This article contributes to the cross-cultural literature on fright sickness and soul loss with an analysis of cases among Quechua indians (runa) in a rural community in the southern Peruvian Andes. One of the aims of this article is to incorporate an emic understanding of the intersection of the cosmological and social landscapes into discussions of Quechua conceptions of health and illness. It outlines Quechua constructions of body, self, and cosmos that are relevant to explaining the concepts of soul/spirit, interior/exterior, and runa/nonruna that are related to soul loss. The illness suffered by victims of fright sickness embodies the Quechua construction of self and is linked not only to broader sociopolitical realities of Peru but also to cosmological beliefs. The diagnosis of spirit loss and fright in this cultural context reveals a crisis of identity: sufferers represent nonruna, or nonhumans. They succumb to fright or soul loss because of an emic concept of vulnerability that transcends the characteristics of gender and age usually associated with soul loss cross-culturally. Treatments, therefore, involve a reaffirmation of ethnic identity and a reintegration of patients into their families in terms of a culturally specific understanding of identity, community, and cosmos.