The Albularyo
In the rural areas, by tradition and because of chronic economic constraints, the albularyos are the general practitioners, the primary dispensers of health care. As with other healers, there is usually a history of a healer in the family-line, their healing a continuum of a "calling," the power or ability bestowed by a supernatural being, often, attributed to the Holy Spirit. Often lacking in formal education, his skills are based on and honed from hand-me-down practices and lore, with a long period of understudy or apprenticeship with a family elder or a local healer. Years of patience and study bring the healer into a familiarity with the lore, rituals and modalities of diagnosis and healing, the prayers, bulong and orasyon, and the use of herbal medicinal plants. Some acquire an expertise in the art of pulse taking and diagnosis.

Mang Ino, Albularyo: He used to hold weekday clinic hours in a corner of the basement parking area in a market/mall in the San Pablo, Laguna area. His sign translates: Look for Tata Ino if you need a massage for a painful body condition. I also treat fractures, dog bites, diabetes, stones, arthritis, heart problems, and many others. I also sell herbal medicines. Clinic hours are from 9 AM to 4 PM. I can also do housecalls if you pick me up from this basement.

In a country with numerous and diverse ethnic communities, the dissimilarities in healing practices come as no surprise. The albularyos minister to rural communities with animistic and mythological ethos, profoundly differing from region to region. In the southern Tagalog areas, the mythological landscape is populated by dwarfs, nunos, lamang lupas, tikbalangs and kapres - creatures that often complicate the conundrum of pathophysiology.

Consequently, many of the albularyo's diagnostic rituals (tawas, luop) and treatment modalities (tapal, lunas, kudlit, pang-kontra, bulong, orasyon) are affected by the belief in these creatures and to the maladies they cause: na-nuno, na-dwende, na-lamang-lupa.

In the northern mountain ethnic communities, the albularyo may still be the general provider of folkloric health care and the hilot a familiar specialist and treatment modality. But the mythological creatures differ – the kapre and the tikblang are amusing details of the Tagalog imagination, as they perform the "kanyaw," bleeding chickens as its blood drains on the perimeters of homes, to drive away the evil spirits; as pigs pigs are slaughtered in search of the right kind of "liver" that will provide clues to causes of human afflictions. (see: Boni)

But whether in the lowlands or the highlands, what is common to the healers is a fervent religiosity, in the God or spirits guiding them in their healing practices, profusely infused with good doses of prayers, bulongs or orasyons, rituals and/or sacrificial offerings.

Although most are available for daily consultations, some practice their craft only on Tuesdays and Fridays, days of the week coinciding with the feast of the Sto. Niño and the feast of the Black Nazarene, when they believe their healing powers to be at their optimum. (See: MiscellaneousTherapies). 

The Hilot
In the rural areas, a"hilot" ambiguously refers to both the midwife (magpapaanak) and the chiropractic practitioner (manghihilot, masahe).

The Manghihilot
In the alternative context, the hilot is a practitioner (or the practice) of the craft of 'chiropractic' manipulation and massage for the diagnosis and treatment of musculoligamentous and muskuloskeletal ailments. In contrast to its western counterpart, the hilot's chiropractic treatment is low on science, high on esotery. 

Usually, hilot is a specialization, but in isolated rural areas, many of the albularyos have a familiarity in the use of this modality.

Most hilots, however, do not have any formal education or training. Other than a breech birth, in some, that is believed to destine or dispose one to this healing art, most rural hilots achieve their skills through an indigenous hand-me-down education.

The chiropractic skill can be imparted to a few chosen villagers deemed by the medico or 'ermitanya' (high priestess) to possess such potential capabilities. These 'ordained' hilots are not versed in the practice of other forms of alternative therapies and their practice is limited only to bodily complaints amenable to chiropractic manipulations and massage. And while the albularyo's 'hilot' practices are aided by a whole bagful of indigenous tools (tawas, bulong, lunas, 'empowered' coconut oil, etc), the 'ordained' hilot's tools are meager: an amulet, an 'empowered' cane, or a nazarene-garb entrusted by the teacher and used during the healing sessions and a few diagnostic rituals.

Numerous techniques exist, varying by region and folkloric esoteria. Common in the practice of hilot in the rural areas is the practitioner's' attribution of the healing effect to God, that it is through His guidance that they are able to manipulate the spiritual and energy channels, hoping to expel evil spirits that may have invaded the patient's etheric space and may have caused the physical ailments. One ancient technique of massage utilizes symbolic patterns of the cross, crown of thorns, the rosary, and the nailed hands and feet. (Hilot. Ancient Therapy of the Philippines)

A common diagnostic procedure to determine the presence or site of malady or "sala" is the "panghihila." After gently massaging coconut oil over the areas of concern, the "panghihila" is performed using a mirror, a strip of cigarette cellophane paper, or a strip of banana frond. Any of these is passed over the body areas. If the material, instead of being pulled smoothly, sticks to a specific spot, this is presumed to be an area of malady - "sala," strain or muscle pull, and the massage directed to this area. (One massage treatment option is bintusa.) The treatment is usually supplemented with wrappings of medicinal leaves.

A few practitioners achieve an expertise in this healing modality, incorporating it with elements of "science" (meridians, trigger points, reflexology, basic anatomy and physiology), gaining knowledge through self-study, membership in a local group with shared interests or barangay workshops.

Alas, in the unrestricted and unsupervised practice of hilot in the rural areas, there are still many unfortunate outcomes: delayed diagnosis of serious maladies and many occasions of attempting complicated fracture reductions without radiographic imaging resulting in non-union, often life-time, deformities.

Like the albularyo, the hilot 's services are "free-of-charge", fearing that set fees will lessen the hilot's healing powers. abilities. Voluntary donations are usually given and accepted: P10 - 100 or in kind - cigarettes, snacks, etc.

The Magpapaanak
The magpapaanak are more popularly referred to as "hilot," a designation confusingly shared with the 'chiropractic' manghihilot. Not uncommonly, the calling comes from a family-line of hilots, and the training usually gotten from a trained practitioner who was a relative, friend or neighbor. Some become a "hilot" because of a spiritual calling, or a message from a supernatural being that grants the hilot the needed power and skills.

The magpapaanak has more than a basic knowledge in herbal medicinal plants, utilizing them in a variety of prenatal needs and postnatal care (See: Suob). Prenatal care starts about the fifth month, the patient followed up every two weeks or as often as needed to assess the progress and fetal position. Any perceived problem is referred early on.

Although the midwives are required to be certified and register annually at the municipal hall, there is no strict enforcement of certification. Quite often, in impoverished communities, deliveries are performed by friends, neighbors or relatives who have gained experience, confidence and the basic expertise in umbilical cord care, albeit uncertified. Too, they often have the basic knowledge on postpartum care and massage, and the use of medicinal herbs for the ritual of suob.

For a sundry of signs by the infant, like unusual amount of crying or restlessness, not uncommonly attributed to unpleasant entities and spirits. A midwife or local healer might take on the task of "pagbubuhos," a pre-baptismal ritual of water application or immersion performed on some infants while awaiting the sacramental church ritual.

The Medico

Occasionally, an albularyo furthers his training, assimilates and adopts new skills and "expertise," merging folkloric therapies with mainstream medicine, incorporating allopathic treatment modalities like acupuncture, injection medications and prescription pharmaceuticals into his practice. Usually, there is a period of understudy or assistantship with a traditional healer from whom is gleaned the traditional elements that is eventually merged with the alternative.

But, alas, the pharmaceuticals, often as antibiotics and analgesics - even steroids - are empirically utilized by the medicos and dangerously added to the management of complicated maladies, prescribed indiscriminately and dispensed without the usual warnings and precautions as to adverse reactions and side effects.

Unfortunately, the use of prescription-type medicines advised or written by alternative healers with hardly a modicum knowledge of pharmacology, has been increasing. Compounding this, many drug stores or "boticas" especially in the provincial areas ­ even some sari-sari stores! ­ dispense prescription-type pharmaceuticals written or advised by the albularyo.

The Diviners and Procedures
 Alternative medicine is replete with a diverse array of rituals used to divining or diagnosing illnesses and maladies. The regional and ethnic variations are many. In some areas, divining is in the purview of the specialist, who does not treat unless the need is emergent, who refers the treatment to the appropriate specialist. However, most healers, if the cause of the illness is unclear or if the pulse-taking fails to suggest a clear cause, would readily utilize a ritual or indigenous diagnostic procedure: luop, hila, or tawas. The diagnostic paraphernalia varies according to the method or ritual used.

The Mangluluop
The mangluluop is a specialist that determines the cause of an illness through the ritual of luop. This differs from the healing ritual of luop that is used for gastrointestinal complaints caused the inhalation of unpleasant odors (See: Luop),

The ritual paraphernalia consists of the kalanghuga (a kind of freshwater or saltwater shell), salt (to weaken the supernatural spirits), benditang palaspas (piece of blessed palm leaves from Palm Sunday), charcoal made from a coconut shell, a coconut midrib and a tin plate. After sequenced fiery concoction of these elements is made on a tin plate, in consonance with prayers and invocations and performing the sign-of-the-cross thrice over the patient, the kalanghuga is examined. The diagnosis is suggested by its appearance: Roughness, a slight affliction; stickiness, a sprain; a figure or form (hugis-hugis), a displeased environmental spirit; brittleness, a really angered spirit. The treatment is then suggested and the necessary alternative referral made.

After the diagnostic ritual, the shell is powdered, and with this, while praying, a sign-of-the-cross is performed on the patient's forehead, both palms and plantar arches of both feet. Then, the ritual paraphernalia are thrown under the entrance stairs to prevent the evil spirits from reentering the house.

The Manghihila
Panghihila is a diagnostic procedure oft used by the manghihilot. The paraphernalia vary: plain strips of paper, strips of cigarette cellophane covers, mirrors and strips of banana leaves. Prior to the diagnosing procedure, the material may be impregnated or smoothed with coconut oil that might have been empowered with prayers (bulong). Coconut oil is also gently massaged over the affected area. The material is lightly placed on the surface of the area or complaint and pulled some distance, lifted, and replaced again on the adjoining area. If the strip of material sticks to the surface, resisting the pull, this area is assumed to be an area of affliction, usually a pulled muscle or sprain (sala). Therapeutic massage is then performed. Bintusa is an alternative.

The Mangtatawas
Tawas is a popular diagnostic ritual performed by most alternative healers that serves in providing clues as to the nature and cause of the illness. (See: Tawas) Pagtatawas originally derived its name from to its chemical nature - alum, an astringent, crystalline double sulfate of aluminum and potassium - and early on, was used exclusively in the diagnostic ritual.

Today, tawas refers to a diagnostic ritual or procedure, utilizing a variety of materials: candles, eggs, mirrors, plain paper, cigarette rolling-paper, and alum.

Faith Healers
In the hierarchy of Philippine alternative healers, faith healers belong to a separate category of 'specialization.' Their numbers are uncertain. A spiritist group in the Philippines - the Union Espiritista Christiana de Filipinas - has an estimated 10,000 members trained in mediumistic-healing scattered throughout the Philippines

However, the rural landscape is replete with stories of simple folk saved from illness or death becoming healers, practicing in relative anonymity or hesitant burgeoning fame, their renown spreading through the grapevine of the rural faithful.

Some start their healing craft as albularyos, medicos or hilots. Although their healing ways differ, they share in attributing their healing power to a higher being - often, a gift bestowed on them by the Holy Spirit; or, that they are merely healing mediums of the Holy Spirit or the Mother Mary. Many remember a divine encounter, a mystical experience, or in their childhood or early adult life, a spiritual possession or being "entered" by a being that guides them thereafter in a life's journey of healing.

On one end of the spectrum of faith healers, there are those like the albularyos, manghihilots and other healers, their healing rituals replete with ingredients of religiosity, icons, prayers and invocations, using the same divining ways of tawas and luop, diagnosing black elves, evil spirits, possessions and sorcery as causes of maladies, dispensing their fringe concoctions of treatments.

On the other end are the faith healers practicing on the fringe: the psychic healers, healing at the distance; the healers whispering and blowing prayers to the diseased areas; healers anointing the bodies with flowers dipped in coconut oil infused with prayers; healers anointing the diseased areas with their own saliva; healers passing icons or crucifixes over the body.

To this group of healers belong the psychic surgeons, those who perform bare-handed surgery, without the traditional surgical accoutrements. They are but a small number; perhaps, over a hundred, and a mere handful, considered "outstanding."

See: Faith Healers