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About the Maestro Tabaquero:

"The informant was a 51-year-old Amazonian traditional healer (curandero) and Maestro Tabaquero with 36 years of clinical experience."

"He is from Peru, but of mixed Amazonian ancestry, as his four grandparents were originally from Peruvian, Colombian, Ecuadorian, and Brazilian Amazonian areas, respectively. Born at the banks of the Peruvian Río Tigre (Loreto Province), the informant was raised by his maternal grandparents who were traditional healers and farmers."

"He was instructed by his grandparents from an early age on and started to train more formally at age 8, via extended forest retreats (dietas; solitary retreats designed to experientially study medicinal plants), as is customary in the training of an Amazonian healer."

"At age 12 he discovered his calling to specialize as a tabaquero, after having been initiated into the tobacco medicine by his Peruvian grandfather. He recalls starting to regularly attend to patients at age 15, but he continued to develop his knowledge and skill in the field of healing and tobacco-based treatments throughout his life, also including periods of study with Amazonian healers other than his grandparents."

"He progressively attained expert status in the field of tobacco medicine and the reputation of a Maestro, a highly esteemed Amazonian healer."

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On the importance of receiving from a curandero:

“The curandero needs to be a curandero. If a person that is not a curandero serves tobacco, he can kill the patient. The medicine is very good—that is why it is called ‘medicine’—but used incorrectly it can kill, like any potent medicine.”

"He explains that if a person serves tobacco to a patient that has a condition for which it is contraindicated, without knowing the diagnostic methods to determine if a patient is apt for the treatment, or if the healer does not understand the effects thoroughly, or does not master the traditional techniques for intervening if needed, the consequences can be fatal."

"For example, some patients may not vomit for certain reasons, which can be dangerous due to an overheated system; they may want to lie down or faint, and a tabaquero must recognize such cases and be able to intervene with the traditional techniques specifically designed for these situations."

"Hence, a skilled and experienced healer is absolutely essential for patient safety, the tabaquero emphasizes. Finally, if the mandatory dietary rules of the tobacco treatment are not followed, this may lead to a series of adverse effects ranging from mild to intense."

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On the work of a tabaquero:

“Tobacco in smoked form has energetic purposes,” says the healer, and describes sophisticated techniques, with different areas of application. The smoke is swallowed to the stomach, he points out, not inhaled to the lungs."

"He highlights that, in order to be able to use tobacco for healing work, an apprenticing tabaquero must first prepare his/her body with the ingestion of medicinal plants in the context of long-term dietary retreats (dietas)."

"Furthermore, the trainee must learn the techniques for soplar (blowing smoke) and icarar (specific chanting for healing purposes)."

"Soplar and icarar are key for what the healer calls “directing the medicine”: Together they function like a vector, linking the curative forces of the healer with the medicinal properties of the plants and imparting it a direction that guides the therapeutic process. He describes these techniques as an integral part of the therapeutic success:

“It is part of the treatment, part of the efficacy of the treatment of the sick person’s body. [… ] If the medicine normally can cure 30%, the curandero by means of his icaro and soplada adds another 70% of therapeutic force.”

"Furthermore, a curandero may blow smoke (soplar) directly onto a patient’s body to “help a sick person rest and recover their energy.” The smoke applied by the healer in this manner is said to have a protective function “like a shield on your outer body.”

"He uses a variety of techniques for this:

“There are manners of soplar, a curandero knows where he needs to blow. There are points on the body where the smoke needs to be blown. [… ] These are energetic points, a bit like acupuncture, for example.”

"He explains that a healer can treat specific illnesses in this manner, for example susto, which is a type of fright or startle response that disrupts the person’s energy system."

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“The curandero does not smoke for pleasure, there is a purpose. He smokes when it is necessary.”

"When asked if the smoking of a tabaquero may eventually have negative health consequences for the tabaquero himself, he explained that a tabaquero undergoes a long-term preparation during his/her apprenticeship for this purpose, preparing the body with specific medicinal plants and diets, so that his body can withstand the work with tobacco."

"For someone without this preparation, he considers it indeed potentially harmful to use tobacco in that manner."

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On tobacco as a plant of power:

"Tobacco has a unique place in Amazonian medicine, explains the healer, in that it is the one plant used to direct or potentiate the others:

“All plant remedies have to be blown with tobacco smoke” before giving them to the patient, says the healer."

"Because of its healing scope and due to its spiritual-energetic force, he considers tobacco as a sort of royal herb among medicinal plants:

“The tobacco’s healing power in the energetic realm is outstanding; I have worked with many other power plants, very good ones, but none of them compared to tobacco in this context.”

"He also describes that tobacco is closely connected to the “tree medicines” used in the Amazonian tradition, which are also fundamental, he explains, by giving strength and stability to a patient."

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"When asked about the difference between tobacco and ayahuasca (given that the latter is very popular in the world currently), he said that “tobacco centers your mind while ayahuasca produces visions and fantasies.”

"He considers that without adequate preparation, it is very difficult for most people to differentiate between the reality and the fantasies of their own mind, which is a problem or risk in ayahuasca."

"He points out that if given to the right patient by an adequately trained healer, both medicines are very valuable. However, he considers that most people using ayahuasca currently are ill-prepared for working with this plant, as this requires an extensive preparation period, which they have not undertaken."

“Ayahuasca is very good, but it has to be given by healers who know, who have trees in their body, and have prepared themselves and can direct the work. Not by just anyone."

"Because today the world is full, there are many who have taken ayahuasca 10 times and are already shamans, and serving ayahuasca—it does not work like that.”

"He therefore considers there to exist a lot of misguided practice and misunderstandings around this plant at present."

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On tobacco as a spiritual-energetic medicine:

"The healer explains that viewed from the Amazonian medical understanding, tobacco medicine, in addition to the plant’s biochemical action, exerts its therapeutic effects via the energetic and spiritual domains."

"These domains or aspects of the human body are significant for pathogenesis “because illnesses first arise in the spirit-body, then in the energy-body, and only then manifest in the physical body,” he explains."

"Aiming to further elucidate the energy aspect of the body, he describes that like nerves, the body is permeated by energy channels, which are in direct relationship with the structures of body and mind."

"In his point of view, the key power of the tobacco plant, thus, lies in its extraordinary capacity to tackle the spiritual-energetic dimension:

“There are many excellent medicines, but for energetic problems, tobacco is number one.”

"He describes that it removes energetic pollutants from the system, thereby increasing the flow of energy in the body, which in turn improves health of body and mind."

"Furthermore, according to Amazonian epistemologies, there are illnesses that are expressly related to spirits (noncorporeal living beings, which can be health- or sickness-promoting)."

"The tobacco is said to be effective for such illnesses because the plant itself is associated with a powerfully healing spirit, which antagonizes malevolent entities:

“With tobacco [these kinds of illnesses] get cured in one go, because demons cannot live where there is tobacco.”

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"The healer illustrates the interplay between physical, psychological, energetic, and spirit-related factors in the description of the immediate effect of tobacco:

“Upon ingestion the tobacco connects to the stomach and, together with its energetic power, connects to the intestines. From the intestines it connects to the brain and nervous system and mobilizes the energy system of the overall body. In the course of this process, vomiting is triggered. So the person tends to vomit, but in these bouts of vomiting, it is not just vomiting:

"the patient frees himself from physical ills, but also—for those that are able to understand this—from a lot of bad spirits, and is also cleaning his energetic field."

"This is what this kind of tobacco that makes one vomit is aimed for. Once the person has vomited, they have freed their mind, heart, intestines, and overall body. There is an energetic change, the person feels lighter, more joyful, more calm, with a more loving connection towards nature, things like that.”

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"Consequently, the healer reports the utility of tobacco for a series of health problems which according to Amazonian epistemics are energetic or spiritual in essence and etiology:

"for instance brujerías, daños, mal del aire, or saladera, which are different classes of illness that have an accumulation of energetic pollutants and/or spirit-related problems in common, and can be treated effectively with tobacco."

"The person suffering from these conditions may exhibit a specific symptom pattern (e.g., insomnia, diarrhea, paranoia, loss of weight, etc.), but once the tobacco treatment has expelled the unhealthy spirits and energetic toxicities from the person’s body, the symptoms disappear, explains the healer."

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"Lastly, in the context of the tobacco plant’s spiritual effects, the healer describes a phenomenon he calls “awakening the spirit-body” of a person."

"He explains that aside from the physical and energy body, every person possesses a spiritual body, which is a natural aspect of the overall human."

"Most people are however unaware of having this part because it is asleep or sick, he explains. The correct application of tobacco may help this aspect to awaken or recover, he explains, and that “if it has awakened, it functions in one’s dreams; the spirit-body starts to do its work.”

"The healer strongly emphasizes the personal and interpersonal significance of awakening one’s spirit-body, as it brings about more understanding and care of others, more compassionate and conscious living."

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More extensive excerpts detailing the work of Maestro Ernesto Garcia follows below:

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On methods of preparation:

"The healer explains that he relies primarily on leaves of N. rustica L. for preparing his remedies, but that other parts of the plant are also useful for certain problems (e.g., the root applied on dogs for skin worms).

“The tobacco [I use] is prepared of leaves, it is called cured, it has a process of curing the leaves, and once they have a color between black and brown, they are ready to be used.”

"He reports making liquid and solid remedies from this tobacco, some for ingestion, others for topical application."

"The Tabaquero reports using many “varieties of preparations and combinations of medicinal plants” in conjunction with tobacco, depending on the type of illness the remedy is supposed to target."

"Liquid preparations for ingestion are what he uses most frequently. Unless otherwise stated, the following sections will therefore focus on this type of remedy."

"The healer uses oral, nasal, or topical routes of administration for his tobacco remedies."

"In case of the nasal route he uses liquid, but not solid tobacco snuff, as he considers the latter (today often called rapé) to have certain disadvantages."

"For topical application he uses tobacco leaves, either as a cataplasm or processed with other plants as an ointment or in the form of a medicated shower (“baño de plantas”)."

"He does not employ enemas of tobacco, but states that this is a common practice in the Amazon and may be useful for instance for intestinal parasites."

"Finally, he makes use of the leaves in smoked form for “energetic purposes."

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On dosage and administration:

"Dosage is determined as a function of type of illness and constitution of a person’s body, nervous system, and energy, the healer explains."

"An oral tobacco dose can range from minuscule to large, and a thorough diagnostic analysis beforehand is critical, the healer asserts:

A tabaquero must learn the traditional Amazonian techniques (e.g., pulsar) for this purpose during his training, explains the healer."

"He must also learn the Amazonian ritual techniques for correctly administering the medicine (e.g., soplar, icarar), and the methods for intervening in case of adverse reactions to the tobacco effect."

"He portrays these methods as a pivotal part of the safety protocol for using medicinal tobacco securely."

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"The healer describes several different contexts for administering oral tobacco, depending on the type of preparation and illness."

"For “strong preparations” he conducts tobacco ceremonies, which can be held for an individual or in a group setting, or he administers the tobacco in the scope of Amazonian dietary retreats (traditionally called dieta)."

"The latter involves a period of several days of social seclusion, strict dietary regime, and daily tobacco ingestion. In yet other cases he may prescribe a tobacco preparation combined with further medicinal plants that target specific health problems."

"For all of these three contexts, however, a specific dietary regime is mandatory:

"On the days of tobacco ingestion the regime is strict, and for several days to weeks after the treatment, specific foods and behaviors need to be avoided."

“Also, one has to know how to eat,” the healer adds, implying that an overall healthy diet during this timeframe is important."

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On applications in the physical health domain:

"The healer lists problems of the respiratory system like sinusitis, gout, parasitic illnesses of intestines, and epilepsy as the main types of physical health problems that he treats with tobacco."

"He specifies that “there is a process for preparing the tobacco which makes it into effective medicine for the lungs. In other uses it may become a poison for the lungs, but if it is processed in the right manner, it is medicine, it cures; the tobacco absorbs phlegm and removes it [from the respiratory system].”

"He goes on to describe a different manner of preparation, which he uses for treating intestinal parasites; a remedy that “is like a purge, it gives you diarrhea, it cleans [the intestines].”

"He explains that in general, tobacco is a hot or heating herb. It is therefore apt to treat inner cold conditions, but not suited for conditions associated with inner heat. Gases in the intestines that arise due to excessive cold, he exemplifies, can effectively be treated with tobacco; yet tobacco is not advised for an acute inflammation in the intestines."

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"The healer points to the interplay between the physical and psychological domains in this context. He describes the existence of a direct connection between intestines and brain, with a chain reaction occurring on account of this linkage when drinking tobacco:

“Physically it [the tobacco] cleans the intestines of parasites and negative energies, but because the intestines connect to the brain, if the intestines get liberated, the brain gets liberated as well.”

"This manifests as improvements to psychological well-being (see next section). He explains that similarly, when mucus and phlegm that block the respiratory pathways get expelled with the help of tobacco, there is an increase of oxygen flow which leads to an “opening of the brain” and an easing or clearing of the mind:

“For many foreigners that are [psychologically] unwell, it is because the brain is closed off of oxygen. Only very little can pass and that is why they feel bad. This is why the tobacco helps, when it makes you vomit and spit out the phlegm, the phlegm that gets removed unblocks the pathways here, and here [pointing to specific spots on the body], and then the person sees things differently.”

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"Another type of tobacco preparation is effective for gout, he continues, a condition he relates to inner cold. Further, topical application of a tobacco ointment is helpful for parasites of the skin. A specific preparation of tobacco combined with other ingredients is used to treat epilepsy."

"Finally, the healer adds that tobacco has benefits also for a generally healthy person, because it fortifies and detoxifies the body. This is why traditionally it is employed also as a preventative or maintenance mechanism to prevent future illness."

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On applications in the mental health and psychosomatic domain:

"The healer continually describes that the tobacco remedy “centers” or “strengthens” the mind. Correspondingly, among the chief indication for this medicine he points to “problems of the mind” or of the “psychic-mental system.”

"According to his descriptions this can include clinical or subclinical mental health issues, but excludes certain severe psychiatric conditions, for which tobacco is contraindicated."

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"He describes therapeutic benefits for psychological processes related to attention (“some people think, and later they forget; others don’t think at all—these things the tobacco helps to clear, or open”), cognitive tendencies (“if previously a person had a destructive mind, [after the tobacco-treatment] they don’t have it anymore, the mind is more constructive, there is a change”), mood and self-image (“a person with a very low self-esteem, if they drink tobacco the self-esteem gets lifted, the tobacco can help”; “the person feels more cheerful, more serene”), as well as fearfulness (“[the tobacco] strengthens the mind, the brain—if previously seeing a cockroach made me react with fear, now the cockroach is my pet, as an example”).

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"The healer describes a tonifying remedy that targets depression or anxiety conditions specifically. Severe clinical cases may require treatment between 3 and 6 months, but 1 month of treatment with this remedy is generally sufficient for milder cases."

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"However, the Tabaquero explains that for certain types of clients with a chronic nervousness (“nervios crónicos”) or an overwrought nervous system (“sistema nervioso muy afectado”), tobacco is contraindicated."

"He explains that for such patients, even though their body would be apt to a tobacco-treatment, there is a potential that their mind reacts to the tobacco effect with panic or loss of control."

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"Tobacco is also contraindicated for severe psychotic conditions. In less severe cases (e.g., mild forms of paranoia), the healer explains that a plant combination that includes tobacco can help, but that in most cases, a more structured treatment frame (also involving counseling) is necessary."

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"Similarly, for highly aggressive or hostile patients tobacco is contraindicated. The healer illustrates that for pathologies that feature excessive heat in the head, such as the former, tobacco may in fact aggravate the condition, due to the heating quality of the herb."

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"Further, in the context of substance use disorders, the healer expresses that although tobacco can help in principle, a more extensive overall treatment frame is needed, and that for such patients tobacco can only be prescribed if they are already abstinent:

“They are generally compromised and their brain affected, requiring another kind of therapy to stop using. After about 6 months without using the drug, then they can however drink tobacco,” which will help the detoxification of body and energy, the healer explains, since the pathology involves both “physical and energetic ills, and the tobacco cleans these things.”

"He points out that for alcoholics, conversely, repeated tobacco ingestion can be used to help them achieve abstinence. This is also the case for cigarette smoking cessation:

“If the person drinks tobacco several times over an extended period of time, then he won’t smoke anymore.”

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"Finally, for psychosomatic pain conditions, the healer stated that tobacco cannot directly treat such conditions."

"It may help indirectly by centering the person’s mind, improving their sleep and appetite; the pain condition itself, however, will necessitate additional treatments."

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"In regards to sleep specifically, the healer adds that topical application of crushed tobacco leaves on the forehead can be very helpful in cases of insomnia or other sleep disturbances."

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On Contraindications, Interactions, Risks, and Adverse Effects:

"The healer reports heart diseases, high or low blood pressure, and severely impaired lungs or other vital organs (e.g., cirrhosis of the liver), as well as a “greatly affected nervous system” and the aforementioned mental illnesses as contraindications for tobacco-treatments."

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"Furthermore, the healer explains that tobacco should not be taken during pregnancy or lactation. In terms of drug interactions, the healer mentions antibiotic drugs, which should not be used in the context of a tobacco treatment with a time lapse before and after being necessary."

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"Moreover, recreational drug users may not drink tobacco until they have ceased usage for at least 6 months. Finally, other powerful medicinal plants should not be used in conjunction with a tobacco treatment."

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"The healer determines the suitability of an individual for tobacco-based treatment via the traditional Amazonian diagnostic techniques, involving i.a. the palpation of a patient’s pulse (pulsar)."

"Whether the elderly can drink tobacco depends on their overall strength and health condition in the context of their age, states the healer:

“If a person, for example, is 70 years old, and has a compromised liver, problems with their prostate, a lot of age-related health issues, then tobacco is not suited for them.”

"Similarly for children, those below 5 years of age are generally treated via sopladas rather than ingestion (minimal age of 6 months for treatment with soplada)."

"He explains that regardless of age, for any Amazonian treatment that requires a strict dietary regime like tobacco, a certain level of physical strength is necessary “because a very debilitated body will not withstand the diet.”