begins in modern Copenhagen, where Utaaq, an old Inuit, sits at a bus stop. He sees a bird from his native Greenland — rare in Denmark — and he remembers a great battle he once had with a wicked sorcerer who used a tupilak — an avenging monster fabricated out of animal parts — to kill other hunters. The young Utaaq goes into the mountains and becomes a shaman, and, upon his return, he kills the sorcerer with his newly acquired skills. The film ends back at the bus stop — an old man, lost in contemporary civilization, remembering his youth.

Perez has had a long-standing interest in the interaction between painting and computer animation. For this film, he created large paintings of acrylic on paper, scanned them at different stages of completion, and created the animation in part by mixing the same image at its different stages, so that the animated image itself evolves in the course of the action.

If you are interested in seeing what this looks like, a four-minute preview of the eleven-minute film is available here.

Shamanism Conference

Diana Vandenberg, Portrait of Ruth-Inge Heinze

The 25th Conference on Shamanism and Alternative Modes of Healing will take place on Labor Day weekend, August 30 through September 1, 2008.

This annual conference was founded by the late Dr. Ruth-Inge Heinze, who died on July 20, 2007, at the age of 88. Heinze was a long-time faculty member at Saybrook Graduate School and Research Center, and was a close associate of Saybrook colleague Stanley Krippner. She also served as adjunct faculty at the University of California—Berkeley and the California Institute of Integral Studies in San Francisco. Her interests included the psychology of shamanism, shamanism in Southeast Asia, and alternative methods of healing. This year the conference will be hosted by Dr. Jurgen Kremer, also on the faculty at Saybrook.

The purpose of the annual conference is to preserve and further the integrity of shamanism, including the exploration of twenty-first century shamanism, and share the latest insights in the field of alternative healing. Current topics include global warming and planetary healing. This year’s conference will include the first Ruth-Inge Heinze Memorial Lecture, to be given by Dr. Krippner. Scholars from a wide range of disciplines are encouraged to submit an abstract on a topic.

This is a working conference, gathering together shamans, healers, scientists, anthropologists, teachers, and artists from a variety of indigenous cultures. Speakers are given twenty minutes to present, followed by general discussion. Both scientific papers and experiential offerings and ritual may be presented.

The conference will be held at the Santa Sabina Retreat Center in San Rafael, California, on the Dominican College campus. For more information, contact Dr. Jane Hawes here.

Learning to Sing

One of the most striking features of Amazonian mestizo shamanism is the icaro, the magic song, whispered, whistled, and sung. The shaman uses icaros to call the spirits for healing, protection, or attack, and for many other purposes as well — to control the visions of another person who has drunk ayahuasca, work love magic, call the spirits of dead shamans, control the weather, ward off snakes, visit distant planets, work sorcery.

It is universally said that each shaman learns his or her own icaros from the spirits themselves; indeed, the poet César Calvo Soriano calls them “untransferable magic songs.” But there are exceptions. First, icaros can be learned from one’s maestro ayahuasquero. My teacher doña María Tuesta told me that I should first learn the icaros of don Roberto Acho, my maestro ayahuasquero; as time passed, she said, and I continued to diet with the plants, I would learn icaros of my own.

And icaros can be learned from other shamans. Indeed, there are many stories of shamans traveling long distances to learns specific icaros. Anthropologist Françoise Barbira-Freedman reports that one of the Lamista Indian shamans with whom she worked traveled from San Martín to the Ucayali to learn the icaro del kapukiri.

Some shamans even visit other shamans incognito in order to steal their icaros. That is why many shamans mumble their songs, or sing in many different languages; the goal is to make their songs hard to learn, to keep them from being stolen. Doña María frequently compared her own open-handedness with the stinginess of other shamans, who do not want to reveal their icaros. “I’m not selfish,” doña María told me. “I sing loud because I’m not afraid to let people know what I know.”

But one’s own icaros most frequently come while dieting with the plants and other substances, in ayahuasca visions, in dreams, in the unheard rhythms of one’s own heart. It is a process that people find hard to describe, especially when the songs are in strange or incomprehensible languages. Musician Alonso del Río, who apprenticed for three years with renowned Shipibo shaman don Beníto Arévalo, talks about this phenomenon. "It doesn't go through the mind," he says, "but between one spirit and another." It has something to do, I think, with solitude. “While you are alone with the sounds of the jungle and its animals,” says Cocama shaman don Juan Curico, “it is a real concert, a choir, that is the silence of the jungle.”

The icaros arrive in various ways. Don Solón Tello Lozano, a mestizo shaman in Iquitos, says, simply, “The plant talks to you, it teaches you to sing.” One may hear the icaro externally, as if sung by someone else, or one may hear it inwardly. Both words and melody may come together, or first one and then the other. One may hear only the words and then complete the melody oneself. Don Agustin Rivas says that he would make a song for each plant he dieted with as its power entered him, with the melodies coming first and the words added later; indeed, the lyrics of some of his icaros were written by Faustino Espinosa, a professor of Quechua. Sometimes, as with don Francisco Montes Shuña, a spirit whistles and sings the melody of the icaro in a dream. Sometimes there is simply an overwhelming urge to sing, and the song and melody come out by themselves.

Three days after Pablo Amaringo had undergone a healing, he was astonished to find himself singing, perfectly, the icaros he had heard there, including the words. “I sang many icaros,” he says, “as if the song were in my ears and on my tongue.”

The third time doña María drank ayahuasca, the spirit of ayahuasca entered into her, and she began to sing loudly. El doctor ayahuasca was in her body, she told me, singing to her, and ayahuasca appeared to her as two genios, spirits, one male and one female, who stood on either side of her — a woman dressed in beautiful clothing, wearing jewelry made of huayruru beads, “everything of the selva, the jungle,” and an ugly man, with bad teeth. Everyone in the room became very quiet, she said, as she sang her new icaro de ayahuasca.

Snakebite

There are two families of venomous snakes in the Upper Amazon — the Crotalidae or pit vipers and the Elapidae or coral snakes. The Crotalidae are called pit vipers because they have a pit or depression between the eye and the nostril on each side of the head, which functions as an extremely sensitive infrared heat-detecting organ. In the United States, there are three genera of the Crotalidae family — the copperhead, the cottonmouth or water moccasin, and fifteen species of rattlesnake.

Fer-de-lance (Bothrops atrox)

In the Amazon, the pit vipers of most concern are the thirty-one species of snake somewhat indiscriminately referred to by the name fer-de-lance or lancehead, all in the genus Bothrops, and all looking very similar, with long bodies and large triangular heads. The lanceheads live in the lowland jungle and average four to six feet in length, although they may grow as long as eight feet. They are generally tan with dark brown diamond-like markings along their sides, and are very well camouflaged. Amazonian pit vipers — as opposed to the colorful coral snakes — have clearly chosen crypsis over warning; it is easy to pass very close to a fer-de-lance without noticing it. Species of Bothrops apparently account for most of the serious snakebites in South America.

Bothriopsis bilineatus

Mestizos in the Upper Amazon generally refer to the various Bothrops species as jergón in Quechua or as vibora in Spanish. The Spanish term cascabel, rattle, usually refers to the genus Crotalus, the rattlesnake, which is not found in neotropical environments, but rather in dry habitats such as the savannahs in Guyana. In the Upper Amazon, the term cascabel may be used to refer to juveniles of the genus Bothrops.

There are also two species of so-called forest pit vipers, in the genus Bothriopsis — the two-striped and the speckled, both exclusively arboreal and camouflaged for tree dwelling, with the color green in their pattern. These forest pit vipers are slender snakes, reaching five feet in length, with prehensile tails, usually found coiled around twigs and bushes.

Bushmaster (Lachesis muta)

Finally, the Amazonian bushmaster or Lachesis muta — the Latin name means silent fate — is the largest pit viper in the world, reaching lengths up to twelve feet. Usually called by the Quechua term shushupi, the bushmaster is found in the lowland rainforest throughout the Amazon. It is generally a coppery tan with dark brown diamond-shaped marks on its back, rather than on its side. It is active at twilight and night, and coils up in the buttresses of large trees, or under roots and logs. After having fed, a bushmaster will remain in place until it has digested its prey, a period of two to four weeks.

Whereas the other neotropical pit vipers bear live young, the bushmaster lays eggs. Because of its length, it can strike over a long distance; because of its large fangs, it can deliver a large dose of venom — probably the largest venom dose of any pit viper. However, bushmasters are very reclusive and therefore rarely encountered; many experienced tropical herpetologists have yet to see their first wild specimen. Thus, few envenomations actually occur, although the fatality rate is reportedly high. I have been unable to find information about the age, physical condition, or treatment of reported fatalities. And it is worth adding that envenomation by any of the Elapidae in the Amazon — primarily fifty-three species of coral snakes in the genus Micruris — is apparently very rare as well.

Crotalid envenomation

Pit viper venom is a complex mixture of enzymes, which varies from species to species, and which is designed to immobilize, kill, and digest the snake's prey. Thus, pit vipers strike and release quickly; coral snakes, on the other hand, have neurotoxic venom, and small mouths and short fangs, so that they tend instead to hang on and chew. Crotalid venom works by destroying tissue, and is capable of causing significant, sometimes disfiguring local tissue damage; but deaths — at least in the United States, where records are available — are very rare and limited almost entirely to children and the elderly.

Indeed, many pit viper strikes in fact are dry and inject no venom, even when there are fang marks. The snake may have recently injected venom and not yet replenished; it may be because humans are much bigger and give off a lot more heat than the snake's usual prey, and this throws off the timing of the venom delivery. Additionally, Crotalids can differ significantly in the toxicity of their venom, even within a single litter.

Cocona (Solanum sessiliflorum)

And pit vipers really want nothing to do with humans. Humans are too big to eat, put out a confusing amount of heat, and are potentially dangerous. As a general rule, you will be bitten only if the snake perceives you as an immediate threat. Snakes hate surprises. That is why pit viper strikes on humans are overwhelmingly on the extremities. In North America, most rattlesnake envenomations are associated with alcohol ingestion on the part of the victim. Rock climbers are at risk for rattlesnake bites because they blindly reach overhead to grab a ledge on which a rattlesnake is sitting in the sun.

Pit viper envenomation can be excruciatingly painful — one expert has said that, on a pain scale of one to ten, rattlesnake bites are an eleven — and the discomfort can last for several days. The envenomated extremity can also become frighteningly ugly, leading to panic in both the patient and the caregiver. Greater or smaller areas of the extremity can turn blue or black, swell alarmingly, and develop large blood blisters. It is altogether an unpleasant experience. There is no question that a Crotalid envenomation is a medical emergency requiring urgent evacuation if possible. However, the first step in treatment is to avoid panic; even without evacuation, most cases result in several days of serious misery and then recovery. More rarely, skin grafts may be necessary. Remember that the fatality rate even for untreated pit viper bites is extremely low.

Ishanga blanca, white nettle (Laportea aestuans)

Mestizos and indigenous peoples in the Upper Amazon use a wide variety of plants to treat snakebite. Ethnobotanists James Duke and Rodolfo Vasquez list twelve genera used for that purpose; Richard Evans Schultes and Robert Raffauf list twenty-nine. My teacher don Roberto Acho Jurama often applies a patarashca, poultice, made of a banana leaf, wrapped around the site of envenomation, filled with the finely chopped tuber of jergón sacha (Dracontium loretense), changed every few hours; he also uses ishanga blanca, white nettle (Laportea aestuans), and cocona (Solanum sessiliflorum), as well as chewed leaves of mapacho, tobacco (Nicotiana rustica), applied directly to the wound. The patient may be given a cold-water infusion of jergón sacha to drink, or cocona fruit boiled with sugar.

Shamans all have their own songs to drive out venom and heal snakebite, usually called, generically, icaro de vibora, pit viper song; remember that icaros generally do not have individual titles in the way that, say, songs do in North America. This icaro is then combined with the definitional triad of mestizo shamanic healing — shacapar, rattling; chupar, sucking; and soplar, blowing tobacco smoke — followed by application of the herbal remedy.

It is hard to judge the effectiveness of any of these remedies. There are few records; there is little long-term follow-up; Crotalid envenomation is frequently self-limiting. There appears to be little empirical basis for allegedly high mortality rates in cases of bushmaster envenomation; a pit viper strike can create a deep puncture wound and severely compromised tissue, so sepsis, especially in the jungle environment, must be a frequent complication. There is evidence that a number of plants traditionally used to treat snakebite — especially those in the family Urticaceae, such as ishanga blanca — have antiinflammatory, immunomodulatory, and thus potentially antivenom activity, which remains to be investigated.