IV. _Empacho._—This famous Limenian mischief-maker is supposed to lurk concealed under almost every form of chronic or intractable disease, and means, in the most usual acceptation of the word, a preternaturally loaded and torpid condition of the bowels: but, on other occasions, the same word is used to express the casual lodgement, in any part of the digestive passages, of some such matter as the fresh rind of a fig, grape, or date, keeping up local irritation and fever. Thus, at one time, the term empacho signifies a confined and inactive state of the bowels; and, at other times, indigestion of some foreign and adherent substance, frequently giving rise to quite a contrary condition of gastric disorder: the former is called simply empacho; the latter is called empacho pegado,—for the removal of which, a table-spoonful, or two, of the liquid fat of a fowl—the _enjundia de gallina_! is a _popular_ remedy. In a large proportion of cases where this cause of mischief is supposed to exist, it has, in fact, no place or existence except in the mind that conceives the notion of it; and, in itself, the fallacy is harmless so long as it is speculative: but the practice to which it leads is often mischievous, and it is with the latter that the practitioner has most to do. It would, indeed, be a hopeless task for the regular practitioners in Peru to reason a Limenian doctress out of her reveries on the subject of empacho, which, when viewed by her as the exciting cause of disease, assumes a Protean character, and is visible to her imagination in mostly every case of ailment, which she, true to her favourite opinion, offers to cure in her own way. The evil effects of a farrago of nostrums, or untimely and inappropriate medicaments applied by the help of the doctress, the educated physician is often called, but sometimes too late, to correct; and the fatal abuses thus arising have, on various occasions, called forth the public and earnest remonstrances of the highest medical tribunal of the country,—but all to no purpose, the practice being rooted in vulgar favour and prejudice. So universal, indeed, is the credit of the Limeña quacks, or curanderas, of whom La Señora Dorotea is the chief, and so general is the use of the instrument called jeringa, (through the medium of which the principal ingredients of this señora’s materia medica are confidently applied,) that it constitutes an essential and conspicuous article of domestic utility. And the great consideration in which this auxiliary is held, as a _sine quâ non_ in the treatment of empacho, and almost every disease, renders it a topic of never-failing conversation.