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Medicine and Politics in Colonial Peru

Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms

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    Medicine and Politics in Colonial Peru
    Book Description:

    By the end of the eighteenth century, Peru had witnessed the decline of its once-thriving silver industry, and it had barely begun to recover from massive population losses due to smallpox and other diseases. At the time, it was widely believed that economic salvation was contingent upon increasing the labor force and maintaining as many healthy workers as possible. InMedicine and Politics in Colonial Peru,Adam Warren presents a groundbreaking study of the primacy placed on medical care to generate population growth during this era.

    The Bourbon reforms of the eighteenth century shaped many of the political, economic, and social interests of Spain and its colonies. In Peru, local elites saw the reforms as an opportunity to positively transform society and its conceptions of medicine and medical institutions in the name of the Crown. Creole physicians in particular, took advantage of Bourbon reforms to wrest control of medical treatment away from the Catholic Church, establish their own medical expertise, and create a new, secular medical culture. They asserted their new influence by treating smallpox and leprosy, by reforming medical education, and by introducing hygienic routines into local funeral rites, among other practices.

    Later, during the early years of independence, government officials began to usurp the power of physicians and shifted control of medical care back to the church. Creole doctors, without the support of the empire, lost much of their influence, and medical reforms ground to a halt. As Warren's study reveals, despite falling in and out of political favor, Bourbon reforms and creole physicians were instrumental to the founding of modern medicine in Peru, and their influence can still be felt today.

    eISBN: 978-0-8229-7387-4
    Subjects: History, Health Sciences

Table of Contents

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  1. Introduction
    (pp. 1-14)

    In his first major publication, a work of rudimentary demographic analysis, a young doctor in Lima by the name of José Gregorio Paredes undertook a novel task. In 1807, just three years after receiving a medical degree at Lima’s University of San Marcos, Paredes attempted to predict how a promising new medical practice might transform the size and health of the city’s population. He concerned himself specifically with the widespread distribution and application of Edward Jenner’s smallpox vaccine, which had been discovered in England eleven years earlier and had recently been made available to doctors in Peru. Drawing on parish...

  2. 1 Cultures of Healing in Colonial Lima, 1535–1780
    (pp. 15-48)

    The seventeenth-century poet Juan del Valle y Caviedes, in his famous workDiente del Parnaso, expressed doubts about both the benevolence and the competence of doctors in colonial Peru. Caviedes portrayed medicine in Peru under Hapsburg rule as an utter disaster, and he claimed it was particularly ridiculed in the capital, Lima. Moreover, Caviedes attempted to persuade readers that true Christian piety, charity, and concerns about healing did little to inspire doctors or shape the provision of medical care in the colony. In his brilliant, hilarious satire written between 1683 and 1691, Lima’s doctors served as pariah figures who excelled...

  3. 2 Professionalizing Healers and the Bourbon Politics of Reform, 1760–1810
    (pp. 49-77)

    In November 1792, creole doctors, high-ranking members of the Church, government officials, and other prominent residents of Lima inaugurated a facility that they believed would transform the role of medicine in society and improve the health of the colony: an anatomical amphitheater. An inaugural speech by the city’s leading physician, Hipólito Unanue, made evident the degree to which these collaborators on medical reforms saw themselves as heroic, patriotic, enlightened subjects working on the Crown’s behalf. Unanue proclaimed that they advocated a new medical model, one based on the value and transformative potential of medicine as “useful knowledge” and one that...

  4. 3 Creole Medical Authority and Peninsular Vaccination Campaigns, 1802–1810
    (pp. 78-117)

    In 1805, a naval surgeon in the port city of Callao, located several miles west of Lima, became the first person in the colony to carry out a new and revolutionary medical procedure that had originated in England. Trained in medicine and surgery and using materials that had recently arrived on a merchant ship from Buenos Aires via Chile, Pedro Belomo successfully transferred smallpox vaccine fluid into the arm of a young boy named Cecilio Cortez.¹ In subsequent years, Belomo’s introduction of the vaccine into the body of a colonial subject would be heralded as a tremendous achievement, as a...

  5. 4 Conquering the Biblical Curse, 1804–1815
    (pp. 118-156)

    On February 7, 1807, chaos erupted in Lima’s centuries-old refuge for lepers, the Hospital of San Lázaro on the north side of the Rímac River. Although archival information on the event is scarce, medical documents and testimony from workers and patients suggest that several lepers undergoing treatment in the hospital rioted and abandoned the facility, “directing themselves to the palace of His Excellency in the form of a commotion.” Living amid endless conflict between secular, creole physicians and a lay religious brotherhood ofveinticuatroswho administered the hospital, patients found themselves pushed to rebel by the overseer (veedor), Esteban Ruíz....

  6. 5 Burial Reforms, Piety, and Popular Protest, 1808–1850
    (pp. 157-191)

    In late May 1808, creole doctors, ecclesiastical authorities, and government officials intruded in unprecedented ways into the ritual life and religious practices of Lima’s ethnically and culturally diverse population. They did so to improve health conditions and increase the colony’s population. Citing royal decrees and a growing body of literature on the risks of residing and worshiping in proximity to the decomposing bodies of the dead (up to this point in time, many had been buried inside churches), officials redirected burials to a new public cemetery beyond the city walls. Furthermore, they called for strict laws to ensure that funeral...

  7. 6 Medical Education and the End of Medical Reforms, 1808–1840
    (pp. 192-217)

    Writing a series of narratives in the late 1830s and early 1840s about his time in South America, the Swiss traveler Johann Jakob von Tschudi provided a revealing assessment of Peru’s creole-led medical reform movement two decades after independence. Von Tschudi focused on medical education in particular and on the expertise of Lima’s doctors more generally. In his analysis, he blamed persistent health problems in the republic squarely on an institution physicians had founded in 1808 to assert their dominance over surgeons, improve the healing arts, increase the number of formally trained doctors, and expand the colony’s population: the Colegio...

  8. Conclusion
    (pp. 218-232)

    Despite the ambition Peru’s creole medical elite displayed under Bourbon rule, in the first two decades after independence their campaigns to create healthy colonial subjects failed to translate into projects aimed at reforming citizens. One reason for this failure was that in the early 1820s the government began to treat creole doctors and members of the Church as competing agents of healing. As a result, several government decisions diminished the position of creole doctors as medical modernizers and reformers. Officials saw the Church as more stable than doctors’ institutions because the Church had reliable networks and resources for carrying out...