To Read between the Lines

Reference Pharmacopeia-Making and Indigenous Studies

In an ethnographic study of Qollahuaya communities of midwestern Bolivia published in 1982, Joseph Bastien noted how medical practitioners saw themselves as part of a 1,000-year-long tradition of medicinal expertise. From at least the nineteenth century onward, he argued, these communities developed a reputation as “Lords of the Medicine Bag” (Qolla Kapachayuh), perhaps capitalizing on a transregional disposition to research for ethnobotanical knowledge in the Andes.³ Bastien advocated for reading their knowledge of more than 980 medicinal plants as a pharmacopeia.⁴ Since around 700 CE, he contended, these healers used the holly-like Ilex guayosa plant as an anaesthetic and even completed complex medical procedures like brain surgery.⁵ Along with substances more familiar to the early modern medicament trade, such as cinchona, contrayerva, and coca, Bastien’s list of Qollahuaya remedies included animal parts, including petrified animals that ritually aid in crossing earthly and celestial realms.⁶

To show the diversity and specificity of such knowledge, he included a table of Qollahuaya medicinal plants, which indicated name, botanical classification, origin, quality (in the bodily theory), therapeutic properties (using Western “pharmacology terminology”), and medicinal uses (see Table 1). Despite its utility, locals’ knowledge about it, and the presence of Spanish imperial forces committed to the Galenic pharmaceutical tradition, I. guayosa did not make it into early modern pharmacopeias, and no singular text emerged as the Andean pharmacopeia. In the nineteenth century, Western pharmaceutical companies took note. While the medical class of Qollahuayas with whom Bastien consulted continued to explain their remedies by reading the body as a hydraulic machine, this corporeal theory interested Western pharmaceutical companies little.⁷ The Qollahuayas’ specific knowledge of plant services, however, did. By 1982, Bastien wrote “that pharmaceutical companies have utilized more than fifty species from the Quallahuaya pharmacopeia for use in manufacturing drugs.”⁸

This is a modern example of reference pharmacopeia-making. Other essays in this special issue have described the category of “reference pharmacopeias” in the HP data set. As part of the collection’s ontology, we understand reference pharmacopeias as recording an idealized or normative set of medicaments, such as those that a practitioner should or could have on hand. Not unlike many earlier reference pharmacopeias in the HP data set, in this modern example Bastien translates healers’ knowledge of local Andean plants for a wider audience, one interested in botanical identification and pharmacological standardization of the effect of these substances. Bastien’s article aims to take seriously the depth of Qollahuaya medicinal experts’ knowledge and share this with the wider world, circumventing the privatized interest of pharmaceutical companies by publication in an academic journal. In so doing, the anthropologist shared corporeal theory from which some working Qollahuaya experts sought to profit. He preserved some of their system’s cosmographic significance while rendering that knowledge supplemental to a universalizing project of ethnopharmacological exchange. Bastien extracts names from his conversations with Qollahuaya experts and triangulates a botanical classification, region of origin, quality in the system of healing, therapeutic properties in pharmacological terms, and medicinal uses, including application. Some of the medical preparations included matés or salads. Others were ritual, such as using coca for casting or divination.

Bastien evoked the term “pharmacopeia” intentionally, ostensibly to lend authoritative credence to the work of Qollahuaya experts. Pharmacopeia enables translation, but translation comes at a cost.⁹ The same impulse rests behind other evocations of the term, such as by Dan Choffnes, who defines pharmacopeia as “a list of medicines with their preparation and usage.”¹⁰ Once created, such lists take on a life of their own, becoming reference texts, accruing the status of fact, and serving as a widely accepted authority in the medical world. How should the HP project navigate these overlapping impulses and distances, to read reference pharmacopeias as translations between material types and knowledge cultures and as tools to share some secrets and hide others? If pharmacopeias are normative sources that standardize global medical knowledge into a Galenic format, evolved from a Mediterranean tradition, how can we read between the lines of these standardization efforts to access the knowledge displaced or erased in the process? Given the centrality of the co-optation of Indigenous knowledge to the imperial capacity of pharmacopeia-making, how ought the project make visible this knowledge-work and avoid perpetuating such co-optation?

Pharmacopeias and Their Discontents

When it comes to accessing Indigenous knowledge of medicine, pharmacopeias are often deceptively bad sources. Over the past two decades, historians of medicine have shown how European-style pharmacopeias erase knowledge of local medicaments and their uses, instead propagating a singularizing Galenic medical tradition.¹¹ For Londa Schiebinger, European bioprospecting missions came with intentional erasures as medicinally potent nature was shoehorned into a narrow band of culturally acceptable European medical commodities. In her study of eighteenth-century Atlantic knowledge, she argued that when it came to natural products used in women’s health, like the peacock flower, many were excluded from published European-style pharmacopeias.¹² She noted, “Even though the peacock flower itself moved easily into Europe, knowledge of its use as an abortifacient did not. Why not? In a period when Europeans prized exotic botanicals—tulip bulbs, coffees, teas, chocolates, spices, and medicines of all sorts—what blocked the domestication of this potentially useful drug in Europe?”¹³ Schiebinger’s explanation was that this came from a “culturally cultivated ignorance—the unspoken but distinct configuration of events that converge to leave certain forms of knowledge unplucked from the tree of life.”¹⁴

Other printed pharmacopeias from Europe and the Atlantic world reveal significant obliterations. As a form, pharmacopeias thrive on overlaps. Throughout their long history of cataloging essential natural simples, the experts and scribes behind these lists consistently highlighted familiar substances. Just as flour, sugar, salt, and pepper form the foundation of a modern recipe, staples like aloe, balsam, rosewater, and sassafras underpinned the remedies essential to any apothecary’s store. These successful medicaments were built on trust, becoming as familiar as a favorite tune that everyone recognized. Whether balsam or sanguis draconis (dragon’s blood), these remedies carried a sense of familiarity, a recognition born from repeated use.¹⁵ Pharmacopeia-makers listed similar medicaments that could—and, by the makers’ reckoning, should—be used across multiple regions. Thus, the form itself simplified, creating likenesses in print greater than in the medicine people practiced. When they did bring in new medicaments, such as balsam of the Indies, they did so by folding them in as new entries without dwelling on their exoticism.¹⁶

To read pharmacopeias, then, was to engage with a genre rooted in replication, valuing the preservation and transmission of established knowledge over the pursuit of invention or novel insights. Like a lexicon, these texts functioned as repositories of shared terminology and trusted practices, offering a linguistic and practical framework that reinforced collective understanding. This stability allowed for the continuity of medicinal traditions across time and space, much like a lexicon anchors language by codifying the familiar and the essential. To read pharmacopeias, then, was to read a genre of replication rather than one that prioritized invention and new learning. As discussed in the Visual Pharmacy essay, Matthew James Crawford and Joseph M. Gabriel have pointed out that “pharmacopeia” has been understood to refer to a “genre of medical writing that lists simple and compound medicaments as well as the techniques for preparing and administering these medicaments according to a specific medical tradition.”¹⁷ The utility of the pharmacopeia was

clearly limited by the fact that the materia medica available in the colonies differed significantly from that available in Europe, in part because of the diversity of Indigenous plants in North America and in part because of the influence of Indian and enslaved people’s knowledge and practice on colonial medicine. Sassafras, for example, was used medicinally by Indigenous peoples in North America, and by the late seventeenth century it had been incorporated into the medical practices of white colonialists. Yet Boone’s edition of the London Pharmacopoeia, not surprisingly, contained no mention of this useful plant.¹⁸

Likewise, Benjamin Breen has asked why, “if diasporic African healing was so important in the pharmacy and medical practices of the early modern Atlantic . . . cures from sub-Saharan Africa itself [are] relatively invisible in early modern European pharmacopoeias?”¹⁹

Perhaps the apothecaries were part of a fundamentally conservative discipline that, while reliant on experimentalism, did not aim to change the fundamentals of natural philosophy or medical practice.²⁰ Clare Griffin extends an American-based historiography about medicines included in and excluded from the Columbian Exchange to understand the inclusion of new medicaments in the apothecary traditions in Russia. She notes that “looking at the histories of medical drugs, food, and spices, we can find numerous examples of how novel substances were incorporated into and even changed a society that initially distrusted them.”²¹ While physicians dispatched on scientific missions might come back with new plants and remedies, these often disappeared into the writings of scientific societies without influencing a wider public, except in the case of a few well-marketed drugs of global origins.²² Due to this narrowness, Indigenous knowledge of medicines was often collected, shoehorned into the pharmacopeia format, and then left little-used in the wider Galenic medical marketplace.

Whether this conservatism was the nature of an apothecary’s practice or the form of the pharmacopeia itself, scholars have suggested expanding pharmacopeias not only beyond authoritative reference texts, but beyond the written form. As discussed in other parts of this Special Issue, Crawford and Gabriel define pharmacopeias as repositories of collective medical knowledge and therapeutic practices within societies, while Pablo Gómez expands the concept to “social pharmacopeias,” incorporating oral and practical medical traditions beyond written texts.²³ By turning to healing among Black ritual practitioners in the early modern Caribbean, Gómez developed methods for moving beyond the material of medicines. Even when reading inventories of a sea-based barber surgeon and the Jesuit College of Cartagena, what matters is not the knowability of these substances but their ungraspability. To reckon with their power, one must read not them but the social situations through which experts tapped their occult powers. Gómez wrote, “Each cabinet was filled with heaps of cures and tales of hope, promises of healing in the form of canafistula, sulfur balsam, Tolú balsam, palosanto, cinchona bark, laudanum, tamarindos, and sulfur acid, as well as scorpion ointment, centipedes, Florentine lilies, and thousands of other substances coming from around the globe.”²⁴ What mattered about these substances was not their knowability but their function drawn from the hidden powers of nature and beyond. Gómez pushes questions of healing into the social context: “The pressing questions these [healing] materials and their histories provoke are therefore unrelated to knowledge about their ultimate nature—an inaccessible realm—or about their biomedical, pharmacological properties and their possible effects on early modern corporealities.”²⁵

If Gómez suggests moving away from materiality as the basis of medicine-making, toward a social pharmacopeia, how might the HP project take seriously the multivalence of medicinal substances? In making this shift, each list becomes an animation of a standardized discursive structure, suffused with hopes, fears, and the promise of cures. When one reads the mention of the term “saxafras” on a price list of medicaments sold in Rome in the early seventeenth century on the platform,²⁶ how might we be reminded of the complex history of transmission behind that substance? When Spanish botanist Nicolás Monardes mentioned the North American plant in his descriptions of so-called New World medicaments, he told a story of Indigenous knowledge at multiple steps removed, but verified through his own experience. When it came to sassafras, Monardes had learned of it when a Frenchman reported to another Frenchman that “the Indians did show them this tree, and the manner how they should use it, and so they did, and were healed of many evils, which surely brings admiration, that one only remedy should work so variable, and so marvelous effects.”²⁷ For many other medicaments, this narrative follows a path of distancing and erasure.²⁸ As sassafras became part of the European canon of medicaments, inscribed into pharmacopeias, those who first knew it best were intentionally erased.

Given these issues of miscommunication, appropriation, and erasure, how can we put Indigenous knowledge and the pharmacopeia in conversation without propagating these tendencies? Recognizing the tension between universalizing projects and those that center local cosmologies of natural bodies, how can we synthesize both approaches while acknowledging the tendency of Galenic pharmacopeias to obscure local and Indigenous knowledge? If we are aware of the misleading nature of these documents, how can we read between the lines of pharmacopeias and juxtapose them with efforts to uncover bioprospecting and other engagements with what Gómez has called “substances with bodily effects”?²⁹ By using this term in our thinking for the HP project, we seek to be aware of the more-than-physical powers of substances often defined in a progressive scientific literature as medicaments. Ex-voto body parts, as discussed in the “Visual Pharmacy” essay, and ground natural products appeared side-by-side in the apothecary shop, and ritual often mattered in the process of healing. By thinking with this idea of “substances with bodily effects,” we seek to preserve the power of context in the business of healing.

Dueling Impulses: Universalizers and Local Cosmologizers

A potential solution lies in recognizing the distinct commitments of various research constituencies. We have come to understand the contrasting impulses of ‘universalizers,’ who seek broad applicability, and ‘local cosmologizers,’ who emphasize cultural specificity. Despite their differing methodologies, both schools of thought have made significant contributions to understanding substances’ effects on the body and, in their own ways, to preserving Indigenous knowledge.

In this framework, the term ‘universalizers’ refers to scientists, scholars, and experts dedicated to acquiring, organizing, and standardizing knowledge about substances with bodily effects for comparison across time and space. These individuals create databases and medical botanical collections that document local plants and their effects on the body, as discussed in “Extractions at the Intersection of History and Chemistry” in this special issue. Universalizers often describe plants using Linnaean binomial nomenclature and identify their bioactive chemical compounds. By constructing a system of knowledge that transcends regional boundaries, this approach assumes a fundamental similarity in nature across different areas of the world.

Along with a broad array of published data sets, an example of a project with such an impulse might be Erowid, a community-based resource that seeks to share experiences and complex interactions between humans and psychoactive substances, vaulting information that spans from the chemical to the cosmological.³⁰ Many universalizing projects exude a confidence in materialism that presumes that substances with bodily effects affect all human bodies according to similar rules. Those who turn to this scholarly impulse often believe in sharing knowledge as a human right. Today, this is a central tenant of the “open-source” community. For them, it is important to share not only successes but also failures, including projects that were “put on ice,” or that research groups elected not to pursue.³¹

Local cosmologizers focus on the unique epistemologies and ontologies developed within and for the benefit of their communities. They value the integrity and completeness of their local knowledge systems, often prioritizing the preservation of their traditions and resisting external influences. Rather than attributing the effects of a medicament solely to its material properties, local cosmologizers emphasize the cosmologies and cultural frameworks that imbue substances with their healing power. For them, the efficacy of a remedy arises through specific rituals and contextual realities. From this perspective, they sometimes view universalizers as another form of local cosmologizers, seeking to integrate or dominate their knowledge systems, a critique often framed in terms of resisting imperialistic tendencies.³²

Many projects of this type seek to engage in recuperative and restorative work with care, taking seriously that knowledge related to healing is secret and sacred in many communities. Recently, digital portals have sought to build respect for Indigenous knowledge traditions into tools for communities and academics. For example, the Mukurtu Initiative has created a “free, mobile, and open-source platform built with Indigenous communities to manage and share digital cultural heritage.”³³ This grassroots project is centered on enabling different communities to store records and establish cultural protocols for accessing those records. As part of the Local Contexts project, which emerged from the Mukurtu platform’s use of traditional knowledge fields to facilitate engagement with that knowledge while being mindful to copyright concerns, collaborators developed traditional knowledge labels and biocultural labels. By using these tags and placing related content behind digital walls, Indigenous communities could control their own content, enhancing and legitimating “locally based decision-making and Indigenous governance frameworks for determining ownership, access, and culturally appropriate conditions for sharing historical, contemporary, and future collections of cultural heritage and Indigenous data.”³⁴

While sometimes overlapping, these two impulses have inherent tensions. What can be shared? For whom? Who, if anyone, has the right to determine the value of the secret? If that value translates into the monetary, how ought it to be distributed? When it comes to the complex cultural, financial, and environmental landscape around Indigenous pharmacopeias, we might reflect on some of the thorny parallels that emerged in the history of genomic research and longitudinal epidemiological studies involving Indigenous people. When it comes to the “conjuncture of genetics and Indigeneity,” Nanibaa’ Garrison has written that it “will remain one of both potential and challenge.”³⁵ Jenny Reardon and Kim TallBear have argued that “while biological anthropologists and geneticists commonly state desires to build an antiracist future, often they do so on conceptual and material terrains that leave intact old links between whiteness and property.”³⁶ Data sets have staying power, and pharmacopeias have long constituted such data sets. Joanna Radin has shown how the creation and circulation of the Pima Indian Diabetes Dataset at once alienated Indigenous people from their medical information and encoded their health information into the training data behind algorithms and machine learning. Resignifying the term “digital natives,” she suggested “the potential to learn from Indigenous peoples who have been at the vanguard in encouraging innovative and decolonial approaches to research. Today’s research subjects are no longer the objects Euro-American knowledge systems designed to make invisible.”³⁷

Of course, all projects involve compromises, technical and otherwise, to satisfy stakeholders. Inevitably different communities will come to diverse conclusions. As HP develops, our hope is that researchers will find resources of value when reading the lines or between the lines of these lists of substances with bodily effects. As each textual pharmacopeia will be accessible first and foremost in its archival or printed format, we hope that this experience of the sources, their logic, and their construction will make it possible for researchers to think with the contexts in which they were made. A system of supralinguistic links and references might showcase what is embedded in these lists. We wonder whether it might be possible approach pharmacopeias as guides to the history of bioprospecting but also as maps of substantive bioprosperities that take seriously the power of nature and objects.

Toward Substantive Bioprosperities

By the late 1980s, Anglophone scientists and the wider public were enthralled with a vision of biodiversity and rallied behind a mission to save a dying world. Under the threat of mining and urbanization, places like the Amazon rainforest could be lost in the next generation, they worried. Imagine all the animals and plants that would disappear if their environments were eradicated. If it were not enough to care about nonhuman lives on their own terms, scientists and activists cajoled people to join their mission with arguments that emphasized the risks a destroyed jungle posed to humanity at large.³⁸ Think of the drugs that could be developed from those plants still unknown to Western medicine, not yet synthesized in natural product libraries, to bolster modern pharmaceutical development.³⁹ After decades of field research among Indigenous communities of the Amazon, Richard Evans Schultes’s work in ethnobotany had gone mainstream, and experimental drug users and botanists alike read about hallucinogenic plants, use of which straddled the line between ritual and medicine.⁴⁰ In that moment, a belief in the whole-wide-world’s inherent unity and the idea that nature’s wonders were a human birthright to be shared, and thus preserved, thrived.

These impulses to render distant knowledge universalizable and thus comparable is a continuation of a Renaissance project, although in modern times it is bolstered by searchable databases and indexed drug lists. Similarities between early modern explorers and modern scientists were not lost on scholars or scientists.⁴¹ When Simon Varey conducted his research on Francisco Hernández (1515–1587), the leader of the first scientific expedition to Mexico organized by the Spanish Crown, he saw transhistorical overlaps between modern ethnobotany and the long-ago historical project. Varey had collected a glowing magazine feature of Mark Plotkin, the 1994 conservation medalist celebrated for his work in medicinal plants. The article begins “Under a Double Rainbow—Whenever ethnobotanist Dr. Mark Plotkin returns to work in this Tirio Indian village in Suriname, northern Amazonia, he’s mobbed by members of the tribe.”⁴² Segueing into Plotkin’s voice, the article continues: “The first time I came here I thought I’d found paradise, I still think it’s as close as we’re apt to get.” Plotkin’s travels to “the field” and his book Tales of a Shaman’s Apprentice echoed the methods from the early modern period. Centuries before, in an entirely different geography, Hernández sought to discover the secrets of healing from experts who were allegedly revered and left unnamed in many of the subsequent iterations of the research. As Varey knew, the Spanish Crown’s motivations were not purely scientific—there was a strong economic and imperialistic drive to claim ownership of New Spanish localities, including their knowledge and resources (see Figure 1). Whether he thought such motivations undergirded modern ethnobotanical work is unclear, but Varey collected one review of Plotkin’s book titled “A Quixotic Search for New Drugs,” with “Fco Hernández” scrawled in pen across the top.⁴³

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Figure 1.

Simon Varey’s annotated copy of J. Worth, “A Quixotic Search for New Drugs,” Natural History (March 1994), Medical Plants and treatments, UCLA SC MS. Coll. 87, Box 1, Folder 27, Simon Varey Papers Relating to Francisco Hernández 1992–2003, SRF Non-Circ Request at UCLA Biomed Special Collections (MS. Coll. No. 87 [Barcode: FF0000547802]), Box 01-03.

The likeness between ancient and modern scientific projects has been chalked up to bioprospecting, a modern term that characterizes an age-old practice. Bioprospecting is an abbreviation of biological diversity prospecting.⁴⁴ Bioprospecting describes the search for particular chemicals in plants or animals with the hope of using them for commercial applications, whether pharmaceutical, medicinal, or cosmetic. In 1992, Walter V. Reid first used the term in the context of economic development, suggesting its potential to enable sustainable economic development for poor countries.⁴⁵ The term “bioprospecting” emerged in the dialogues of international institutions—the World Trade Organization, the United Nations, the World Bank—and encouraged the acknowledgment and establishment of uniform patent laws. The 1992 Convention on Biological Diversity (CBD) sought to reconcile the need to conserve the environment with recognizing its utility for economic and social development. The CBD’s treaty sought to preserve biological diversity, accentuate sustainable use of its components, and facilitate fair and equitable sharing of benefits arising from its resources. While the treaty’s emphasis on the even distribution of resources is distinctly modern, scholars have read it as an effort to correct a much older problem.

Those who criticize bioprospecting focus their critiques on how the universalizing aims of bioprospecting obscure local cosmologies. Some critics have contended that bioprospecting represents the use of inherently “Anglo-American moral and political thinking” to compensate Indigenous people for their knowledge—an endeavor that has ultimately perpetuated legal and normative frameworks that allow biopiracy to occur.⁴⁶ Others, such as Vandana Shiva, characterized bioprospecting as an expression of the “commodification paradigm,” an ideal that has preserved the power dynamics of the current international order and successfully safeguarded the material interests of invaders in neocolonial relationships. Tantamount to theft, Shiva argued that bioprospecting’s exploitation illustrates the dichotomy between knowledge systems but also posited that the current disparities in power in the international order depend on hierarchies of knowledge systems. Shiva describes Indigenous thought as collective knowledge systems that have been built over thousands of years. In her eyes, the modern intellectual property system undermines and exploits this age-old, Indigenous knowledge base. More specifically, she characterizes bioprospecting as a form of biopiracy because bioprospecting implicitly reflects a belief in normative systems of consent and compensation, a Western paradigm of knowledge and morality.⁴⁷

Abena Dove Osseo-Asare has turned to a different emphasis altogether: bioprosperity. In Bitter Roots, Osseo-Asare charts the narratives of six plants’ transformation from plants to drugs in Africa’s pharmaceutical industry and reveals the normative and dualistic understandings of bioprospecting as a purely Western neocolonial practice. She highlights clashes between domestic African pharmaceutical and biotechnology companies and Indigenous groups, illuminating the complexities of exploitation within Africa’s pharmaceutical landscape. On one hand, she critiques the normative bioprospecting paradigm as exclusive, univocal, and representing one people and one history.⁴⁸ However, at the same time, Osseo-Asare also illustrates the difficulty in charting a truly multi-vocal history of medicine, and the impossibility of awarding equitable compensation to all parties involved in drug-discovery. Eschewing the terms of “bioprospecting” and “biopiracy,” which tacitly imply and accept Western control over other nation’s pharmaceutical industries, Osseo-Asare imagines an alternative mode of both characterizing and exploring pharmaceutical industries from the past and present. Osseo-Asare’s names this alternative framework, “bioprosperities.” She suggests that using the term when investigating and chronicling the histories of pharmaceuticals allows historians to reimagine the industry as a locus of shared knowledge and resources, primed for exchanges between nations on an international scale. Rather than focus historical narratives on bio-prospecting agreements, Osseo-Asare argues for exploring the use of plant medicine in places such as Africa, “before the establishment of bioprospecting agreements.”⁴⁹

When it comes to reading HP, how might researchers read these lists as substances in their context and alienated from their nature, as reflecting bioprospecting attempts and sometimes preserving a more-than-material access to hidden worlds? Perhaps the path forward could involve space for “substantive bioprosperities,” reading beyond the written words on the pages of pharmacopeias. As discussed already, “substantive” draws on Gómez’s notion of “substances with bodily effects,” a more capacious and less teleological alternative to “medicaments.”⁵⁰ Likewise, “bioprosperities” draws on Osseo-Asare’s discontent with the extractive tendencies of pharmaceutical research to search for cures in distant landscapes only to uproot natural products to process in distant laboratories. While Osseo-Asare uses the term to describe the creation of local medicinal knowledge outside Europe and North America, we suggest that “substantive bioprosperities” should appear in local engagements in these regions as well. The term “prosperities,” as opposed to a singular “prosperity,” highlights the many parallel incarnations (of medicaments) that exist across time and space as healers, ritual practitioners, and cultivators, refined substances with bodily effects to treat their communities. The history of pharmacopeia-making has been riddled with an impulse to pigeonhole multifaceted engagements with substances into a standardized format and Euro-American experimental apparatus.

What might a research agenda toward substantive bioprosperities look like? Scholars of Native American and Indigenous studies have encouraged early Americanists to center “spoken, image-based, material-object, and Indigenous language texts” as an “archival expansion.”⁵¹ HP must be read only as an access point to a deeper, experiential web of knowledge honed by experts across nature, time, and space.

Substance Talk

“To be native to a place, we must learn to speak its language,” Robin Wall Kimmerer has written in Braiding Sweetgrass, a book that is equal parts mediation and manifesto.⁵² In her reckoning with her identity as a member of the Maple Nation and a student of plant science, Kimmerer reflects on what it means to learn Potawatomi, the language of some of her ancestors. By suffusing her life with this vocabulary and grammar, she finds new ways to address kinship and togetherness, building toward a vision of nature resting on the potential of reciprocity rather than the inevitability of exploitation. When reading those pharmacopeias that fold in knowledge of native experts, learning plant names beyond their Linnean terms means reckoning with a new language of a place, and engaging with its circulation means playing a game of telephone complete with mistranslations both intended and accidental. As we have seen, pharmacopeias prioritized overlaps. But what happened when there was no written roadmap to be printed and reprinted? In initiatives like Bastien’s to learn Qollahuayan remedies, how does the pharmacopeia facilitate substance talk?

Ethnobotanists have taken on this translation effort, creating an internationally legible written record of orally preserved knowledge.⁵³ Paula De Vos has argued that efforts to organize and compare local medical approaches “have contributed to an ever more complete picture of the efficacy and wisdom of traditional medicine from virtually every corner of the globe.” Such projects are catalyzed by “a sense of urgency among researchers to record this information, largely because there is substantial evidence that these knowledge traditions, which are usually communicated orally, are quickly eroding.”⁵⁴ If younger generations lose interest in the language, a chain of connection to community life is broken; when the sustainability of traditional species of medical plants becomes threatened by deforestation, degradation, and invasion of nonindigenous plant species, the knowledge becomes insecure, destined to be forgotten. A new generation of ethnobotanists aims to walk the line between universal and local cosmologization with care, with a deeper integration of medicinal plants known to local healers in drug discovery. In her self-definition as “the plant hunter,” ethnobotanist Cassandra Quave suggests (as Varey did in the case of Hernández) that some of the world’s most urgent problems could be solved through some of the oldest remedies. Her descriptions of the “jungle” and the botany of the Peruvian Amazon are mediated through a medicine man named “Don Antonio,” who ran an ethnobotanical garden.⁵⁵

Language loss comes with dire consequences for both local cosmologizers and universalizers.⁵⁶ With the extinction of a language, an entire cosmology dissipates. To make the argument for the loss to universalizers, scholars in evolutionary biology and environmental studies have sought to prove exactly how much unique medical knowledge would be lost with the disappearance of a language. Rodrigo Cámara-Leret and Jordi Bascompte aim to answer three questions through ethnobiological data synthesis: Does modern medical knowledge exhibit a stronger association with threatened languages or threatened plants? To what extent does Indigenous knowledge act as a greater driver in the loss of unique medical knowledge, compared with ecological extinction? Finally, what is the degree of linguistic uniqueness of medical knowledge, and how could that be ascertained by connecting individual plants to individual languages?⁵⁷ In this sweeping project, the researchers used data sets from the Native American Ethnobotany Database, integrated findings from field research in northwest Amazonia, and relied on an ethnobotanical review of 488 references and 854 herbarium specimens for New Guinea to examine 236 Indigenous languages and 12,495 plants. For northwest Amazonia, they relied on Schultes’s publications, which folded in a half century of field research.⁵⁸ Here again, the lists of substances with bodily effect took on new life as authoritative, filled with quantifiable lines of language-rich fact to be collected and compared transregionally.

The authors used phylogenetic language trees to visualize the spread of unique medical knowledge among languages in North America, northwest Amazonia, and New Guinea, regions they consider to have “high biocultural diversity.” They used IUCN Red List classifications for medicinal plant threats and the Agglomerated Endangerment Status to determine the threat levels for languages. From all of this cross-integration, they concluded that 73 percent of medicinal plant services in North America, 91 percent in northwest Amazonia, and 84 percent in New Guinea are linguistically unique and only known in one language. Notably, a large portion of this unique knowledge is linked to threatened languages, highlighting the connection between language loss and the disappearance of medical knowledge. This relationship implies that the loss of Indigenous medical knowledge is more at risk from language extinction than from biodiversity loss, particularly with the foreseeable extinction of 30 percent of languages by the century’s end.⁵⁹ These are devastating numbers, and using them in an argument might convert a wider public to action for preserving language differences. Like the biodiverse rainforest, if the tragedy of the commons were to win out, humanity holistically would suffer.

Where does this leave us? At minimum, with a few recognitions and aspirations. Substances with bodily effects work through the sociability in which they are cited and used in the past and today. To facilitate their study means enabling connections—whether through their makership, organization, or mentions of substances with natural origins and bodily effects. However, these connections are in the eye of the beholder. To study HP, one must keep in mind their potentials and perils, their adherents and their discontents, the knowledge they preserve and that which they erase. Like the figure-ground perception, flickering like the Rubin vase illusion between seeing the outline of a chess piece and a human profile, only one reality is visible at a time, but both coexist.⁶⁰ A path forward requires not only critique but synthesis.