Abstract. − Among the Miskitu people of eastern Nicaragua, illness and other afflictions are often said to be caused either by a spirit directly or through sorcery where a sorcerer is said to have “worked” with one or more spirits. Local healers make this distinction by examining the symptoms of the afflicted and by using various divinatory techniques. To diagnose an illness as caused by sorcery may, however, lead to interpersonal conflicts, revenge, and physical violence directed at both the supposed sorcerer and the healer. By presenting narratives about healing, suffering, and spiritual beings, I explore how afflictions by spirits are understood and dealt with, and examine how the healers handle the consequences of a sorcery diagnosis. [Nicaragua, Miskitu, spiritual afflictions, sorcery, healing]