Using the example of the Wõthïhã of the Manapiare River Valley, Amazonas State, Venezuela, I challenge the image of the indigenous Amazonian as an expert in herbalism. I argue that the observed absence of medicinal plant use in early Wõthïhã ethnography, rather than reflecting researcher oversight, reflects the centrality of shamanism. According to Wõthïhã shamanic cosmology, herbal medicines, while useful to relieve symptoms and treat minor injuries, fail to address the underlying cause of illness. Using a combination of quantitative and qualitative methods, I find that as the role and influence of shamanism have dramatically decreased, the Wõthïhã have turned elsewhere for medical treatment. Biomedical remedies have shown to be effective, thereby encouraging an acceptance of symptom-specific treatments. Biomedicine’s patchy availability, however, has encouraged the Wõthïhã to look beyond biomedicine. Several folk healing traditions are being incorporated by the Wõthïhã, each with its own herbal tradition.