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Aztec advances in health (19): arthrocentesis

24th Jul 2022

An Aztec person’s inflamed joint - Florentine Codex Book X

This is the nineteenth in a series of entries based on information in the Encyclopedia of American Indian Contributions to the World by Emory Dean Keoke and Kay Marie Porterfield (2002).
Arthrocentesis is an operation performed to remove fluid from the knee joint - a technique invented by the Aztecs... (Compiled by Ian Mursell/Mexicolore)

‘An excessive amount of fluid [main picture shows a swollen joint, from the Florentine Codex] causes difficulty in mobility, range of motion, and flexion of the joint. This common condition is also very painful. Modern physicians treat it by puncturing the area with a needle to drain the fluid. Most are unaware that the Aztec... invented this treatment in pre-Columbian times. Hundreds of years before Western doctors, ancient Mesoamerican physicians used a thorn to lance or puncture the knee to drain excess fluid accumulated in the joint.’
At least two 16th century sources mention this:-
• The Badianus Manuscript prescribes:-
’Against pain in the joints. A poultice of the following herbs shall be prepared: cuauhtzitzicaztli [Urera sp.], tetzitzicaztli [Cnidoscolus sp.], colotzitzicaztli [Cnidoscolus sp.], patlahuaztzitzicaztli [Tournefortia hirsutissima], and xiuhtlemaitl [Pectis sp.]

‘Further, the part affected by stiffness should be lanced with the bone of an eagle or a lion and afterwards the aforementioned plaster mixed with honey should be applied.’
• Bernardino de Sahagún, in his Primeros Memoriales also mentions lancing of the joint (pic 2):-
Tlaquaallavazliztli. ynic pati moço vitzauhcatica. quiça yuhqui nopalalactlj. ‘Swelling of the knee. It is cured by puncturing with a maguey thorn. [A liquid] resembling cactus water comes out.’

According to the highly accomplished and award-winning Mexican clinician and researcher Donato Alarcón-Segovia this is an accurate description of therapeutic arthrocentesis to relieve abnormal accumulation of fluid in a knee and would be an effective treatment.

Sources:-
• Encyclopedia of American Indian Contributions to the World by Emory Dean Keoke and Kay Marie Porterfield (Facts on File, 2002)
• Aztec Medicine, Health and Nutrition by Bernard Ortiz de Montellano, Rutgers University Press (1990)
• Primeros Memoriales: Paleography of Nahuatl Text and English Translation by Thelma D. Sullivan (University of Oklahoma Press, 1997).

Picture sources:-
• Images from the Florentine Codex (original in the Biblioteca Medicea Laurenziana, Florence) scanned from our own copy of the Club Internacional del Libro 3-volume facsimile edition, Madrid, 1994
• Image from Primeros Memoriales scanned from our own copy of the Facsimile Edition, University of Oklahoma Press, Norman, Oklahoma, 1993.

Aztec limerick no. 37: ode to needles:-
If an Aztec had a joint much inflamed
Excess fluid was speedily blamed;
With a needle t’was lanced
- A technique quite advanced,
Arthrocentesis today it is named.