In the rural areas, after all the treatment modalities - the physician's, the albularyo's, the hilot's, and other healers - have failed, patients and families often resign to the possibility that the illness was caused by a spell ­ na-kulam, na-enkanto, na-nuno or na-asuwang. These various modalities of hexing or spell-casting continue to be prominent in the mythology and rural tenets of health and healthcare.

The treatment modality, considered by some as another form of prayer, is usually in the purview of an albularyo who has specialized in the craft of antidotes and counterspells (pangkontra).

Although "kulam' conjures up images of full moons, howling dogs, needles and rag-dolls, it is, as often, dispensed as "good spells" concocted for an endless variety of mundane concerns.

A book on "Kulam" by Tony Perez is a compendium of such spells, for day-to-day needs: for good fortunes, against bad luck, to improve the appetite, to protect a loved one, to prevent nightmares, to become attractive to someone or to counter bad thoughts. It expounds on the craft with new-age element; 20-minute spells that are prayer-based, meditative, inner-healing, life-force driven with easy ingredient accessibility. Also, it proposes that anyone can learn to practice the craft. 

Set and light up the candle on the dessert bowl and place on the altar. With the black ball pen, write down the name of the person, 44 times on the rose-colored stationery. Cut into 44 length-wise pieces and place in the dessert bowl. Add the 1/4 kilo of bean sprouts and mix with the stationery. Sprinkle 4 tsp of Aji-No-Moto. Sprinkle the red and black peppers around the candle. After 20 minutes, blow out the candle. Repeat nightly until the candle is consumed.