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Cebuano Mananambal

In Cebu, located in the Visayas region of the Philippines, a traditional albularyo is called a mananambal and their work of healing is called panambal. Like the general albularyo, mananambals obtain their status through ancestry, apprenticeship/observational practice, or through an epiphany and are generally performed by the elders of the community, regardless of gender. Their practice, or panambal, has a combination of elements from Christianity and sorcery which appear to be opposites since one involves faith healing healing while the other requires Black magic, Witchcraft, etc. The combinations are a reflection of the legacies left from the conversion to Catholicism of the islands from Spanish colonization, since the Indigenous of Cebu had direct contact with the Portuguese explorer Ferdinand Magellan, and on-going Indigenous practices before colonization. The panambals cover natural and supernatural illnesses using a wide range of methods. Two common methods used are herbal medicine and orasyon, healing prayers deriving from a bible equivalency called the librito.

Mananambals treat major and minor ailments. These ailments include but are not limited to: headache, fever, cold, toothache, dengue fever, wounds, Infection, cancer, intellectual impairment, and other illnesses thought to be caused by supernatural creatures. Aside from biological treatments, patients may also come to mananambals to form or break any form of relationships from marriage to friendships. Treatments are dependent on the type of sickness and on the mananambal themselves.

The use of Herbal Remedies

Herbal remedies are conducted in a variety of ways including decoction (tea making), expression (pounding of the plant then applying the extract on affected area), and infusion (infusing plants in water for a certain period of time then applying the result to affected areas). These particular botanical remedies involve extracting the essential parts out of the plant material, and can be transformed into oil, ointment, and other forms of medicine. The Rubbing of Lana is the use of botanic oil from coconut and rubbing it onto affected areas. Plant materials consist of leaves, tree bark, and roots. Herbal extracts can either be consumed or applied to affected area(s).

Plants for herbal medicine are obtained through a panagalap or the search for plants in mountains and forests which then undergo fumigation or palina. Aside from plants, this yearly concoction search also scavengers for potions, candles, oil, and amulets.

Biophytum sensitivum, also known as sensitive plant, is used by some mananambal to treat fatigue.

A plethora of medicinal plants are used in the Cebuano region and as mentioned above, depend on the mananambal and their diagnosis of the illness. Common plants used by mananambals are Mangagaw (Euphoria hirta) for dengue fever, Dapdap (Erythrina variegata) for hemorrhoids, Tuba-Tuba (Jatropha curcas) for arthritis, Noog-noog (Solanum) for hyperacidity, Wachichao (Orthosiphon aristatus) for kidney problems, Sabana/Labana (Soursop) for cancer, and Kipi-kipi for fatigue (Biophytum sensitivum). Kipi-kipi is a plant known around Southeast Asia for its instant sensitivity to touch.

Orayson

Oraysons encompass the Catholic aspect of the panambal. As mentioned above, oraysons are given by the librito which has an unknown origin. There are theories that connect the librito with the Spanish missionaries either before or during colonization because of its Latin texts. This form of treatment can be done through the blessing of a medicinal object given to the patient by prayer or blessing the patients directly. Oraysons can be combined with other treatments.

Other remedies

Botany and prayers can be combined with other remedies. Tayhop is a ritual procedure performed through the combination of the blowing the patient's head gently with prayer. Another ritual procedure that is accompanied with orayson is tutho, the application of saliva on the patient's head.

Supernatural procedures consists of panubay, using supernatural manifestations to diagnose the patient, and pagtamabalsa nasuldan which is the performance of exorcism.

Due to the Philippines' position as a geopolitical gateway to Southeast Asia, medicinal influences from visitors and immigrants to the islands influenced and formed remedies. Certain mananambal methods aligned with their neighboring countries, such as China. One of these shared methods is Cupping therapy, an ancient therapy method using special suction cups on affected areas of the skin.

Cebuano Mananambal in the present

Mananambal practice is on-going into the present. In 1997, the Philippine Government enacted theTraditional and Alternative Medicine Act (TAMA) legalizing Indigenous medicine. Patients that seek help from mananambals are more commonly found in the low-income class and are in isolated communities because of the payment options. Paying the shaman is either not necessary or cheap. It can also be in the form of trade for life-stock and food.

The practice treats illnesses a variety of ways based on its own universal law and natural Law (physical manipulation, herbal remedies, and dietary/life style advice). Manghihilots are either chosen by maestros or master albularyos, or through apprenticeship. Gender is not a limiting factor since they can be any gender. When chosen, their trainings include a pilgrimage to a sacred mountain to perform the oracions, or words enabling the communication with the spirit world or the panawagan. Similar to the albularyo practice, the hilot is a fusion of spiritual and medicinal practices with physical manipulation and the focus of healing the whole body being the main distinctions between the two practices. Illnesses were referred to as pilay and were defined by imbalances in the body which are explained by their enkanto, or unseen entities, elements, and manifestations in the body. This practice shares similarities with India's Ayurveda and Traditional Chinese Medicine.

Traditional Chinese Medicine similarities

The geopolitical position of the Philippines as either being the gateway to either enter or exit Southeast Asia has allowed the exchanging of medical knowledge between immigrants, whether they are colonial predecessors or neighboring countries. The Chinese diaspora (see also: Chinese mestizos) showed one exchange. The trade between China and the Philippines was recorded as early as the eighth century and enhanced in the sixteenth century. The activity of trade during the sixteenth century was especially active because of the Manila-Acapulco Galleons. The methods used by manghihilots is similar to the Chinese acupuncture study of the Yellow Emperor's Body, the idea that the body through fluids of energy known as a yin and yang, in Traditional Chinese Medicine (TCM). Native Filipino medicine uses the four elements (earth, water, fire, and air) to diagnose conditions while TCM views the conditions of the body through the Five Element Theory: fire, earth, wind, metal, water, and wood. Another similarity is the diagnosis of imbalance caused by engkantos, or the unseen entities within the body. For instance, the manghihilot may describe a person who is having trouble breathing air by calling that trouble engkanto sa hangin meaning air entity. This person's actual condition may be asthma according to Western medicine. In TCM, this imbalance may be explained by the imbalance set between yin and yang (the force of yin may be dominating the body and vice versa).   Other similar approaches to diagnosing include herbs (not necessarily accompanied by the blessing of it shown in the Albularyo practice), taking patient history, facial diagnosis, and tongue diagnosis. Current research on the Hilot shows that it is not clear as to whether or not the Chinese medicine had a direct influence on the Hilot or the Hilot had an influence on TCM because it is not clear whether these Hilot methods were a coincidence of similarities or borrowed from Traditional Chinese Medicine since the people coming from Southern China were primarily involved in commerce. It is also not clear which Indigenous practices originated from Ayurveda. It is not known whether these merchants had medical knowledge.

Framework: spiritual and material

Research shows two components in Hilot healing: the spiritual component and the material component.

The spiritual component treats the relationship between the body's attitude and universal energy. In other words, the goal is to bring the body back to harmony. This focuses on inner change. One way this can be achieved is through the Banahaw Devotional Technique. Tracing its origins to the fifteenth century, this technique requires the performance of orasions and sacrificial rituals to influence the body's spirit. The goal of this is to ask for forgiveness from God. Depending where the manghihilot and their patient are located, the popular location to perform this technique is in the active volcano of Mt. Banahaw, located in Luzon. Following the Banahaw Devotional Technique is the Pagpapahalaga, or the Valuing Process in which the goal is to direct inner change to outer change with the use of inner understandings. These inner understandings is presented within the following three modules: mabuti (self-honesty), makabubuti (sincerity), makapagpapabuti (consequential goodness). The Banahaw Devotonal Technique and Valuing Process are treatments for inner conflicts within the body such as stress which causes the imbalance of the four elements.

The physical material component is addressed through four modalities and this time focuses on external forces in order to restore balance between the four elements. The bio-chemical modality promotes chemical component changes through the process of breaking down foods, herbs, vitamins, and minerals. The neuro-electrical modality is the use of electricity, in the form of positive and negative ions, to break down material goods in the body. The goal of the third process, electro-magnetic field (EMF), is to cause a change in the neuro-electric field to restore the normal function of the body's cells. The final modality is the bio-mechanical process which is the modality that has chiropractic similarities. This process focuses and manipulates the interaction of bones, tendons, and muscles to restore their normal functions. The direction of treatment among all four modalities is from material components (outer) to the inner components of the body.

Hilot in the present

The sophistication of the practice has evolved overtime and is still being practiced primarily in rural areas of the Philippines. The challenges of incorporating traditional/alternative medicine into the Philippine national health care system shows the competition against Western medicine because of the stigma of superstition and the lack of scholarly evidence to prove alternative medicine effective. There are organizations advocating for the fusion of both western medicine and alternative medicine out of the Traditional and Alternative Medicine Act (TAMA) passed in 1997 to make healthcare accessible in rural areas. The Philippine Institute of Traditional and Alternative Health Care (PITAHC) is one of the advocacy groups formed from TAMA and one of their objectives is to: "Encourage scientific research on and develop traditional and alternative health care systems that have direct impact on public health care". With this objective, the organization advocates for the continuation and legitimization of hilot. The ancient practice of the hilot has become a debate in public health policy in the Philippines.