The Gray Zones of Medicine: Healers and History in Latin America [1 ed.] 0822946858, 9780822946854

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The Gray Zones of Medicine

The Gray Zones of

MEDI c INE Healers & History in Latin America ——————————————————————— Edited by Diego Armus & pablo F. Gómez

University of pittsburgh press

Published by the University of Pittsburgh Press, Pittsburgh, Pa., 15260 Copyright © 2021, University of Pittsburgh Press All rights reserved Manufactured in the United States of America Printed on acid-free paper 10 9 8 7 6 5 4 3 2 1 Cataloging-in-Publication data is available from the Library of Congress ISBN 13: 978-0-8229-4685-4 ISBN 10: 0-8229-4685-8 cover art: José Guadalupe Posada, El doctor improvisado (México: Antonio Vanegas Arroyo, ca. 1889–1918), 5. M1238, Posada Collection, box 1, folder 5, Cuento. Courtesy of the Department of Special Collections, Stanford University Libraries. cover design: Alex Wolfe

CONTENTS Acknowledgments vii Introduction Diego Armus and Pablo F. Gómez 3 1. Domingo de la Ascensión and the Criollo Healing Culture of the Seventeenth-Century Caribbean Pablo F. Gómez 11 2. The Curing World of María García, an Indigenous Healer in Eighteenth-Century Guatemala Martha Few 26 3. Calundu: A Collective Biography of Spirit Possession in Bahia, 1618–Present James H. Sweet 40 4. Dorotea Salguero and the Gendered Persecution of Unlicensed Healers in Early Republican Peru Adam Warren 55 5. Pai Domingos: Healing Slavery in Nineteenth-Century Bahia, Brazil João José Reis 74 6. Mystic of Medicine, Modern Curandero, and “Médico Improvisado”: Francisco I. Madero and the Practice of Homeopathy in Rural Mexico at the Turn of the Twentieth Century Jethro Hernández Berrones 89

7. Herbs, Roots, Amulets, and Prayers in the Practices of “Saint” Vicente and other Healers in São Paulo in the 1910s Liane Maria Bertucci 108 8. Recognition without a Diploma: The Wanderings of the Healer Indio Rondín in Early Twentieth-Century Colombia Victoria Estrada and Jorge Márquez Valderrama 123 9. The Miraculous Doctor Pun, Chinese Healers, and Their Patients in Lima, 1868–1930 Patricia Palma and José Ragas 138 10. Stepping through a Looking Glass: The Haitian Healer Mauricio Gastón on the Romana Sugar Mill in the Dominican Republic in 1938 Alberto Ortiz Díaz 155 11. Jesús Pueyo: The “Modern Argentine Pasteur” of the 1930s and 1940s Diego Armus 170 12. Doña Hermila Diego: Zapotec Healer, Entrepreneur, Social Activist, Media Star in Modern Mexico Gabriela Soto Laveaga 189 Notes 211 Selected Bibliography 249 List of Contributors 253 Index 255

ACKNOWLEDGMENTS We came up with the idea for this book after a talk Diego Armus gave in Madison, Wisconsin, where he was invited to speak by Pablo Gómez. What followed is par for the course. The support of many people and institutions allowed us to organize an intensely productive workshop where participants were able to discuss drafts of their articles in great detail. The Department of Medical History and Bioethics, the Latin American Caribbean and Iberian Studies Center, and the Anonymous Fund of the College of Letters and Sciences at the University of Wisconsin, Madison, provided financial and administrative support for the event. In addition to the book’s contributors, Sheila Cominsky, Joshua Doyle-Raso, and Natalia Botero Tovar also participated in the workshop and provided valuable feedback on all chapters. The enthusiasm and support of Abby Collier, our editor at the University of Pittsburgh Press, was essential in completing this project. The Department of Medical History and Bioethics at the University of Wisconsin and the Department of History at Swarthmore College have efficiently assisted with editorial work. Two anonymous reviewers bestowed valuable suggestions for improving the final version of this book. We would like to thank all the book contributors for both crafting engaged and engaging narratives about the rich histories of the individuals and groups discussed in their essays as well as for their efforts in completing them amid a global pandemic that has upended all of our lives. Finally, our recognition goes to two medical doctors who are not in the “gray zones of medicine” but who do understand what we are aiming for with this volume: Pablo Gómez would like to express his gratitude to Carolina Sandoval for all of her love and support. Diego Armus thanks Laura Laski, as always, for her warmth and companionship.

The Gray Zones of Medicine

Introduction

Diego Armus and Pablo F. Gómez

Speaking to inquisition officials about his successful practice in Caracas, Venezuela, African health specialist Domingo Congo declared in 1658 that he had been treating patients from all walks of life for years and that the accusations that had brought him to the attention of the Holy Office stemmed from professional jealousy. Congo told the officials that “the doctors of Caracas are my enemies because I heal the sick people they leave as incurable.”1 From the sixteenth century onward, practitioners like Congo, laboring outside or in the margins of the world of licensed medicine, have continued to be key providers of health care for people of all social extractions in Latin America and the Caribbean. In spite, or as a consequence, of these healers’ success, professional, governmental, and ecclesiastical authorities tried to suppress or ignore their practices. The majority of these health practitioners made use of a variety of therapeutic tools, including methods firmly situated outside of normative/legal therapeutics, as well as others that were in a more or less intense dialogue with licensed medicine. We know about them because of the documentary trail they left in legal, ecclesiastical, medical, and journalistic records as a result of their prosecutions or popularity—or through advertisements of their cures in the printed media. These historical actors thrived in a gray space between legality and criminality. This book is about the trajectories of these practitioners, mostly neglected 3

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in historical scholarship, and the fundamental role they had while working in interstitial spaces between official and unofficial medicines in shaping Latin America’s many worlds from colonial times to the present. A 1999 article suggested that scholarship on the history of science and medicine in Latin America appeared ready to “take off.”2 The prediction was just partially right. Although social studies on Latin American science, in general, have been growing in relevance, they are still in quite a preliminary stage two decades later. The situation, however, is different for the studies of health, disease, and medicine, already a vibrant and well-consolidated subfield of historical inquiry.3 Today, monographs, articles, bibliographies, state-of-the-art reviews, edited volumes, and textbooks, as well as panels in conferences and thematic workshops, are recurrent features, frequently in conversation across the Anglo-American, European, and Latin American academic worlds.4 Latin Americanists from many disciplinary backgrounds—historians, medical anthropologists, public health scholars, sociologists, and cultural critics— have been unveiling a domain where health, medicine, healing practices, and disease meanings are contestable, debatable, and subject to controversy. They have recreated, revised, or adjusted questions and problems discussed in other academic milieus. They have also occupied a terrain previously monopolized by traditional historians of medicine, physicians, and antiquarians. Now, diseases and health issues are time and again discussed as slippery, ambiguous, complex entities constructed and framed historically, taking into consideration the individual and the collective as well as the sociocultural and the biological. For the past two decades, scholars working on the history of disease, health, and medicine in Latin America have focused on themes that highlighted epidemiological trends and metaphors associated with specific diseases; the influences of foreign players in the shaping of state health policies; the subtle or undisguised efforts to institute a presumably proper, civilized, and ordered hygienic code that society at large should engage in; and the state and civil society initiatives aimed at disciplining and/or assisting the population, particularly its popular sectors. They also have paid some attention to issues that this book explores, we believe, in great detail: discourses about the exchange of medical knowledge and therapies in the Atlantic world as well as its adjustments in the many Latin American peripheries; the racialization of certain diseases and more in general the relation between maladies and race; the social and political role of creole and mixed-race healers within their communities; the medical practice and the more or less overt state efforts during colonial and republican times aimed at

INTRODUCTION

making diplomate medicine as the only legitimized healing practice; and the illness narratives offered by sick people and health care practitioners. This vibrant historiography can be broadly organized in three approaches that have plenty of overlaps: the new history of medicine, the history of public health, and the sociocultural history of disease and healing.5 Histories of heroic biomedical treatments and biographies of famous doctors are no longer the dominant analytical perspective. Beyond their specific contributions, these somewhat traditional narratives were aimed at reconstructing the “inevitable progress” generated by university certified medicine, to unify the past of an increasingly specialized medical profession, and to emphasize a certain ethos and moral philosophy that is presented as distinctive, unaltered, and emblematic of medical practice throughout time. The renovation of these histories, by contrast, tends to see the history of medicine as a more irregular and faltering process. In dialogue with the history of science and historical demography, it discusses the epidemiological, social, cultural, and political contexts in which certain initiatives, doctors, institutions, and treatments “triumphed,” making a place for themselves in history as well as for those who failed and have been forgotten.6 The history of public health emphasizes political dimensions: looking at power, the state, the medical profession, the politics of health, and the impact of public health interventions on mortality and morbidity trends. To a large extent, this is a history focused on the relations between health institutions and economic, social, and political structures. Practitioners of the history of public health, at least some, research the past in order to reduce the inevitable uncertainties that mark every decision-making process, thereby facilitating (in general rather than in specific ways) potential interventions in the contemporary public health arena.7 The sociocultural history of disease and healing emphasizes the complexity of both illnesses and health as concepts, and not only as problems in themselves but also as tools for discussing other topics. This scholarship’s focus has been applied to a wide array of subject matters, including the sociopolitical dimensions of particular diseases; the increasing medicalization of modern societies; the cultural uses and representations of diseases and illnesses; the class, race, gender and age dimensions of diseases; the place certain diseases had in the making of nationhood ideals as well as in the many Latin American modernities; the responses of ordinary people vis-à-vis taking care of their own health; and finally, the ways different historical times, social groups, or even individuals have defined for themselves the etiology, transmission, appropriate therapy, and meaning of

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a given disease, definitions that reflect not only changing medical technologies and knowledge but also broader influences, including religious beliefs, gender obligations, nationality, ethnicity, class, politics, and state responsibilities.8 These three lines of inquiry undoubtedly reflect an effort to move away from the limitations of yesteryear histories of medicine. All of them take medicine to be an uncertain and contested terrain, where the biomedical is shaped as much by human subjectivity as by objective facts. They also discuss disease and illness as problems that have not only a biological dimension but also social, cultural, political, and economic connotations. The rapid expansion and increased sophistication of this historiography keeps unveiling new issues that motivate novel interpretative perspectives. This volume is intentionally designed to address at least two of these emerging issues. First, it aims to provide a reading of medicalization as a historical process, giving relevance to the many uncertainties and limitations not present when such a process was becoming consolidated. This recognition allows for the understanding of official medicine and later biomedicine as historically located processes whose seeming social and cultural dominance was never preordained, or inevitable, nor was it ever complete. Second, The Gray Zones of Medicine emphasizes the unrelenting resilience of health care providers offering services on the fringes of official medicine, often as hybrid practitioners using very diverse medical traditions, such as healers, herbalists, bonesetters, midwives, and many others—from colonial times to the present. It highlights their existence not only in the centuries when medicalization was just emerging and marginal, as in the case of seventeenth-century Cuban healer Domingo de la Ascención (chapter one), but also in modern societies when biomedicine and medicalization became hegemonic, for instance, in the Argentina of Jesús Pueyo during the 1940s (chapter eleven). The examples of María García in eighteenth-century Guatemala, Dorotea Salguero in nineteenth-century Peru, and Hermilia Diego in twenty-first-century Mexico (discussed in chapters two, four, and twelve, respectively) reveal the persistent presence of health practitioners laboring outside or in the margins of the world of licensed medicine, providing health care for people of all social extractions in Latin America and the Caribbean. In spite of having being separated by three centuries and working in very different social and cultural settings, readers will also recognize similarities between the strategies used by practitioners in early modern times—like de la Ascención and those like Mauricio Gastón, a Haitian health practitioner very active in the Dominican Republic

INTRODUCTION

in the 1930s—when biomedicine was already well established (chapter ten). The case of the Indio Rondín, both a healer and a licensed physician in early twentieth century Colombia (chapter eight), underscores the importance of recognizing the existence of licensed doctors and popular health practitioners who do not conform to the crystallized dichotomy of the legal and illegal medical practices. Plenty of health care practitioners—more than what the existent scholarship has suggested so far—have been walking loosely over the realms of many medicines, combining resources and approaches, and, even more importantly, relating to and being perceived by the sick as primary and powerful sources to deal with their illnesses.9 In other words, with The Gray Zones of Medicine, we want to signal the limits of analytical categories that box in health practitioners and their systems of knowledge about the human body within well-identified or so-called traditional medical systems (Amerindian, African, European, Asian, or a mixture of them) that can be contrasted with so-called Western medicine (in itself another problematic label) or biomedicine. Moreover, the term “medicine” itself can be problematic if understood as a referent to Western medical practices. In this volume, for lack of a better word (one that does not require the creation of yet another composite of neologisms), we are using the term medicine as encompassing of healing and sanitary practices that go far beyond those of allopathic medicine and biomedicine. For the past five centuries none of these medical traditions and cultures have been static. The historical actors and societies examined in this volume were involved in vibrant and constant processes of knowledge and technological exchange as well as reimagination of their medical cultures. The dynamics and intensity of these exchanges diverged significantly across the vast geography and historical scenarios of Latin America. This is because the realm of what constitutes healing cultures encompasses all aspects of life, in addition to a multitude of historical actors. As a consequence, it is not enough to study processes of exchange by focusing only on encounters between health practitioners. Instead, it is imperative to study the interactions between health care givers and the sick, as well as the sociocultural dynamics in the communities in which medical practices ensue. All of these have influenced how the people living in Latin America have been thinking of and experiencing disease and health. This is clear in the cases of Chinese healers in late nineteenth century Lima (chapter nine), the homeopath Francisco Madero, later president of Mexico in the early 1910s (chapter six), and the bacteriologist Jesús Pueyo and his antituberculosis

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vaccine in mid-twentieth-century Argentina (chapter eleven), all very illustrative of how dense and situated those encounters have been. Making things more complicated, the available historical evidence reveals how both the sick and health care providers easily switched to or practiced different medical traditions. This was true for elite European physicians practicing in colonial times in Latin America, for non-elite creole healers of mixed ethnic backgrounds in early Latin America, and for Western-trained nineteenth- and twentieth-century Latin American physicians. Uncertainties about the best sets of treatments and the lack of effective therapies have fueled these types of code-switching historically. And the arrival of biomedicine, with its paradigms, practices, experts, and institutions, did not put an end to these patterns. The persistence of a variety of medical traditions in Latin America during the twentieth and twenty-first centuries, as exemplified in the essays in this volume, indicates that biomedically defined effectiveness is not enough to dismiss the relevance and endurance of the gray zones of medicine. This volume departs from recognition of the enormous benefits that biomedicine and modern public health interventions have brought to the region. But because health matters encompass such a large number of fundamental issues related to human existence and the imagination of lifeworlds, it is not surprising that people continue to look for therapeutics that go beyond those defined by modern Euro-American scientific tenets. A veritable cornucopia of terms already exists to categorize and somehow congeal in recognizable ways, the result of encounters, conflicts, and exchanges among diverse medical cultures. Plenty of concepts “compete for survival” in a sort of “jungle” that keeps on adding new nuances and emphasis: hybridity, acculturation, syncretism, fusion, cross-fertilization, appropriation, crystallization, mestizaje (as mixing), and many others.10 The benefits and shortcomings of each one of these concepts is no doubt a matter of debate. For the purposes of this volume, we want to emphasize that regardless of the terminology, the trajectories of the health care practitioners discussed in the following chapters resist easy categorization. None of these terms—for different reasons but broadly because they still depend on the identification of artificial departing points for thinking about the resultant admixture—does justice to the types of dynamics present in the gray zones of medicine. They all remain analytical constructs with which most of the historical actors examined in this volume might or might not identify themselves. An additional complication emerges from the fact that the terms scholars

INTRODUCTION

have used to describe, depict, or qualify the historical actors and their activities examined in this volume—curador popular, curandero, sanador, charlatán, médico, científico—have varied enormously over the past five centuries and across the region’s vast geography, one that is full of idiosyncratic ways of speaking. Translations into English of the part- or full-time occupations or professions to which these terms refer are quite unsatisfactory and do not completely capture their localized meanings. This is why, and in an intentionally imprecise and loose way, the essays included in The Gray Zones of Medicine talk about their protagonists as healers, health specialists, or health practitioners, depending on specific historical circumstances. We do not think about the health care practices depicted here as examples of a medley of seemingly stable medical systems, such as Galenic/Hippocratic, European, Congolese, or Nahuatl. These perspectives, as a number of scholars in multiple fields have argued, are the legacy of colonial, legal, professional, and even historiographical analytical frameworks. Intentionally or not, they ultimately emphasized social and cultural segregations and dichotomies. It is our contention that they are not apposite for examining the fluid and rich realm of healing practices in Latin America and, for that matter, of many other regions of the world.11 Something similar can be said about the classical periodization of Latin American histories in colonial, republican, and modern stages, or in preand post-bacteriological times in the history of medicine. Although to a certain degree inevitable to organize a narrative of the past, these labels, categories, and periodizations are similarly insufficient to fully capture the experiences of both health care givers and the sick who populate the essays included in this book. The chapters that follow unveil healing trajectories that are located yet unbounded constellations of material, performative, and rhetorical practices. In these unstable territories, health care givers—along with their communities—adapted and confronted the ever-changing challenges of individual and collective healing, as in the case of the resilient Afro-Brazilian complex of ritual and healing practices called Calundu (chapter three). These healers—as well as the other practitioners portrayed in this book— displayed health care practices situated in and out of formally defined corpora of knowledge, in realms that by necessity were porous, in flux, and with elastic borders. That is why we intentionally opted for the somewhat vague expression of “gray zones.” More largely, this book aims to reveal the possibilities and limitations of writing history of medicine, health, and diseases through biographical accounts. It challenges dominant historiographies of medicine and science that have by

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and large reserved biographies as a way to examine the lives of those who can fit well within tightly defined intellectual and professional histories of official medicine. Here we examine cases like that of nineteenth-century Bahian Babalawo Domingos Sodres, an enslaved African who turned financial entrepreneur through the capital accumulated with his healing practices (chapter five), or that of Saint Vicente and other herbalists working in early twentieth-century Sao Paulo (chapter seven). Like the other chapters, these essays offer rich stories illustrative of the persistent presence of health care givers in Latin American historical scenarios. These women and men, while located on the margins or outside of official medicine, have competed, complemented, adjusted, or dialogued with licensed physicians, surgeons, public health officials, and medical institutions in a variety of temporal, cultural, and social spaces. In other words, these health practitioners are not discussed in isolation and are certainly not exoticized. Instead they are contextualized, engaging them fully with the complexities of their times and places. In sum, in this volume we want to make evident how histories of healing not defined within the narratives of hegemonic biomedical knowledge, careers of successful doctors, public health initiatives, and research and medical institutions can provide a unique window to uncover larger social, cultural, political, and economic historical changes and continuities in Latin America. The biographies of the health care practitioners discussed in The Gray Zones of Medicine unveil fragments of the history of health and disease in the region, from Mexico to Buenos Aires and from Rio de Janeiro to Bogotá, that are only legible outside of the binary frameworks of legality/illegality, learned/popular, modern/traditional, or of orthodoxy/heterodoxy. The history of these healers highlights the power of biographical narratives to illuminate intricacies and resilient features of the history of health and disease throughout five centuries. They are linked by the gray interstitial spaces in which they ensued as well as by the entangled ways in which these health practitioners related to and shaped the particular historical settings in which they lived.

{1} Domingo de la Ascensión and the Criollo Healing Culture of the Seventeenth-Century Caribbean

Pablo F. Gómez

On November 24, 1664, Domingo de la Ascención’s life was irredeemably shattered. In a fateful moment, his existence was swallowed whole by the machinery of empire and Spanish colonial bureaucracy, a realm from which Domingo would never emerge again. Early in the morning that day, he was captured by inquisition officials in San José del Cayo, Cuba. Domingo probably had already heard rumors for weeks about his imminent capture, but, bound by the constraints of his precarious existence and as he himself expressed, feeling protected by a community he had served for decades, Domingo did not flee into hiding in the forest around San José that he knew so well. After all, he was one of the prominent healers in the region surrounding San José. Like many members of his community, Domingo was also an enslaved person.1 Paradoxically it is because of the tragedy that befell Domingo that morning that we know of his existence. After spending almost three months in jail in Havana, Spanish crown officials embarked Domingo in a patache bound for the city of Cartagena de Indias in February 1665 to answer to accusations that he was a “sorcerer.” Upon his arrival, Domingo was transferred to the feared jail of the Holy Office (one of only three in the Americas). The specific set of circumstances that determined Domingo’s fate are unknown. It is obvious, however, that at least part of the community that Domingo had been serving for the past 11

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twenty years or so had turned against him. As a healer, he was a crucial resource for the rural communities around San José. But Domingo had also developed a reputation as someone with enormous power for healing bodies and manipulating the natural world and threats to the region’s social fabric. The power that allowed him to heal also made him a menace to the established social and intellectual hierarchies (including that of licensed medicinal practice). Before he was arrested, thirty witnesses, prominently among them Domingo’s master, had sent secret denunciations and testimonies to Cartagena where inquisitors decided to issue an arrest warrant and a deportation order from Cuba to the New Kingdom of Granada to face trial.2 Through the life and practices of Domingo, we can examine several themes crucial for the study of the cultures of healing and diseasing in the seventeenth-century Caribbean, and indeed, most of the South Atlantic and early Latin America. Domingo’s practices were not exceptional, even if knowing the particularities of his case is. After all, practitioners of African descent like Domingo dominated the marketplace of healing and diseasing in the Caribbean throughout the seventeenth century.3 No other extant record from the seventeenth-century Caribbean, however, so vividly portrays the number and types of therapeutic cases administered by a Caribbean healer who was neither a physician nor a surgeon. With notable exceptions, most histories of colonial medicine have focused on the practices of licensed physicians, surgeons, apothecaries, and popular healers living in urban spaces in cities like Lima or Mexico City. 4 And yet, a large number of the population in colonial Latin American spaces, the majority in the Caribbean, lived in rural settlements with little to no access to the learned Galenic/Hippocratic practitioners and the colonial institutions that appeared in the region from the sixteenth century (including hospitals that in most cases were no more than a couple of dilapidated rooms under the care of a cleric).5 In these rural locales, it was left to practitioners like Domingo de la Ascención to tend to the needs of a population that was largely of African descent. Most of these Black Caribeños were criollos/creoles (born in the Americas), and their families had lived in the region for decades after their arrival from Africa. Many also had Amerindian or European ancestry, and most communities (certainly those in the northern New Kingdom of Granada—today Colombia—Panama, and Cuba) were in close contact with maroon communities made of people of African descent as well as Amerindians and even Europeans.6 The history of health practices in the early modern Caribbean, thus, is best understood through the practices and lives of people like Domingo de la

DOMINGO DE LA ASCENSIÓN & CR IOLLO HEA LING CULTUR E

Ascención. Their history, in part because of the prevalence of disease and death as the main demographic, social, and cultural shapers of the Caribbean, also opens up a window into a world that is difficult to categorize—one in which social hierarchies, fears, wonder, respect, and suffering—travel unexpected routes grounded on a materiality that is not evident in traditional evaluations of institutional and learned medical histories of Latin America.7 CA R IBBEA N MIGR ATIONS A ND PEOPLES

Domingo de la Ascención was born in Cuba sometime around 1640. Very little is known about his family except that, in Domingo’s words, “his parents and grandparents” were from “Guinea.”8 By the time Domingo was born, the Spanish Caribbean had been the recipient of the majority of kidnapped Africans that had arrived in the New World until then.9 Captive Africans forcedly came to the region to work in gold and silver mines in New Spain, Peru, the New Kingdom of Granada, and copper mines in eastern Cuba. Most Africans coming to the New World and to the seventeenth-century Caribbean arrived from West Central Africa. Domingo’s ancestors, on the other hand, were more likely part of the “West African wave” that brought immigrants from the Senegambia and Bight of Benin regions to the Caribbean during the early seventeenth century.10 He grew up around San José del Cayo (see figure 1), and his master purchased him sometime around 1650.11 Like most healers in the Caribbean countryside, Domingo worked as an agricultural laborer. His master had a small farm that provided food staples—pork meat and cultigens—for the city of Havana and Santiago.12 Most of the people living in these rural spaces lived out of subsistence agricultural practices. This was not, it has to be underscored, the Cuba of the plantation world of the eighteenth and nineteenth centuries. At the time, Havana functioned as a crucial strategic commercial and military outpost of the Spanish empire and it was the last stop and rendezvous place for the Galleon fleet on its way back to Europe. Most of the economy of the island was geared toward the provisioning of the fleet and military garrisons located in Cuba.13 Spain’s hold in most of the Caribbean lands was, however, tenuous. Smuggling was rampant, and the vibrant network of peasant villages that dominated life east of Havana and in eastern Cuba, and where Domingo lived, were in constant contact with English, Dutch, and French interlopers in an era of increased imperial competition for resources in the Caribbean.14 Domingo lived at a time of profound transformations in the region. By the

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Figure 1.1. San José del Cayo region around 1650. Archivo General de Indias, Seville, Spain, Mapas y Planos, Santo Domingo 82.

DOMINGO DE LA ASCENSIÓN & CR IOLLO HEA LING CULTUR E

time of his capture, most people of African descent were creoles and free either in the largest urban settlements of the region—Cartagena de Indias, Havana, Veracruz, and San Juan—or in a constellation of free Black towns, haciendas, and villages in the countryside of Cuba, the northern New Kingdom of Granada, Panama, New Andalucia, Hispaniola, or Puerto Rico.15 Even though he was an enslaved person, Domingo was relatively free to roam the forest and towns around San José del Cayo. He declared to inquisitors that he “grew up in the countryside and learned how to cure through different trips into the forest.”16 Records show that Domingo traveled constantly around the countryside of eastern Cuba, healing patients on his own, as happened when his master sent him “to look for a certain person” and ordered him not to spend more than eight days in the place. After one return, Domingo’s master reprimanded him because he had “stayed thirteen days,” to which Domingo answered that “he had stopped to examine a very sick person.”17 Like many enslaved people in the Spanish Caribbean, when not assigned to specific labor on their farms, Domingo was free to practice his own “oficio” (craft). In urban spaces they would provide food and other activities related to the service economy of the region, or if they had the training, they worked as specialized artisans, such as masons, carpenters, blacksmiths, apothecaries, or, as in the case of Domingo, health practitioners. Masters would rent their slaves, including healers, for contracted work in their specialties. At the same time, and more frequently, enslaved health practitioners were free to develop their own clientele and would pay their master either a determined monetary amount every week or a percentage of their gains.18 Many saved enough to pay for their manumission, and, in many cases, buy slaves themselves; owning and renting slaves was a matter not only of social standing but also of economic mobility.19 Slavery was, in other words, a very intimate affair, especially in the case of enslaved healers who were often the main health providers for their masters and their families (as in the case of Domingo). A PLACE OF CA LENTUR AS, APOSTEM AS, A ND WOUNDS

Through Domingo’s history, we can learn about the main health concerns preoccupying seventeenth-century Caribbean folk. When he first appeared in front of inquisitors in August 25, 1665, Domingo was asked “if he knew the cause of his imprisonment.” He said that “for eighteen years, he had cured people of the etico disease [consumption] and of colds with herbs” and that he was “knowledgable of the natural remedies.”20 Like many early modern healers, Domingo

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had specialized in a specific set of ailments. The fact that Domingo became a specialist in the treatment of colds, fevers, and consumptive diseases points out that these were some of the most common ailments in Cuba at the time. Domingo also said that in addition to these illnesses, during the past two decades he had healed dozens of people of “wounds, and buboes.”21 As was the case with respiratory diseases, buboes (masses originating from skin tumors, abscesses [“apostemas”], and eruptive skin diseases such as smallpox, measles, typhus, and plague) were also prevalent in seventeenth-century Caribbean locales—places that, as indicated above, were in constant contact with visitors and the microbes they carried with them and in their boats from all over the Atlantic region. Wounds incurred during military confrontations (as a result of both interimperial conflict, and during infighting between different local groups within the Caribbean, including between European, Black maroons, and Amerindian polities), personal conflict, family violence, and those resulting from work-related accidents, were also the norm in the Caribbean. Moreover, bodily violence was a fundamental component of slave-master relationships and punishments not only through lashing but also through other forms of pain infliction (like punctures, finger amputations, and burns, among others) and formed the basis of slavery disciplinary regimes. Bodily injury, torture, and pain elicitation were also central to judicial and inquisitorial structures and sentencing. In addition to these (more recognizable to modern eyes) afflictions, Domingo was also a specialist in the treatment of other types of bodily problems. In his first appearance in front of inquisition officers, Domingo said that he had effectively treated “more than fifty people of the evil eye.” Witnesses in his trial also recognized Domingo as a specialist in the identification of “males de yerbas” (poisoning, or spells).22 Seventeenth-century Caribbean people conceived of what we consider to be the natural world as one populated by numinous entities and energies that had direct and visible effects on their corporeality. Personal and communal grievances were often settled through the channeling of invisible spiritual energies which, even if imperceptible to the untrained eye, had identifiable symptoms and corporeal signs, and could be transmitted through inanimate (if possessed) objects. Poisoning, indeed, was not only related to the effects of nefarious physical substances but also to the spiritual effects of a variety of material elements. In the Caribbean, as in Europe, a vibrant world of healers using spiritual therapeutics was sanctioned by the Church and professional organizations.23 In Spain, for example, saludadores, ensalmadores (those who cured by reciting

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ensalmos—incantations or prayers), and santiguadores (those who cured by making the sign of the cross) practiced in the open. Church and governmental officials, including regulatory boards like the protomedicato, tolerated these health practitioners. Physicians and ecclesiastical authorities normalized the therapeutic power of saludadores by explaining that their cures worked based on the individual balances of their four humors as given to them at birth by a divine creator.24 Thus, even though contemporary Europeans in both the Old World and the Americas also depended on spiritual therapeutics including those performed by priests and missionaries, their toleration did not extend to most unlicensed healers, especially those of non-European descent. In the Americas, colonial authorities labeled ritual healing practices of communities of Amerindian and African descent as demonic. 25 Paradoxically, Caribbean people of European descent thought of practitioners like Domingo as not only suspect of being the originators of males de yerbas but also as particularly suited for their treatment and prevention. A TROVE OF CUR ES

Domingo’s clientele was cosmopolitan and included people who had either grown up in different Cuban locales or arrived from Europe and other Caribbean spaces. His patients also came from a variety of places in West Africa and West Central Africa.26 This assortment or people came with an equally diverse number of beliefs about the origins of disease and healing. Domingo’s practices, unsurprisingly, were equally incorporative and variegated. When inquisitors asked Domingo who had taught him how to heal, he said that “he did not have any teacher.” Instead, he said he had learned from experience. There was a reservoir of knowledge in the Caribbean hinterland from which Domingo tapped for the crafting of his own therapeutic armamentarium. He said that he had heard “his master and other personas” talking about the utility of several botanical elements for different diseases. It was, in all likelihood, from his interactions with the community around el Cayo that he learned that the herb rodo de alacran was helpful “for healing wounds,” that “guayacan water” was an effective cure for buboes and colds, and that chamomile provided alleviation for a variety of “calentures” (fevers).27 Domingo also said he knew about the preparations involved in “specific cures he mentioned,” because a Black woman named Catalina de Orense, a healer herself, “had told him” about the herbs and had instructed him about how “a plaster of cassa de tostada was a good

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remedy” for some spell-caused diseases.28 He also used plaster preparations to treat patients suffering from bone fractures and knife wounds.29 The history of Domingo’s healing practices and his materia medica also bring to the fore the everyday sexual violence permeating the world of slavery. Domingo had fame as a master in the preparation of abortifacients, such as the herb he administered to an enslaved person whose “master had gotten her pregnant.” Following an expertise developed through trial and error—and mostly drawing from the knowledge of women and midwives around eastern Cuba—Domingo advised the woman that the unnamed herb “needed to be taken at noon for it to have an effect.” In his prescriptions, Domingo specified not only when the herbs had to be administered but also when they needed to be collected. Regarding one of the herbs in question, also unnamed in the record, Domingo said that it needed “to be picked at noon to be effective.”30 He also insisted that for the herb cayaya to have effect, it should be picked at midnight. Here Domingo was referring to another powerful and common trope of early modern medical practices. That he referred to specific times and dates for the administration of his treatments speaks to his knowledge of widely disseminated beliefs in the importance of cosmological/astrological calculations for administration and preparation of remedies,31 that is, to the importance of celestial/astrological factors as a determinant of both bodily conditions and the properties of medicines themselves. Ideas about the influence of the celestial sphere on earthly body conditions were common not only in Europe but also in American locales, even before the arrival of modern Europeans.32 This is another instance where the labeling of the origins of a practice (as European, for instance) would confound its multiple roots. The exchange of knowledge about healing procedures was the norm rather than the exception for early modern Caribbean health practitioners.33 And these interactions transcended social and ethnic lines of all classes. Domingo de la Ascención told inquisitors that his own master’s wife, Marcia Romero, had “asked him many times about whether she could offer to her son and daughters and her slaves” some of the herbs and roots with which he cured. Domingo eventually provided Marcia with the herbs and roots and told her to make “a stew” that she should apply over the afflicted part of the sick person’s body.34 For the treatments of “internal diseases,” those without visible external manifestations, such as skin eruptions or tumors, Domingo most commonly used different kinds of purges and other beverages.35 For instance, in 1650 when treating the daughter of one Andres Barbosa, who had fallen ill after eating a coconut and drinking its “foul water,” Domingo used a “piece of cloth, soaked

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in warm water,” which he used to wash the sick woman, and a purgative that looked like “white water” that he had prepared with herbs and dissolved flour. After drinking the concoction, the sick person vomited and developed diarrhea, “purging” in this way the offending matter causing the disease.36 Domingo used similar methods for treating and diagnosing Juana, an enslaved woman working for María de las Nieves. Domingo first gave the enslaved woman “some herbs” and proceeded to place his hands on the part of her body “where the pain was present” and “sucked” it to identify the cause of Juana’s illness. To end the diagnostic procedure, he wrapped the affected body part “with a piece of fabric of satin that contained the herbs.” Domingo then declared that Juana’s disease “was caused by cold.” He treated Juana with “some powders . . . while wiggling his head” and gave her “a purge” prepared from kernels and wine. Juana’s vomit and feces physically evidenced the effectiveness of the procedure.37 In another case, Domingo made use of diluted wine as an enema for his purges.38 All these were mainstay procedures of early modern European medicinal practices. Among the ingredients of Domingo’s medicinal preparations were pieces of “unicorn” horn (most likely deer antler), which he used for cases of yerbas (sorcery) and poisoning and a variety of ailments without an evident external causing agent.39 He did so when curing Luisa, a Black enslaved woman from El Cayo. Domingo diagnosed Luisa as suffering from yerbas and said “that another black had done evil to her.” For the cure, he prepared a beverage with unicorn horn and “a little bit of water.” The use of “unicorn” horn might seem as fanciful to modern eyes. But unicorn, as well as elements such as “dragon’s blood,” purges, and enemas were essential parts of the pharmacopeias of early modern learned European physicians and apothecaries, and figured prominently in their medical treatises. By and large, early modern European therapeutic elements were not based on any sort of identifiable biomedical pharmaceutics. Indeed, the use of unicorn horn was widespread not only in learned medical practices but also in popular medical manuals circulating in Europe and the Americas, and it is highly likely that Domingo learned about these treatments from practitioners or patients living around San José. In addition, in his inquisition trial, Domingo referred several times to the “cold” or “hot” nature of the diseases he was treating, as in the case of Juana. For the treatment of these ailments, Domingo used medicines that would be indicated (given their specific “qualities”) to counter the nature of the disease under treatment according to contemporary understandings of Galenic/Hippocratic humoral theories.40 Domingo, a specialist in the treatment of fevers, rubbed his patients’ arms

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and armpits with the herb culantrillo when they had calenturas or gave his clients beverages made out of chamomile and an herb called cayaya (which he also placed on his patients’ bellies).41 Cayaya is one of the hundreds of botanical elements of Amerindian origin that made it into the pharmacopeia of Caribbean health practitioners that did not appear in the vaunted histories of medicines such as Cinchona bark. None of these botanicals, products of the exchange of knowledge about healing plants between Amerindians and people of African descent, made it to European compilations of materia medica. Among them were unidentified plants like Anamú, Ariajua, Beuvera, Cañoco, Capitana, Carara, Carcoma, Cayaya, De Santa Maria, Escobilla, Grango, Guano, Orejon, Patailla, Pullon, Rodo de Alacran, Rompesera, and Tuatua that appear only in inquisition records after being specifically mentioned by Black practitioners in their trials.42 Others, like the herb limpiadientes, are briefly mentioned in manuscripts by European physicians like Juan Mendez Nieto at the end of the sixteenth century. 43 In addition to these herbs, hundreds of bodily procedures, therapeutic elements, tools, and curative rites that Black ritual practitioners used in Caribbean lands—and which were among the most common therapeutic practices across the region throughout the seventeenth century—also never made it to European medical literature.44 They were, if you will, never translated into the languages and epistemes of the West.45 Domingo commonly used Christian prayers and signs when healing his patients, especially when he thought that the disease involved the sort of “spiritual poison” that was common to bodily afflictions related to spells. For instance, he healed a woman with “dysentery by giving her a preparation” that he put on the woman’s belly “in a cloth with some herbs [while] making crosses.”46 He also used prayers for the treatment of “evil eye.” This affliction was particularly dangerous for young children, and he diagnosed it on the basis of “what the parents of the children told him” and by paying close attention to the characteristics of “enemies [the parents] might had.” For treating children sick with the disease, Domingo “loomed over the creatures and blessed them from the forehead to the navel” while saying, “Where I put my hands, I heal the wounds by the grace of the Holy Cross.” While crossing the children, Domingo also said, “Where I make the signal of the cross, [may] the virgin put her hands, God’s angel (sic), and where I put my hand, the virgin does [as well]. May God heal you.”47 By the 1660s, Christian rites had already been incorporated as part of syncretic traditions in a variety of South Atlantic religious systems, most prominently in West Central Africa. The kingdom of Kongo, for instance, had been by then at least nominally Christian since the sixteenth century.48 Belief of “evil eye” was also widespread

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throughout the Atlantic. Thus, it would be a mistake to think that these rites only summoned European religious traditions. Domingo also made use of other practices in order to bolster his authority over bodily matters. His master declared that, among other things, Domingo was able to predict the possibilities of healing or dying with his patients. On one occasion around 1660, he said that a sick person he was treating “should have died by a determined hour.” That he did so was surprising to his master, as they were standing seven leguas (about twenty-one miles) away from the house of the sick person. While they were discussing this event, according to declarations of both Luzcano de Figuera and Domingo, “a person arrived in their house and told them that the said person had died at the time that [Domingo] had predicted.”49 Domingo also used spiritual technologies to predict the outcome of diseases.50 For instance, when treating the enslaved woman Luisa of yerbas, as indicated above, Domingo tied “a round pebble” that he used “as a remedy for dysentery and headaches . . . around her right arm” wrapped in cloth. He said that “if the ribbon broke,” Luisa would not have “any cure,” but that “if it did not break it was a sign that [her disease] had been cured.”51 Domingo provided a visible element in the ribbon for the interpretation of his claims and predictions. These types of predictions were common in a variety of West African and West Central African traditions. What is more, one of the fundamental skills taught to practitioners in early modern European medical schools was the ability to provide an accurate prognosis for sick patients, many of whom they never met in person (this was obviously in different contexts from those that Domingo practiced).52 What Domingo was doing, in other words, was an essential part of his practice in a competitive world in which predicting health outcomes was expected, and indeed demanded, by patients. Domingo also used healing elements historians have labeled as having an Amerindian origin. Around 1660 he was healing a woman from ventosidades (bloating and flatulence) in El Cayo. Domingo visited “one night and he arrived at the room where the sick woman was and asked for a cigarette of tobacco.” He ordered the patient to “[lay] her body straight” in her bed and inhaled “the tobacco and blew smoke throughout the chamber and then he took out a small gourd with which he walked around the bed and the corners” of the room. Domingo specifically asked the woman “to swallow as much smoke as she could.”53 As a number of historians have examined, tobacco was an essential part of Amerindian (specifically Caribbean) healing, social, and religious rites. Its use became a common element in the ritual practices of Caribbean healers.54

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Domingo also made use of wondrous acts to bolster his position as a powerful healer with access to mysterious resources. In one of these cases, Domingo applied “white-hot knives” to the legs of a man named Agustín who “was sick of a pain in one of his legs.” Agustín said that inexplicably he “did not feel the fire of the knife but, instead, a sort of tickling” when Domingo put the knives on his body. He also seemed to be able to convert water into blood, and, in another occasion, Domingo “took a knife” and “squeezing it with both hands” made “blood . . . come out of the knife,” in the presence of several witnesses, while proclaiming that anybody who “step[ped] on the blood” would be “hurt.”55 During his inquisition trial, Domingo explained that these seemingly supernatural events, whose occurrence he confirmed, had in reality, very earthly explanations. About the bleeding knife, he said that he had “suck[ed] hard his own gums” and passed the knife through his mouth, “cutting his gums” before squeezing it. And he said that he had converted water into blood by using “a silver tack” he also hid in his mouth.56 Candidly, he said that his actions were intended to “startle the rest of the people present.”57 Obviously, in grounding his rites and the production of astounding phenomena in an understandable physicality, Domingo was skillfully positioning himself outside possible inquisitorial accusations of demoniac collaboration. In his use of these wondrous and seemingly deceitful methods, Domingo exemplifies common strategies among healers of all stripes to use inexplicable events to position themselves as powerful manipulators of the bodily realities of people around the Caribbean. POW ER A ND CONFLICT

The power that Black ritual specialists like Domingo developed to manipulate and control the natural world, and particularly the world of disease, was one that was clearly threatening to licensed healers who confronted them physically and in judicial and ecclesiastical courts. Domingo did not escape these confrontations. Around 1663, Domingo became embroiled in a fight with surgeon Francisco de Trujillo in San José. Domingo had been treating a patient named Miguel de Redines for a wound. After evaluating the patient—coterminous consultations with several healers were common at the time—Trujillo suggested curing the injury by wrapping it in “cardenillo plaster” (copper acetate plaster). Domingo riposted to the surgeon asking him, “Why do you want to cure the wound” if it is “already healed and the only thing lacking is the skin?” Trujillo did not take lightly to this rebuke of his professional expertise—one delivered by an illiterate

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Black enslaved person. He slapped Domingo in the face and screamed at the Black healer, telling him that “he was a dog that went around curing without knowing how to read or write and that if he would see him [Domingo] doing this again he [Trujillo] would carry him to the Inquisition.”58 In all likelihood, Trujillo followed through with his threat, and his denunciation to the inquisition (anonymized in the record of Domingo trial) was part of the accusation that would end up befalling the Black Cuban healer. Similar dynamics defined the relationship between Domingo and Francisco de Pavia, his master. Pavia was convinced of Domingo’s powers and control over the workings of human bodies and nature. He frequently called Domingo to cure him and his family. Once, when Pavia’s wife Marcia was sick from “calentures and bloody diarrhea,” he called for Domingo. The Black healer “touched her face and right leg” and felt her pulse (another basic diagnostic element of learned European medical practitioners), which he found to be “very accelerated.” After examining Marcia, Domingo declared that “she would not have calentures anymore,” a prediction, and seemingly miraculous healing, that Pavia reported to inquisition prosecutors.59 Pavia also told inquisitors that Domingo was able to transmute between human and animal bodily forms. Pavia testified that after he had once punished Domingo by whipping him so badly that the he had to spend eight days in bed, he had seen a “feral boar” around his house bearing the very same wounds he had inflicted earlier on Domingo. He even sent his dogs to attack the boar, but the dogs refused to do so, after which he came back to Domingo’s shack and threatened to “kill him with a lance if he [became a feral boar] again.”60 It is clear then that the skills that made healers like Domingo to be sought after by patients could also be important threats to the colonial societal and professional medical order. To be clear, the historical record shows that most seventeenth-century Caribbean Black ritual practitioners lived their lives without attracting the attention of the Inquisition. But some of them, like Domingo, ended up being captured by judicial and inquisitorial authorities, more often than not, after the denunciation of their masters and other health practitioners. DOMINGO’S M A N Y EXILES

Domingo’s existence ended in the last months of 1666. After having been declared guilty of being a “sorcerer,” inquisitors condemned Domingo, who had already spent two years languishing in jail, to an “Auto particular de Fe.” On August 22, 1666, an already debilitated Domingo walked the streets of Cartagena with a

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rope around his neck, a candle in his hand, and sorcerer insignias. The auto de fé took place in the Santo Domingo church, and in it, Domingo’s “crimes” were announced to Cartagena’s community. Domingo repented of his “sins” during the ceremony. After the mass that followed the auto de fé, one that “many priests and slaves” attended, Domingo was tied to a post in the plaza in front of the church where he received one hundred whip lashes. He did not recover from this punishment. A cursory note at the end of his inquisitorial record informs that Domingo died on December 1666, a few months before he could be “sent to fulfill his exile sentence” outside of Cartagena and Cuba. Far away from his family and the community he served, Domingo disappeared in the inquisition jail gallows. The multi-originated healing practices of creole Blacks like Domingo have similarly vanished in most of the literature on medical practices of colonial Latin America. The lives and trajectories of people like Domingo are hard to square with the main narratives at the center of most scholars’ work on the topic, which focus on the development of professional medicine and the concomitant segregation of non-licensed—mostly non-European—healers, non-European healers’ resistance to the evils of slavery and capitalism, or the tracking of the survival of African or Amerindian healing traditions in colonial society. Indeed, historians of healing practices in the African diaspora have by and large been interested in how African-originated medical cultures get translated (or lost) as they move through these discreetly identified epistemological realms.61 As Domingo’s case demonstrates, however, the histories of healing that emerge from the Black cosmopolitan communities of seventeenth-century Caribbean locales do not travel through the usual channels of histories of the survival of African traditions. Black practitioners like Domingo were omnivorous consumers of healing cultures from all around the Atlantic and developed highly successful practices on the basis of multi-originated medical traditions and technologies. The early modern Caribbean healing creole/criollo cultures exemplified by Domingo’s practices are also barely apposite for being inserted in methodologies for the analysis of medical practices in colonial Latin America that depend on examining exchanges between supposedly distinct healing traditions (the so-called medical mestizaje). These traditions only appear as discrete fields of analysis through the organizing lenses of histories of medicine that think of non-European healing cultures on the basis of imperial, colonial networks and categories, and the universalizing idea of a modern transnational connectivity.62 The lives and practices of people like Domingo show that most of the knowledge around healing produced in places like San José del Cayo circulated in

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intellectual social and cultural spaces whose existence belie commonly accepted analytical frameworks in which official European licensed medicinal practices supposedly dominated the medical landscape in colonial Spanish territories. They demand a different sort of analytical engagement that can be profoundly illuminating. In the early modern Caribbean, the healing practices of people like Domingo prevailed. Domingo’s history provides a window into the lived experience of disease of the seventeenth-century Caribbean and the bodily preoccupations of most people living in the region. The linkages made evident in Domingo’s fractured life do not traverse the analytical routes of survival or mestizaje—nor do they depend on ideas about colonial dynamics or ruptures. The history of the gray zones of medicine that dominated life in early modern Caribbean historical spaces allows for the ideation of different wholes. Seemingly fragmented and isolated island and coastal spaces can be departing points for the imagination of different, more inclusive kinds of histories of healing.

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{2} The Curing World of María García, an Indigenous Healer in Eighteenth-Century Guatemala

Martha Few

In early December 1705, a young married woman named doña Isabel Sánchez de León reported to inquisition authorities in Santiago de Guatemala, the capital city of colonial Central America, about her suspicions that her cousin’s mulata servant, later identified as Felipa Jérez, consulted the Indigenous healer María García.1 A brief illness had left Jérez blinded, and García, according to her patients, had a well deserved, widespread reputation for treating eye illnesses, attracting female and male patients from different economic statuses and ethnic backgrounds from across the region. The sick and their families sought her out and paid her in money or goods to treat them in their houses or in García’s own home in Ciudad Vieja, a small town on the outskirts of the capital. One of her patients went so far as to characterize García’s home as a kind of “hospital,” where she administered medicines and cures and nursed the sick back to health.2 García treated not only blindness but also stomach sicknesses, toothaches, dropsy (hidropesia), and supernatural illnesses cast by ritual specialists or caused by malevolent forces. She was sought out by Friar José Vélez, a Franciscan priest, to heal his physical symptoms of sorcery, and by an unnamed pregnant Black woman to cure her symptoms of dropsy, characterized by the watery swelling of the body’s tissues and cavities. Many of García’s treatments involved the herb tesumpate, administered in healing potions, tisanes, and poultices and adjusted 26

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with other medicinal materials to tailor the dosage to specific illnesses and symptoms. Some patients described becoming atarantada (dazed) after their medical treatments with tesumpate, implying that they entered some sort of altered or perhaps hallucinogenic state. This aspect of García’s medical practice and suspicions that she used sorcery caught the Inquisition’s attention. THE INQUISITION A ND COLONI A L HEA LING CULTUR ES

In some ways, it is surprising that we know anything at all about María García, her patients, and her medical practice. As an Indigenous female healer who worked in the informal economy and drew on Mesoamerican medical cultures and botanical knowledge, she must have worked hard to build her profession as a healer and at the same time not to draw the attention of inquisition and civil authorities. Reconstructing the lives of female healers like García is thus challenging, as there are few Indigenous voices in the archives to speak directly to the extent and operation of Mesoamerican medical cultures under Spanish colonial rule. Rather than hearing from the Indigenous healers themselves, the sources record the words of the Spanish elites and European travelers who consulted them on behalf of themselves or their sick families. And those firsthand reports and descriptions of Indigenous medical specialists that do exist are often due, as in García’s case, to their criminal and religious prosecution by the institutions of the church and local colonial authorities.3 All of these sources are shaped by the colonial and interpersonal conflicts of those involved in the proceedings. Nevertheless, this glimpse of María García’s life and medical practice shows how Indigenous women and men remained active participants in Mesoamerican medical cultures—in García’s case, almost two hundred years after the conquest era—and how curanderas and curanderos (healers) played important but often unacknowledged roles in the daily life of this multiethnic colonial society. Although readers today might find it strange that the Inquisition, the policing arm of the Roman Catholic Church, would monitor medical practice in colonial society, those living in Guatemala at that time were not surprised. This is because medicine and curing as understood and practiced in Spanish America—whether by Mesoamericans, Europeans, Africans, or criollos—combined religious rituals and learned medical practices. In the early seventeenth century, the highest inquisition court in the viceroyalty of New Spain was located in Mexico City. The Holy Office also had subcourts in other major cities of the viceroyalty, such as Santiago de Guatemala. Inquisition officials investigated a wide range of crimes:

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heresy and apostasy, witchcraft and sorcery, pacts with the devil, bigamy and concubinage (especially among Spanish elites), solicitations in the confessional, blasphemy, and the possession of prohibited books—crimes that often had roots in physical, mental, and spiritual illnesses and crises. At the turn of the eighteenth century, Santiago was a bustling capital of approximately thirty thousand residents, the majority of whom were mixed-race and Black, with Spanish and Indigenous residents each making up about 15 percent of the city’s population.4 Mesoamerican practices related to illness and medicine tended to enter the archival records only when civil, criminal, and inquisition officials policed them. Colonial authorities constructed Mesoamerican medical cultures in terms of idolatry, human sacrifice, and the occult, terms established by the church in this colonial setting. It was in this context that inquisition authorities charged María García “por curandera y embustera” (for being a healer and a liar) with one of the comisarios (inquisition’s deputies) asking García directly if she healed “using the demon[ic] arts of spell casting, enchantments, [or] charms.”5 Guatemala’s Inquisition attempted to shape and contest Mesoamerican medical cultures by discounting them as ineffective or by characterizing Indigenous and mixed-race healers as sorcerers.6 I use the phrase “Mesoamerican medical cultures” to indicate that there was not one unified culture of Mesoamerican or Indigenous medicine but rather overlapping practices that varied by Maya ethnic group and by environment, which influenced both the illnesses diagnosed and the local knowledge of plant, herbal, and animal-based medicaments mediating disease symptoms or offering cures.7 Mesoamerican healers plied their trade within heterogeneous New World medical cultures that operated in Central America beyond the colonial period’s end. In Guatemala, as María García’s case exemplifies, colonial and Mesoamerican medical cultures and practices coexisted and intertwined in complicated, generative ways. M A R Í A GA RCÍ A’S MEDICA L PR ACTICE THROUGH THE LENS OF INQUISITION TESTIMON Y

Guatemala’s inquisition investigation into García began in late 1705. Inquisition officials, led by comisario Archdeacon Juan Feliciano de Arrevillaga and a royal notary, first questioned María García in early 1706, in her hometown of Ciudad Vieja.8 Her testimony and those of others involved in the case were not recorded as a word-for-word transcription. Instead, a notary first drafted notes about the

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conversation and then composed a formal detailed summary according to legal protocols for these types of religious documents. The summary of García’s legal testimony provides details about herself and her medical specialties, healing methods, and client base. We must remember, however, that García provided testimony under duress, fearful that she might be jailed or have her house searched and belongings confiscated, frequent outcomes of inquisition cases in Santiago de Guatemala at this time.9 María García did not know her exact age, though the notary judged her to be about fifty years old. She was the widow of a man named Juan García, a soap maker. The notary recorded María García as of legitimate birth—that is, her parents, Domingo de Salazar and Melchora de los Reyes, were legally married. During this first interview, the notary recorded García’s ethnicity as mestiza— which in this context meant a person of Indigenous and European ancestry, or a person of Indigenous descent who spoke at least some Spanish and perhaps did not wear Indigenous-style clothing—though the inquisition sources at times described her as india, an Indigenous Mesoamerican woman.10 Whether García was mestiza or Indigenous may seem a small detail, but this distinction mattered greatly as to whether García could be prosecuted by the Inquisition. The reasons for this lay in the longer history of this Spanish colonial institution, which had roots in the social experiences and legal cultures of post-Reconquista state-building efforts in Spain. Pope Sixtus IV had in 1478 granted Queen Isabella and King Ferdinand the right to set up the Holy Office of the Inquisition in Castile and Aragón, where the first tribunals began in 1482. Starting in 1532, the Viceroyalty of New Spain established the Inquisition on an informal basis, run by members of the missionary orders there and the bishop of Mexico. In these early years the Mexican Inquisition targeted mainly the newly converted Indigenous populations; however, many in Spain and New Spain found the punishments meted out to native peoples too harsh. To temper these excesses, the crown formally established the Holy Office of the Inquisition in Spanish America in 1571 and set up a bureaucracy of inquisitors composed entirely of Spanish men. These were professionals who in theory would adhere to formal guidelines on investigation, testimony, and punishment of denounced women and men. Thus, the Inquisition targeted all ethnic and social groups except Indigenous peoples, whom the Inquisition could no longer officially prosecute for religious crimes. This now fell under the jurisdiction of a parallel institution, the Provisorato de Indios. By categorizing María García as mestiza, not Indigenous, the notary placed her within the Inquisition’s legal jurisdiction.

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García denied using sorcery or having made a pact with the devil to enhance her medical abilities. Rather, she said that she was a curandera, a healer, and that she had practiced this ministerio (calling) for many years. With this, García invoked the complicated racial politics of medicine and healing in colonial Central America, where formal medicine was shaped by the University of San Carlos’s medical school, established in 1680 in Santiago de Guatemala. The faculty and curriculum of San Carlos’s medical school were reenergized during the eighteenth century, producing a small but influential number of Guatemalan-born medical doctors and scientists.11 However, only men who could prove limpieza de sangre (purity of blood) could attend university and legally practice medicine as doctors licensed by the Protomedicato, the bureaucracy regulating medicine and public health in colonial Spanish America. Purity-of-blood laws effectively barred converted Jews and Muslims from university in Spain, and in Spanish America the laws likewise prevented Indigenous people, Blacks, and mixed-race men from attending university or applying for licenses to legally practice medicine. As a result, though curanderas and curanderos provided a significant amount of medical care in Guatemalan society, their practices remained illegal throughout the colonial era. Colonial hospitals, especially in important urban areas, were key sites for health care, combining both medical practice and religious ministry. Indigenous women worked in these spaces as cooks, laundresses, or cleaners, but formal medical practice remained in the hands of Spanish male doctors and priests. In colonial Central America, hospitals cared for specific social and racial-ethnic groups. Guatemala’s first hospital, the Royal Hospital of Santiago, opened in 1553, treating only those of Spanish descent. The Hospital San Alejo treated Indigenous patients exclusively, while the Hospital de San Pedro only accepted priests. The Hospital de San Lázaro, also known as the “Hospital of the Incurables,” quarantined lepers and others with diseases that doctors diagnosed as contagious. In 1630 the religious order of San Juan de Dios took over the administration of the first two hospitals, and by the late seventeenth century the order administered all of Guatemala’s hospitals, which reinforced connections between religion and healing.12 Despite the presence of hospitals in the capital city, the sick were mostly treated in the home by family members, bonesetters, midwives, barber-surgeons, and curanderas like María García. In response to inquisition authorities’ questioning, García described how she learned to heal from Gabriel de Varaona, an Indigenous man from her hometown. Ciudad Vieja was a primarily indigenous community with an exceptional history: it was first populated by Nahua, Zapotec, and Mixtec warriors who

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had accompanied a small number of Spaniards invading Central America from Mexico from 1524 to 1528.13 García may have been a descendant from this group of migrants from central Mexico and Oaxaca, or from Kaqchikel Maya speakers, another Indigenous ethnic group who lived in Ciudad Vieja. Whatever the case, living in this multiethnic Indigenous town and learning her medical skills there from an Indigenous man meant that she was exposed to a variety of rich Mesoamerican medical cultures and botanical knowledge. Gabriel de Varaona taught García about the medicinal qualities of tesumpate and helped her develop her skills in treating blindness and eye illnesses. Under inquisition questioning, García denied ever having heard of a woman named Felipa Jérez, whose blindness treatments started off the inquisition investigation. García did admit to curing “many people” with tesumpate, including a man named don Francisco, whose surname she could not remember but who lived in the home of doña Alfonsa de Sotomayor, which was located next to the cathedral along Santiago’s plaza mayor (main plaza). García stressed that she had successfully cured him only using a plant-based treatment made of tesumpate, not with spells or sorcery. García claimed tesumpate was simply a common plant, a “thorny rose-colored bush whose berry is purplish black,” similar to a blackberry or brambleberry bush. She claimed that the plant did not have any supernatural, hallucinogenic, or other dangerous qualities. This may have been true. Or perhaps, faced with increasingly pointed questions from inquisition officials, García was attempting to deflect interest in the plant by downplaying any of its features that the comisario could associate with sorcery. I have not been able to identify tesumpate. It may be a Hispanicization of a Nahuatl plant named tezompahtli (written also as tezonpahtli or tezompatli), mentioned by Francisco Hernández, a Spanish doctor who traveled to Mexico in the sixteenth century to investigate Indigenous medicine and botanical knowledges, as useful for treating coughs and stomach illnesses.14 Most of the likely references to tesumpate come from sources created in central Mexico, but none mention psychotropic properties, or the herb’s usefulness in treating eye illnesses, which suggests that perhaps the plant referred to by García case was not the same plant. POLICING MEDICINA L PLA NTS ASSOCI ATED W ITH PR EGNA NCY R EGULATION IN COLONI A L SOCIETY

García testified that sick people “de todos estados y calidades” (of all statuses and ethnicities) frequently came to consult her for a cure. She enjoyed a

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widespread reputation as a skilled healer that crossed lines generally thought to have separated members of colonial society—be they racial-ethnic, rural/ urban, or economic. When severely ill patients arrived, García treated them with a tesumpate-based cure and then cared for them in her home “for eight or more days until they were healed.” García admitted that she used tesumpate, sometimes “mixed with some medicines from the Boticario [pharmacy].” But beyond that, she claimed that she had never taught anyone else the medical trade or made a pact with the devil, as the inquisition interrogator suggested.15 From their questioning of García and the case’s witnesses, it is clear that inquisition authorities remained fixated on two aspects of Garcia’s practices that were central to Sánchez de León’s unsolicited denunciation of the Guatemalan healer, with which this essay opened. First, authorities remained suspicious of García’s tesumpate-based cures, considering their properties dangerous in religious terms. Second, authorities remained convinced that supernatural means must have been central to García’s medical practice, given that an Indigenous man had trained her in the healing arts and that the potions and cures she administered left her patients in an altered state. However, a third concern emerged seemingly out of nowhere, perhaps because of rumors circulating in the capital: the inquisition comisario asked García about a pregnant Black woman whom she had treated for dropsy, pressing García on whether tesumpate had abortifacient properties and whether she administered the herb to intentionally cause an abortion. Inquisitors asked García “what kind of remedio [cure] she had given to a Black woman so that she could abort her child [niño].”16 García, denying the accusation, answered by explaining “that a short time ago she had administered a bebida [curative drink] to a Black woman but the Black woman did not tell her that she was pregnant, only that she had dropsy, and because it was dropsy she administered the herb tesumpate.”17 Since the conquest period, Spanish authorities had perpetuated stereotypes portraying colonial women, especially Indigenous and Black women, as being actively involved in abortion practices, and having the knowledge and skills to use plant-based means in such procedures. Thus, the Inquisition’s interest in tesumpate’s possible abortifacient properties probably stemmed from broader Catholic Church efforts to catalog and describe gendered and Indigenous local medical knowledges of abortifacient plants, and prevent women from regulating reproduction.18

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Male colonial elites in eighteenth-century Guatemala during the Enlightenment were also very interested in cataloging local plants with abortifacient properties. Such interest in abortifacients was integral to imperial efforts to collect, catalog, and study plants, animals, and material objects found in Spanish America.19 This information circulated as common knowledge in colonial Central America, and New Spain more broadly, via curaciones (cures), remedios (remedies), and recetas (recipes). In his natural history of colonial Guatemala, Francisco Ximénez described how the cocolmeca bark cured typhus and the associated epidemic fevers called tercianarios and cuaternarios.20 Ximénez reported this based on his experiments with the bark, calling it “a marvelous thing,” one of the most important “god-given plants.”21 He further noted that cocolmeca restored healthy menstrual flows and “ma[de] barren women fecund.”22 Eighteenth-century Mexican periodicals reported that Maya people from Rabinal, a town in highland Guatemala, said that pine nuts (piñón del pino) had similar properties. Rabinal medical specialists used both of these plants to treat typhus and to “provoke” menstruation.23 Maya communities in highland Guatemala also used the leaves of the juanislama plant made into a poultice to treat flujo de sangre (bloody flux), a sickness associated with miscarriage and its aftermath.24 Public health campaigns against epidemic diseases, especially as they became centralized and increasingly targeted Maya populations in colonial Central America, provided another space for knowledge exchanges regarding the properties of local plants. Among the medicinal plant samples that Francisco Geraldino, then alcalde mayor of Totonicapán, sent in the 1780s to the audiencia president who was gathering such items to forward to Spain, were leaves, sap, and bark from the Savino tree (madera de Savino), which commonly grew along the region’s riverbanks. Savino tree elements—prepared as healing poultices, medicinal baths, curative drinks, or mixed with sugar—caused sweats and cut short typhus and other fever-related diseases. Geraldino warned, however, that medicines made from the tree’s sap “should not be used on pregnant women because it is a very strong abortifacient (abortivo).”25 In this context, it is not suprising that inquisition officials remained both curious and worried about García’s use of tesumpate. However, their investigations into García’s medical practice were not initially centered around the use of suspicious botanicals. Instead, García’s initial encounter with the Inquisition was spurred by the accusations of a number of female residents in Santiago de Guatemala. These women mantained that García practiced sorcery and accessed the supernatural.

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Figure 2.1. First page of Francisco Geraldino’s botanical survey of medicinal plants, trees, mosses, and their properties in the province of Huehuetanango and Totonicapán, February 2, 1784. AGCA A1-6088-55135, “En obedecimiento y cumplimento de Despacho y Supremas,” f. 37, Courtesy of the Archivo General de Centro América, Guatemala City, Guatemala.

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GENDER, ETHNICITY, A ND SORCERY IN COLONI A L SOCIETY

Doña Isabel Sánchez de León first brought García to the Inquisition’s attention, when “sin ser llamada” (without being called; of her own volition) she told officials about the supernatural events that occurred when her cousin’s servant sought a cure for blindness. Sánchez de León testified to the Inquisition that the servant, whom she described enigmatically as “a mulata named Felipa, blind with a broken throat,” had lost her sight a few months before, in August 1705, from what the servant felt were supernatural means.26 The servant, Felipa Jérez, was a thirty-year-old widow and described herself not as mulata, but as mestiza. She said she was a weaver and also worked as a cook for a young widow named doña Juana Aragón, whose home was located just off the city’s main plaza. One night around eight o’clock, as Jérez mixed a cup of hot chocolate, she heard a knock on the door. She opened it to find a peddler, a tall woman wearing a black mantilla, a kind of long scarf or shawl worn by women over their head and shoulders. The peddler tried to convince Jérez to buy a mantilla from her, and when she said she was not interested, the woman tried to persuade her to buy some thread. Jérez took the items in her hands to examine them but then decided not to buy anything. She returned the items, closed the door, and returned to the kitchen and her chocolate. At that moment, Jérez felt a severe pain in her head and eyes, so severe that she could not finish making her chocolate, and she went straight to bed. When Jérez’s employer, doña Juana, returned later that same evening, she found her servant crying out from the pain in her eyes and head. Doña Juana, like many women in colonial society regardless of ethnicity or background, first treated Jérez herself with some undescribed home remedies. These had no effect. Jérez’s symptoms worsened to include a sudden onset of blindness, confirmed when she could not see the candle held in front of her eyes. The next morning, doña Juana asked the physician don Vicente González to come treat Jérez in her sickbed. González medically examined the woman, prescribed various treatments (whose specifics were not recorded), and told the women that Jérez would never recover her sight. Testifying to the Inquisition, doña Juana declared, “It is public knowledge in this city that [Jérez] is blind despite having clear eyes,” hinting that her continued, stubbornly incurable blindness, without any physical indication of sickness in the eyes themselves, pointed to supernatural causes. Most of Santiago de Guatemala’s urban population, to some degree, shared

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the idea that illness could have supernatural origins, whether it be fright (susto), evil air or winds (mal aire), or aggressive sorcery practiced by female and male ritual specialists, who were reputed to be steeped in the dark magical arts. Such ritual specialists, it was believed, worked alone, with other supernatural beings, or at their clients’ request. As a number of historians have shown, in colonial Mesoamerica, supernatural illness was thought to explain strange and incurable illnesses, deformed births, or physical transformations whose onset coincided with some sort of familial, interpersonal, or community conflict.27 Ideas about supernatural illness were shared across racial-ethnic and status lines—Aragón and Sánchez de León were both elite women, as signified by the use of the term doña in the inquisition documents. More obviously, colonial Guatemalan institutions, such as the Inquisition, also paid heed to ideas about the supernatural causation of disease, as evidenced by the numerous cases of illness or “poisoning” related to sorcery appearing in eighteenth-century judicial and ecclesiastical records. The Inquisition clearly thought that the accusations of magical healing against García were both plausible and worrisome. Inquisition officials pursued the case against María García on and off for eight years between 1705 and 1713. They alerted the Mexico City inquisition office of the charges and questioned multiple witnesses, including García herself, repeatedly. Inquisition authorities even searched García’s home. Under duress and with “much fear,” García had turned over the keys to her house to Captain don Guillermo Martínez de Peredo, who, with the inquisition notary in tow, searched the premises while García remained in confinement, perhaps in the inquisition court or the city’s jail for women. It is also possible that she was held in a casa de recogida (house of enclosed women), a colonial Guatemalan institution often run by women in lay religious orders, such as the Third Order of San Francisco. Some women entered these houses voluntarily—after becoming widowed, for example—while others, who had fallen into the Inquisition’s hands, were kept there involuntarily.28 The inquisition records catalog the suspicious materials that Martínez de Peredo and the inquisition notary had found at García’s house. They brought back to the inquisition comisario “a large gourd cup” (una jícara grande) filled with “diverse roots herbs and reliquías [lit., “relics,” some type of religious object, charm, or amulet] and cotton.” They also found various “paper packets of seeds in small gourds, small jars, cups made from gourds [tecomates], and fabrics.” All of these items were evidently part of García’s healing tools and pharmacological arsenal. In addition to the seeds, leaves, roots, and other plant materials that she

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used in her healing recipes and cures, inquisitors also collected some undescribed religious items or amulets from her home. Unfortunately, the Inquisition was either unable to specifically identify any of these materials, or, as was often case, did not think these details were relevant to the process. This seems paradoxical, especially given the inquisitors’concerns about the properties of tesumpate.29 In addition to the material evidence they confiscated, inquisition prosecutors relied on the somewhat sensational descriptions provided by García’s patients for making their case. These included testimonies about García’s supernatural healing methods given by the blind woman Felipa Jérez, her sisters, a single mestiza servant named Cecilia de Cuellar, a widowed mestiza weaver named Luciana de Jérez, doña Isabel Sánchez de León, and doña Juana de Aragón— Sánchez de León’s widowed sister and Jérez’s employer. Together these witnesses provided a narrative of the supernaturally tinged nighttime journey that García took to heal the blind woman. The details of this journey led Jérez—as well as inquisition authorities and today’s readers—through a ritual landscape associated with illness and healing in the Guatemalan capital and surrounding communities. After becoming blind, Felipa Jérez could no longer perform her job as a kitchen cook and servant. Instead, she started working as a laundress, using her young daughter to help her. Clues from the testimonies indicate that Jérez had a difficult life; in her mid-thirties she was widowed, her body physically marked by an injury or illness described as a “broken throat.”30 Jérez did have others she could rely on, especially her two adult sisters, the daughter, and, to some degree, her employer. Even so, her sudden onset of blindness threatened her survival and that of her family, forcing her into more physically demanding work that required exposure to the elements. This likely made Jérez willing to pay García to cure her, even though Jérez felt pressured to do so. One day while washing clothes, Jérez was approached by a mysterious woman who apparently did not identify herself and offered to cure Jérez for a price. Jérez declined the offer. This same mysterious woman—whom witnesses eventually identified as María García—approached Jérez again a month later, offering to cure her blindness for twenty pesos. The two bargained, and Jérez agreed to pay ten pesos for the treatment. García came to the house where Jérez worked a short time later, on the feast day of Saint Francis Xavier. Jérez was waiting for her, covered in amulets of the Holy Trinity, perhaps both to protect herself from evil (in light of the strange visit on which she blamed her blindness) and in the hopes of aiding a successful cure. García brought Jérez from the capital to her home in Ciudad Vieja and placed curative powders in

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Jérez’s eyes. She then gave Jérez a medicinal bath and then covered her eyes with a cloth. Jérez told inquisition authorities that the cure left her feeling dazed, to the point that she did not know what she was doing or saying.31 Blindfolded and dazed, Jérez attempted to make her way alone from Ciudad Vieja back to Santiago de Guatemala. As she walked through the night, she marked her journey’s progress through sites significant to the colonial religious landscape: she tripped over the bricks from a church damaged in a recent earthquake and made her way through the Alameda, the Campo del Calvario, and the convent of La Concepción. She then passed through the small hamlet of Santa Lucía and its parish church. Both honored Saint Lucy, the patron saint of eye-related illnesses and blindness.32 Jérez said that she “felt as though she flew through the air” as she made her way through the countryside and back into the capital, blaming García’s medical treatments for her altered state. Jérez’s sisters repeated the blind woman’s assertions about flying but said that it was García who had “carried Felipa through the air” back to the capital. They also claimed that a cabrito (a young male goat), “dancing” bulls, and a mysterious woman in white appeared to Jérez. These strange apparitions cemented the supernatural quality of García’s cures: goats, dancing bulls, and flying women were all well-known tropes in early modern period iconography of female witchcraft. According to her sister Luciana, Jérez arrived “dazed and stunned” to her sister’s house in the middle of the night, with “hierbas y tierra” (herbs and earth) clutched in her hands. Luciana took these away from her sister and burned them. When Jérez awoke the next day, she had recovered her sight. Later that same day, she returned to the small Santa Lucía church to give thanks. Despite García’s success in healing Jérez’s blindness, inquisition officials were not impressed. In the end, the Inquisition punished García by forbidding her to practice medicine: “With this declaration the said Señor Comisario ordered that [María García] not use these cures on any persons in this pueblo, or outside it, under any circumstances, for any pretext, motive, reason, request, plea, nor should she move to a different house for this end [to practice medicine], [or] even if she is asked to by any person of whatever status, character, or condition who comes to her house to ask for a cure.”33 Padre Matheo de Utrera, parish priest of Ciudad Vieja, was responsible for monitoring García to ensure that she abided by the Inquisition’s sentence. The punishment was significant: it left the widowed García without a source of income and ostensibly with no other trade or means to support herself.

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A RCHIV ING COLONI A L MESOA MER ICA N MEDICA L CULTUR ES

María García’s story provides a window into the rich medical world of Indigenous healers in colonial Guatemala, a story that was only archived because some of her patients and neighbors decided to denounce her to the Inquisition. Otherwise, readers would likely know nothing about García’s work as a healer in colonial Guatemala. This shows that inquisition sources provide important information that, if used carefully, can help reconstruct in general terms the medical practices of Indigenous female healers, even when they appear in the archival record via legal proceedings by those who wished to police them, and open windows into the broader landscapes of popular healing that dominated life in colonial Latin America. These same sources can also be mined for information on patients and their families, neighbors, and employers and how they thought about and explained illnesses and their causes. The testimony of Jérez and the other women involved reveals how healing often took place in the home, with outside specialists—whether licensed medical doctors, such as the one called on by Jérez’s employer, or unlicensed healers like García, who peddled her services door-to-door—brought in only in certain cases. In colonial Guatemala, healers and the sick intertwined medicine and religion, and resorted to religious amulets, religious sites, and charms, as well as herbals, apothecary preparations, and learned physician’s procedures, to protect health or treat an illness. Even when Indigenous healers did successfully cure their patients, as García did with Jérez, popular beliefs and stereotypes about Indigenous peoples—that they could both cure and cause illness, that their Indigenous background made them more likely to draw on the occult—left such practitioners, unlike their licensed counterparts, open to suspicion, persecution, and arrest, even as they provided much needed medical services in colonial Guatemala.

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{3} Calundu A Collective Biography of Spirit Possession in Bahia, 1618–Present

James H. Sweet

The biographies of individual healers in the Atlantic World are crucial to helping us understand histories of the body, circulations of medical knowledge, and evolving ideas about the power of the (super)-natural world. By tracing the lives of “professional” and popular healers over the longue durée, early histories of ideas about science, medicine, and the body come into sharper focus. In this chapter I take a slightly different approach, turning my biographical gaze onto a single idea and charting its genealogy from the seventeenth century through the late nineteenth century and to the present day. By concentrating on collective ethnographic ideation, even as we analyze the practices of individual healers, we can begin to see not only the importance of specific African healing spirits on Brazilian bodies but also the ways succeeding generations of Brazilians reconfigured these spirits into new other-worldly expressions of the body— through Catholicism, dance, and even blind anger. African ideas about bodily vulnerability and spiritual power have persisted in Brazil, providing crucial explanatory mechanisms for individual and collective health during times of rapid historical change.

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CA LUNDU DEFINED

In 1697 in Jaguaripe, Bahia (in northeast Brazil), Manuel de Brito invited a slave woman named Gracia to come to his property to help him locate a missing canoe. Gracia, a diviner and healer, was widely known for her powers. Indeed, she traveled from her master’s home in Ilha de Maré, more than twenty-five miles across the Bay of All Saints, in order to reach Brito’s property. Gracia arrived at Brito’s house on a holiday, freeing Brito’s slaves to join her in the planned ceremonies. The festivities began in the late afternoon in Brito’s slave quarters, with generous servings of sugar cane liquor (aguardente). By late in the evening, the congregants began to dance and sing to the sounds of tabaque drums. Around midnight, the drumming reached a frenzied crescendo, when Gracia suddenly fell to the ground as though she had fainted. Then, rising to her feet, Gracia began uttering words “from her throat . . . in a falsetto voice” that she said were “her children.” Brito asked if the children knew where he might find his missing canoe. They revealed that it had been stolen by a slave on a neighboring property, who sailed it twenty miles down the coast to the village of Guaibim, where it ended up in the possession of slaves belonging to one Andre Cavalo.1 Gracia’s ceremonies lasted well into the night—“from midnight until sun rise”—according to one account. In addition to divining the location of Brito’s lost canoe, other white Brazilians danced with Gracia and requested aid from her “children.” Caterina Camella asked if her husband, João Coelho, had a girlfriend in the city center. Teresa de Brito wanted to know if her husband, Simão Francisco, was living “illicitly” with another woman on a sugar plantation in Mathuim. At the conclusion of the ceremonies the following morning, Brito paid Gracia and ordered his slaves to take her back to her house in Maré. According to several witnesses, Gracia was well-known across the region, and she earned her living through her divinations and healing.2 Gracia’s ceremonies eventually came to the attention of the Portuguese Inquisition, which accused her of “fetishism, superstition, and Calundus.” All of the eyewitnesses to Gracia’s ceremony matter-of-factly called it “calundu.” The inquisitors noted that “these dances and calundus are very frequent and common” in Bahia. Particularly concerning was Gracia’s “invocation of the devil in her dances,” which allegedly “caused great scandal among faithful Christians.” The vicar of Bahia, Lourenço Ribeiro, argued that calundu “caused so much prejudice to Christian souls” that only a “prompt remedy or punishment” could

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save people from this “damned superstition.”3 Lourenço was not alone in this assessment. More than ten years earlier in 1685, Father Domingos das Chagas wrote from the same town of Jaguaripe that the “diabolical pacts” of slave “fetishers” should be punished because “many white people cure themselves with [calundus] with such little unease of conscience as if they worked a very moral thing.”4 So what were calundus, and how did the Inquisition believe the devil manifested himself in these ceremonies? The word calundu derives from the Angolan term “kilundu,” the generic name for any spirit that possessed a living person. Using historical linguistics, we can identify a broader field of meanings through which Angolans likely understood calundu in West Central Africa and Brazil. The root–lundu–derives from the proto-Bantu verb dund, which means “to store up; add to.” This verb, focusing on the active quality of accumulation, was widely distributed across Central Africa, encompassing a geographic swath from present-day Kongo/Angola to the Swahili Coast. From this proto-Bantu verb emerged the noun stem dundu, meaning “hill.”5 In the Kongo/Angola region and its immediate interior, the term dundu more specifically came to mean “antheap” or “termite mound.”6 Taken in the aggregate, the innovations to dund indicate both the action of accumulation (of health, wealth, and knowledge, for instance) and the product of that accumulation, like an anthill. As Kairn Klieman and others have noted, hills served as “receptacles for ancestral first-comer spirits who control the fecundity and fertility of people and land.”7 Anthills and termite mounds represented entire underground worlds where reciprocity functioned at a frenzied pace, as each insect cooperated for the benefit of the whole nest. At the juncture of the underground world of deceased ancestors and the world of living human beings, anthills and termite mounds represented robust vectors of social reproduction and spiritual power. West Central Africans articulated ideas that tied accumulation to spiritual power and social reproduction in even more obvious ways. For example, one of the largest mountains in Angola was a dormant volcano between Libolo and Kisama, known to locals as “Moulondou Zambi,” or “mountain of spirits.”8 When the French traveler Jean Baptiste Douville visited the area in the 1820s, residents explained that the mouth of the volcano served as “the entrance of spirits into the other world.” If the volcano rumbled or the ground shook, people believed that the cause was “the movement of spirits going to their future homes.” Nobody dared climb the mountain for fear that flames would leap from the mountain and swallow them up. Some witnesses reported that the “vomiting part of the

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fire” was the entrance to the world of the dead, and when their relatives died, they could see the flames emerge from the dormant crater, offering the spirits “free entrance,” before descending back underground.9 It does not take a lot of imagination to recognize how people came to understand these hills and mountains as endowed with awe-inspiring spiritual power. The dangerous, chaotic energy contained in these vessels might be harnessed for good or for bad, to harm as well as to heal. Just as ancestral spirits possessed hills and mountains, so too they could enter the heads of human beings. These spirits of deceased ancestors possessed the living for a variety of reasons but usually as punishment for lack of proper veneration. Kilundu most often manifested as chronic illness, eating away at a person’s soul until the person demonstrated respect and obedience to their ancestors. Failure to placate ancestors on a broader scale could lead to calamities like volcanic eruptions.10 Certain healers (nganga) had the power to harness the kilundu and learn their desires. These nganga utilized spirit possession ceremonies involving drinking, music, and dancing to call deceased ancestors into their heads to divine the cause of illness and prescribe remedies. Kilundu could reveal all manner of hidden or “secret” information, like the location of Brito’s stolen canoe, or the identity of João Coelho’s concubine, or even news from overseas. Thus, kilundu was at once the active, additive cause of illness, anxiety, corporal vulnerability, and social instability, as well as the potential cure for these ailments, via a powerful healer. CA LUNDU IN BA HI A

The proto-Bantu dund, “adding to,” “accumulating,” “storing up,” very likely formed the metonymic foundation for several Kimbundu concepts familiar to historians of Brazil. For example, scholars generally translate the Kimbundu term malungu as “giant canoe.” The additive process of packing the “giant canoe” with individual, natally alienated people resulted in the Brazilian malungo, glossed as “shipmate,” but signifying new kinship ties forged through the experience of the Middle Passage. Like calundu, malungu implies “filling up” as a catalyst for empowerment. The enslaved passed through the oceanic world of the dead (calunga) in the “giant canoe” and emerged as a new family. Ultimately, the Kimbundu lund and lung roots gesture toward broader concepts of lineage expansion and social reproduction crucial to the survival of enslaved Africans in the Americas.11 Kilundu likely arrived in Bahia by the late sixteenth century, as large numbers

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of slaves from West Central Africa began flowing into the Portuguese colony’s largest ports. Over the course of the seventeenth century, only around one hundred thousand Portuguese immigrated to Brazil.12 Meanwhile, more than three hundred thousand Africans arrived in Bahia alone, roughly 80 percent of these hailing from “Angola.”13 Most of these Africans (as well as Europeans) brought with them an understanding that illness derived from some form of spiritual malevolence. Given the noxious environment of colonial Brazil—and most Atlantic locales during the early modern era—healers were in great demand. The first references to spirit possession in Bahia come from 1618, when “the negros from Guiné . . . called the dead to hear them . . . playing musical instruments and singing and eating and drinking with great excess.” These ceremonies included the sacrifice of animals and anointing the sick with the blood, probably as offerings to the offending kilundu. According to testimonies, these “fetishers serve all the Guiné slaves in Bahia.”14 Throughout the seventeenth century, Angolan men and women made cures in Bahia using ceremonies that were almost surely derived from kilundu. A man named Francisco Dembo (Ndembu), who lived in Itaparica, had achieved great fame as a healer when he was denounced to the Inquisition in 1634. Witnesses recalled stories of Dembo’s healing going back to the early 1620s, and he was still plying his trade more than ten years later. Dembo claimed that “the souls of his children” from Angola came to him to provide cures to his clients. When the children possessed Dembo, he spoke in a “high, nasal voice,” “in the language of Angola and Portuguese.” At times, Dembo’s children requested offerings of wine and liquor, which Dembo imbibed. Though Dembo stated clearly that his deceased ancestors were the source of his cures, his accusers insisted that he was “speaking with the devil.”15 By the final two decades of the seventeenth century, calundu was well entrenched in Bahia. Gracia’s divination of the canoe in Jaguaripe was one of many calundu cases brought before the Inquisition during this period in Bahia. That so many Angolan healers rose to the scrutiny of the Inquisition is striking, an indication of the ways calundu was beginning to spread across Bahian society. In the 1680s and 1690s in Rio Real, a woman named Caterina cured with “ulundus,” which she said were “her relatives who died in Angola, the homeland of the said negra.”16 In 1686, a woman named Dona Maria “cured various persons” in the city of Salvador with rituals that included singing and dancing to tabaques, drinking “wine and other liquors,” followed by spirit possession. During the same year, witnesses in Tijuca denounced a slave named Lucrecia, who danced wearing a

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crest of feathers on her head before falling to the ground “like a dead person.” Her followers then “rained white flour on her face” and she rose to her feet speaking in a different voice, explaining the sources of illness and the medicines that would cure them.17 In 1701, an Angolan named Branca danced calundus, also in Rio Real, to the sounds of tabaques and canzas. Wearing only a white loincloth, Branca had stripes of white clay painted on her torso. After hours of dancing and singing “in the language of Angola,” Branca fell to the ground as if she were asleep. When she was unconscious, two of her compatriots outfitted her with a “painted cat skin” and a band of red taffeta around her waist, a white cloth on her chest, as well as a “naked dagger” and a little hoop, one held in each of her hands. When she rose, she spoke in a voice that others said was that of nganga, and she called for her deceased eldest son. She offered her son food and drink, including an alcoholic beverage known in Kimbundu as “aluá.” Channeling the power of her deceased son, Branca offered remedies to cure a white woman of blindness.18 As these cases demonstrate, at the turn of the eighteenth century, calundu was a very specific Angolan-derived possession ritual with its own unique choreography aimed at removing malignant spirits that caused illness. Given the virulent disease environment and social anxieties of colonial society, alongside a majority Angolan population, it should not surprise us that Portuguese or Brazilians of European descent resorted to African healers. Nevertheless, European involvement in Angolan rituals generated great discomfort among those who believed that these rituals were an invocation of the devil. Portuguese observers often reduced all Angolan spirits (quilundo, ulundu, lundu) to the work of Lucifer. Brazil’s most famous seventeenth-century poet, Gregório de Matos, cautioned against Portuguese men and women taking part in “satanic” calundus. And a famous literary “Pilgrim” claimed that calundu was a pact with the devil aimed at deceiving people to sin, leading them down the path of perdition.19 Despite these negative assessments, the fact that calundu rose to the attention of authors and poets reveals the extent to which the idea of calundu penetrated deeply into the broader society as a set of embodied ailments or anxieties. In 1694 in Sergipe, a Portuguese man named Domingos Pinto Ferrás slept soundly in his bed one night when he was awakened by his wife’s restlessness. After a brief period of agitation, Ferrás claimed he suddenly felt for his wife “a vehement burning of sensuality that he only experienced before marrying her.” When he informed his wife, Maria Pereira, she responded that these “must have been her Lundus, which in the language of the blacks from Guiné are demons or malignant spirits.” Ferrás rejected Pereira’s response as insolence, but he was convinced that she

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and her mother were out to harm him. He complained of fatigue, anxiety, and a “strange smell” emanating from his body, which he believed to be “some balm of the devil.” Ferrás gave his wife and mother-in-law several beatings, accusing them of trying to bewitch him, before he eventually denounced them to the Inquisition.20 The number of calundu cases denounced before the Inquisition reached a crescendo in the first decade of the eighteenth century.21 By this time, several generations of native-born Bahians had lived in the Angolan-majority villages around the Bay of All Saints. Angolan language, culture, and ways of being suffused white and mixed-race communities, even as the Catholic Church tried desperately to prevent its followers from adopting “diabolical” practices. Among mixed-race slaves, the church faced an uphill battle. In 1713 in the town of Tapagipe de Riba, just outside of Salvador, three women presided over a ritual community, regularly healing with “Lundus,” and following much the same choreography we have described previously—dancing to musical instruments, spirit possession, transformation to “falsetto” voices, speaking in the “language of Angola.” What makes this particular healing center unusual was the lineage of the matriarchal leadership. Two women named Lourença were the principal vectors for channeling the ancestral spirits; one of these women was a “negra,” the other a “mulata.” The third woman, who everyone deferentially called the “Queen,” was a mulata named Ignes, the aunt of the mulata Lourença. Ignes did not dance in the calundus. Rather, she sat silently until the spirits possessed her, a sign of her experience and power. Given the fact that Ignes was a mulata, she was at least second-generation Brazilian. It seems likely that her mother was Angolan. Despite having a Portuguese father, she learned her mother’s Kimbundu language and ritual practices and continued them. Moreover, she passed these ideas on to her niece, Lourença, also a mulata, insuring that Angolan language, ideas, and ritual practices would continue to thrive in Bahia for at least a third generation.22 Catholic priests and other pious observers bemoaned the influence of Angolan healers in Brazil, certain that rituals like calundu lured good Christians to Satan’s side. Nevertheless, church officials sometimes capitulated to calundu. In August 1715, Father João Calmon seemed to concede that the devil was winning the battle. He complained bitterly that the Lisbon Inquisition Tribunal was “very distant from this Bahia, where the fetishism and foolishness that the Negroes make, which they call Lundus or Calundus, are scandalous and superstitious, and it is not easy to avoid them, since even many whites can be found in them.”23

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Just a year later, the dean of the Cathedral of Salvador, Sebastião do Valle Pontes, successfully appealed to the Provedor Mor to release his slave Domingos from galley service. The state had sent Domingos to the galleys because he was “found with others in a calundu house.”24 If Catholic priests could free their slaves from forced labor for taking part in calundu, could the practice really be considered a crime? One year later, in 1717, a French traveler recorded what he believed to be a “comedy” or a farce in the Convent of Saint Claire in Bahia. There, Catholic nuns, priests, government officials, plantation owners, and foreign dignitaries celebrated Christmas mass. As part of the festivities, the nuns, nearly all of whom were the daughters of important sugar plantation owners, performed a strange act involving song and dance. One portion of the nuns sat in a balcony playing musical instruments discordantly. On the floor of the church, another group of nuns danced counterclockwise in a circle, each jumping, flailing, and singing her own song. Suddenly, the music and singing stopped, and one of the nuns fell to the floor. When she rose, she sat in an armchair and began a “long speech . . . in corrupt Portuguese, such as that spoken by the slaves.” The “speech” was a recital of the “gallant intrigues of the Officers of the Court of the Viceroy,” publicly revealing “the mistress of each one and citing her good and bad qualities.” The viceroy’s nephew, embarrassed by the revelations of his wayward behavior, stormed out of the church in anger.25 Though the author does not use the word “calundu” to describe the scene in the convent, it is clear that the nuns followed the choreography of calundu ceremonies that were so common throughout the region and that they would have witnessed growing up. On the one hand, the performance might be read as a satire. On the other, it could be read as a singular opportunity for cloistered, female nuns to speak the unspeakable, to reveal “hidden” truths eating away at the social fabric of high society. The gendered aspects of calundu are crucial here. As we have already seen, the white woman Maria Pereira claimed that her lundus awakened her husband’s desires. Likewise, the hierarchy of power in the calundu at Tapagipe de Riba was decidedly matriarchal across at least three generations. Perhaps more telling is the broader matriarchy of calundu in the African-descended communities of Bahia. Of the dozen cases denounced before the Inquisition between 1692 and 1722 that I examined, eleven involved African-descended women. Calundu provided a rare vector for women to embody social, political, and spiritual power that was most often the preserve of white men. In this way, the embodied spirits

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in the convent endowed the nuns with the authority to heal prominent men of their demons, just as would have been the case in actual calundus performed by Central Africans and their descendants. Whether satirical or not, the calundu in the convent thoroughly subverted white male dominance, a tactic the nuns could have learned only from witnessing the calundus performed by Black women. The broad social and political power of these Black, female healers was implicit in the nuns’ mimicry and the audience’s knowing adherence to their prophecies. Even as the majority of Bahia’s white folk seem to have embraced the embodied aspects of calundu—through illness and spirit possession—deep tensions persisted over the precise source of these Angolan powers. During the early decades of the eighteenth century, it appears that white people’s embrace of calundu in Bahia could only occur in the context of farcical “comedies” like the one in the convent or as subversive, sinful practices alongside demonically possessed Angolans. In this way, calundu remained distinctly alien, dangerous—Angolan spirits that were inaccessible and unknowable to most white people. In the 1730s, slave owners in Bahia approached a Carmelite priest named Luís de Nazaret to ask if he could exorcise the demons that were making their slaves ill. Father Nazaret examined the slaves and determined they were infected with calundus. He conceded that “exorcisms did not remove that caste of fetishes because they were a diabolical thing,” and only the “Negroes” possessed remedies to calundus. Rather than attempt to remove the malignant spirits himself, Father Nazaret urged the owners to take their slaves to the experts on calundu, the Angolan healers.26 To be clear, I am not arguing that the majority of people in Bahia held the view that calundu was “diabolical” or sinful. On the contrary, as the foregoing cases have shown, white slave owners frequently appealed to Angolan healers to solve their most intractable problems, and whites eagerly took part in rituals of spirit possession. Catholic nuns even replicated these rituals inside a Catholic church! Nevertheless, everyone understood that calundu was subversive and potentially dangerous. What made calundu dangerous was its capriciousness, its instability, and perhaps most importantly, its invisibility. Calundu manifested primarily as inexplicable illness or anxiety that plagued the body, or through mediums who provided remedies to these ailments. The unhealthy disease environment of Bahian slave society was new and unfamiliar, resulting in symptoms that European doctors and priests could not explain. When healers of Angolan descent, mostly female, claimed power over these unfamiliar, invasive forces, performing elaborate rituals that invited the spirits

CA LUNDU

into their own bodies, they ceded complete control of their corporality. Their bodies became vessels for the soul, mind, and voice of a deceased ancestor. As the spirits washed over them, they literally became different people from another dimension of existence. By embodying the spirits of their Angolan ancestors, these healers staked a lineal claim to the knowledge of these ancestors and the ailments they caused. The Catholic Church wanted to reduce these spirits to the work of the devil, but the reactions of people like Father Nazaret belied a much broader recognition that Angolan healers possessed specialized knowledge about the body. If calundus were truly “a diabolical thing,” the priest should have been able to remove them through exorcism. But calundus were something else altogether. Just like the Catholic priests who channeled God’s energy to exorcise demons, so too did Angolan healers channel the energy of their ancestors to rid people of malevolent spirits. And only Angolan-descended healers possessed the knowledge over how to harness and control these dangerous spirits. THE TR A NSFOR M ATION OF CA LUNDU IN BA HI A

References to these distinct forms of Angolan calundu continued in Bahia at least through the middle decades of the eighteenth century; however, the idea of calundu underwent a series of transformations after the 1730s. Beginning in the last decade of the seventeenth century, the Bight of Benin replaced West Central Africa as the primary origin for Bahia’s slave population. This is not to say that Angolans ceased to arrive in Bahia. On the contrary, they still constituted around 28 percent of slave imports between 1700 and 1740; however, slaves from the socalled Mina Coast represented more than 60 percent of Africans arriving in the same period.27 This new “wave” of African immigration into Bahia decisively altered the cultures of slave communities. In 1742, the archbishop of Bahia noted these transformations in a letter to Lisbon, in which he underscored “the great need for a Tribunal of the Holy Office, because beyond the negros being almost innumerable, there doesn’t pass a month that don’t arrive at this port two or three ships of these people from the Mina Coast and others, not only practicing their barbarous and diabolical rites, but they excite those who were already here, almost forgotten, who then accompany them.”28 The bishop recognized a crucial trend: The shiploads of Africans from the Bight of Benin joined with those slaves already in Bahia to practice their “barbarous and diabolical rites.” These newly arrived Africans brought with them novel rituals and practices that ultimately expanded the Luso-Brazilian meaning of calundu to a form that would have been

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unrecognizable to first-generation Angolans, or for that matter, Brazilians, just a generation earlier. During this transitional period in the origins and composition of the slave trade, Luso-Brazilians did not distinguish between the various African ritual forms they witnessed. Rather, they resorted to terms that were already familiar. Observers reduced African music and dance to calundu, regardless of the origins of those engaged in these practices. Thus, calundu became a generic form of African music and dance, shorn of its specific Angolan ritual meaning. Several examples from the second half of the eighteenth century illustrate this trend. In the city of Salvador in 1754, an African slave named Custódia Gege, “celebrated Calundu parties” in which she “invoked the Devil.” Custódia’s master argued that her celebrations were “dedicated to the saints of her land,” almost certainly voduns. Nevertheless, authorities arrested more than a dozen slaves and free Blacks, including at least three other so-called Jejes from the Bight of Benin.29 In 1785 in the Bahian town of Cachoeira, six more Jeje slaves were accused of calundu.30 For witnesses, the Africans’ singing and dancing appeared to be calundu, but the ritual implements—a feathered arrow, coins, calabashes, and overall choreography did not adhere to the Central African ritual. Moreover, the language of the ritual was not Kimbundu but rather “the language of the Jeje.” Unsurprisingly, Luso-Brazilians grafted their generations of knowledge about calundu onto seemingly similar African practices, regardless of their origins. Even as far away as Lisbon, observers mistook specific rituals from the Bight of Benin for calundu. In 1771, a free Black woman named Teresa de Jesus denounced a woman named Maria as a calunduzzeira. In another apparent reference to voduns, Teresa asserted “the same saints they worship here, they also worship in the calundus of the Mina Coast.”31 Thus, across the Portuguese-speaking world, the distinctly Angolan ritual elements gave way to a generic form of calundu, essentialized as any African singing, dancing, and spirit possession for “diabolical” purposes.32 Even as calundu evolved into a generic term to describe a number of African ritual forms, it took on yet another meaning for white Brazilians and Portuguese, who turned lundu into a popular dance. In 1775, Domingos Caldas Barbosa, the Brazilian-born son of an Angolan mother and a Portuguese father, performed lundu in some of Lisbon’s wealthiest salons. Barbosa drew elements from the music and dance performed in actual calundu rituals and naturalized them to the lighter, more lyrical, Portuguese modinhas.33 This new lundu dance became popular among Lisbon’s well heeled, including at the royal court. The dance quickly made its way back across the Atlantic, where at least one government

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Figure 3.1. Johann Moritz Rugendas, “Lundu Dance” (1835).

official described lundu as common among “whites and pardos,” in contrast to the “more indecent” dances performed by Africans of various “nations.”34 Lundu remained a popular dance in Portugal and Brazil well into the nineteenth century. For example, a famous Johann Rugendas painting from 1835, entitled “Lundu,” shows a rustic scene of mostly white people dancing around a fire to the sound of a lone guitar. Similarly, in 1837, a Portuguese glossary defined “lundu” as “dance practiced among the negro peoples of the Congo and Bunda nations, from whom we get the name.”35 By this time, the long-version term “calundu” had all but disappeared from the Brazilian documentary record. Various African religious gatherings came to be known as Candomblé, while dances involving Africans were called batuque. We can surmise that Angolans in Brazil continued to perform calundu ceremonies—and describe them as such among one another—but the Luso-Brazilian variant of the term lundu referred to a dance performed by whites. I have written elsewhere that calundu “lost nearly all of the distinct Central

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African religious meaning that it had in its original form in seventeenth-century Brazil.”36 However, it seems clear that the central idea of calundu—the embodiment of some powerful, invisible spirit—lived on for many decades, even to the present. Though the Jeje men and women who conducted ritual practices in Bahia in the late eighteenth century never would have called them calundu (and, in fact, were probably performing some variant of vodun), the common denominator between the various African practices was spirit possession. Even in the high-brow, lyrical lundu dance, one can find the residues of spirit possession. After all, dancing is a window onto the spirit world, the vector through which dangerous spirits can pass into living bodies and transform them into mediums of otherwise inaccessible knowledge. Thus, even though the word “calundu” seemingly disappeared from the Brazilian lexicon for much of the nineteenth century, the spirits of possession survived in other guises. CA LUNDU’S MODER N R ELEVA NCE

After years of dormancy, these residues of calundu as spirit possession began to reappear in the documentary record by the late nineteenth century. Perhaps the most famous reference appears in Machado de Assis’s classic work Dom Casmurro, when the character Capitu complains of insomnia, headaches, dispiritedness, all of which she attributes to “her Calundus.”37 The Brazilian Dictionary of the Portuguese Language, published in the 1870s and 1880s, included “words and phrases that originate in Brazil . . . and are not found in Portuguese language dictionaries.” Here the word calundu is defined as “frenzy, ill humored, anger, an attack of nerves, hemorrhoids, nervousness.”38 The etymological discussion of the term seems to underscore its relative unfamiliarity. The first etymological entry speculates that the term is from the Guaraní “acânundú,” meaning “headache, to have a fever, feverish.” This is followed by a general statement: “Calundu in Angola is a part of fetishism.” The editors acknowledge the historical connection between Angola and Brazil, referencing the poet Gregorio de Matos. They also note that the shortened version, lundú, is derived from Angola, though they erroneously assert that “the prefix ca- is diminutive and pejorative” in Angola. Finally, they note that there was a sugar farm outside of Rio de Janeiro that was called “Calundu.”39 During the same year that the Brazilian Dictionary of Portuguese Language appeared, the explorer, soldier, and politician Henrique Beaurepaire-Rohan published his own volume of popular, spoken Brazilian Portuguese. His entry

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for calundu is more straightforward: “Ill humor that overcomes people and makes them insufferable because of their irascibility. In this way, one says that an individual is of calundu, or with his calundus, when his disposition is to be impatient with everything and all.” The author, who grew up in Niteroi, Rio de Janeiro, speculates on the etymology, “I believe it to be an African vocabulary. In my infancy I heard it many times pronounced by slaves of the Angolan race.”40 Here, it is clear that the idea of calundu survived colloquially in Brazil’s slave communities across the nineteenth century, though the frequency of use and the meanings were diffuse. While these definitions provide us with an abstract sense of calundu’s meaning at the turn of the twentieth century, a concrete example will help illuminate further.41 In the late nineteenth century, the Brazilian state of Bahia annexed an old town house (sobrado) into the compound of the Governor’s Palace. Like most sobrados, this one had a large, main entry door, which government architects converted into a portal for coachmen to enter and exit the palace grounds. Outside this principal entry, a Portuguese immigrant named Joaquim Grulha operated a tobacco shop, where “a great number of black Africans and other plebeian people” gathered to purchase cigarettes and to smoke and gossip. From time to time, Grulha lost his patience with the unruly gatherings, and the crowd suffered his wrath. When Grulha fell into these episodic bouts of “impertinency and discomposition,” the plebeian folk concluded that he was “with the calundu.” Thus, the gate entering into the governor’s palace came to be known colloquially as the “Calundu Gate.”42 Grulha’s periodic outbursts of anger clearly captured the meaning of calundu outlined in the dictionaries, and the subsequent labeling of the “Calundu Gate” gestures toward the rough-and-tumble scenes of Afro-Brazilian life that provoked his irritation. However, there is something missing from the definition—an implicit silence that seems to suggest a longer, deeper history of calundu. By the late nineteenth century, the word reflected a set of embodied behaviors—gestures, brusque words, obstinate silence, or darting eyes—that indicated intense irritation. Yet the Afro-Brazilians gathered at Grulha’s tobacco shop described him as being “with” the calundu. In other words, the calundu was not the actual behavior but rather the trigger for the behavior, some additive, external force that seemed to make Grulha lose his faculties. In short, calundu was the kind of impulsive, capricious anger that washed over certain people during fits of pique, as if they were literally possessed by an outside spirit. Bahians of all stripes understood the embodiment of unpredictable, furious

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anger as calundu. But if that fury emanated from an outside force, how do we characterize that force? Where did it come from? What was its history? And how did this force come to be widely understood in vernacular Brazilian language as a set of embodied behaviors? Brazilians in the late nineteenth and early twentieth centuries had no way of knowing that calundu had once been understood as a distinct, Angolan spirit possession ritual. However, the vestiges of Angolan knowledge systems survived. Modern science and biomedicine have solved many of the mysteries that were once the purview of the “masters of Calundu.” Yet there are still powerful, dangerous, invisible forces that can render people sick, depressed, or psychotic. Mental health issues, in particular, sit firmly in the “gray zones” of medicine and healing. In the absence of other explanations, calundu stands as an important explanatory mechanism for states of body and mind that are inexplicably outside the “norm.” Even today, short bouts of silence, irritability, or emotional instability are frequently attributed to calundu.43 Though modern Brazilians can laughingly dismiss their calundus, they also serve as familiar comfort—as ancestors, as history, as a predictable body of knowledge that harnesses the unknowable and makes it known. This is a tribute to the dozens of mostly female Angolan healers who plied their craft under the oppressive conditions of Brazil’s seventeenth-century slave society. By tracing the longue duree history of calundu as an idea, we can see the ways that calundu evolved as a composition of healers, slaves, slave masters, Catholic priests, nuns, government officials, and others. The biographies of individual Angolan healers are crucial in rendering this composition, but these biographies only provide us a glimpse of broader ethnographic ideation. Calundu still represents capricious, other-worldly expressions of the body, even today. The durability of the idea across more than four hundred years of history in Brazil is the true signal of its breadth and power.

{4} Dorotea Salguero and the Gendered Persecution of Unlicensed Healers in Early Republican Peru

Adam Warren

Having consulted various doctors in search of a cure for an illness “of the chest and legs”1 without experiencing any sort of relief, Father Bernardo Tejada turned away from the care of licensed and approved physicians in the early years after Peru’s independence from Spain. Rather than continue to seek treatments from figures such as José Manuel Valdés and Miguel Tafur—prominent physicians in Peru’s capital, Lima, who were involved in medical education and the regulation of medical professions—Tejada instead solicited the services of a notable local folk healer, Dorotea Salguero, during a visit to the city. Claiming elsewhere to be a healer who, thanks to an education she attained from a wise botanist, managed “to acquire some knowledge of the qualities and virtues of many herbs from the mountains and the countryside, supplied for the relief of humanity from its ordinary maladies,” Salguero treated and successfully healed him. In doing so, she allegedly achieved what her more formally trained rivals, Lima’s licensed physicians, could not. This encounter between a priest and an unlicensed healer would be unremarkable in early nineteenth-century Peru were it not for the extraordinary trust Tejada placed in Salguero’s skills and the attention, both favorable and unfavorable, that Salguero’s work received. Having returned to his curate in Huamantanga, a village in the province of Canta in the high Andes to the north and east of Lima, 55

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Tejada fell ill once again. Although sources do not describe the precise nature of his malady or its relation to his previous illness, one source, a court testimony left by witness Joaquín de San Martín, states emphatically that Tejada ordered that “this woman, in which he placed all of his trust, be brought to him.” And so Salguero, a healer with no formal training or license, undertook the considerable and difficult eleven-thousand-foot climb to Huamantanga, where she not only healed Tejada once again but also treated and cured another gentleman suffering from the same illness, who in preparation for death “had already confessed.” Allegedly viewing her work as an act of charity, she went on to treat “various sick people in the village, without taking [even] a half real from the poor.”2 The story of Salguero’s efforts to treat Tejada is unusual in that it involves a coastal, urban-based healer’s arduous journey to reach a patient in need in a remote corner of the Andean highlands. Tejada’s confidence in Salguero and respect for her work over that of licensed physicians, however, was far from extraordinary. Rather, in the 1810s, 1820s, and 1830s Salguero commanded a large and loyal following in Lima among many who benefited from her treatments or witnessed her successes treating others. In this way, Salguero constituted one of the city’s most popular health practitioners and arguably its most successful and well-known female healer. She therefore stood as a threat to the formal, increasingly male-dominated, medical professions in the city. For her part, Salguero described herself as merely a “resident of this capital,” who learned to heal with herbs based on training as well as her own observations. She noted that through long and well-calculated attempts and experience, she found that such herbs contained “vital relief, health, and the means to prolong life (as much as nature permits) in slighting a premature death, resulting from the common problems from which the animal economy suffers.”This knowledge led her to treat “within and beyond the capital” a large number of people suffering from a range of diseases, “always practicing on the sick who have been abandoned to their own devices by the medical faculty, or who have lacked the resources to attain [such doctors’] assistance.”3 Salguero treated patients in her home and in homes across the city, allegedly providing her services only when patients requested them, and treating the poor free of charge. She would occasionally accept payments for the cost of ingredients used in treatments as well as voluntary payments for her services. As a result of her successes, she claimed, she had found herself in competition with the country’s chief medical examiner, or protomédico (a licensed physician who headed the protomedicato, a tribunal and bureaucracy charged with regulating the medical professions), Miguel Tafur. He

DOROTEA SA LGUERO & GENDER ED PERSECUTION OF UNLICENSED HEA LERS

had her arrested in the late 1820s and 1830s, placed on trial twice, and held “incommunicado in diverse prisons, and in the most degrading spaces with major criminals.” Tafur and other licensed doctors, she alleged, even sought to banish her from Lima, “or send me, I don’t know where, like a classic delinquent.”4 Salguero was but one kind of health practitioner within a diverse, complex, and competitive medical marketplace of healers in Lima and other parts of the country. She worked alongside purveyors of treatments situated both within and outside the traditional occupational categories of bleeder, midwife, pharmacist, barber, surgeon, and physician. Many occupied the gray zones of healing that this book discusses and would be considered herbalists or ritual specialists today. Drawing on multiple medical traditions, they outnumbered their formally trained, licensed counterparts. Physicians’ criticisms of their services reached such levels in the press following Peru’s independence in 1821 that they led historian Hermilio Valdizán to publish a scathing depiction of Salguero a century later. For Valdizán, Salguero served as the quintessence of the dangers folk healers posed to both the public and the medical profession.5 Subsequent scholars such as Juan Lastres, José R. Jouve Martín, and Lissell Quiroz have offered more generous assessments of Salguero. Although they have not focused on her as a historical figure worthy of study in her own right, they have used her story to shed light on the practice and regulation of medicine and healing in early postcolonial Peru.6 By drawing on a range of documents related to Salguero’s work, her navigation of Lima’s social milieu, and her persecution, this chapter will build on these earlier studies in multiple ways to provide a fuller picture of her life and work within the gray zones of medicine. Published accounts of her arrests and trials illuminate her relationships with patients and how she defended her right to practice as a healer in the late 1820s and early 1830s. In addition, debates in Lima’s main newspaper, El Mercurio Peruano, as well as La Floresta and El Telégrafo de Lima show how Salguero’s case scandalized residents of the city and acquired significance beyond the question of her abilities as a healer. At one level, these materials suggest that at the heart of this case was the question of how the tenets of classical and economic liberalism might apply to the healing professions in Peru after it became an independent republic and what status the old institutions of Spanish colonialism might maintain in such a society. However, they also suggest that Salguero was particularly vulnerable to the protomédico’s wrath as a female healer, one who lacked access to institutions her male counterparts enjoyed, and who had to confront and defy stereotypes. Put succinctly, gender shaped Salguero’s persecution during a time of male medical professionalization. Salguero’s published

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defense thus constitutes a defense of female expertise and the rights of women to practice healing at a time when others sought to bring about their exclusion. THE LIFE A ND METHODS OF A FOLK HEA LER

There is little that we know about Dorotea Salguero’s life with any sense of certainty. She was born, most likely in Lambayeque, on Peru’s north coast in 1770 and died in Lima around 1838.7 In her defense published in 1831, Salguero characterized herself as “an elderly and defenseless woman,” providing some indication of her age.8 Salguero had taken up residence in Lima by 1809, the year in which residents of the city began to recognize her talents and refer to her as “doctora.” Salguero gained fame and popularity by word of mouth among customers and friends, few of whom cared about the origins of her training. Her fame lasted for nearly thirty years, and according to Valdizán, she rivaled in popularity the city’s most famous doctor of the period, Hipólito Unanue, who served as protomédico from 1807 to 1825.9 Marriage and baptismal records suggest that Salguero first married in 1798 and may have moved back and forth between Lambayeque and Lima during the 1810s, a decade for which we have little information about her. Records list a “Dorotea Salguero” as also marrying in Lambayeque in 1813 and having her son from that marriage baptized in Lima’s parish of Santa Ana.10 However, it is impossible to rule out that there could have been more than one woman by that name, and Salguero’s published defense makes no mention of her marital status or her family. Based on correspondence in Lima’s leading newspaper, El Mercurio Peruano, we do know that she had at least one daughter. The physician José Manuel Valdés, writing under the pseudonym of “Suadel” (a practice that was common in Lima’s press), noted that after Salguero’s second arrest in 1830, her daughter appeared at his home one evening to beg for the healer’s release. Using this story to cast doubt on Salguero’s character, Valdés claimed that having explained to the daughter the conditions of her mother’s release, which was contingent on her ceasing practicing healing, “the girl lamented with tears, telling me that her mother was inflexible, and that not even her confessor had been able to subdue her.”11 As a woman from Lambayeque, Salguero hailed from a part of Peru known for its large, free and enslaved population of African descent and that population’s influence on local customs and rituals, including healing practices. In descriptions of Salguero’s methods in documents related to her arrests and trials, however, she was characterized as an herbalist who drew on the healing traditions

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of Indigenous peoples from the Andes. Her practices involved the use of enemas and douches, baths, a fermented corn beverage known as chicha, and homemade concoctions made with Andean herbs. She had learned about these methods through consulting other herbalists and healers working within the gray zones and had refined her skills through practice and experience treating the sick. A portion of this learning took place in Lima. For example, Valdés described her as using a chicha recipe she had inherited “from a Peruvian barber who lived on Melchormalo Street, and who has been administering the treatment as Salguero does for over thirty years.”12 Although Salguero emphasized the Indigenous origins of her treatments, this does not necessarily mean that she was unfamiliar with the healing practices of Peruvians of African descent, or that their approaches to discovering treatments failed to form part of her work. Rather, as Pablo Gómez has described for the early Spanish Caribbean, healers of African descent went to considerable lengths to incorporate local flora and fauna from the Americas into their healing repertoires and pharmacopeia.13 Such processes of medical pluralism had been underway on Peru’s coast for centuries before Salguero’s birth, and they are likely reflected in Valdés’ description of the barber’s recipe above: most barbers in Lima were of African descent, yet a beverage of Indigenous origins, chicha, formed the basis of this barber’s treatment. Salguero’s own methods likewise reflect this practice of drawing from multiple traditions, although she makes no acknowledgment of the influence of non-Andean approaches to healing in Lambayeque and Lima. In Lima’s broader community of healers, this may have been a strategy to distinguish her approach from those of others. Salguero’s treatments also appear to have lacked any reliance on ritual practices, whether they be of Indigenous, African, or Spanish origins. None of the charges brought against her made any reference to the use of magic, spells, or witchcraft. This was the case even though a writer who published under the pseudonym “The Meddling Woodcutter” (El entrometido leñalero [sic]) and who had known her since 1809 noted that her rivals referred to her in that period as a “bruja,” or witch.14 Instead, Salguero emphasized mundane treatments drawn from the natural world, none of which required the intervention of a pharmacist or physician. In perhaps a deliberate strategy to portray herself as a knowledgeable empiric and expert healer at a time when professionalizing doctors and surgeons depicted magical treatments and cures as typical of female healers, especially midwives, and as an affront to proper medical practice, she claimed none of hers possessed special powers.15

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By the 1820s, Salguero was, of course, part of a larger urban society in Lima, in which much of everyday healing involved herbal remedies. Home medical manuals known as recetarios proliferated in the city in the eighteenth and early nineteenth centuries, providing ordinary people and folk healers with specific instructions for the development and administration of treatments for particular ailments using flora and fauna. In some cases, the materials described in these manuals could be acquired fairly easily in Lima’s markets and in the pharmacies of its hospitals. Most surviving manuals from Lima focused on materials gathered in the Andean highlands, which constituted important components of Indigenous healing repertoires.16 This was the case even though Lima’s own Indigenous population had long been relatively small, constituting just 8.2 percent of the city’s residents, according to a 1791 census, and was far outnumbered by people of African, Spanish, and mixed descent.17 Inclusion of these materials thus reflected the disproportionate influence of Indigenous Andean medical knowledge on popular medical knowledge and practice in a coastal, multiethnic, and multiracial urban, social, and political milieu. As a practitioner who claimed to have incorporated Andean herbs into her treatment repertoire, Salguero serves as a further example of this medical pluralism. That said, she also sought to differentiate herself from others by claiming to possess secret and specialized knowledge unavailable in books or medical training. Salguero’s claims to exceptional knowledge in a city with a small Indigenous population were corroborated by José Braulio Camporedondo, a member of Peru’s Congress, who esteemed and defended her. In reference to Salguero’s work, he argued “great prizes should be given to those who discover the virtues of infinite plants, with which even the indigenous people of the entire republic made their marvelous cures.”18 Many of Salguero’s patients agreed with Camporedondo and suggested her empirical knowledge gave her advantages over more formally trained physicians. For example, “Defenders of Truth and Justice” (Los defensores de la verdad y la justicia) wrote that “Salguero is a better professor than the physicians, because in the space of twenty and some odd years that she has made cures in practice, she has discovered the merit of herbs.”19 Speaking broadly about herbalists, another of her supporters, “O.S.A.,” reflected Peruvians’ widespread confidence in Indigenous medical knowledge. Expressing skepticism about physicians’ training, which was grounded in theory instead of experience, he wrote that for correct diagnoses, “I will turn to the Indians of the highlands and their simple medicines, no matter how many doctors there are in the civilized world.”20 Support also becomes clear in the published statements of seventeen

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witnesses who attested to the value of Salguero’s treatments during one of her trials. Indeed, Salguero was so successful at healing that many championed her skills over those of her licensed rivals. D. Tomás José Morales, for example, argued that Salguero provided superior treatments through “her simple, homemade, curative method,” which he suggested surpassed those of two of Lima’s most famous eighteenth-century doctors, Cosme Bueno and Gabriel Moreno. Doña Manuela Figueroa, on the other hand, stated that she sought Salguero’s help for her daughter’s “fistulas in her mouth” after most of the city’s doctors claimed her condition to be untreatable. Forty days after Salguero began administering “herbs, homemade remedies, and a chicha that she puts together,” the mother found her daughter to be “healthy and well, when in the three years that the doctors treated her she got worse and worse, despite the many payments made.”21 In yet another case, an actual doctor, Dr. Erazo, allegedly asked Salguero to treat Angela Reyesta, a woman whose angina he could not cure. Salguero administered homemade remedies and cured Reyesta within a few days, leading the patient to assert that “if the doctors pursue Salguero it is because she sends back healthy those they have declared lost causes and abandoned.”22 Beyond Salguero’s reputation as an herbalist, evidence suggests that she was regarded as knowledgeable and successful in treating women’s reproductive and gynecological problems. Historian Lissell Quiroz describes her in two separate publications as a “partera,” or midwife.23 I have found no evidence that Salguero described herself in this fashion or that she oversaw cases of childbirth. Nevertheless, there is widespread evidence that she assisted in related health matters. For example, Salguero treated a woman following a difficult birth that had resulted in an embryotomy, a procedure in which the fetus is removed from the womb in pieces. Accompanied by her mother and another woman, the patient had appeared at Salguero’s home to plea for the herbalist’s help after spending two months receiving treatment for her pregnancy from physicians in one of the city’s hospitals. She was hemorrhaging blood and suffering from severe abdominal pain, and physicians had allegedly abandoned her after putting her “in the deplorable state in which [others] saw her, already feeling in her nature the symptoms of death.”24 Over three days, Salguero managed to stop the flow of blood and resolve the abdominal pains, restoring the woman’s health.25 Further evidence of Salguero’s success in matters of gynecological and reproductive health can be found in her trial records. Fernando Aristizabal, for example, declared that he begged for Salguero to help his daughter, who was gravely ill with “a growth on her cervix.”According to Aristizabal, thanks to “some herbs

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[Salguero] gave her so that she could self-administer her douches, [the daughter] became healthy and well.”26 Likewise, Feliciana Trucius testified that she suffered from “severe maternal inflammation” and sought treatments from various doctors for over a year. When Salguero finally took over her case, “she made her healthy and well with just some herbal remedies, home washes, and baths in the sea.”27 Testimony also suggests that those who sought Salguero’s assistance made little distinction between her broad identity as an herbalist and her narrower reputation as a healer of gynecological and reproductive maladies. Baltazara Flores de Paredes, for example, was so pleased with Salguero’s treatment of “an ulcer that she had on her lower lip” that she requested the healer’s assistance in treating her “criada,” or servant, who suffered from what was most likely a rectovaginal fistula. According to Flores de Paredes, “the corruption of her body was unbearable for the whole house” and a notable doctor, most likely Miguel Tafur, had declared that “the problem had no remedy.” Salguero, however, informed her that she had “certain herbs so effective that it was likely she could heal the servant with them.” This proved to be true. Flores de Paredes then had Salguero cure three children “of a tenacious dysentery prompted by measles” and two servants “who were almost exhausted afflicted with fevers, full of ulcers, and quasi worn out.”28 As Flores de Paredes’s example shows, Salguero treated a wide range of patients with respect to age, social position, and other characteristics. Many spoke effusively of her talents. While Congressman José Braulio Camporedondo testified that “far from being punished, she should be rewarded” for her successes, a resident of the capital of humbler background, Miguel Blanco, declared he wished he had “ten thousand tongues with which to publicize the prodigious work that [Salguero] undertakes for the benefit of humanity, which looks more like miracles than remedies.” Blanco had not only been cured of dysentery after consulting Salguero but had also seen Salguero treat and heal several others, including “two most ill poor people.”29 In this way, Blanco’s testimony reflected the confidence many of Lima’s residents placed in Salguero, and perhaps in other folk healers working in the gray zones, despite the efforts of licensed doctors and surgeons to police them. Salguero’s life and work point to the persistence, strength, and influence of such practitioners in early nineteenth-century Peru. A FOLK HEA LER ON TR I A L

Salguero first encountered trouble in 1827. That year, the protomédico, Miguel Tafur, approached a judge to accuse her of treating patients in various homes in

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the city, including her own, where she supposedly ran a hospital and “posed as physician, surgeon, and apothecary, in order to increase scams [against patients] following the murders she committed.” According to Salguero’s court-appointed attorney, Manuel Cayetano de Loyo, Tafur did not list the names of the people allegedly killed under her care but “warned her twice to discontinue the work, and on the third occasion she answered that the protomédico had no reason to interfere with her.” Claiming that such actions warranted punishment, Tafur asked the judge to subject Dorotea to “expatriation or banishment in accordance with the law.”30 Salguero responded to these accusations by denying she had committed the acts for which she was accused. That is to say, she worked within the parameters of Tafur’s accusations, rather than challenging his authority to level them against her. She claimed generally to cure free of charge those “contaminated with syphilis, sores, etc.,” who had been abandoned by physicians, and that in more grave cases she “called on professors” to help. Furthermore, she denied running a hospital in her home and declared never to have employed medications from the pharmacy “nor any variety that might cause harm at all,”31 focusing instead on herbal preparations. This behavior, she believed, demonstrated her respect for the boundary between licensed and unlicensed healers, which the protomédico saw himself duty bound to enforce. Two surgeons and a professor of medicine, however, contradicted Salguero’s claims. The surgeon Agustín Martínez testified that Salguero “occupies herself with curing the sick in her home as well as outside of it, and for that reason they call her the doctor of San Cristóbal Street.” While he knew of no medications that Salguero herself made, he alleged that she had called him “on various occasions to attend to the sick, already in a state of dying.” For his part, Francisco Román testified that he had not only met patients who came to him after she treated them unsuccessfully but also had encountered a girl named Anjelita, who had paid for treatment, rather than simply compensating Salguero for the cost of ingredients. Román allegedly “had always seen many sick people in [Salguero’s] doorway,”32 and like the third witness, the surgeon Eduardo Pompeyo, he believed she was treating the sick there and elsewhere. Despite what Loyo, Salguero’s attorney, later characterized as a dearth of evidence, the judge ordered Salguero captured and drew on the prosecutor and the military to do so. Salguero was imprisoned on June 21, 1828, and subsequently placed on trial, where she was found guilty of curing without sufficient knowledge and in violation of the protomédico’s orders. The judge, however, decided

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Salguero had already suffered enough for her crimes through imprisonment. He ordered her “freed under the judicial warning that she not go back to healing, and that in the case that she does, she will have to be banished from this capital as is laid out and indicated for charlatans.”33 Two years later, three doctors—Valdés, José Eujenio Eizaguirre, and Ramón Castro—denounced Salguero before Tafur, the protomédico, for healing. They accused her of appearing in the home of a sick woman, Manuela Vidal, whom they were treating for acute colic. There, Salguero allegedly dismissed the doctors’ treatments, suggested that Vidal try a different method, and sought to charge the patient for the visit, for an enema, and for a remedy she had prepared. Although Vidal refused Salguero’s treatment, the doctors themselves expressed outrage and accused Salguero of violating the terms of her release. In their view, she had behaved scandalously, had infringed on their domain, and had violated the ban on healing. Tafur forwarded the doctors’ denunciation to the courts along with documents of his own, in which he requested that Salguero be arrested and tried not only for violating the court’s previous instructions but also for contravening colonial legislation that he believed remained in effect. In particular, he cited a royal decree issued on November 21, 1733, which formed part of broader legislation governing the protomedicato. In Tafur’s interpretation of this law, which “had sentenced those who practised medicine lacking proper authorization to a hefty fine and banishment from the city,”34 Salguero must be severely punished for her actions. In response, the prosecutor, Santiago García Paredes, ordered Salguero’s arrest and the court imprisoned her, “basing this on her proven disobedience of the protomedicato.”35 Authorities forced Salguero to confess, but her confession in no way resembled what the protomedicato sought. Rather than admit to breaking the law, Salguero claimed the encounter in the home of Manuela Vidal had been an act of revenge fueled by well-established rivalries between herself and the three physicians, which stemmed from a previous dispute over a patient. Salguero reiterated that she only treated those whom licensed healers abandoned, that she only assisted those who requested her services, that she never used pharmacy medications, and that she believed administering a homemade remedy to a neighbor was “a work of charity and a matter of religion.” Moreover, while she engaged in charity when treating the poor, in other cases she admitted receiving money as “a kind of compensation for the expenses such remedies require.”36 Building on this confession, Salguero’s attorney, Loyo, argued that even

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though her accusers––Valdés, Eizaguirre, and Castro––constituted her enemies and also witnesses in her trial, none of them could prove she was at fault or had committed a crime. In his words, none could identify “a fact indicating as such.” Moreover, due to their bias and questionable motives, what was taking place “was the mere apparatus of a trial and a criminal libel without an apparent or presumed corpus of crimes: a glass lantern with neither an oil reservoir nor a lighted wick.”37 To this extent, Salguero and Loyo once again defended her within the framework of the accusations against her, alleging that her behavior differed from the descriptions of crimes committed. However, this was not their only tactic. Also at issue was whether colonial legislation remained in effect, or whether it contradicted liberal principles on which the republic was supposedly founded. By challenging the legal basis of her prosecution and questioning the protomedicato’s legitimacy as a tribunal under Peru’s Constitution of 1828, Loyo aggressively moved beyond the parameters under which Salguero was accused. He ultimately questioned whether policing folk healers constituted a legacy of colonial tyranny. Concepts of the individual within classical and economic liberalism formed the foundation of Loyo’s defense of Salguero. He argued humankind possessed rights and duties based on universal and inherent attributes of “liberty, individual security, equality and property: primitive gifts with which man is born.” Among other things, these afforded individuals free will to choose their type of healing, since patients were owners both of their health and of the means to repair it. According to Loyo, this was enshrined in article 149 of the Constitution of 1828. In addition, Loyo suggested Salguero had the right to offer her services as a folk healer and the obligation to do so as a member of an “ordered and rational society.” His reasoning followed the same logic of mutual obligation and charity as the idea that “the parched person has the urgent right to ask for water, and he who has water has an undeniable duty to provide it.”38 In Loyo’s view, the political institutions that had dominated countries, especially countries governed through absolutism like Spain, had undermined such rights and duties. They were thus incompatible with the practices of a republican government. If Loyo’s defense of Salguero rested on the question of how an ostensibly liberal republic could be governed by an absolutist monarchy’s laws and institutions, then its success depended on arguing that the protomedicato was the quintessential Spanish institution, one not meant to survive more than a few years following independence. Loyo argued that the Crown gave the protomedicato excessive oversight by concentrating in it legislative, executive, and judicial

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powers. It wielded “privileges and prohibitive, penal, and directive laws”39 and therefore acted in a despotic fashion both in Spain and the Americas. Moreover, while in 1826 it was decided in Peru that protomedicatos could continue to exercise economic and directive functions until new laws were approved, such tribunals were not to perform their more contentious functions during that time. 40 Finally, in 1828 the new constitution essentially nullified the protomedicato by acknowledging only two special tribunals, those of commerce and mining. Additional legislation abolished all others. In response to Loyo’s defense and the prosecutor’s presentation, the judge, Pascual Francisco Suero, ultimately ruled in favor of Salguero, though in a way that left her legal status as a healer in doubt. For Suero, the case revealed inconsistencies in how colonial legislation should be applied to republican life. While he concluded that Salguero could not be prosecuted under the 1733 royal decree and related laws because she had not committed the acts that the legislation associated with charlatans and swindlers, he believed new legislation was needed. He therefore ordered that the protomedicato cease bothering and pursuing Salguero “for now, while the court consults with the national representative body, meeting currently in Congress, on various and grave points of doubt that emanate from this genre of cases.”41 Loyo thus effectively handed the question of folk healers’ rights over to lawmakers. As Salguero’s case moved out of the courts, the folk healer took a more public and visible role in her defense. The resulting materials, including her prepared address before Congress, shed light on how she envisioned both her work as a female folk healer and the persecution she endured. While it is impossible to distinguish with certainty her views from Loyo’s, her address differed from his writings in emphasizing her gender. In doing so, it revealed how she publicly critiqued her rivals’ actions and advocated for her right as a woman to practice healing in a liberal republic. Salguero, first and foremost, used the language of citizenship to frame her persecution as a violation of her rights and to claim a space for herself as a woman in newly independent Peru. Arguing that the protomédico lacked the authority to bring charges against her and that the judge therefore lacked the power to place her on trial, she insisted that the case was an attack “against every liberal principal, borne either of a conceptual error regarding the character of our institutions, or of the determination not to observe them as a tribute to and out of respect for the colonial ways that we had just banished.” In this sense, she reasoned, the courts denied her right to exercise her skills freely as any citizen

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would, imperiling her means to earn a living. Noting that people are condemned “to live from [their] sweat and occupation,” and that “he who works is worthy of [God’s] mercy, which nobody has the right to refuse or contradict,” she argued the protomédico lacked “the discretionary power to want to deprive me of food and of the means to acquire it.”42 In this way, Salguero positioned women as possessing the inalienable right to work in a profession of their choosing at a time when this was far from the case. Salguero also employed gendered language strategically to portray herself as someone who wielded little power and who had been rendered a victim at the hands of exceptionally powerful men. In particular, she described herself as an “unhappy woman” and “a zero in this land.”43 The first term served to elicit sympathy and pity from male legislators and readers of her address. “A zero in this land,” on the other hand, conveyed her relative insignificance and her subordinate position within a patriarchal society. However, in spite of her lack of power, she claimed physicians wanted to confine her for the rest of her life, “as if sent to the presidios of Ceuta, Melilla, or Oran as the travelers depict, or to the island of Juan Fernández, according to the celebrated Chilean writer Dr. Egaña’s description, or to the tunnel in the Potosí mountain.”44 In this sense, she navigated various gender roles to call out the injustice of her own persecution at the hands of the city’s licensed and approved healers while also portraying herself as defenseless. Finally, Salguero transcended her expected gender role by boldly critiquing the temporary nature of the court’s decision and the uncertainty of waiting for Congress to resolve the matter. She saw this predicament as resulting from a legal process that was shoddy, even if some of the underlying principles themselves were sound. She not only argued, as Loyo did, that the protomédico lacked authority to make accusations against her but also claimed the protomédico’s own motivations should be questioned. In her view, Tafur intended to keep her permanently entangled in the courts through a series of corrupt practices, thus preventing her from performing her work. This, she claimed, directly infringed on her rights as a citizen, even as her talents were debated within and beyond the walls of government. A SCA NDA L IN THE PR ESS

Salguero was not only tried in Lima’s courts. Indeed, by the time she was first released from prison in 1828, her case had already become a spectacle in Lima’s

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press. The Mercurio Peruano published articles and correspondence about Salguero as early as January 1827. In one, she was praised as “the great nurse of this capital,” and it was noted that “she is sought after by enlightened men, and there are countless examples of individuals whom she has returned from the grave after the physicians sent them off.”45 Not all newspaper coverage, however, proved flattering. Following her release from prison in 1828, the Mercurio Peruano published the judge’s order in its entirety and included without attribution a warning directed at her. Signaling acknowledgment of her age but not necessarily her social standing by addressing her as “doña,” the warning stated: “If despite this sentence and notification Da. Dorotea should continue to heal [others], which is to be feared given her audacity, there should not be any more indulgence for her; since the person who with insolence and impertinence violates laws insults the sovereignty that sanctions them, and the supreme authority who orders their observance.”46 Debate in Lima’s press about Salguero and her cures became more contentious after her second arrest in 1830. Published letters, in particular, positioned Valdés and his allies against her supporters. Writing multiple letters to the Mercurio Peruano and signing as “Suadel,” Valdés made it his personal crusade to discredit the healer and counter the praise others offered of her work. For example, in a February 18, 1831, letter, he launched new accusations against her, alleging that she had managed to kill not only three prominent men suffering dysentery but also two women with gynecological problems. One of the women, Ignacia Trejo, had sought her assistance in defiance of physicians for the treatment of a uterine polyp, for which Salguero had her drink a concoction. According to Valdés, Trejo afterward “was afflicted with so much vomiting and so many bowel movements, with inflammation of the abdomen, that they transported her in a hand-held chair to the Convent of the Descalzas, moribund and suffering cold sweats.” She died three or four days later. In the second case, Salguero visited a servant suffering from a type of vaginal candida known then as “flores blancas,” or white flowers. Following treatment, “the fever and pains were so intense, that not even bleedings, nor lukewarm baths, nor opium could calm them; and the unhappy woman died of gangrene, shrieking in the saddest way day and night.”47 Others joined Valdés in casting doubt on Salguero’s skills and emphasizing the threat she posed to the public. In doing so, they depicted Lima’s licensed physicians and formally trained healers as intervening on behalf of those her ignorance harmed. In an article titled “Miracles of Da. Dorotea Salguero,” an anonymous author wrote of passing by the Hospital of Santa Ana one morning

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and seeing a moribund woman in the doorway, whom “Da. Dorotea had been treating in her hospital home for men and women.” According to the author, when Salguero noted fatal symptoms, she sent the woman away. Upon her arrival at Santa Ana, it appeared “she had been bled from one hand, and the wound was so big, that it was as if they had opened the vein with a knife, not a lancet.” Ultimately, a hospital employee, Dr. Heredia, “helped her, comforting her and having the sacrament of the last rites administered to her.”48 Such accusations of abandoning patients in a grave state were something both sides employed in the press, and they served to undermine claims of expertise, goodwill toward patients, and dedication to the principles of charity. Defenders of Salguero, however, combined such claims with scathing critiques of physicians. For example, having asserted that Salguero possessed legitimate scientific knowledge of botany and that doctors persecuting her lacked that knowledge, “Defender of Virtue” (Defensor de la Virtud) declared “they have made her drink the dregs from the cup of bitterness, with neither the law, nor public authority, nor the advanced enlightenment of the times having served to protect her.” Noting that she had managed to heal patients whom physicians had abandoned to die, he questioned why anyone would seek to slander her. “An Impartial advisor” (Un consejero imparcial), on the other hand, listed the reasons why he would seek Salguero’s care over that of a doctor. Among them, he stated that while he knew many patients whom she had healed after physicians had abandoned them, he knew of no case where the opposite was true. Denigrating doctors’ knowledge and skills, he noted that even “savages healing at the same time with herbs are more robust and live longer than we do, despite so many pharmacies, and so many specialists full of studies, observations, degrees, and books, etc. This is irrefutable.”49 Defenders of Salguero also responded in the press to what they perceived to be Valdés’ gendered attacks and esteem for the foreign. Addressing Valdés, “P.J.L.O.A.” accused the physician of trying to exile a female Peruvian healer and destroy her professional life in order to elevate his own standing. Moreover, he insisted that by simultaneously persecuting Salguero and supporting Benita Paulina Cadeau Fessel, a French midwife who had recently arrived in Lima to great fanfare, Valdés betrayed his countrywomen. Cadeau Fessel benefitted from advantages that Salguero and other female Peruvian healers lacked, having acquired formal training and a diploma in midwifery abroad. Peruvian women, in contrast, could not enroll in Lima’s medical school or its university. Considering these circumstances, “P.J.L.O.A” asked should it not cause delight “that a

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Figure 4.1. An anonymous resident of Lima completed this gouache-on-paper portrait of one of Dorotea Salguero’s accusers and critics, Dr. José Manuel Valdés, around the turn of the twentieth century. Over time, Valdés came to be remembered as a founding father of Peru’s male-dominated medical profession. In contrast, and perhaps as a reflection of broader patterns of misogyny, there are no surviving images of Salguero herself. Anónimo limeño, El doctor José Manuel Valdés, según Pancho Fierro ca. 1890–1910. Museo de Arte de Lima. Donación Memoria Prado.

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Figure 4.2. Dorotea Salguero’s address to Peru’s Congress circulated in print in 1831 as part of a larger account of the criminal cases brought against her. Titled Defensa hecha a favor de Da. Dorotea Salguero . . . [Defense Made in Favor of Da. Dorotea Salguero . . . ], the published work also included patient testimonies and materials attributed to her lawyer, Manuel Cayetano de Loyo.

Peruvian, being a woman, and not possessing as many studies as the columnist chooses, acquired the discovery of some herbs for the benefit of humanity?”50 Critics in the Mercurio Peruano, however, seized on this difference in access to education, attacking Salguero and other female practitioners working in the gray zones to defend Lima’s exclusively male community of physicians. “The Amanuensis” (El amanuense) wrote that Salguero sold patients “the incorrect

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drugs that a mind belonging to her sex and class is capable of mixing together.” Likewise, “The Disabuser” (El desengañador) argued she treated “the foolish, among whom she occupies a distinguished place.” “An Incognito” (Un incógnito) called Salguero “an intrusive curandera, who only knows the recipes from some old book, like the Florilegio medicinal, and those she has learned from the doctors themselves.” Given her lack of formal studies, he suggested she would endanger patients with her treatments, “not knowing the disease for which they should be administered.” Finally, “A Lover of Humanity” (Un amante de la humanidad) extended these critiques to other women. He suggested pharmacists should write prescriptions in Spanish, not Latin, “since it has already become fashionable that women and children help in the pharmacies.” Given their lack of formal training and knowledge of Latin, he argued, they risked dispensing incorrect treatments that could prove poisonous and “affect the lives of men.”51 Those who defended Salguero in the press sought to counter these depictions. Ultimately, however, from the perspective of Lima’s reading public, Salguero’s “newspaper trial” never resulted in fully dismantling the status and authority of licensed male physicians over female healers. Valdés, for example, proposed to resolve questions of Salguero’s knowledge by having other healers judge her remedies, writing that “if you know an herb that is effective for one or more diseases, show it to the government, so that if experts declare that it is unknown among doctors, they can test it with due circumspection.”52 In this same letter, however, Valdés dismissed her knowledge by asserting that only physicians “know the timing and circumstances for prescribing”53 bleedings, quinine, and opium. Even one of Salguero’s defenders, “an Impartial Advisor” (Un Consejero Imparcial), expressed condescension toward Salguero in ways that reinforced perceptions of inadequate female knowledge. After encouraging doctors to “study less and get things right more often,” he wrote that he would advise Salguero that “when she goes about visiting her patients in her calash, she carry with her continuously her book in order to read it.” He reasoned that this way “she will have present the patient’s disease she is going to cure, and she will learn to characterize the difference between what is called vicho and dysentery, and which of these is inflammatory, bilious, and malignant.”54 Salguero thus became a public figure who could never escape the misogynistic paternalism of others. In January 1837, the government of the recently formed Peruvian-Bolivian Confederation issued an order yet again banning Dorotea Salguero from treating and healing the sick in Lima. Addressed to Valdés, who became protomédico

DOROTEA SA LGUERO & GENDER ED PERSECUTION OF UNLICENSED HEA LERS

in 1835, and signed by the prefect of the Department of Lima, General Manuel de Aparicio, the decree read simply as follows: “In accordance with the statutes to which this Tribunal is subject, you shall proceed to prohibit doña Dorotea Salguero from continuing to heal as she has done to this day. May God protect you.” Published in the newspaper El Telégrafo de Lima, the decree appeared alongside orders from Valdés. Having long vilified Salguero in the courts and in the press, he ordered the resolution carried out as worded. Furthermore, he demanded that “in the event of disobedience, she will pay fines and will suffer imprisonment and other penalties that may be imposed on her in accordance with the laws. Make this known to the prosecutor so that he may keep watch over this curandera’s conduct.”55 For Valdés and others who had opposed and persecuted Salguero in years before, this decision had repercussions far beyond her case alone. According to the article, the protomédico would now unleash “his accredited zeal for the prestige of medicine and the wellbeing of his fellow citizens. From now on the North Peruvian State will no longer suffer from the plague of so many charlatans and curanderas that infest it.”56 Nevertheless, one month later, on February 6, 1837, a new decree annulled the previous one and allowed Salguero to resume healing the sick. Issued in response to twenty-six separate letters of support as well as “the skill of the petitioner in the treatment of some diseases,” the decree stated that she possessed adequate knowledge as a healer and that until Congress took a position on the matter, “the sentence pronounced on 2 April 1831 shall be neither altered nor contravened and shall likewise be declared to be in effect.”57 Dorotea Salguero passed away in 1838. Why, ultimately, was she pursued, arrested, brought to trial, and left in a state of professional and legal limbo in the first decades after independence? As Jouve Martín and Lastres have argued, concerns about professionalization and desires to elevate the status of licensed physicians fueled opposition to Salguero’s work in the gray zones.58 Nevertheless, it was significant that Salguero, the most popular folk healer in Lima, was a woman. Although not all doctors in the city disliked her, Tafur, Valdés, Eizaguirre, and Castro saw Salguero as a female threat to a fragile male profession. In this sense, Salguero became the first prominent figure over whom battles about the relationship between gender, rights, citizenship, and the medical professions would play out in early republican Peru.

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{5} Pai Domingos Healing Slavery in Nineteenth-Century Bahia, Brazil

João José Reis

This chapter examines the divining and healing activities of Domingos Sodré (c. 1797–1887), an African follower of the Afro-Brazilian religion known as Candomblé—a practice that is still widespread in Brazil today and is particularly prevalent in the state of Bahia.1 By the time Domingos appears in the mid-nineteenth-century historical records, Candomblé was a religion in formation, precisely in Bahia, but it already counted with multiple terreiros (houses of worship) in the then province of Bahia, including in its capital, Salvador. Candomblé as a religion does not have centralized authority figures or institutional structure. Instead, each high priest or priestess overssees his or her own individual terreiro, although there have been historically charismatic Candomblé leaders who stood out to be recognized by other temples and society at large as representatives of the religion. Members of Candomblé, who had in the past often experienced long periods of initiation rituals, periodically dedicate public ceremonies to their deities that involve drumming and dances that induce spirit possession. Besides these public events—which should be relativized because Candomblé was a semi-clandestine religion far into the twentieth century—much of the activities pertaining to Candomblé take place on more intimate settings and include divination and healing practices (both for members and outside clients), animal sacrifices and prayers, ritual cooking, and ritual preparation of medicines 74

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and offerings—the latter two of which are commonly related to one another. These tenets of Candomblé were all in place in the nineteenth century, where our story belongs.2 Nineteenth-century Brazilian authorities used the term Candomblé to identify not an organized religion, which they did not consider to exist, but any aspect of the non-Christian spiritual life of Africans. Candomblé practices of divination and healing appear linked to notions such as “superstition,” “witchcraft,” and “sorcery,” among others, used to downgrade African spiritual worldviews and medicinal practices. Although divination and healing were part of Candomblé as an organized religion, neither was exclusively held in terreiros as they are not nowadays. The majority of cases involved individuals who operated outside the realm of organized temples, although they could still be somehow associated with one or several terreiros. Divination, for example, was used to identify to which god or goddess a devotee should dedicate his or her life in a terreiro, and, upon the death of its leader, divination helped decide who should succeed the leader. Of course, divination was more commonly used for mundane, practical purposes, such as the identification and solution of classical problems pertaining to love, money, and health issues. Slavery was the cause of a number of ailments suffered by nineteenth-century Bahian African bondmen and women, especially the enslaved, usually due to overwork, malnutrition, and physical and moral punishment. What is more, many slaves considered the condition of slavery itself to be a disease that they often explained through a mental framework of witchcraft. Africans often understood their capture in Africa, their transportation aboard slave ships, and their enslavement in plantations and cities across the Atlantic to be the result of a witch’s labor. In addition, some enslaved Africans regarded white people, at least on first impression, as witches who would eat their bodies to possess their souls either during the middle passage or as soon as they disembarked in the Americas.3 Not surprisingly, members of the Bahian slave communities commonly saw witchcraft as the cause of multiple physical and spiritual diseases. When slaves fell ill, masters often sent them to conventional doctors. But the enslaved themselves also sought their own medicine men and women, in some cases with the assent of their masters, and looked for diviners and healers specialized in curing witchcraft. In many ways, enslaved Africans considered slavery, if not a disease in itself, the cause of many afflictions, and they commonly identified their masters as culprits. Slave masters, therefore, needed to be controlled, pacified, or

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sometimes killed. However, none of these measures would necessarily do away with individual slavery, which could only be overcome by acquiring freedom. The conquest of manumission alone could cure slavery. And it was in this realm where Domingos found his niche.4 INTRODUCING DOMINGOS SODR É

Domingos Pereira Sodré, whose African name is not known, belonged to a Yoruba-speaking ethnic group (or “nation,” as African ethnic clusters were called at the time all over the Americas), which in Brazil was known as Nagô.5 He was born in the city of Èkó or Onim (Lagos, in present-day Nigeria) of parents who apparently were also brought to Brazil as slaves.6 Domingos and his parents may have been victims of a war provoked by a dispute over the throne of Lagos that began sometime in the mid-1810s and lasted through the mid-1830s.7 African chiefs and merchants sold an unknown number of prisoners in this war to slave traders, primarily from Bahia, who were among the most active traffickers on the Slave Coast, as most of the Bight of Benin littoral zone was then called. But not all captives sold in Lagos were victims of this local conflict. In the Yoruba hinterland, a cycle of bloody civil wars that followed the decline and final collapse of the powerful Oyo kingdom also produced serious destruction, population displacement, and thousands of captives who were similarly trafficked to Brazil.8 Between 1801 and 1850, slave traders brought close to three hundred thousand Nagô/Yoruba captives to Bahia through Lagos alone.9 Domingos Sodré, and perhaps his parents, were among them. The Nagôs came to represent close to 80 percent of the African-born slave population of Salvador by the early 1860s. Some of these Nagôs were Muslims, but the vast majority were devotees of the religion of the Oris�as—the Yoruba gods and godesses whose worship became hegemonic in the local Bahian African community during the course of the nineteenth century. Domingos was an expert in this religion.10 DOMINGO’S A R R EST

Sometime in the mid-1810s, Domingos disembarked in Brazil and was sent to a plantation in Santo Amaro, the most important town in the Recôncavo, the sugar region in Bahia. He became a slave of milicia colonel Francisco Pereira Sodré, whose family owned at least three sugar plantations and more than two hundred slaves.11 Domingos’s years of servitude coincided with a period of slave

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agitation that saw more than thirty revolts and conspiracies both in Salvador and the Recôncavo. At least four of these rebellions occurred in Santo Amaro itself and the neighboring district of São Francisco do Conde. Most of these revolts were carried out by Nagô slaves, Domingos’s countrymen.12 There is no record of his involvement in any of these uprisings. On the contrary, he fought under the leadership of white planters, his master included, in the 1822–1823 War of Independence in Bahia against the Portuguese colonial forces.13 Despite being seriously wounded in battle and hospitalized for almost a month, he remained a slave after independence. Perhaps unable to continue working in the plantation due to his injuries, sometime after the war Domingos moved from Santo Amaro to Salvador where he lived off his “business”—probably as a small merchant, as he told police officers when they arrested him for a few days in 1853 due to rumors of yet another “African conspiracy.” Profits from his “business”—which probably included what he earned as a diviner/healer—allowed him to amass enough money to buy his manumission. In 1844, Domingos paid the heir of his master, who had died about ten years before, 550,000 réis for his freedom, the average price of a male slave.14 Less than two decades later, on July 25, 1862, at 4:30 p.m., the police arrested Domingos, who was by then approximately seventy years old, at his home on charges of being a Candomblé practitioner.15 At the time, Domingos lived in a populous neighborhood of Salvador, which represented at least 14 percent of the city’s close to one hunded thousand inhabitants.16 Ironically, the Candomblé priest’s home lay a few steps from a convent and a seminary where Catholic priests were trained. Domingos had rented a two-story building where other Africans, including slaves, also lived as his tenants. (It was common in urban Brazil that slaves lived by themselves and paid their masters an agreed-upon amount from their weekely earnings.) Five other people were arrested with him. Among them were Ignez, probably Domingos’s slave, and Delfina, also a slave who worked as a street-cloth vendor, and who lived as a common-law wife with Domingos. Delfina, whose full name was Maria Delfina da Conceição, would officially marry Domingos nine years later, after obtaining freedom herself.17 When arrested in 1862, Domingos was formally accused of receiving goods stolen by slaves from their masters to pay for his services as a diviner and healer. According to one of the reports, the police found some jewels and two wall clocks that they suspected to be stolen property. The jewels, some of which belonged to Delfina, included pieces made out of coral and gold, silver necklaces, a crucifix, earrings, silver chains, and several rings. In addition, and more importantly, the

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Figure 5.1. Domingos Sodré lived in this densely populated neighborhood when he was arrested in 1862. His house was a few steps away from the Santa Teresa convent and the Catholic seminary on the right. Photographer unknown, c. 1870s. Arquivo da Fundação Gregório de Matos, Salvador, Brazil.

police also recovered “several articles of witchcraft . . . in extraordinary numbers” from Domingos’s dwelling.18 The ritual objects confiscated by the police included four metal rattles, two cutlasses—one made of metal, another of wood—fifteen pieces of cloth decorated with cowry shells, a quantity of loose cowries, and a gourd filled with a white powder, besides other “mystic ingredients.” The cutlasses were probably Oris�a symbols (or instruments of the deities’ identity and power), and the decorated pieces of cloth were probably of the type worn by initiates in trance, possessed by a god or goddess in a structured and controlled ritual ceremony. The presence of these garbs is evidence that Domingos and/or other residents in his house had connections with established Candomblé terreiros where such rituals were performed in accordance to a specific calendar. The cowries were sea shells of a specific shape that West Africans used as currency. Cowries also adorned and empowered different ritual objects or served as divination devices on both sides of the Atlantic. The rattles could be used both in divination sessions, to consult or praise spiritual beings privately, or during collective spirit-possession ceremonies.19

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The police also found in Domingos’s house wooden representations of African deities and a metal statuette that the chief of police referred to as “a small devil made of iron.”20 A local newspaper described these and other statuettes as “lascivious figures capable of adorning a temple of the god Pan or Priapus.”21 This is not surprising. It is highly likely that among the objects confiscated at Domingos’s house there was at least one representation of Es�u, a Yoruba god who usually displays an erect penis—like Priapus, the Greek god of fertility. Starting in the eighteenth century, Europeans associated Es�u with the Christian devil both in Brazil and in Africa.22 Although Es�u is present in several different settings of Yoruba religion—as the principle of life and fertility, and the gatekeeper of temples—this image in particular may be taken as evidence that Domingos was a babalawo, a priest of the Ifá divination system, in which Es�u plays an important role as the first to be informed about the result of a consultation. Above all, Es�u is also the messenger who takes sacrifices to other gods, and he punishes humans who fail to give away the offerings prescribed by the diviner. Ifá divination, as a tool to forecast and solve all types of problems (including physical diseases and social malady), was essential to Yoruba life in Africa and Nagô life in Bahia.23 Ifá crossed the Atlantic in the hold of slave ships to become preeminent in Brazil and other American shores, especially in Cuba. The most common device of Ifá divination is a set of sixteen loose palm nuts, which may have been registered in the 1862 police report among the “insignificant objects” found in Domingos’s house. The police also found a “silver chain with several objects” attached to it, a description that evokes the �òpè�lè�, another key Ifá divination tool. The white powder (kaolin perhaps) mentioned among the ingredients found in Domingos’s possession usually make up the support where the diviner draws signals that represent the progress of the divination session. There is, thus, direct evidence that Domingos Sodré was a diviner. Referring to his ritual objects, the arresting police officer reported that they were “used for witchcraft and divination, with which the said African entertained those who sought him . . . to predict their future.” But Domingos was not just any diviner. The police officer defined him as the “chief of the order of divination and witchcraft” in Salvador, strengthening the impression that Domingos was a true babalawo. Furthermore, the police reported, “This African man is known by the name of papai [daddy] Domingos, and has established his reputation as a diviner.”24 Pai is a direct translation of the Yoruba term baba, or father, which forms expressions such as babaloris�a, a priest of the Oris�as, and babalawo, “a father of the mysteries or of knowledge,” a diviner in the Ifá system. 25 The title

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of papai or pai meant that Pai Domingos was a high male authority in the world of Candomblé, and I will use this title to refer to Domingos hereafter. PA I DOMINGOS

Pai Domingos had come from Lagos, where, as was the case in other Yoruba kingdoms and chiefdoms, the art of divination was widely appreciated, feared, and a place where a diviner could reach a position of preeminence, if not absolute necessity, in state affairs. According to a Yoruba historian, the Ifá oracle represented “the most important piece in the king-making machine” in nineteenth-century Lagos, where the choice of political leaders was decided or at least confirmed through divination. In Lagos, accusations of witchcraft confirmed by a babalawo easily ruined the reputation of powerful or not so powerful people.26 Pai Domingos grew up in an environment where divination played an enormous religious, social, and political role, and he was likely trained to perform this role. Such training meant assiduous dedication to memorize hundreds of verses that were to be adequately chosen and recited during consultations, according to the disposition of divination pieces thrown on the divination board. The Ifá verses recommended specific offerings clients should make to appease the gods or specific medicines— to be used by clients—that the diviner would usually prepare himself. Thus, the diviner doubled as a medicine man, a feature that is duly recognized in ancient versions of Ifá practice in Yorubaland.27 To become a papai, or a baba, in Bahia, surrounded as he was by thousands of countrymen familiar with and used to consulting diviners in their homeland, Pai Domingos must have been a competent diviner/healer, an expert tried and tested by other priests and by his Nagô clientele. There was, in other words, certainly some sort of collective oversight and sanction of Pai Domingos’s performance as an oracle, or the police would have not labeled him as a leading expert in divination. When Pai Domingos was arrested, witchcraft per se was no longer a religious crime as it used to be during colonial times under the Portuguese Inquisition. Although Catholicism was kept as the official religion of independent Brazil, according to its 1823 constitution, still binding at the time of Domingos’s arrest, African religion, divination, and healing practices appeared in the police records framed as more prosaic crimes, like disturbing the public order with loud drumming, illegal exercise of medicine, or poisoning. In the case of Pai Domingos, the police responded to a specific complaint by a slave master whose female slave

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had allegedly stolen from him to pay for services provided by the diviner. The police chief wrote that slaves sought Domingos’s advice and expertise to obtain “their freedom through witchcraft.” More than larceny, the threat to the institution of slavery explained Brazilian intense repression against Candomblé, as contemporary civil authorities believed that “these superstitions are much more damaging in a country in which a large part of its wealth is employed in slaves.”28 M ASTER TA MING

The assumption that witchcraft could help slaves obtain manumission by softening the will and even killing their masters was widespread in Brazil. In Pai Domingos’s case, freedom and witchcraft were intimately related because he was believed to have the ability to prepare special potions that slaves secretly administered to masters aiming to weaken their willpower when the time came for slaves to negotiate their manumission or when masters wrote wills and testaments in which, among other instructions, they selected who among their bond men and women should be rewarded with freedom upon their deaths. Masters could free all, some, or at least one of their slaves in the hope that such a gesture would count favorably when time came for them to face the divine judgment. In this way, Pai Domingos became a key player in a pious Catholic protocol leading toward a good death for slave masters and mistresses. But African healers’ proceedings in defiance of slave owners could have other goals, such as appeasing their wrath against slaves who stole from masters, disobeyed their orders, idled, or ran away. The idea of using ritual means to control a slave owner’s power—their right to punish or reward slaves—was signified in the expression “amansa senhor” (master taming). Throughout the Portuguese Atlantic World, slaves employed different methods to tame their masters. This witchcraft culture of resistance persisted in independent Brazil. In his 1869 book Vítimas-algozes (Victims-Executioners), abolitionist writer Joaquim Manuel de Macedo made the poisoning of a slave master the central plot of a chapter entitled “Father Raiol—the Wizard.”29 The novelist learned about this kind of event in the streets of Rio de Janeiro, a city that held a concentration of close to eighty thousand slaves in 1849 (the largest urban slave population ever recorded in the Americas), and offered plenty of masters to tame.30 In the introduction to his novel, Macedo wrote about the many effects produced by the libations prepared by the “black herbalist, the practical botanist who knows the properties and infallible actions

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of roots, leaves and fruits” aimed at “weakening the physical and moral strength of men and [achieving] what they [the slaves] call amansa senhor.” 31 It is relevant that master taming was an expression invented by the slaves themselves—“they call [it] amansa senhor”—to express their medicinal strategies to fight master authority. In Bahia, cases of masters poisoned by their slaves appear time and again in police records. Slaves used herbs and roots known to African medicinal experts, as well as poisons purchased or stolen from apothecaries and innkeepers—arsenic sulfide being the most common. For that reason, the sale of “poisonous drugs” to slaves was strictly forbidden, and a Salvador municipal ordinance banned it altogether without a “prescription or note from a duly authorized Professor [of medicine] stating the quality and quantity, the name of the persons who intend to purchase it and to what end.”32 However, the use of plants could not be subjected to such tight control. This was the method employed in 1860 by a slave named Manuel to poison his master and two of his female slaves, the latter probably being collateral victims who sampled their master’s leftovers.33 In Pai Domingos’s neighborhood in 1879, a slave patiently killed his mistress by introducing small doses of certain thinly macerated leaves each day in her habitual glass of wine.34 Pai Domingos himself did not seem to engage in the killing of one’s master line of business, however. Instead, his expertise lay in the taming of masters. The Afro-Brazilian pharmacopeia was rich in herbs that could be used for attack and protection, to heal and to harm, and their preparation was accompanied by incantations recited by a babalawo. Among the herbs that Nagô healers used was guinea weed (petiveria alliacea), which was also known precisely as master-tamer/amansa-senhor.35 This plant bears antispasmodic properties, so it was ideal for relaxing both seigniorial muscles and minds. When its powdered roots are served, usually mixed in innocent food or drinks, it “causes hyperexcitation, insomnia and hallucinations, followed by lethargy and even imbecility, and softening of the brain, tetanus-like convulsions, paralysis of the larynx and death within approximately one year, depending on the doses ingested.”36 Slaves used other kinds of plants to protect themselves from their masters’ violence, plants that also became known as amansa-senhor. This was the case with mulungu, or coral shrub (erythrina speciosa), which, conveniently, has soporific properties allowing, for example, slaves to escape during the night to visit friends and lovers and attend festivals and Candomblé ceremonies while their masters fell into profound sleep. The director of the National Museum in Rio de Janeiro, João Baptista Lacerda, wrote in 1909, two decades after the abolition of slavery,

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that he had gathered from Black herbalists information on plants from which “slaves obtained the poison they used on their masters . . . all narcotic, irritating and paralyzing plants.”37 The herbs used to tame masters therefore composed a veritable medicinal complex, not limited to one or two types, and produced a variety of mollifying effects fit for each occasion. But medicinal plants could be good for a number of ailments if appropriately administered. One of the persons arrested with Pai Domingos in 1862, a fifteenyear-old slave named João, suffered from a chronic lung disease.38 His master, a rich African merchant and slave owner, had apparently sent him to the healer for treatment, or the boy approached Pai Domingos by his own volition. Herbs could also be used to fabricate symptoms of illnesses (such as fever and swelling) for slaves wanting to skip one or more days of work—another form of slave resistance. In one case, a mistress asked the police to arrest and punish her slave woman, a bread seller, for having arranged with “evil Blacks” to take medicine that led her to become “disfigured by swelling.” The mistress had already spent good money with a conventional doctor to cure her to no avail, meaning that African medicine could beat its Western counterpart.39 In addition to plants, other elements of nature appear in the therapeutical chest of nineteenth-century Africans in Bahia. An 1859 Bahian police report about an African medicine man and diviner, who went by the name of Grato, listed some of the objects confiscated in his house, which included “several drugs . . . , pots where roots, leaves, reptiles etc. were cooked; large lizards, bred and tame . . . ; and others dead, cooked and reduced to concoctions.” The police specified the use Grato gave to these ingredients, echoing what they said about Pai Domingos’s practices: “They say he sold [them] to slaves to tame their masters and to the ignorant so they could be lucky in business and love, making the biggest profits he could pluck from the former and the latter.”40 NET WOR K ING

Pai Domingos and his party received an exemplary punishment in 1862. His ritual objects were taken to a police station and burned; those made from metal were sent to the War Arsenal to be melted in its furnaces. The three or four slaves arrested with the diviner received twelve strikes of a ferule on the palms of their hands, a common domestic sanction also adopted by the police. Because freed persons could not by law receive physical punishment, the arrested Africans holding such status spent between four and six nights in jail. Pai Domingos spent

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four. Apparently, the police could not prove that he received stolen goods or that he was aware that they had been stolen. Before being released, Pai Domingos had to sign—with a cross because he was iliterate (or was only able to “read” oral texts)—a document in which he committed himself to abandon “witchcraft” and to find “an honest” job or else be expelled from the country—a punishment repeatedly used against “African sorcerers” in Bahia, with the full support of the central government in Rio de Janeiro.41 It is possible that some distinguished white man protected Pai Domingos from a harsher punishment, as persons from all walks of life, not only slaves, attended his divination and healing sessions. According to a newspaper report at the time of his arrest, “clean people wearing neckties,” meaning whites, sought out the diviner’s services.42 By the second half of the nineteenth century, Candomblé had won the souls of numerous free Bahians. In 1868, a list of individuals who attended a Candomblé house in Pai Domingos’s neighborhood included, according to a news report, “married ladies who seek specific (ingredients) that would make husbands remember their conjugal duties; slaves who seek ingredients to tame the will power of their masters; . . . and even businessmen to obtain good deals!”43 Nearly twenty years earlier a Catholic newspaper had already reported that “there are people who in fact do not belong to the lowest ranks of society who believe in such wretched things.”44 Thus, divining for and healing slaves were clearly just one aspect of a diviner/ healer’s job in the world in which Pai Domingos moved about. At that time in Bahia, whites not only sought Candomblé as clients but a few had already become socially and even ritually involved with it, including highly placed policemen. One district police officer (subdelegado) was denounced by the newspaper O Alabama of having been possessed by an African spirit during a public ceremony that he attended in the company of his family.45 According to the newspaper, police officers were supposed to suppress Candomblé, not join it. In another report, the same newspaper denounced that the police allowed Africans to freely disseminate “rude customs that testify against the civilization of the people.”46 Therefore, not even the police ranks were protected from Condomblé’s ability to recruit acolytes and sympathizers. Among the white folks who looked for advice from Pai Domingos was a district bailiff who was said to be a constant inebriated presence at his house. However, the bailiff was probably not the person who helped the African priest at the time of his arrest in 1862. A more likely candidate was the true subdelegado of the parish in which Pai Domingos lived (the freed man was arrested by

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a temporary substitute subdelegado). He may have negotiated with the police chief for a lighter treatment for Pai Domingos, avoiding, for instance, his deportation—given that the said subdelegado, on the occasion of his arrest, also served as Pai Domingos’s lawyer in a case in which he accused another African freed man of stealing a large sum of money from a manumission society that the diviner managed.47 Manumission was intrinsically related to Pai Domingos’s divination and healing chores. Like other manumission or credit societies in Bahia of the time, members of the one led by Pai Domingos belonged, in their majority, to the same ethnic nation, in this case the Nagôs, who sought to reproduce a similar institution, called es�uss�u, in their homeland. In Bahia, hire-out slaves made weekly or daily deposits, setting up a pool of funds from which they could borrow on a rotational basis.48 Slaves borrowed money to pay the full price or part of the cost of their freedom, loans that were to be repaid with interest. The loan could also be used for other purposes besides manumission, such as paying debts, rentals, or weekly fees owed to masters. Freed persons who had already paid their loans to the credit club could retain membership as a form of investment. Members paid leaders of manumission societies like Pai Domingos to collect, hold, protect the money, and redistribute it as credit or profit at periodical meetings.49 In 1862 Pai Domingos worked in the freedom business in two ways: as a diviner/healer who promised slaves to facilitate freedom and as the organizer of a manumission society. The connection between the two ends of his venture never came to the attention of the police, but it is not difficult to imagine that some of the money he received from his divination and healing practices went to the manumission society. He probably advised through divination for slaves to join the association he headed. At the same time, through offerings paid for by their enslaved clients, Pai Domingos prepared potions to soften the masters’ mood when the time came for slaves to negotiate the terms of their freedom. For all of his work in manumitting enslaved Africans, Pai Domingos was himself a slave owner. In Salvador, as many as 20 percent of African freed persons owned at least one slave in the mid-nineteenth century, and some had paid their manumission by substituting themselves with another slave that they had bought, usually young African captives recently disembarked from a slave ship. Pai Domingos apparently preferred or could only afford to buy older slaves. In December 1850, he bought a thirty-two-year-old slave woman named Esperança. She must have learned a lesson or two about master taming because five years later she was given her freedom without condition or payment, only “for her good

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services,” according to master Domingos. Records show that by 1855, the diviner already owned two other slaves that he also manumitted, a woman named Umbelina and a nine-year-old creole boy called Theodoro. It is unclear whether Umbelina paid for her freedom, but the boy received his without any reimbursement. Pai Domingos declared that he cherished the boy as he had brought him up—meaning, in all likelihood, that he was the son of one of the diviner’s female slaves—and freed him under the condition that he stayed with, respected, and served well until Domingos’s death.50 Pai Domingo was already preparing for his death in 1855, as suggested by the will and testament, written that year, that the police found among his belongings when he was arrested seven years later. A man over sixty years of age, Pai Domingos had lived long for his epoch’s standards and may have thought that he would not last much longer. The making of a will was an important step toward preparing for a good death, for besides disposing of one’s property—including slaves—it contained instructions about Catholic funeral rites and other spiritual matters.51 Pai Domingos was not exclusively a Candomblé devotee after all. Like many Africans in nineteenth-century Bahia, he had also adhered to Catholicism. His 1855 will has disappeared, but in another one he wrote in 1882, he declared he was a “true Christian,” with unusual devotional emphasis at this point in the history of Brazilian attitudes toward death, by then more secularized. He also remembered at the occasion that soon after his arrival in Bahia he had been baptized as a Catholic on his master’s plantation chapel. In his will, Pai Domingos asked that his Catholic Brotherhood of Our Lady of the Rosary, the most popular devotion among Blacks, carry his body to the cemetery to be buried alongside his departed ritual brothers. Twenty years earlier, the police had found the walls of his living room covered with framed pictures of Catholic saints, in addition to a well-kept oratory where nicely garnished saints were on display. While these saints occupied the living room, the Oris�as resided in the back rooms. The fact that one religion was on display and the other kept secret had obvious strategic reasons but does not mean that he only pretended to be a Catholic or that Catholicism represented a smoke screen for a more “authentic” religiosity. Pai Domingos was baptized, married, and died a Catholic, though not just a Catholic. We can even imagine that, besides herbs to heal humans and sacrifices to appease African gods, he prescribed to his clients Catholic amulets, prayers, and masses to obtain help from specific saints. He may even have used a crucifix found in his house as a ritual instrument.52

PAI DOMINGOS

Given Pai Domingos’s reputation as a major diviner and healer, it is likely that, at least by the time he was arrested, he lived mostly off his ritual practices. He certainly did not abandon divining after 1862 but probably moved it away from home, perhaps as an itinerant diviner and healer.53 Of course part of his income came directly from the work of his slaves, who were certainly employed in the urban job market, probably as street vendors, like so many enslaved and freed women in Salvador. Among the objects the police found in his house, there was a bundle of African cloth (panos-da-costa) and a box made of wood and glass that African women typically carried on their heads while walking up and down the streets selling these and other goods. In early May 1887, Pai Domingos died of apoplexy at the estimated age of ninety. His wife, Delfina da Conceição, passed away a year later, at eighty-three, a few months after the abolition of slavery on May 13, 1888. Gone was the system that had brought both Africans from their homeland never to return. Delfina was buried beside her husband in the Brotherhood of the Rosary Cemetery.54 PA I DOMINGOS, A N A FR ICA N LADINO

Domingos was like many African slaves who had managed to buy freedom and acquired a small measure of prosperity in Imperial Brazil. He not only owned slaves but he also bought a house, rented another, and opened a bank account. But he had prospered through methods that were not at the disposal of the majority of freed Africans. Pai Domingos made at least a substantial part of his living as a diviner and healer, probably a babalawo, a specialist of the Yoruba Ifá oracle. He used his spiritual authority to become the chief of a manumission club formed by other Africans, most of them belonging to his own, powerful African ethnic nation, the Nagô. Pai Domingos negotiated positions and relations both inside and outside the African community and African religion. His divination and healing activities attracted white clients as well as African-born and Brazilian Blacks. He was able to help slaves in their battles with masters—therefore to “heal” slavery—at the same time that he himself was a slave master. Many white individuals also crossed his path in non-ritual circumstances, which is clear in the notary, court, police, and ecclesiastic documents where his name appeared as slave and real estate owner, as a plaintiff and suspect, as godfather, and husband. His social and cultural fluidity was also reflected in the religious sphere, since he moved between Candomblé and Catholicism. By connecting divining/healing practices and leading a credit society, Pai

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Domingos demonstrated that he knew how to interpret the society in which he lived. He offered a large segment of Bahian society a solution to “heal” their physical illnesses. More crucially, he crafted ritual and financial practices intended to heal Africans from the disease of slavery through his manumission society and prescriptions of master-taming medicines. Pai Domingos adroitly navigated the different social and cultural dimensions of the world in which he lived and that he helped build, exploring its contradictions while at the same time embodying them. Pai Domingos was a ladino African, ladino being a “native” concept that in both Portuguese and Spanish languages meant an enslaved or freed African-born person who had learned the local language and acquired other elements of the New World culture—which included African ladino cultures other than his— without abandoning much of his African customs and world views. Unlike Hispanic America, in Brazil the locally born Blacks, and only they, were known as crioulo/creole; there was no confusion between the two social identities: African and creoles. Domingos himself never ceased to be an African in spite of his immersion in and his familiarity with the society in which he lived as a slave and later as a freed man. He reconstructed and performed his persona based on cultural materials—in his case mainly religion/divination/healing—brought from his Africa, mixing them with local and other African cultural items, and ressignifying them in Brazil to serve the purpose of survival, prosperity, and empowerment in the white man’s land. Ladinization—now used as the historian’s concept—is an adequate term to define and describe the trajectory of Pai Domingos and many other Africans like him in the worlds of Atlantic slavery.

{6} Mystic of Medicine, Modern Curandero, and “Médico Improvisado” Francisco I. Madero and the Practice of Homeopathy in Rural Mexico at the Turn of the Twentieth Century

Jethro Hernández Berrones

This liquid in your bottle will make you the greatest doctor known in the present century. One drop of this fluid will cure any sickness, and I include any sickness known to be fatal or incurable. —Death to Macario

Writing at San Pedro de las Colonias in the northern state of Coahuila, Mexico, Francisco I. Madero entered, in August of 1901, the case of María de los Ángeles in his clinical notes.1 She was thirty-five-years old and “seemed to be sick of blennorrhagia.” Madero prescribed “Chamomilla,” a homeopathic remedy for excessive menstruation or uterine hemorrhages.2 For the modern reader, chamomile suggests an herbal remedy usually consumed as an infusion. Madero, however, extracted small sugar globules from a brown, dark vial labeled with the plant’s name and included in a first-aid kit commercialized by Julián González and Co. He diluted the globules in a glass of water, shook the dilution vigorously, and gave a spoonful of water to the patient.3 Los Ángeles may have thought Madero was a great doctor who healed his patients miraculously with water from a vial. Thinking Los Ángeles would heal, Madero wrote in his notes “discharged” exactly on the same day he prescribed the remedy, but Los Ángeles returned five days later because “nothing changed.” The homeopath tried other remedies 89

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without success until he learned his patient’s symptoms might have resulted from susto—fright, a condition that curanderos or healers in Coahuila associate with the loss of soul.4 Consequently, he prescribed magnetic passes—a practice he learned from his engagement with Spiritism—that “proved her well,” and he continued “magnetizing” her when she described “emotional” symptoms, and giving homeopathic medicine when she described physical symptoms. The last entry on October 9 expressed that the patient only improved with magnetizations. Consequently, Madero gave her magnetized water. The lack of further entries suggests that Los Ángeles got well, at least well enough to stop coming back to see the healer. Madero’s clinical notes offer an unusual window into the historical practice of domestic homeopathy in rural Mexico at the turn of the twentieth century. Most historians of Latin America associate popular healers with non-European medical traditions, African or Indigenous ethnic backgrounds, and low socioeconomic status. These healers were famously subjects of reform or control in Latin American countries’ modernizing efforts.5 For this reason, their stories have usually appeared in the historical record through the lens of reformers who framed them as unorthodox, irregular, sinful, illegal, or nonscientific. Madero, however, does not fit in this framing. As a member of one of the wealthiest families of the Porfiriato (1884–1910)—the period when Porfirio Díaz ruled uninterruptedly, bringing technological and economic progress to the country at the cost of social inequalities and political repression, Madero enjoyed an elite education abroad and introduced progressive agricultural and social innovations in the family’s haciendas (large estates dedicated to agricultural production, mineral extraction, industrial transformation or any combination of these activities). Unexpectedly, he also led one of the military revolts that helped end Díaz’s three-decade rule, becoming the first elected president after the outbreak of the Mexican Revolution in 1910. A decade before beginning his political career, he engaged in the practice of Spiritism and homeopathy, two novel approaches to religion and medicine in vogue around the world.6 Influenced by spiritist and homeopathy’s parallel conception of body and disease, and spiritist morality and ethics, Madero developed healing practices for his personal as well as his community’s bodily, moral, and economic well-being. Madero’s records of his homeopathic and spiritist practice, thus, offer medical historians a different kind of healer, one who uses global cultural innovations to challenge religious and medical orthodoxy from the top of Mexican society. In this chapter, I explore the relationship between Madero’s spiritist and

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medical ideas in the context of his healing practice in the early 1900s. Madero’s clinical records reveal a facet of homeopathy and domestic medicine in Mexico rarely preserved in historical records. In these sources, Madero emerges as a modern and pragmatist hacienda administrator who looked after the health needs of his workers with a modern therapeutic system in line with his religious beliefs and economic needs. Spiritism and homeopathy were innovative approaches that intellectuals, physicians, and people without academic training discussed and used to understand the immaterial and material elements of human life at the turn of the nineteenth century. Madero appropriated these ideas and practices to promote his own progress and that of his family and workers. However, with the secularization of society and medicine in nineteenth-century Mexico, metaphysical explanations of healing and the domestic practice of medicine became objects of critique among learned circles in the nation. These circles believed that academically trained physicians should be responsible for the health of all Mexicans, yet most Mexicans looked for health in the “gray zones” of medicine inhabited by different kinds of healers. Madero inhabited a zone where the boundaries between modernity and tradition, metropolitan center and rural periphery, professional and domestic medical practice, science and religion, and facts and faith blurred, unintendedly framing for himself a kaleidoscopic image as a mystic of medicine, a modern curandero, and an “improvised doctor.” MEDICINE A ND HEA LING DUR ING THE POR FIR I ATO, 1884–1910.

Porfirio Díaz rose to power promising to turn Mexico into a politically and economically stable country. Díaz followed the advice of the científicos [the scientists], a political group educated in Europe who believed in the potential of science to structure society in an orderly way to attain social peace and economic development.7 Díaz and his advisors promoted foreign investment to exploit and export natural resources; the introduction and expansion of railroad, mail, and telegraph networks to make trade efficient; and the modernization of cities with electrification and sanitation projects to improve the population’s safety and lifespan. Politically, Díaz proposed a short-term dictatorship that formulated laws and regulations intended to stabilize political and social life. He established an educational system that introduced positivism, a philosophy intended to homogenize Mexicans’ secular understandings of nature and society. During Díaz’s term, Mexican economic and social development varied among regions and different social groups, depending on how closely aligned they were to Díaz

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or the científicos’ particular economic or political interests. An incipient middle and working class emerged in urban and mining centers, but the vast majority of Mexicans worked in haciendas under exploitative conditions. Díaz minimized political and social tensions by creating police forces that he used at his discretion. The delicate balance between development and exploitation, and political stability and social unrest led to a series of strikes and armed mobilizations in the late 1900s. Díaz’s modernizing projects had a great impact on public health and medicine, though most of the developments took place in the nation’s capital. In the first decades of the twentieth century, Mexico City had the largest and most important medical school in the country, students practiced in seven hospitals, and faculty innovated at three research institutes. Physicians in the countryside aspired to Mexico City’s unification of research, teaching, and clinical practice, but they struggled to sustain even one single hospital. With the aim of creating a healthy environment in the capital, the Consejo Superior de Salubridad (Superior Sanitary Board) formulated a comprehensive sanitary code to police epidemic outbreaks and other medical emergencies, medical licensing, pharmacy products and sales, food production, and urbanization projects. Juntas de sanidad—local sanitary boards—and delegados de sanidad—sanitary delegates—extended the Consejo’s functions to the whole country. These institutions were the first efforts in Mexico to create a sanitary system that protected the health of citizens. Yet, as with medical institutions, juntas’ limited resources made sanitary measures aspirational beyond the nation’s capital. Poor funding, lack of institutional presence, and poor sanitary improvements characterized sanitary efforts beyond Mexico City. Saltillo, the capital of the state of Coahuila, for instance, did not have a medical school; yet, licensed doctors trained elsewhere staffed the local junta and implemented some sanitary measures.8 By the end of the Porfiriato, Coahuila had ninety-eight allopathic and twenty-two homeopathic physicians, or about one practitioner per twenty-five hundred inhabitants (Mexico City and a neighboring town’s ratio were one per one thousand).9 Medical doctors in Coahuila usually lived in ports, mining centers, and some haciendas. The limited reach of academic medicine and sanitary services in the country had a negative impact on the standing of doctors among patients in both urban and rural settings. Popular culture offers some insights into patient’s perceptions of academically trained doctors. In the play El consultorio medico (Doctor’s Office), Antonio Vanegas depicts the interaction between patients and a doctor in an urban setting. Here, a doctor wearing a black vest, bow tie, and tailcoat

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receives patients in his consulting office, decorated with framed paintings, wooden and cushioned chairs, and a bookshelf filled with thick volumes. He sees four patients: an alcoholic Indigenous man who drinks pulque—a fermented beverage; a middle-class young woman who suffers pain from wearing stockings; a gentleman who wants to grow his brain to increase his talent; and an old woman who suffers spasms but never takes the prescribed medication. The doctor offers treatments to all. The Indigenous patient cannot afford to pay for the prescription and leaves the office feeling betrayed by the ad that read “free consultation”—not prescription. The ones who can afford to pay leave satisfied. The audience learns that the doctor prescribes the same treatment to the first and the second patients; homeopathy, a symbol of remedies for impossible cures, to the third patient; and a continuation of treatment to the last one. The complacent doctor cares little for his patients and a lot for the money. At the end of the day, socializing with his colleagues compensated for his professional frustrations. In this view, medicine was just a frivolous business where the treatment is less important than the provider’s skills to keep the paying customers satisfied.10 Academically trained physicians shared this behavior with competitors who had partial or no academic training. A large number of individuals offered a complex mixture of remedies and therapies for sale to satisfy the health needs of patients. Among these healers figured those offering remedies and therapies: bloodletters, surgeons, bonesetters, apothecaries, itinerant nostrum sellers, homeopaths, traditional midwives, faith healers, hydrotherapists, hypnotists, and curanderos, among many others.11 They were very successful. Patients who experienced surprising recoveries—usually after having heard unpromising prognosis from academic doctors—disseminated their stories, helping promote a particular healer’s practice or a particular product’s sales. For this reason, academic physicians tried with little success to dissuade what they believed were uneducated patients from consulting with healers or using their products by framing healers as moral, ethical, and legal threats to the expansion of modern medical science.12 Despite their success, these healers, like their academic counterparts, seldom visited rural towns and villages. In the countryside, most inhabitants sought medical help with traditional midwives, herbalists, and curanderos as had been used for centuries. These traditional healers used a combination of religious rituals, physical manipulations, and Indigenous pharmacopeia inherited from their precolonial and colonial ancestors.13 The healers that predominated in the sparsely populated northern states of Mexico were those associated with unorthodox Catholic healing

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traditions. Their healing powers resulted from the direct communication with Jesus Christ and his saints, who usually revealed to the healer in isolated places after suffering life-threatening accidents or diseases and having received the don—gift—from a voice they heard during their convalescence. Many healers anonymously fulfilled the health and devotional needs of Mexicans living in northern states. Some gained wider fame, including Santa Teresa Urrea—“la santa de Cabora” in Sonora; José Fidencio Cíntora Constantino—“el Niño Fidencio”—in hacienda El Espinazo, Nuevo León; and Don Pedro Jaramillo, in the South Texas valley.14 Domestic medicine was a third line of medical care to which literate Mexicans in urban centers and the rural countryside usually resorted. The wide availability of recetarios—collections of medical recipes—and domestic medical manuals in nineteenth-century Mexico occurred alongside the dissemination of enlightened values promoted by liberals among social elites after independence, efforts to disseminate knowledge and educate free citizens, and a growing distrust for academically trained physicians and their new medical science. The use of recetarios and domestic medical manuals empowered patients in need of medical advice. Patients took their health into their own hands and provided medical care to people in need when other healers—academic or otherwise—where not available.15 In a century when academic physicians sought to establish a reputation, organize professionally, and create a monopoly of health care, domestic medicine found itself in an ambivalent position. It gave patients knowledge to deal with medical emergencies and common maladies in the absence of physicians or healers, but it also gave patients the opportunity to appropriate medical knowledge and provide medical services to others, competing with academic medical ideas and practitioners.16 Francisco Madero was part of the Porfirian modernizing culture, though framed by the peculiar conditions of northern Mexico. Madero’s family owned a hacienda in Parras and land in the village of San Pedro de las Colonias, in the southern corner of Coahuila. Madero attended a Jesuit college in Saltillo, the state’s capital, and then studied commerce in Paris and agriculture in the United States. Once back, he administered the family lands where he introduced modern irrigation techniques, exploited newly valued natural resources, industrialized agricultural processes, and internationalized crops and products aided by the newly built railroads that connected Saltillo with Mexico City and the United States.17 Due to the scarcity of the labor force in the north, landowners experimented with economic and social security incentives aimed at retaining laborers

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and preventing them from taking jobs in the mines or haciendas offering better labor conditions.18 Madero was a pioneer of this approach, founding schools and clinics for his workers, orphanages for destitute children, and community kitchens for full- and part-time laborers.19 In the same line, he offered private medical care to sick workers using domestic homeopathy. His socially oriented projects kept the financial health of the larger hacienda enterprise he managed. Madero’s hacienda became the most profitable in the region and gave his family a strong political position. Porfirio Díaz’s competing interests favoring foreign investors produced the political tensions that called Madero into action against Díaz’s dictatorial ruling in 1910.20 Madero’s healing practice brought medical modernity to Coahuila’s rural environment in the 1890s. It introduced an innovative therapeutic approach that city dwellers had begun to use a few decades back. He accessed spiritist and homeopathic knowledge through traditionally academic forms of knowledge transmission. Madero offered globules, water, or magnetic passes to treat his patients’ illnesses. These treatments were, on one side, based on a scientific rationality that defied orthodox academic medical theories, and on the other, aligned with the rationality that framed the miraculous healings of curanderos like Teresa Urrea and Pedro Jaramillo. Spiritism and homeopathy first played a role in his individual moral development and the social improvement of his immediate surroundings without challenging an academic medicine absent in rural Coahuila. Later, with his ascendance to the national presidency, his homeopathic practice and spiritist beliefs meant a challenge to the modernizing model that the Porfirian society had constructed for three decades. SPIR ITISM A ND HOMEOPATHY IN MEXICO A ND M A DERO’S LIFE

Madero’s spiritist and homeopathic practices began while he implemented technological developments in his family lands after 1893, though these ideas had been circulating in Mexico since the 1870s. The subtle forces and energies that allowed the electrification of cities and telegraphic communications also provided scientific, technological, and progressive explanatory frameworks that drew intellectuals and entrepreneurs to discuss and practice spiritist phenomena and therapeutic novelties such as homeopathy.21 Spiritism provided a coherent view of the natural and moral world Madero lived in, a progressive world where positivist science supported new therapies and new religiosities seeking to improve people’s lives.

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Spiritism offered an enlightened alternative to Catholic religiosity in a rising nation where tensions between the Catholic Church and the secular state permeated Mexican society. Spiritism offered an alternative religiosity based on sensorial evidence of the materiality of the spiritual world and the metaphysical forces’ influence on the physical one. Relying on spiritist theories, the Frenchman Allan Kardec proposed a moral system based on the incarnation of souls to perfect themselves through charity, compassion, knowledge acquisition, and work.22 Because Spiritism offered an alternative morality that challenged orthodox Catholicism and its empirical base aligned with positivism, many Mexican liberal intellectuals and politicians adopted it. Some among the científicos practiced the doctrine, created learned societies, and published a magazine in the 1870s and 1880s in Mexico City, from where it was disseminated.23 Madero became part of the networks that continued practicing and disseminating Spiritism in Mexico after its popularity in the capital waned. Spiritism offered an evidence-based line of thought with the potential to nurture political disagreement and challenge Porfirian rule, threatening the fragile stability of the regime.24 If Madero’s spiritualist practices aligned with progressive religiosities and political thought in Mexico, the científicos and the Porfirian elites satirized them in newspapers during Madero’s political mobilizations in the late 1900s. However, at home in San Pedro and before he began his political career, the contact with spirits reassured Madero in his business, family, and personal decisions in an intimate way. Perhaps more importantly, his spiritism allowed him to connect tradition and modernity, linking healers in northern Mexico with the project of positivists to form industrious individuals who transformed their natural and social world through knowledge, work, and charity. San Pedro was an isolated place. The railroad connected Mexico City with Saltillo, from where visitors took a 110-mile road to Madero’s hacienda in Parras first and then to San Pedro. In the solitude of a rural life, Madero experienced the threat of disease and found the moral support to confront it with the practice of Spiritism. He had devoured Kardec’s books when in Paris.25 There he tried to transcribe what spirits dictated but without success. Back in San Pedro, he was able to hone his spiritist skills. Once he became comfortable and confident with his abilities, especially when communicating with “Raúl,” the spirit of a younger brother who had died tragically a few years back and who became his guide, Madero used his spiritist tools to seek moral reassurance and medical advice in deciding the homeopathic remedies he used to treat his family.26 Spanish immigrants had introduced homeopathy in Mexico during the

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mid-nineteenth century. Thanks to their publicizing campaigns and academic efforts, the first homeopaths in Mexico gained an important number of followers among patients, apothecaries, businessmen, and physicians. They formed societies, published journals, and opened dispensaries and pharmacies. Their activities led Díaz to fund both a homeopathic hospital and a homeopathic school in 1893, making homeopathy a constitutive element of the medical landscape in Mexico City.27 Homeopathy, originally developed in Germany by Samuel Hahnemann, was based on the idea that substances producing a set of symptoms in a healthy individual cured diseases expressing a similar set of symptoms in sick individuals. Homeopaths diluted medications many times in order to reduce their toxic effect and “potentiate” their therapeutic effect. Mexicans received homeopathy ambivalently. Many well-educated elites and physicians maintained that it broadly departed from positivist medicine, that homeopathic dilutions contained only water, and that unscrupulous medical entrepreneurs used them to deceive their clientele.28 Less dogmatic physicians believed that, in the hands of academically trained practitioners, homeopathy had a positive or factual therapeutic effect.29 Outside academic medicine, homeopathy spread to members of Mexico’s elites such as Madero.30 Following the tradition of domestic medicine, they consumed it as a modern medical commodity that translated medical science into the everyday language of non-technically trained people.31 In turn, these literate individuals used homeopathy to provide healing services to people who could not read homeopathic manuals or who could not afford the trip to visit a doctor. Popular short stories, novels, and films portray incredibly successful curanderos who had received the gift of healing from Death and who used remedies that resembled homeopathic medicines. The main plot of El doctor improvisado, The Third Guest, or Macario, has Death paying a favor back to a poor laborer with healing powers. The laborer becomes rich and famous using his medical gifts, but he is unable to escape his deadly fate. Similar to the play El consultorio medico described above, medicine in this case is a business transaction, and the healer, like the physician, does not know exactly how medicine works. In contrast to the physician in the play, the laborer in the tale, as Death’s emissary, truly knows the patient’s ultimate fate, cure, or death and earns money for it. Though the healer cannot control his patients’ fate, he cares about them. His medical gift earns him his patients’ trust. They come from near and far and belong to all social ranks and economic positions. In some versions of the story, the doctor prescribes drops of a special water he personally gives to patients whenever Death tells him they

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◀ Figure 6.1. With a gift from Death and dressed in a European-style suit, as most doctors did in late nineteenth-century Mexico, the story’s curandero administers drops of water to treat and heal his patients, earning him their trust, economic wealth, and physician’s jealousy. El doctor improvisado (México: Antonio Vanegas Arroyo, ca. 1889–1918), front cover, M1238, Posada Collection, box 1, folder 5, Cuento. Courtesy of the Department of Special Collections, Stanford University Libraries ◀

Figure 6.2. The illustrator José Guadalupe Posada’s association of the curandero’s water drops with homeopathy and an urban medical practice in the ad suggests the blurry boundaries between the dichotomies—religion/science, popular/academic, healers/physicians, for-duty/for-profit, private/public, rural/urban, working class/ elites—that framed healing practices and patients’ choices in early twentieth century Mexico. El doctor improvisado (México: Antonio Vanegas Arroyo, ca. 1889–1918), p. 5, M1238, Posada Collection, box 1, folder 5, Cuento. Courtesy of the Department of Special Collections, Stanford University Libraries.

will not die. Like homeopathic treatments, this water seems a miracle medicine for impossible cases. Patients in these narratives are always satisfied and grateful, if not resigned, with the healer’s prognosis. Only the audience becomes aware of the supernatural skills of the laborer and his healing water, as if all Mexicans tacitly knew that health and disease had a supernatural explanation and only those with a supernatural gift could tell one from the other.32 Similar to other healers’ experiences in these stories, Madero’s healing practices connected ideas about the supernatural world with moral improvement,

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bodily processes, and economic betterment. Madero learned about homeopathy in 1896 through recommendations from his extended family and friends. He bought his first homeopathic manuals from Julián González in 1899 and continued obtaining homeopathic supplies from him throughout his life.33 He preferred González’s kits because they “were easier to use than other first-aid kits that required deeper study.”34 Kits were also much less expensive than bringing an academically trained physician to the hacienda. Madero used homeopathy domestically between 1901 and 1902 to provide medical charity to his workers and community, and to indirectly benefit the family business. At the same time, homeopathy offered Madero elements to link the physical processes of disease and healing with moral improvement. In his private correspondence and works, homeopathy became a personal vehicle for spiritual progress in line with precepts in Kardec’s Book of Spirits. Madero used homeopathy to provide the empirical evidence for Spiritism. González’s manuals synthesized homeopathy as a medical system that studied the actions, reactions, and balance of the vital force, “an immaterial principle whose action constituted life.”35 Since disease was a disarray in this force, homeopathy used remedies that “did not need the physical or chemical properties of the medicinal substances, but their medicinal dynamism.” Homeopaths carried out experiments to understand the dynamic action of homeopathic medicines in the body. Homeopathic domestic manuals compiled the set of symptoms and diseases each medicine treated. Madero adopted these ideas from González’s manuals and aligned the materialistic idea of vital force and magnetism with the spiritual world. He made this association explicit in his Manual espírita, written while he treated patients with homeopathy.36 Madero sustained that the “animistic forces came exclusively from neither spiritual nor material sources and [their] complex and mixed nature worked admirably as proof that our material body was ruled by a spiritual entity.”37 Madero’s notion of the body framed his understanding of disease origin as a disarray of “psychic, [particularly] magnetic, phenomena.” “[M]agnetism . . . [or] vital fluid,” he explained, that “worked as an intermediary between the soul and the body. When such a fluid weakens, there is disease; when it vanishes, death.”38 Madero made magnetism the center of disease explanation. He argued that severe wounds might cause death because they obstructed channels of vital fluid circulating in the body. In order to heal, mediums transmitted their “healthy and strong” vital fluids to a “weakened organism” and produced “a reaction in the fluids of the latter” that healed physical complaints. However, one spirit told him that

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magnetism was particularly useful for “moral infections,” colds, body weakness, and nervous diseases; therefore, Madero was more prone to use magnetism with ailments he considered moral or emotional.39 In this line of reasoning, homeopathic globules or magnetized water worked at the physical and spiritual level because their dynamism strengthened the individual vital force of a diseased patient. Magnetism was also at the core of the relationship between individual moral improvement and health in Madero’s worldview. The Manual indicated the skills someone had to develop in order to become an intermediary between the natural and the spiritual worlds—a medium. Madero himself went through this process. As he began treating patients, spirits informed him about the importance of disease as a means for purification. One of the spirits told him, “Your disease is a punishment too, and you will not heal until you correct yourself. I am sure that if you healed now, you would follow the path of corruption you were in before.”40 Raúl’s spirit told Madero that his headache was a consequence of tobacco abuse. The spirit commanded him to “stop smoking, because such a foolish vice does not do any good to you and it profoundly harms your health.”41 Following his spiritual advisors’ guidance, Madero quit smoking after he fell sick, stopped drinking after his mother suffered typhoid fever, and married Sara Pérez to abandon his previously dissolute love life. In the Manual, Madero explained that moral improvement, healing, and the practice of Spiritism reinforced each other in the process of individual and social betterment. Moral improvement got a person closer to the spiritual world, increasing this person’s magnetism. A greater magnetic force improved the healer’s chances to cure patients. In turn, healing advanced the medium’s spiritual progress. Spirits reminded Madero reiteratively that mediumship “elevated [a mediums’] spirit over others”42 and that mediums should use the received medical “light” to “enlighten the path of [their] brothers, once it withdrew [mediums] from darkness.”43 Raúl’s spirit specifically equated medicine with “the power of working as intermediaries of good spirits who came to heal those who suffered.” As with curanderos, Madero’s medicine was a spiritual gift not a personal skill. Yet, the given healing power increased as the medium exposed himself more frequently to the spirits’ influences and used that influence for the charitable act of healing. M A DERO’S HOMEOPATHIC A ND M AGNETIC HEA LINGS

Madero’s clinical notes are an exceptional resource to understand how healers without academic training practiced homeopathic medicine. In contrast to

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patients or homeopathic physicians’ accounts edited and published for publicity, Madero’s notes are not concerned with how his observations might have fit the homeopathic corpus, nor do they uniquely praise the success of homeopathic treatments. Madero had 235 patients in the span of nearly two years (March 27, 1901 to November 25, 1902). He treated a wide variety of patients, of which thirteen visited him recurrently. Fifty-seven percent were women and forty-two percent were men.44 They were forty years of age on average, ranging between two months and seventy-five years. Patients usually came to consult him in person, but a few used correspondence. He attended between one and five patients per day in 1901, though visits decreased the following year. The demography of the people who consulted Madero and the type of interactions they had with him suggest that he was not the only, or even the main, medical provider for his patients and that most of them used other resources in the area, including their own domestic remedies, other healers, and licensed physicians at other haciendas or mines. Yet he devoted all his attention to them. Spiritism, homeopathy, and trust in patients’ suffering were combined in Madero’s healing practice. Spiritism guided Madero’s conviction to study homeopathy diligently, and he believed spirits guided him in his selection of the homeopathic remedy. But Spiritism did not play a role in his interactions with patients.45 Raúl’s spirit encouraged him to “study [his] books deeply” and “each case thoroughly to find the most adequate medicine.”46 Yet Madero was not in a trance when he consulted his patients. Rather, he heard his patients’ narratives attentively in an effort to understand their environment, their emotions, and their physical ailments and to find the right homeopathic remedy. The clinical notes reflected the associations patients made between their physical ailments and their surroundings, and Madero wrote them down to confirm them. For instance, one patient associated “several rheumatic pains [with] thermal work,” and another one “a swelling nose [with] breathing in the presence of a cadaver.”47 Other entries show Madero’s voice when interpreting his patients’ histories and translating them into technical terms. Symptom descriptions detailed evacuations, different sorts of pain, types of fever, nervous disorders, and skin rashes. On some occasions, symptoms and their localization became the disease’s name, as when patients were “sick of stomachaches,” “sick of intermittent fevers,” and “sick of infertility.” On other occasions, Madero used technical terms such as blennorrhagia, metrorraghia, rheumatism, neuralgia, and pneumonia, and names of infectious diseases such as herpes, dysentery, influenza, pertussis, typhoid fever, flu, and consumption. It is unclear whether he actually correlated these

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diseases to their microbial origin; yet, Madero’s notes evidence ways in which domestic healing guides conveyed technical terms to their readers, and readers connected these terms with a language everyone understood, the language of symptoms. Madero and his patients seldom attempted to establish the cause of disease, but the few entries that did so conform to a recurrent pattern. In line with contemporary associations between the female body and female behavior, susto [fright], disgusto [disgust], and coraje [anger] usually caused pain or menstrual disorders. Similarly, and echoing the widely accepted public health framework of degeneration, ingestion of alcoholic beverages correlated with liver and nervous diseases. And in line with Hippocratic theories of humoral balance, specific foodstuffs caused indigestion, stomachaches, or diarrhea. 48 Homeopathic remedies were Madero’s preferred treatment for physical ailments. He used magnetized globules or magnetic passes when complaints were predominantly emotional or mental. His notes do not show the detailed symptomatic analysis for which homeopaths praised their system and that made homeopathic manuals long and exhaustive. Some entries just noted the homeopathic remedy in association with a symptom or the name of a disease. Madero used the same remedy for different symptomatic descriptions. For instance, he used “Belladonna” in people experiencing stomach, tonsil, or liver pain, or with cough, nervous attacks, burning sores, swollen eyes, sore throats, headaches, or blenorrhagia. Madero always used specific homeopathic substances for particular ailments. For instance, he used “Mercurius solubilis” for skin rashes or for promoting suppuration in wounds. He also preferred to use remedies suitable to the patients’ working conditions and living environment, such as “Plantago” for intermittent fevers. González’s manual recommended “Ipecac” or “Nux vomica,” but Madero chose “Plantago” because the manual recommended it for people who grew vegetables in low and humid lands, as in his hacienda.49 Finding the right remedy for his patients was hard, yet spirits reassured Madero about the choices he made. When he treated his mother from a typhoid fever that did not recede, Raúl’s spirit told him that the right medication was not always the one selected by the consensus of a group of physicians.50 Madero’s choice of homeopathic medicines sometimes improved certain conditions, but he shifted to new homeopathic remedies when complaints persisted. He used magnetism to boost the effect of homeopathic medicines or to treat patients when homeopathy had done its physical job. As the introductory vignette shows, Madero only used magnetism in cases that hinted at an emotional etiology that

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produced headaches, chest pain, nervous attacks, and general body weakness and pain. Madero posed his “hands on the back or the affected part and mentally call[ed] for God and the good spirits’ aid; after a moment, [he] felt his arms and hands shake; this sensation [lasted] as needed; when shaking cease[d] for a long while, it mean[t] it [had been] enough.”51 The inconclusiveness of his clinical notes as well as the itinerant nature of Madero’s patients suggest the ephemeral relationship between doctor and patient in the region. Sporadic and inconsistent visits left the patient in a constant search for health and the practitioner uncertain about the outcome of his intervention. Madero’s practice was sometimes effective. He reported only a few cases when the outcome was uncertain and only one when the patient died. Patients who never returned may suggest they felt relieved from their symptoms or that they looked elsewhere for relief. The itinerant nature of labor in the early 1900s in rural Mexico might have also made it difficult for Madero’s patients, most of them laborers, to attend a second consultation with him. In this case, consultation by correspondence was an option for literate patients. Returning patients suggests they trusted Madero and came back when possible. He also knew his limits as a healer, seeking professional medical help when his mother’s intermittent fevers did not recede, securing funding for students interested in homeopathy to study this system at the national school in Mexico City, and designating homeopath Dr. Ignacio Fernández de Lara for his cabinet when Madero became president.52 Homeopathy and magnetism in the hands of Madero provided one line of healing—perhaps the first and only one for many patients—through a modern and empirically based therapeutic approach to the permanent and itinerant population in the region of Parras. Homeopathy and magnetism fulfilled Madero, his family, workers, and patients’ bodily and emotional needs, giving them hope, treating their illnesses, and offering relief in the face of sometimes incurable diseases. In doing so, Madero also contributed to the physical and emotional well-being of his own and other itinerant laborers, promoting the social stability required for the economic growth of the region. What was the meaning and relevance of Madero’s homeopathic and spiritist practice in the context of medical history in Mexico at the end of the Porfiriato? Madero represented a bridge between academic and popular medicine, a bridge that promised to bring health services to a larger part of society, given the limits of academic medicine and public health efforts. In line with the culture of progress in the Porfiriato, healthy laborers would result in individual and

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national economic growth. Homeopathy and Spiritism aligned with Madero and his laborers’ own medical and religious believes given their sociocultural and economic contexts. Academic medicine feared precisely the power for popular appeal that Madero’s healing practices represented. Ricardo E. Manuell, president of the National Academy of Medicine, said as much during a reception to congratulate elected President Madero for his decision to acknowledge the academy as a consulting body for the new government in matters of sanitation and medicine.53 Manuell argued that medical science had defeated most of the “plagues” of the country with one exception, the free practice of medicine of which homeopathy was the most iconic example. For him, homeopaths were a “national flora that corroded the nation,” whose practice of prescribing globules, which lacked any medical substance, turned them into “murderers,” and “criminals,” who left a wounded person bleeding. Manuell had reasons to fear the growing presence of homeopaths in Mexico. In about four decades, they had become an important presence among academic and popular medicine. About 10 percent of academic physicians in the country were homeopaths, and according to Juan Antiga, a homeopath with academic credentials, there were about 250 unlicensed homeopaths practicing all over the country.54 Madero’s particular inclinations to homeopathy and rise to the presidency seemed to align with an endorsement of a more open practice of medicine and of religious healers, threatening the privileged position academic medicine enjoyed during the Porfiriato. This threat had been present at the time in both medical and popular literature. The popular and contrasting images of physicians disengaged with their patients and of committed healers—whose skills and remedies contained in vials with water depended on divine intervention—were widely disseminated during the Porfiriato. The alignment of Madero’s healing practices with the latter might suggest another reason for his popularity among some circles of Mexican society. Madero’s healing activities placed him as an intermediary of the two medical worlds that existed in Mexico during the Porfiriato, the popular and the academic one. As a hacienda owner, Madero represented social elites to which academic physicians belonged, but as a healer, he resembled curanderos to whom most Mexicans concurred in the search for health. He was not, however, either of them. His religious and medical knowledge did not derive from precolonial Amerindian or syncretic colonial Catholic traditions. Madero was a man of his time who incorporated modern religious philosophies in his own life and used novel medical approaches to his own, his family, his workers, and his neighbors’ benefit. The impossible cures homeopathy represented in popular plays

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in Mexico City became miraculous cures in the hands of Madero in Parras. Madero’s healings filled the space between traditional and modern medicine, religiosities, and ways of living, created in Mexico during the Porfiriato. In this cultural space, these dichotomies collapsed into plural forms of medicine, which, despite efforts of academic medicine to the contrary, most Mexicans used in the early 1900s. To the eyes of academic physicians, he was an “improvised doctor.” To his patients, he was another curandero, a modern one perhaps. To his family and friends, he was a mystic of medicine, one who used a therapeutic method suitable to his moral, practical, scientific, and social needs. How extended in México were healing practices similar to those of Madero? The association of homeopathy with domestic medicine and surprising cures that changed people’s personal and professional lives continued after the revolution. For instance, Rafael López Hinojosa, narrates that a friend took him in the 1920s to see a homeopathic healer whom they reached traveling by train into the eastern limits of Mexico City and walking for an hour through undeveloped land, the rural skirts of the capital. López Hinojosa did not believe at first in the efficacy of the content of the small dark vials, which may have seemed to him just water, and he threw them away.55 As patients in Doctor improvisado did, he learned about the efficacy of healing water years later when a close relative, his grandmother, told him that homeopathy relieved her from an imminent surgical intervention. López Hinojosa began a homeopathic treatment and surprisingly the stomachaches he had suffered for years stopped. Convinced, he studied homeopathy formally, became a licensed doctor, opened a large clinic, and founded a laboratory and pharmacy that manufactured and distributed homeopathic medicines throughout the twentieth century. A couple of examples suggest cross-fertilization between alternative religiosities and homeopathy. Arnold Krumm-Heller was a German doctor interested in occultism who migrated to Chile in 1893. He was part of several networks of spiritists, theosophists, and freemasons attempting to extend their activities in Latin America. Madero met him in the congress of Spiritism organized in Mexico City in 1906, two years later after Heller had established a homeopathic practice.56 Juan N. Arriaga, another strong advocate of homeopathy in the Porfiriato, attended the second congress of Spiritism in Mexico City in 1906, but his multiple translations and academic articles on homeopathy do not display the links between Spiritism and homeopathy of Madero’s personal notes. Heller and Arriaga’s engagement with Spiritism suggests that alternative religiosities may have played a role in their medical ideas and practice, as it did in Madero’s. Some homeopaths connected

MYSTIC OF MEDICINE, MODER N CUR A NDERO, & “MÉDICO IMPROVISA DO”

to masonic circles, but this relationship seems to have served political purposes rather than influenced their medical activities. As Madero connected homeopathy with Spiritism to explain bodily and moral improvement, other scholars incorporated homeopathic theories to explain Indigenous behaviors and practices. In a study of loving spells among the Indigenous population in the 1920s, anthropologist Pablo González Casanova suggested a conceptual relationship between the action of homeopathy and certain kernels at the base of corn cobs that Indigenous populations used in rituals for turning back unrequited love.57 The kernels ran contrary to the rest. They therefore seem to have a similar— therefore homeopathic—action in the affections of the person who received the spell. These examples suggest that homeopathic ideas began to spread among the Mexican population in association with popular religious and healing practices, although given the personal and domestic nature of these practices, historians have found it difficult to document them. Madero’s practice constitutes one of the first well-documented cases of the intersection of these popular religions and therapies. Mexicans’ widespread understanding of health and healing as a supernatural gift provided spaces for the prevalent overlap of homeopathy with miraculous healings among urban and rural populations. This intersection usually had political and economic motivations. Spiritism and homeopathy offered a common language shared by landowners and their workers. A highly educated hacienda owner living in rural Mexico, Madero used the two practices to attract and retain men and women in a region with no doctors, scarce laborers, competitive wages, and high mobility. A free healing service in line with laborers’ medical beliefs may have increased the chances to retain a healthy labor force for the economic progress of the hacendado and the country. Homeopathy and Spiritism compensated for the limits of academic medicine during the Porfiriato, contributing to the economic progress to which the regime aspired in ways that contradicted medical and public health modernization.

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{7} Herbs, Roots, Amulets, and Prayers in the Practices of “Saint” Vicente and other Healers in São Paulo in the 1910s Liane Maria Bertucci

In 1920, Frederico Carlos Hoehne, a researcher at the Butantan Institute, published a book entitled O que vendem os hervanários da cidade de São Paulo (What herbal stores sell in the city of São Paulo), in which he presented his observations of these commercial establishments (location, conditions of the building, etc.) and their owners. He wrote in detail about the products that could be purchased in these places. Hoehne was commissioned to write this work “with great urgency” by Dr. Arthur Neiva, director of the State Sanitation Service of São Paulo, an administrative body with authority over the Institute.1 In the late 1910s, the Butantan Institute, established in São Paulo in 1901 and recognized internationally for the ophidian studies of Dr. Vital Brazil,2 was also involved in studying toxic and medicinal plants, and Hoehne was in charge of the garden and the botanical section of the Institute.3 However, why was it so urgent to study the herbs sold in the city? São Paulo was an important commercial and manufacturing center, with approximately 580,000 residents. Additionally, besides individuals born in the city, including descendants of slaves, there were people on the streets who had recently arrived from other regions of Brazil as well as many immigrants, especially Italians, Portuguese, and Spaniards.4 Frequented by a number of these people, the herbal stores in the city sold products that were used in healing practices 108

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inherited from three continents: South America, Europe, and Africa. These stores were places where knowledge was exchanged and combined, including many ideas that had been condemned by doctors because they were classified as faith healing. Therefore, the survey conducted by Hoehne can be identified as a scientific effort to broaden the scope of knowledge on plants and an action to combat healers, many of whom manipulated and prescribed products sold in herbal stores. Based on Hoehne’s book, this chapter discusses texts from newspapers and magazines published in São Paulo and memories and accounts of actions by men and women who claimed to have healing skills—handling herbs and roots and making potions,5 casting “spells” (with hair, crosses, etc.), distributing amulets, or saying prayers. Condemned by doctors, pursued by the police, and lambasted in articles in the press, these healers prescribed cures for the body and for the happiness of the soul, and their customers included people from a wide range of social groups. At this time, Vicente Rodrigues Vieira, known as “Saint” Vicente, was perhaps the best example of the popularity that some of these healers achieved in São Paulo in the 1910s. HEA LERS A ND CH A R LATA NS: W H AT IS THE DIFFER ENCE?

Arthur Neiva was a director of the State Sanitation Service between December 1916 and April 1920. From the early days of his tenure, the doctor, who had traveled around a considerable part of the Brazilian interior and was familiar with the popular use of Brazilian flora and fauna,6 sought to curtail actions classified as charlatanism and faith healing. He went so far as to request legal measures from the secretary of the interior of São Paulo State, under whose authority he worked.7 In those days, charges of charlatanism were mainly leveled against individuals who flouted legal regulations (such as the state sanitation code), combining the idea of miracle cures with modern scientific innovations, of which those based on the discoveries of Luigi Galvani (1737–1798) and Michael Faraday (1791–1867) deserve to be highlighted. The studies of Galvani related to bioelectricity and Faraday’s research on electric currents were used in the nineteenth century by doctors to treat migraine headaches, asthma, nervous disorders, paralysis, and more.8 From the beginning of the twentieth century, the growing use of electric lighting in cities led to a fascination with and popularization of electricity and its potential among Brazilian people. In São Paulo in the 1910s, many institutes or massage parlors advertised treatments using electromagnetic equipment. Thus,

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in January 1918, O Combate published advertisements for “Dr. Wilson’s Electromagnetic Suspenders,” which, according to the manufacturers, could even cure impotence. In September of that year, the Orthopedic Institute advertised in the O Estado de S. Paulo newspaper a special electric belt to relieve the discomfort caused by an inguinal hernia.9 At first the sale and use of equipment or products like the suspenders and electric belt, as well as the treatments offered at massage parlors, were not in violation of health regulations. However, some practitioners and owners were accused of charlatanism in articles published in the press, and were targeted by the health authorities. The main reasons for these actions were false promises of cures or suspicion of illegal medical activities, such as prescribing medicines for profit. Therefore, the word charlatan was associated with unjust enrichment and scams. However, accusing an individual of being a charlatan and seeing him punished was no easy task. People could use false names, change their address, and, in their advertising, alter the healing powers that they promised. Consequently, a number of difficulties arose when the police attempted to take action following a request from the State Sanitation Service or in response to complaints from the public (including in texts published in the press).10 Pascoal de Luca was one of these cases. This man, according to a report by the director of this government agency, claimed to be a teacher of natural methods, referring to himself as an “operating masseur,” which suggested that he operated/cured through massage techniques. He apparently had a wealthy clientele, as he worked out of Number 5 Largo São Bento in downtown São Paulo.11 In November 1917, he was charged by the health authorities with practicing medicine illegally, although in his defense he claimed that he only gave “electric massages.”12 He was clearly not arrested, as in December Luca was advertising his massage parlor in A Gazeta newspaper. However, in his advertisement, he claimed to be a “massaging scientist” who did not charge for his services. Rather, he only asked people to buy the book he had written called Paz, amor e fraternidade (Peace, Love, and Fraternity).13 In his advertising, Luca replaced the word “operator” with “scientist,” a term that was not associated with one specific activity (after all, what were the legal delimitations of a scientist?), and requested a form of remuneration for his services that could not be classified as unfair or abusive. These tactical changes14 certainly afforded him greater freedom in his actions. When it came to faith healing, a wide range of practices was available. However, ever since Brazil was colonized, distinguishing between the actions of a healer, witch doctor, “pajé” (similar to a shaman), and “benzedeira” (a woman of

HER BS, ROOTS, A MULETS, & PR AYERS IN THE PR ACTICES OF “SAINT” VICENTE

faith, often Catholic, who prays for people’s health to improve15) has been a very difficult and often futile task.16 Healers were generally identified as individuals who, using herbs and other products or saying prayers, believed in their powers of healing or to relieve the suffering of others. In Brazil during the Fiscatura period, from 1808 to 1828, a healer could operate legally as long as he worked within the restrictions imposed by the government. These restrictions stipulated that only native plants could be handled and used to treat “diseases of the [Brazilian] land,” a definition that was difficult to determine and even harder to enforce. To gain authorization from the Fisicatura and operate legally as a healer, an individual needed to pay for an evaluation process in order to be granted a healer’s “charter” or “license.” A “charter” required the payment of several examiners but did not need to be renewed. A “license” was cheaper but had to be renewed on a regular basis. It was often obtained by simply presenting a declaration signed by highly respected people, attesting to the skills of the healer. According to Tânia Pimenta, few individuals sought the Fisicatura to obtain either of these authorizations, and many healers continued to offer cures, including for diseases that were “not native” to the country and handling plants with healing properties that were brought from Europe.17 When the Fisicatura was abolished in the context of the organization of the Brazilian empire (starting in 1822) the legal practice of limited actions of healers ceased to exist. There was greater persecution of these individuals amid the gradual changes that reorganized the work of health professionals in Brazil, with the creation of medical associations, the restructuring of the curricula of medical schools of Bahia and Rio de Janeiro, and the publication of specialized journals. These actions helped to broaden the social space in which graduates of these learning institutions could work. However, healers continued their practices and, as the twentieth century began, still had many clients, including in the cosmopolitan city of São Paulo in the 1910s, despite complaints from doctors and persecution by medical and government authorities. SELLERS OF HER BS, ROOTS, A ND MUCH MOR E

As raw material for medicine approved by the State Sanitation Service of São Paulo and a component of formulas prescribed by doctors, herbs and roots were also fundamental components of so-called homemade remedies and potions that healers prescribed to their clients. In this context, when it came to combatting healers, the trade of plants

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aroused great interest and much concern among the medical and governmental authorities. In the 1910s, herbs, leaves, seeds, roots, and other products to help people maintain or regain their health were sold by large herbal stores on the main commercial streets of São Paulo, such as General Carneiro, Santa Ifigênia, and Conselheiro Crispiniano. They were also sold in little stalls in the city’s Old Market and other locations around the city. The pharmacies were the main buyers of herbs and roots, and the Santa Isabel, Paulista, and Guaraná herbal stores were among the major sellers of these products. These establishments distributed catalogues of their products and even delivered their goods in other cities. Furthermore, the residents of São Paulo were also among the customers of the herbal stores, and it was popular to consume teas and ointments to relieve bodily ailments. These familiar customs were also combined with recommendations from domestic medical dictionaries, like that of Dr. Pedro Luiz Napoleão Chernoviz, published in Brazil since the mid-nineteenth century. The dictionary of Dr. Chernoviz, which was updated and reissued until the early decades of the twentieth century, spread information among the Brazilian population on health care and contained information regarding basic care of diseases—always reminding individuals that it was important to see a doctor.18 Aimed at lay people who prepared remedies, the advertising campaign of the Paulista Herbal Store claimed that in the store it would be possible to “find all the medicinal plants that you need at home for a medical emergency.”19 Many of these products were sold in the large herbal stores or at little stalls in the Old Market. The products available in these establishments included Jatai honey drops and bravo lemon drops to relieve chest pains and coughs; capybara, coati, or fox lard to make ointments; and teas for a variety of illnesses. These teas included soft elephant’s foot (Beaucarnea) to relieve fevers and rheumatism, Punarnava to fight diseases of the liver and kidneys, American ginseng tea to cure gonorrhea and diseases of the womb, and Catuaba bark to cure impotence.20 In these places it was also possible to find the invigorating guarana plant used by various indigenous tribes, and Costa pepper (from Africa) used in fortune-telling and as food for the orishas.21 There were also “figas”22 and other amulets, printed prayers (many with images of saints), and products for “defumação,” the burning of a combination of dry leaves and resins to cast out evil spirits.23 Beliefs and traditions, part of the population’s customs,24 were also used for commercial purposes, as shown in an advertisement by the Guaraná Herbal Store: “That best time of year is approaching (Easter Saturday, at midday) to

Figure 7.1 “Father Ignacio”—a little stall where medicinal herbs and little birds were sold in the Old Market. Frederico Carlos Hoehne, O que vendem os hervanários da cidade de São Paulo (São Paulo: Casa Duprat, 1920).

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perform ‘defumação’ and banish all evil spirits from your home, relieving you of the evils of jealousy, the evil eye and all other types of evil influences that all human beings are subject to, and for this purpose the one and only renowned and true African “defumador” is recommended.” 25 However, in another advertisement by the same herbal store, one can see how even the major traders of herbs and roots shared the convictions of their customers. The advertisement claimed, “There is no point in other herbalists looking at us with the evil eye . . . because it won’t do them any good, especially here where we specialize in African and indigenous items.”26 The so-called evil eye was a very common belief in Brazil, a belief that was most likely brought to the country by the Portuguese.27 In 1912, Drs. Arthur Neiva and Belisario Penna confirmed during a scientific expedition to the central region of Brazil that a “truly startling” number of people believed in the negative power of a single look or the mere presence of certain individuals.28 As Hoehne observed in 1920, people from all walks of life who frequented the herbal stores of São Paulo purchased products for defumação, amulets, and prayers. The botanist believed that this situation would only change when all the plants sold in herbal stores were studied, scientifically classified, and those that actually had healing properties were prescribed by doctors. This would help to demystify the use of these vegetable products and thus disassociate them from superstitions.29 However, if Hoehne’s proposed scientific cataloguing would be difficult to achieve in the large herbal stores where the products were duly stored and displayed to consumers, then when it came to the commerce of herbs and roots in some city squares and in the Old Market of São Paulo, the situation would be even more complicated. The botanist described the sales points in the Old Market as dirty, badly lit, and extremely disorganized, with many baskets of seeds and bundles of herbs stacked in piles as well as jars with “repugnant” oils, bundles of vines and tubers, and the dried skins of snakes, alligators, lizards, and armadillo hanging from the ceiling.30 Furthermore, Hoehne also found that the sellers of herbs and roots, whether in large stores or the little stalls in the Old Market, frequently changed the names of the products they sold and often did not provide much information about them. The botanist understood that these strategies were intended to keep the business profitable for herbalists, as the sellers’ knowledge attracted customers.31 These strategies also worked to keep the health care practices and the treatment of diseases alive and away from medical and scientific control.32

HER BS, ROOTS, A MULETS, & PR AYERS IN THE PR ACTICES OF “SAINT” VICENTE

THE HEA LERS OF SÃO PAULO: POTIONS, A MULETS, A ND PR AYERS

In the first pages of his book, Frederico Carlos Hoehne made a distinction between healers and herbalists. To the botanist, a healer was an individual who diagnosed, prescribed, and supplied herbs and roots to sick people without identifying these products. Meanwhile, the owner of an herbal store, although he “sometimes” performed a diagnosis, generally only sold products requested by customers.33 Therefore, as there was only a thin line separating healer and charlatan (a distinction based on the fact that a healer actually believed in what he did), the difference between healer and herbalist was determined by easily moved goalposts, as shown by the constant changes in the names of products sold in herbal stores and the concomitant variety of information on their properties. Whether or not they were confused with herbalists or charlatans, the number of healers in São Paulo in the 1910s was high. The news headlines in the city were revealing: “The plague of healers,” “Witchcraft champions,” and “In the kingdom of the healers,” were just some of the headlines.34 In the early 1920s, an article in A Capital praised the action taken by the directors of the Sanitation Service against men and women who claimed they could cure ailments of the body and soul, thereby swindling people and breaking the law, and representing unfair competition with “competent professionals” (i.e., doctors) in the field of health in São Paulo. Furthermore, these healers operated as far afield as the districts of Santana and Penha and the suburbs of Consolação and Brás near the city center. These newspaper reports identified lists of products and instruments that healers used in their practices: leaves, roots, bark from trees and bushes, animal furs and potions, prayers, candles, crosses, and holy water. Some of the names of the healers were also published, including Angelina, Fortunato, Filomena de Jesus, João Rocha, Thomaz Vicenzi, and many others.35 In some news reports published in the newspapers, it is possible to perceive, on the one hand, an attempt to associate faith healing with the exploitation of popular good faith and, on the other hand, reports on how many people in the city believed in individuals who claimed to have faith-healing powers. Thus, A Capital triumphantly hailed the arrest of the “mulatto” healer Manuel de Freitas, accused of extorting money from a “naïve person” to cure a “secret ailment,” but at the same time also reported that “Uncle” Dicto, an Afro-Brazilian known as the “Witch doctor of Belém,” was a famous healer because many people believed

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he had managed to make a soldier vomit a ball of “woman’s hair,” sewing threads, and worms.36 Sometimes the news about the material used by one these individuals was a little more specific. In July 1918, in a report on the arrest of “Nhá” França Camargo, it was written that she claimed to know “the art of curing incurable diseases” and that she was carrying snake skin, holy water, a wooden cross, hair, and aconite.37 In the popular Chernoviz dictionary, aconite was recommended for treating asthma, hydrops, and rheumatism but with the warning that if taken in large quantities, it could cause a person’s death.38 In the same month as the arrest of “Nhá” França Camargo, the magazine A Rolha and the newspaper A Nação denounced the actions of Rosa Divina dos Anjos, who claimed that she had been “sent from heaven,” said prayers, and, with the money of her followers, paid for the promises that they made. She relieved the suffering of her followers by “anointing” their foreheads and chins of her believers with her saliva.39 According to Peter Burke,40 the use of saliva by Spanish saludadores (healers) in the fifteenth and sixteenth centuries was commonplace, and they offered bread dipped in saliva to clients. In Portugal, Francisco Bethencourt 41 identified saludadores who often combined prayers with spittle as part of their healing actions. This use of saliva may be associated with European therapeutics, diffused in colonial Brazil, also using the excreta of men and animals in potions due to the vital force they possessed.42 Identified as the result of miscegenation and poor education, faith healing was problematized by doctors and scientists, and its practitioners were often stigmatized as degenerate and carriers of certain types of madness, 43 which strengthened the fight against them beginning in the early twentieth century. 44 The notion of degeneracy, formulated by Bénédict-Augustin Morel (1809– 1873), entered the 1900s as a “generic psychiatric category”45 and was combined with theories of evolution and heredity. This spurred the formulation of notions regarding the ideal type of human (white European) and the existence of imperfections resulting from “certain circumstances of life” (e.g., alcoholism) that would be passed on to offspring.46 At the turn of the twentieth century, these theories garnered enthusiasts in Brazil and the miscegenation of the population led many doctors, lawyers, writers, and others to doubt whether the country would rank among the nations that were considered civilized.47 However, the diffusion of experimental medicine, which diagnosed many Brazilians as sick rather than degenerate, and the sanitary movement in the second half of the 1910s, which intended to establish national policies on public

HER BS, ROOTS, A MULETS, & PR AYERS IN THE PR ACTICES OF “SAINT” VICENTE

health, helped to change the pessimistic perspective of a number of people concerning the future of the country.48 The whitening of the population continued to be a significant item on the agenda, but the members of the sanitary movement considered it imperative to sanitize the city and countryside, teach people hygienic and healthy practices, spread medical and scientific precepts regarding how to avoid disease, combat addiction, and strive for the birth and development of healthy offspring. Sanitary ideals were very often combined with eugenic theories that were spreading around the country at the time. 49 According to Dr. Renato Kehl, founder of the São Paulo Eugenics Society (1918), in his book Eugenia e Medicina Social (Eugenics and Social Medicine) he wrote that to combat dysgenic causes, it was essential to “teach individual, urban and rural hygiene” and, through “simple explanations,” divulge information on the causes of diseases and ways to avoid them.50 At this time, Kehl contemplated proposals, arguing in favor of restrictions on marriage for “damaged” people (sufferers of syphilis, alcoholism, and tuberculosis, etc.) and the importance of educating men and women to help them make a good choice of partner and avoid degenerate offspring.51 However, beginning in the early 1920s, a time when the São Paulo Eugenics Society was “paralyzed,”52 Kehl, in close contact with Germany, radicalized his ideas. Based on determinist and racist perspectives, Kehl began to defend the passing of laws to ban the reproduction of people classified as degenerate and feeble, to make premarital examinations compulsory, and put restrictions on the immigration of “undesirables” (e.g., Asians).53 Kehl’s ideals were shared by several of his medical colleagues (sometimes only partly), but he also had his critics, such as the eugenicist Edgard Roquette-Pinto.54 In the years that followed, the themes of sterilization, premarital examinations, and immigration spurred intense debates, and there was a legal development regarding controls on immigration, with the establishment of annual quotas. The 1934 Brazil Constitution limited the number of immigrants from a country to 2 percent of the number of their fellow countrymen who had settled in Brazil in the last fifty years. This resolution favored European immigrants.55 However, irrespective of the different approaches to eugenics and the discussions that took place, the need to combat healers continued to be part of the medical agenda in the 1920s and 1930s. As in previous decades, the fight against healers was among the actions proposed to improve the health of the Brazilian people. In the late 1910s, according to the doctors, in addition to taking care of the population’s health, it was also necessary to educate people about their health

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because ignorance could lead to accepting the advice and prescriptions of healers. This viewpoint gained many enthusiasts at the time. Two articles published in A Capital, in March and April 1917, claimed that an “old mulatto” female cook and the female owner of a boardinghouse were among the people seduced by healers in São Paulo,56 and in 1919, a text was published in the anarchistic newspaper A Plebe, denouncing ignorance and poverty (due to economic exploitation) as causes of belief in faith healing:57 “Giuseppina Possani, aged approximately 37, who lives on Rua dos Italianos, had an ailment that some people said was incurable. After using up all her savings and even allowing herself to be exploited by healers, she tried to kill herself yesterday. . . . When will poor working people have the means to receive proper treatment for their illnesses, which are mostly caused in the workplace?”58 However, despite such comments, healers were not limited to working with the poor and the supposedly ignorant. In May 1919, a note published in the magazine O Parafuso condemned the activities of a healer known as “Saint” Roque, who lived in Guapira (a suburb of São Paulo). The text pointed out that so-called high society men and women were visiting the place “in search of ‘Bentinhos’59 [to] cure their ailments.”60 A few months later, in August 1919, the anonymous author of an article in A Capital expressed his indignation at the fascination of literate people who dressed “in the most refined fashion” with healers. The author requested that the medical and government authorities take action and asked: “Where have you ever seen cultured and civilized people allowing themselves to be easily taken in by the ravings of a black “retinto” [i.e., very black] with thick lips, a Spaniard who’s as thick as two short planks or a scared outcast from Italy, dirty, ignorant and barely able to stand up because he has such violent delirium tremens?”61 The question remained unanswered but, in addition to demonstrating the diversity of people who were adept at healing, provided evidence of the multiple origins of men and women—Black and white who operated as healers—and the prejudice of many citizens of São Paulo toward these people. Nevertheless, attitudes toward people of African descent were racist (Black “retinto,” with thick lips), while prejudice against Spaniards and Italians highlighted negative features (lack of intelligence, lack of cleanliness, and alcoholism). Was there a difference between the social perception of a white healer and a Black or mixed-race healer? It is possible. A hotly debated topic since the nineteenth century, the whitening of the population— which took new turns with the diffusion of eugenic theories—may even

HER BS, ROOTS, A MULETS, & PR AYERS IN THE PR ACTICES OF “SAINT” VICENTE

have resonated in opinions published in the newspaper A Capital in 1919. In the following years, the positive attitude of the São Paulo elite toward marriage between people from São Paulo (idealized as descendants of the first Portuguese people and Indians) and newly arrived European immigrants demonstrated how important it was for the elite to assimilate these white immigrants to create the “modern” and progressive white identity of São Paulo.62 “SA INT” V ICENTE

In São Paulo during the second half of the 1910s, due to his popularity and the diversity of customers he attracted, perhaps the most famous healer was Vicente Rodrigues Vieira, who was known as “Saint” Vicente, and probably of Portuguese descent or mixed-race. He lived in the district of São Caetano, about sixteen kilometers from downtown São Paulo. This healer treated poor people, important politicians, and young people from rich families. In the late 1910s, the rumor spread that Saint Vicente was a protégé of Washington Luís, the mayor of São Paulo, as he had saved a relative of his or one of his children from death (there were two competing versions of the story). However, nothing was ever confirmed or denied.63 According to some reports, in the early years of the twentieth century, Vicente Rodrigues Vieira was a farmer and lived with his family in the village of Santo Amaro (in São Paulo State). He must have already earned a reputation as a healer because at that time he was sought out by a woman who claimed she had been deceived by doctors and that he cured her with his prayers. To show her gratitude, this woman, who lived in São Paulo, donated land in the district of São Caetano to Vieira. The healer moved to the land with his wife and children between 1906 and 1909.64 On this little farm, Saint Vicente and his family built a house and a chapel. They grew coconut trees, started a “large cereal plantation,” and built tanks to breed fish in the river that ran through the land. Saint Vicente had a “fleet of donkey carts” (in other words, donkeys used to transport goods in large baskets of vegetable fiber that hung over the flanks on both sides of the animals’ bodies), a truck, and a car that was driven by his son-in-law or one of his employees. The little farm had an electricity generator and an ice-cream machine, which was not common at the time, especially in rural districts. For approximately eighteen years, the healer welcomed his followers at his house and, as the number of visitors grew, places were built near his residence to sell food and drink and to serve

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as guesthouses for those who had come on long journeys and could afford to pay for lodgings. These services were administered by his children, his son-in-law, and other members of Saint Vicente’s household.65 To arrive at the farm, many of his followers traveled by train to São Caetano and, as if they were on a pilgrimage, walked the dusty road (or muddy road in the rainy season), with stretches of bush and swamp that led to the healer’s home. Those who could afford it rented one of the six carts available at the train station—these vehicles enabled a slightly quicker and more comfortable journey along what was popularly known as the Healer’s Road.66 From these narratives, it may be inferred that Saint Vicente helped to stimulate the economy of São Caetano, and there is no doubt that a number of people who lived in the district gained financially from his presence. The healer, who they said “did not charge fees and did not give out medicine,”67 welcomed people with his right hand raised and touched each of them on the shoulder. He then wrote the names of the supplicants in a notebook. Beside their names, he drew a cross and said that he would put them “in the lights.” He advised his followers to say prayers and come back later to “tell him if they were better.” He accepted donations.68 According to a report published in O Parafuso in 1917, Saint Vicente prayed, read the Gospels, but said he did not “speak over people”; in other words, he did not bless them.69 Similar information was written by a priest in 1913 in the Tombo (record) book of the parish of Santo André, a village near the district of São Caetano. According to the text, Vicente Rodrigues Vieira was a charitable man who did not prescribe medicine, did not demand payment from those who sought him, and only prayed for the needy. The priest ended his text with a question: “He is not a sorcerer, nor does he serve spiritism. What could he be?.”70 The priest’s question seems to indicate that he could not reach a conclusion. Certainly, he did not consider Vieira a saint, as many people must have called him, but neither did he condemn his prayers that sought to relieve the suffering of others, at least in the eyes of his followers. However, did Vieira at any time refer to himself as a saint? It is impossible to say. Nevertheless, referring to a healer as a saint was not unusual in those days, perhaps due to these individuals’ combination of healing actions and religious beliefs, notably from the perspective of “popular Catholicism.”71 By combining elements of Christian doctrine with religious practices from other cults, especially those of African origin, “popular Catholicism” was systematically condemned in Brazil from the turn of the twentieth century, based on the ultramontanist reforms in the Catholic Church that reaffirmed papal power and

HER BS, ROOTS, A MULETS, & PR AYERS IN THE PR ACTICES OF “SAINT” VICENTE

Roman orthodoxy. In this context, positive declarations like that of the priest in the region of São Caetano with regard to Vieira, were increasingly condemned by the upper echelons of the Catholic Church in Brazil. Despite considerations, such as those written by the priest in 1913, that might set Vieira apart from other healers, statements concerning him, recorded in the mid-twentieth century, showed similarities between his actions and those of other healers. According to one of these narratives, a girl began to walk again after Saint Vicente had passed “a ring of black stone” over her body. Years later, a resident of São Caetano, recalling the cases recounted by his father, claimed that many people who followed the healer’s orders cast their crutches aside and “began to walk.”72 In late 1917, O Parafuso denounced the actions of Vicente Rodrigues Vieira. According to this magazine, in addition to saying prayers, he claimed to be a “doctor who treated for free” and could cure “incurable diseases.” He also promised to arrange engagements, break up couples, and bring lovers together, among other feats.73 These complaints culminated in criminal charges being filed against him. However, at his trial the main witness for the prosecution did not appear, and the healer was acquitted. Vieira retaliated and sued O Parafuso.74 The outcome of this case remains unknown. Over the next few years, he continued to build up a following of believers but also detractors, as indicated in a commentary published in A Rolha magazine in April 1918: “Mme. M also believes in the miracles of the healer from São Caetano. She has been a devout follower since the bearded charlatan guaranteed that Dr. X would become her lover.”75 As a way that was often used by the press to protect identities, the letters M and X were certainly initials of the people that were involved but reveal little about who these individuals were. However, the forms of address used, Mme. and Dr. (at the time, a physician, lawyer, or engineer) could be signs of the social position of both (a female cook, for example, was not called Madam) and in the case of the woman would also indicate her marital status. Thus, by referring to the healer as a charlatan, in other words, a con man, the text revealed that Saint Vicente not only continued to operate but had followers among members of a social group of well-educated people (after all, they were a madam and a doctor), who, in the opinion of Frederico Carlos Hoehne and many other doctors and residents of São Paulo, would not resort to healers. Vieira died in 1925 at the age of fifty-two. One of his sons, Bento, attempted to fill his father’s shoes but in 1929 was arrested and charged with practicing medicine illegally.76 He did not have his father’s luck, who had been acquitted of

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a similar accusation in 1917. In 1949, when few descendants of Vicente Rodrigues Vieira remained in São Caetano, the healer’s little farm was divided and urbanized, and new houses were built on the site. At that time, few buildings remained from the time of Saint Vicente, and a few years later there would be none.77 Nevertheless, tales of the healer continued to circulate among the residents of São Caetano, becoming part of the memory of a time when the place began to grow, when it was still a district of the city of São Paulo. FINA L CONSIDER ATIONS ON HEA LERS A ND THEIR PR ACTICES

In São Paulo in the 1910s, knowledge of health and diseases stemming from different traditions was part of the daily lives of people who lived in the city, and many people visited herbal stores to purchase raw material for their “homemade remedies” and amulets or products for defumação. In this context, a number of healers gained clients and fame thanks to their healing practices. They prepared potions, made special gestures with their hands (with or without objects and plants), made signs (like the sign of the cross), and said prayers. Hints of the scope of their knowledge can be perceived through Frederico Carlos Hoehne’s recognition of the knowledge of sellers of herbs, who preserved this knowledge by constantly changing the names and information on plants. It was also difficult for the botanist to separate what he considered to have actual healing properties from what he would classify as superstition or useless. Regarding the diversity of practices, popularity, and clientele of healers, the news reports on “Nhá” França Camargo, Rosa Divina dos Anjos, and “Uncle” Dicto, and press reports and memories of Saint Vicente are significant in terms of the number and social diversity of people who sought out these individuals. Therefore, even considering that the newspapers and magazines were printed with a certain intention in mind and that the narratives regarding Vicente Rodrigues Vieira are mostly memories that have been handed down through the decades, the articles, reports, and considerations of the healers demonstrate how knowledge of centuries-old cures, many brought from other continents, was combined, reinvented, and used by many residents of São Paulo in the early twentieth century.

{8} Recognition without a Diploma The Wanderings of the Healer Indio Rondín in Early Twentieth-Century Colombia

Victoria Estrada and Jorge Márquez Valderrama

Rafael Antonio Uscátegui S., better known as Indio Rondín, was an itinerant physician who worked in nearly twenty-three municipalities across six central Colombian departments between 1912 and 1934. While the myth of his life presents him as an “Amazonian Indian,” it seems that he was actually a city-dwelling mestizo who liked to be associated with Indigenous people. Rondín was a man of flesh and blood, although we do not know exactly when or where he was born. He is believed to have died in a tragic accident while drunkenly riding a horse. Official archival information contains data about Rondín from 1912 to 1930. He was already renowned as a physician and as a manufacturer and vendor of medicines. To a lesser extent, he also worked in several places as an authorized dentist. Despite the lack of evidence to prove he may have pursued university studies, there is no doubt—given the remedies he distributed, his certification as a pharmacist, and his license requests—that he practiced allopathic medicine. As stated above, his given name was Rafael Antonio Uscátegui S. He apparently added the “Rondín” part himself, to complete his “professional” name as an itinerant doctor, and incorporated it into his signature. It is an evocative pseudonym, as it refers to someone who roams and observes; he thus portrayed himself as a guardian of poor people’s health. In May 1930, when he submitted his request to the authorities to legalize his license as an authorized physician,1 he 123

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was living in Bogotá. According to his account, however, he was already involved in making and trading several patent medicines (remedios específicos or secretos, specific or secret medicines)1 by 1912. Some of these medicines had been licensed by the authorities. As for Rondín’s place of origin, a kind of legend has emerged. In this version of the story, General Rafael Reyes (1849–1921), the president of Colombia from 1904 to 1909, designed an initiative to “civilize” Indigenous people: a project that consisted of “hunting a few savages” and bringing them to the city to be instructed and pressured into changing their way of life. Once the process was finished, they would be released among their fellow Indigenous people and expected to replicate their own “civilizing” process. One such “savage” is said to have been Rondín, the only one who “survived the experiment.” He went to school, and his inner Amazonian anthropophagus faded away as he was transformed. He was sent to New York, but his big-city experience was interrupted when Reyes left office, and his initiative to “civilize savages from the Amazon” was met with increasing ridicule. Rondín, abandoned to his fate, was deported back to his country by immigration officers. Without any form of income, he capitalized on city dwellers’ “unbelievable naiveté” and decided to become a dealer of patent medicines. He made ointments and drew crowds with tales of his tribe. He traveled around Colombia before settling in Bogotá; later, he started working in inland towns and cities. Since the early days of his career (1939), some people accused him of having no traditional knowledge of plants at all; they claimed he resorted to “the most trivial elements for his formulas.”2 According to another account, he was a real Indian, a healer, a “real culebrero,3 a maker of ointments, balms, and syrups extracted from medicinal plants, derived from certain secret formulas of which he believed he was in sole possession.”4 They say he would gather the villagers in the town square on market day, summoning them with the latest music from his gramophone and amplifying his voice with the horn to praise the healing power of his medicines.5 One chronicler discusses his remarkable charisma and his death: “Rondín’s personal magnetism was so powerful, his tribune-like eloquence so great, that he became a key political leader in the place [Líbano, Tolima] . . . Arrogant and generous, he set up his own laboratories in the town square. He died the way such a legend must. On a night of carousing, he was riding his beautiful white horse and lost control of the beast, which broke into a gallop and ran into a steel pole . . . A vast pool of blood remained, in which many of his admirers did not hesitate to soak their handkerchiefs.”6

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Figure 8.1. Locations and approximate years of Indio Rondín’s activities.

TOW NSPEOPLE IN NEED OF MEDICA L CA R E

In 1914, the Colombian state began to organize a public health system with university physicians, for whom public hygiene “became an instrument of modernization and progress,” at the helm.7 These sanitary reforms coincided with

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efforts to regulate the practice of medicine and the production and circulation of drugs. We found Rondín’s file among hundreds of similar ones (789, to be precise): one of many records of successive applications for authorization to exercise medicine without a diploma. They came from many parts of Colombia, most dating between 1905 and 1940. For various reasons, Rondín’s case is especially illustrative among the allopaths. It provides information on the operation of what would later become a lower branch of the medical profession: tolerated physicians. During Rondín’s period of activity, various decisive events affected the debate on authorized physicians and the state’s control over their practices. Another aspect of his case is the range of positions he assumed: allopathic physician, pharmacist, peddler, healer, dentist, and culebrero. This shows the multifaceted supply available in the Colombian therapeutic market at the time. Rondín knew how to take advantage of all such forms by activating, through formal applications and statements, the bureaucratic apparatus of drug patents and professional licenses in many towns and cities. His case—including the breaches and contradictions he learned to implement to his own advantage— reveals the operations of the recently instated mechanisms of control over the medical profession. Through the enactment of Law 83 of 1914,8 many medical practitioners uncertified in medicine and other paramedic trades (pharmacy, midwifery, therapeutic botany, homeopathy, healing, odontology) had to apply for licenses so that they could legally continue to exercise their occupation. Only those who could prove they had been practicing for five years and who could submit certifications from other physicians and neighbors that attested to their honorability and skills, could keep practicing. As allopathic doctors, they would only be allowed to practice in remote municipalities or regions where no university-educated physicians were available. With the enactment of Law 12 of 1905 and its regulatory decree 592 of the same year,9 licensed physicians could then compete with university medicine, represented by the few university-educated physicians practicing in early twentieth-century Colombia. Law 83 of 1914 represented an effort to harden restrictions against doctors practicing without diplomas, which is why official records show a surge in applications being submitted at that time. In the 1920s, medical practice continued to be characterized by a similar liberalism: each new regulation introduced exceptions allowing for a limited number of uncertified physicians to exercise this occupation. In the reforms of 1905, as well as in those passed in 1914 and 1920, community support remained a

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decisive element when it came to granting or extending a license. As of 1929, with the creation of the Central Board of Medical Degrees (Law 35), licenses granted by state governors started losing their validity, and practitioners were forced to obtain them in Bogotá.10 This law increased the bureaucratization and centralization at work in the license authorization process, which subjected applicants to one- or two-year waiting periods in hopes of discouraging them. The dense and intricate regulation of the medical occupation in Colombia illustrates a singular process of medical professionalization.11 Historically, this process developed in terms of the contradiction between the pugnacity and tolerance of university-educated physicians with respect to those who practiced without diplomas.12 The former were still scarce, while the latter provided a rich therapeutic panorama that has been analyzed in the field of medical anthropology.13 As for the presence of university medicine throughout the studied period, Louis Schapiro, a US physician representing the Rockefeller Foundation in Colombia, estimated that there were almost twelve hundred physicians across the country in 1919. By 1937, an official census showed that there were 1,512 practicing physicians; even so, 64.5 percent of Colombian municipalities did not have one.14 The participation of university medicine in providing medical care to the Colombian population was very weak. Besides, the sanitary situation was alarming due to the prevalence of parasitic, infectious, epidemic, and endemic diseases; minimal hygienic standards; scant prevention efforts; the limited access to clean water; and the virtual nonexistence of sanitation systems (septic tanks, sewers, etc.). There was an incipient public sanitary apparatus, which was still in the process of being solidified, and its operations were fragmentary and uneven, varying considerably by region.15 This context offered favorable conditions for people continuing to seek out health care options that existed beyond university medicine, which was very expensive for the poor. Most people resorted to popular itinerant healers. In this sense, doubts emerge as to how much impoverished people even trusted university-educated physicians, as they were the new arrivals to this market. THE HEY DAY OF PR ACTICE

We can identify two specific periods in Rondín’s life as an itinerant doctor. The first extends from 1912 to 1919, during which he obtained certificates from several university-educated physicians who testified to the effectiveness of some of his medicines. The other period encompasses the decade of the 1920s, marked by

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testimonies from patients who praised his medications, and recollections from neighbors defending his services and generous prices. During the first period, Rondín used physicians’ testimonies to promote his medicines. During the second one, however, he submitted his products to state control, which meant they were examined by an official laboratory. He obtained state licenses to produce and sell ten of his products in 1928: this was a personal circumstance associated with the 1920 creation of the Commission of Pharmaceutical Specialties (CEF, after its name in Spanish), the regulating body of the Colombian medication market.16 Rondín’s case is unique as he presented himself as both a pharmacist and a physician: a pharmacist who invented and produced his own medicines. Before 1920, university-educated doctors provided the recommendations that Rondín appended to his license applications in order to sell the medications he produced himself. Such a strategy was intended to gain the approval of the Central Board of Medical Degrees and was admitted as evidence of the expertise and integrity of tolerated physicians. Rondín obtained recommendations from sixteen physicians from eight different municipalities of the Andean region.17 He used most of these recommendations in a printed advertisement he would distribute as a flyer as he traveled from place to place. On one such flyer, he promoted “Dr. Fournier’s anti-syphilitic drops”18: a product name that evokes the prestigious French dermatologist and venereologist Jean-Alfred Fournier.19 In his ad, Rondín praises Fournier’s contributions, and guarantees that the French scholar had invented the treatment method. Indeed, the ad echoes one of Fournier’s works on syphilis as a hereditary etiological condition and appropriates its promotional and moral message aimed at future mothers. In Chocontá, a university-educated physician certified the efficacy of two other products, “Rondín” and “Antidol,”20 in April 1917. In Anolaima, Cundinamarca, in May 1919, two surgeons who were alumni of the National University of Colombia said that “the formulas in the preparations ‘gotas antisifilíticas’ (anti-syphilitic drops), ‘Mentholatum,’ and ‘Vermífugo indio’ (Indian vermifuge) . . . contain toxic substances, but they cause no harm to the body at the prescribed dosage.”21 Even sanitary authorities approved the production and sale of Rondín’s medicines. In June 1917, he wrote to the mayor of Bogotá and requested permission to openly sell his patent medicines: “anti-syphilitic drops, Rondín, Antidol, and Pomada Garantía (Guarantee Balm) or Mentholatum . . . on public thoroughfares and squares.” He claimed that several university-educated physicians had certified the effectiveness of his medicines. Authorities responded that he would

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have to send samples of the medicines to the city laboratory and pay two pesos for each patent medicine to be studied. In 1917, the head of the laboratory at the City Directorate of Hygiene and Sanitation claimed: “The formulas presented by Mr. R. Antonio Uscátegui as the compositional basis for his patent medicines are more or less acceptable for some of the ailments or diseases he claims to alleviate or cure.” Bogotá’s director of hygiene and sanitation deemed that “a provisional license may be granted,” which was not to exceed thirty days, “while the patent medicines are synthesized in the laboratory.”22 Rondín obtained permission from the Bogotá authorities on May 15, 1918, and used it to sell his products in several municipalities in Cundinamarca.23 A MEDICINE VENDOR

In May 1930, in a brief he addressed to the minister of education, Rondín claimed that he practiced several professions simultaneously: as a manufacturer and dealer of patent medicines, a vaccinator,24 a dentist, and a tolerated physician (“allopath 25”). In this missive, he makes a triple request: (1) he wants general permission to sell the pharmaceutical products he makes himself, (2) a license to practice medicine anywhere in Colombia (or in places with no university physicians in operation), and (3) national authorization to prescribe the pharmaceutical products in his possession. Nevertheless, he was most concerned about continuing to sell his own medicines legally. In this regard, Rondín’s requests involve the patent medicines in his possession that he intended to sell in different regions. Apparently, almost all of the medicines in his factory were branded and legally patented. Rondín claimed he had “a great number of licenses granted by several Authorities of the Republic,” which authorized him to sell them freely.26 He employed a range of strategies as a salesman: the old peddler’s method of advertising his wares by hawking; itinerantly, wandering among towns and cities; establishing agreements with distribution agents, usually pharmacies, many of which were managed by university-educated physicians; and through his own drugstores, the existence of which (in Bogotá and Líbano) is supported by considerable evidence.27 It would be difficult to account for all the reasons behind the commercial success of his medicines—a success proclaimed by himself, his friends, and his customers. Although his commercial strategy consisted of live performances in public spaces, he also used other means, such as printed advertisements (flyers, posters, labels, and newspaper ads). Nevertheless, he seems to have gained

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renown primarily by peddling in many Colombian towns. In terms of access to medicine, it would appear that the methods practiced by itinerant healers brought them into closest contact with the clientele, since these healers were the ones visiting the most remote villages. By contrast, university physicians tended to establish a doctor’s office or a drugstore and wait for their prospective clients to come to them. A UNIVERSITY-EDUCATED A ND R EGULATED PH A R M ACIST

Rondín complained that his licenses and patents were only respected in certain places. For instance, they were not even acknowledged in Manizales in 1928 and 1929, where the municipal authorities banned the “free trade” of Rondín’s patent medicines and all others offered by hawkers.28 From the nineteenth century onward, the sale and advertisement of patent medicines was reported in the West as quackery and swindling,29 and Colombia was no exception.30 There, however, the negative view of patent medicines intensified in the second half of the twentieth century, when university medicine had conquered certain institutional spaces.31 It is no wonder that the itinerant Rondín harnessed diverse resources to defend his trade, such as recommendations from his neighbors that attested to his “competence, honorability, honesty, and discretion in exercising medicine.” In this way, he emphasized the ethical implications of his work and how, in his view, his moral commitment distinguished him from other patent medicine vendors: he was “a model citizen who had spent most of his life trying to do good for humanity without exploiting anyone.”32 What the Manizales municipal administration banned was not the sale of Rondín’s pharmaceutical products, which were already authorized by law, but the activity of selling them “freely through the peddling system and through talks in public squares and thoroughfares . . . as such a system is viewed as gravely detrimental to the interests of the involved parties.”33 The authorization request that Rondín signed and submitted to the director of hygiene in the department of Caldas aimed to secure a license, similar to the one he had already obtained in Tolima, “[to] sell freely in Caldas . . . without hindrances, requirements, or systematic opposition, and to offer and announce the items, in a legal and efficient way, by means of the newspaper, flyers, the cinema, amplified by a horn, or any other current and authorized means, for instance, in the auctions stipulated by the code of commerce.”34 Rondín’s arguments were up-to-date and fully present in fierce disputes

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throughout the 1920s, including the debate on patent medicines, the one on “heroic drugs,”35 the one on legal and generalized tolerance of charlatans, and the one on the limits between “trade” and “profession.” According to Rondín’s representative, his client did not sell items “of banned trade, such as heroic drugs” in 1929, so his request for a sales permit became unnecessary. He was only asking for permission out of deference to the hygiene director. Moreover, he said, “Indeed, Mr. Rondín is no quack or vulgar speculator, nor is he a charlatan or a trickster in search of gullible, simple-minded people to exploit: he is a certified pharmacist.”36 In this regard, Rondín himself had said in the introduction to his file, “I do not prepare one single medicine, but several. And I invest all my attention and pharmacological knowledge in their preparation. Such knowledge has been recognized by the nation in Article 45 of the Directorate of Hygiene and Public Assistance that corresponds to the department of Tolima, in which I am acknowledged as a certified pharmacist.”37 His claim to be a “certified pharmacist” does not appear to be groundless. In August 1926, the secretary of Tolima’s Departmental Board of Hygiene signed the records of the exam set to Rondín to decide whether he should be granted the “license to exercise the pharmaceutical profession.” According to resolutions 334 of November 14, 1925, and 345 of February 16, 1926, issued by the National Directorate of Hygiene, Rondín obtained the highest score38 on this test, administered by three physicians. Registering the trademark “A. Rondín S.” granted him access to a list of Laboratorio Rondín Uscátegui & Co. products that, according to the owner, could be identified by the label, also registered in 1926: “Antidol, Indian Water, Indian Balm, La Reina Cream, Coty Cura (drops and ointment), Capilina, Anti-Dandruff (soap and Indian lotion), Cornicide, Anti-Syphilitic Drops, Epticas Drops, Hielol (magic remedy), Blampiel Soap, Cough Syrup Linimentum, Green Mentholatum, Corn Killer, Molarina, Palusan, Sublime Panacea, Chocoana Paste, Rondín (Indian remedy), Rheumaticure (ointment and syrup), Child-Saver (Indian vermifuge), Sanagono, Rondín Healer, Usarine (La Reina toothpaste), USAR Tropical Wine, Veterino, and those I may acquire later as my legitimate property.”39 Ten of Rondín’s medicines, patented by the CEF between April and June 1928, were later certified by the same agency in October of that year. This allowed Rondín to manufacture and sell them freely all over Colombia. It seems that the resolution issued in Manizales applied to all of Caldas, as the mayor’s office in Armenia also banned the trade of patent medicines through peddling.40 Likewise, in Calarcá, the authorities restricted this liberty to trade,

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claiming that drug patents would not suffice to authorize their sale and that any potential vendor would have to obtain a license from the Ministry of Hygiene.41 The hygiene director in the department of the Valle del Cauca authorized the sale of Rondín’s patent medicines in May 1929, citing a CEF document that grants each medicine a license. It warns, “This license does not grant its recipients the right to practice medicine or surgery in any of its forms, nor may they sell poisonous substances without a physician’s prescription.”42 Police regulations of remedy-trafficking and peddling were not new, nor were they limited to Caldas. Rondín had already run into trouble in Tolima in 1924. Agreement 10 of Líbano’s Municipal Council, dated May 23, reads, “Given the need to put an end to abuses by some traveling agents, who endeavor to sell and dispense drugs and so-called patent medicines, with which they undermine people’s health, exploit them, and take advantage of their ignorance; that, with their recitations and speeches, the announcers of such merchandise cause a nuisance, and generate noise and disturbance that hinder free passage . . . the sale of patent medicines and drugs, no matter their origin, is prohibited both in the already established public markets and in those pending establishment within the Municipality.”43 The case of Rondín’s patent medicines is just one of the hundreds that were marketed and subject to the official control and regulations pertaining to brand-name pharmaceuticals in Colombia. During Rondín’s peak, this control was dispersed among municipal, state, and national authorities. That is, it did exist, but it was not centralized in any official laboratory; rather, it was highly empirical, and tests were administered by different laboratories. The CEF did not have a laboratory of its own; it began operations due to scandals regarding the composition of some popular pharmaceutical specialties.44 LA BELS A ND SAV IOR NA MES

The names of Rondín’s products evoke the therapeutic imaginary of the times. Catchy and expressive, they sometimes refer directly to the instructions for a given drug or its remedial effects (“CoughSyrup,” “Antidol”45). In other cases, Rondín resorts to strong images associated with religion and mythology: “Sublime Panacea,” “Indian Balm,” “Savior Vermifuge,” and “Restorative San Antonio.” In still others, he appealed to the names of famous medicine manufacturers who had attained renown in other places. In the case of the anthelmintic “Child-Saver,” the rhetoric functions not only through the name but also through the image on the label: an allegory in which five

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Figure 8.2. Ad for Child-Saver Laxative, in Jorge Ferreira Parra (aka Colorado), Novena al glorioso senador San Laureano de Chía (Líbano: Tipografía Renovación, 1932). Courtesy of Leónidas Arango.

children are ascending into heaven and carrying a syrup bottle stamped with a picture of Indio Rondín. There is a direct association between health and salvation, and the image serves as an obvious allusion to Christian redemption. It suggests the intent to communicate with an uneducated public, which may have constituted its primary clients. Another advertising resource becomes evident in the same label, under the visual allegory, printed in a smaller size. It consists of two portraits of Rondín: in one, he wears a suit; in the other, Indigenous attire. This is a clear reference to his status as a mestizo doctor. Moreover, the label also displays the commercial license number: a form of authorization granted prestige to brand-name medications. We must emphasize that Child-Saver was a laxative. At the time, the sale of vermifuges was a verifiably steady business. On the one hand, the general population, especially children, was beset by countless intestinal parasites. On the other hand, the deworming effects of anthelmintics were evident in the short term. As a result, brand-name laxatives proliferated. The therapeutic discourse exemplified by the label (“it contains no calomel or santonin,” “it requires no special diet or period of use,” “unrivaled against worms,” and “the tape-worm is its prey,”) highlights the benefits, ease of use, and nontoxicity of the product. Such arguments sought the approval of both consumers and the authorities.

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By 1940, Rondín’s products were still on the list of medicines authorized for sale in Colombia 46—a sign of the considerable difficulties involved in controlling the manufacture and trade of brand-name pharmaceuticals in the first half of the twentieth century.47 THE VOICES OF A FFLICTED HUM A NITY

Public acknowledgment of Rondín’s practice becomes evident through the habitual legal means established for tolerated physicians at that time. Such means consisted of the presentation of briefs, signed by neighbors, before a civil authority. In many cases, the patients and clients themselves signed and submitted the documents. The standard procedure was to do so at the mayor’s office or before a judge. In one such document, recorded in San Martín, Meta, in May 1924, the case in favor of Rondín was based on his charity toward the defenseless and the needy: disadvantaged people who lacked access to private medicine. These kinds of briefs always underscored the patients’ poverty, the physician’s generosity, and his prodigious labor on behalf of “afflicted humanity.”48 The documents contain various patient testimonies backed by the signatures of dozens of witnesses to their recovery. For instance, in Ibagué, one brief stresses Rondín’s generosity in 1922. It chronicles a clear exchange of favors: the physician provides his patient with medicines, and the patient helps him expand his popularity. “I was sick with a flu, which had affected my kidneys, liver, and head. At that moment, Mr. Antonio Rondín, a drug distribution agent from the Red Cross house, came to my place and unselfishly gave me two boxes of Mentholatum, a bottle of Indian Syrup, and another of Cough Syrup. I took these medicines with due faith, and I am now entirely rid of the ailment that afflicted me.”49 Recovery could be almost miraculous, although it was associated with the drug and not with the doctor. Such was the case in Anolaima, in 1924, where a third party prescribed Rondín’s medicines. The narrative illustrates the reality effect based on temporal and locational details and circumstances, something frequently present in testimonial forms: “Having suffered a fit on the afternoon of the eighth of the current month in this town, he immediately lost consciousness and was beset by some kind of black cancer. Once a dose of Indian Balm had been applied to him, he regained consciousness at once and remained perfectly healthy from then on.”50 Two other recovery narratives, both in Líbano, Tolima, in 1924, are certified by two patients who had been dismissed as hopeless cases by university

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medicine. They went straight to Rondín and subsequently attested to their “radical recovery.” Both are cases of external ulcerations. One was on the patient’s shin; it had afflicted him for seven months and already damaged his tendons. In the document, the patient claims that after consulting with Rondín and using his remedies, he was “radically healed, as the whole town has witnessed.” The second ulceration, “covering an entire leg,” had entailed twenty-one years of suffering, hospitalizations, and treatments by multiple physicians; the patient refers to it as “leprosy.” Rondín cured him, free of charge, in only four months, and the case is narrated as yet another example of his infallibility as both a physician and a pharmacist.51 These healings were spectacular insofar as their effects were highly evident: eradicating sores, making the patient walk again, and, in any case, acting where university certified medicine had failed. Rondín did not intend to promote another kind of medicine but rather to popularize his own (allopathic) means through drugs of his own trademark. Patient testimonies proved to be a powerful advertising strategy in a diverse and competitive market. While healers such as Rondín could employ this rhetorical form for publicity, university physicians had already objected to the ethical coerciveness of the tactic and did not want to look like charlatans.52 University-educated physicians did not have to legally justify their practice. Those without diplomas did, but when they sought to justify themselves, they resorted to practices that had been important and popular in the Western medical market—a market already globalized through the circulation of patent medicines and brand-name drugs.53 Rondín represents the myth of the traditional, charismatic shaman, a kind of redeemer. At the same time, he also presents the figure of the charlatan denounced by the official medical discourse. The mundane elements that fed the myth include his supposed Amazonian origins, his reputation as a charismatic peddler, and his tragic and public death. Rondín’s fame is evident in the recommendations on record, both from physicians and from the people, of his practice. These documents reveal several key aspects of his occupation and contextualize him among common practices and discourses of the day. Colombian laws pertaining to the medical field protected the practice of recommendations, a practice that did not only entail certifying the approval of certain university-educated physicians; in fact, some bureaucrats supported physicians without diplomas, which was hardly unusual in early twentieth-century Colombia. Popular renown came about via the everyday practice

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of medicine and the charitable deeds with which each tolerated physician sought to bolster his reputation. Endorsements from university physicians certainly increased prestige. Most importantly, however, they meant reinforcement in the face of police and sanitation authorities. In examining these two forms of favoritism, we see two processes in action: the official medical establishment’s tolerance toward physicians without diplomas and the bureaucratic regulations they had to confront.54 The need to control uncertified physicians was part of the agenda of Colombia’s official medical apparatus in order to safeguard the medical profession from competing impostors, as well as to protect consumers from fake and potentially dangerous medicines. Controlling medical practices implied very different obstacles in major cities, in towns, and in the countryside. The distance between urban and rural determined several specific realities. In the most remote towns and in the countryside, inhabited by a largely rural society, university medicine was scarce; healers performed the trade. Nevertheless, they shared a cordial coexistence with the tolerated physicians—a reality that can be explained partly by the fact that the presence of university medicine in Colombia was still scarce in the first four decades of the twentieth century. Indeed, medical professionalization was a slow process in the country. Despite several earlier attempts to train and certify physicians, formal medical studies started in the 1870s. The recourse to “physicians trained by experience” was an old habit practiced by patients, tolerated by university-educated doctors, and occasionally licensed by the authorities. In the history of Colombian medical arts, a 1930s healer lived, worked, and acted in a moment of transition. His figure was still rooted in nineteenth-century attitudes, gestures, and stereotypes, which are copied from popular and traditional medicines. The range of roles carried out by Rondín (peddler, healer, culebrero, pharmacist, drug manufacturer, physician, and dentist) does not detract from his adherence to the allopathic system in several ways—particularly when he pursued the production, prescription, certification, and circulation of medicines, and when he turned to medical authorities to validate his eclectic practices. Ultimately, this adherence to university medical discourse by a supposed practitioner of folk medicine helps us understand the extent to which that discourse had proliferated. It also allows the inference that institutional medicine was beginning to dominate, that it had the law on its side, and that it was taking a stance in the struggle to monopolize a heterogeneous therapeutic market. Rondín’s folk elements lie not in his medical system as such but rather in his performance and marketing strategies. While he adopted folk elements, he may

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not have been a traditional healer defying the limitations of university medicine. His rise in the popular market of patent medicines shows the highly commercialized nature of brand-name medicines and the weak sanitary regulations at work in the industry, which was in the process of legalization. Rondín’s case offers an example of the meaningful presence of physicians without diplomas in towns and villages; of their importance and insertion into local life; of their political influence; and of their bonds with authorities, villagers, and markets. It also illustrates how health and illness are a means of diffusion for cultural practices and imaginaries—which, for centuries, peddlers have spread through their gestures, their constant journeys.

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{9} The Miraculous Doctor Pun, Chinese Healers, and Their Patients in Lima, 1868–1930

Patricia Palma and José Ragas

Amid the outbreak of one of the worst yellow fever epidemics in Lima in 1868, persistent rumors about doctors who performed successful treatments and cured people rapidly flooded across a desperate city. The timely appearance of Chinese healers was praised by patients and the media, in a context where all other professionals or Western medicines seemed to be ineffective. Word on the street said that Chinese healers possessed “miracle drugs” and treatments to alleviate yellow fever symptoms and cure the disease. The rumors grew in proportion to national desperation, and some news reports even mentioned a Chinese healer who allegedly had resuscitated someone from the dead.1 Limeños (the residents of Lima) infected with yellow fever went to Lima’s Chinatown, where Chinese herbalists had been offering their skills for only a few years. The surprise of finding a cure in such unexpected healers was expressed by the local press: “It sounds like a joke, but the fact is that the Chinese doctor cures and saves those hit by the epidemic.”2 Who were these “Chinese doctors” whose timely presence saved Peruvians from such tragedy?3 Between 1849 and 1874, Peru hosted nearly one hundred thousand Chinese immigrants as part of a trend that moved thousands of them across the Pacific to the Americas. The end of African slavery and the need to supply the labor force with cheap manpower was the catalyst for one of the most impressive 138

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displacements of human energy in modern times. By the time the immigration program came to an end in the mid-1870s, the Peruvian capital had been transformed into one the largest hubs of Chinese diaspora in the Pacific—only after San Francisco and Los Angeles in California. 4 Cities like Havana or San Francisco witnessed emergent and vibrant communities with their own Chinatowns. Chinese immigrants altered the social, political, and economic landscape across the Americas, bringing not only their labor force in agriculture but also new traditions. Among these new traditions, medicine was one of the most important yet understudied contributions of the Chinese diaspora in the country. Although small in number, Chinese healers played a significant role in the social, medical, and political Peruvian landscape. This chapter traces the emergence and consolidation of Chinese healers in Peru between the epidemics of 1868 and 1930, when Peruvian authorities declared the trade of Chinese medicinal herbs illegal. Drawing from a varied body of sources, including criminal records, newspapers, and advertisements, we aim to illuminate the process of how Chinese practitioners became an affordable alternative to Western and professional doctors, challenging the medical repertoire by offering new treatments and products to the local population. Unlike the United States, where Chinese healers published books and treatises explaining the characteristics of their treatments, Chinese healers were mainly silenced in Peru.5 Chinese healers became a disruptive force in the monopoly of Western medicines in Peru. While most traditional historians of medicine have portrayed the medicinal market as an area of tension between doctors and imposters, the distance between both groups was more rhetorical than real.6 Despite the impressive investment of resources by professional doctors to “unmask” and prohibit the practice of Chinese healers by accusing them of being “quacks” and “charlatans,” the truth is that many of them enjoyed the same reputation as those who graduated from the School of Medicine of Lima.7 Chinese doctors appropriated the commercial strategies employed by the medical guild to become a competent factor in the medical market. Through the use of professional business cards, advertisements, pharmacies, and medical establishments, they rapidly learned how to adapt their own skills and resources to cross strict social, cultural, and racial postcolonial boundaries and appeal to a non-Chinese population. In order to provide a clear account of the complex relationship between Chinese healers, professional physicians, and local patients, we showcase three specific moments during which Peruvian doctors confronted Chinese healers and their patients, and created discourses that advocated for and against them:

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(1) the yellow fever epidemic of 1868, (2) the legal discussions of 1876 and 1888 regarding the status of Chinese herbalists in the country, and finally (3) the illegalization of Chinese herbalists and herbs in 1930. CHINESE HEALERS DURING THE YELLOW FEVER EPIDEMIC OF 1868

For most of the nineteenth century, licensed medicine in Peru was practiced by a small group of physicians, most of them Peruvian-born, who came primarily from the School of Medicine in Lima, also known as the San Fernando School of Medicine. Founded in 1856, the School of Medicine was the country’s only medical school until 1957, and it dictated the parameters for how medicine should be taught and implemented in the Andean republic. Peru’s breakup with the Spanish empire not only ended the Protomedicato but it also fostered the massive loss of Spanish doctors from the former colony. Between 1820 and 1860, national medicine lacked the necessary capacity and personnel to respond to health issues—a problem that became even more visible during the multiple epidemic outbreaks experienced by the young republic. Yellow fever arrived to the port of El Callao in February 1868 after a decade without major epidemics. It rapidly propagated to the nearby city of Lima and other major urban areas along the Pacific coast. The 1868 yellow fever epidemic was not exactly a surprise for Peruvians, due to the rumors coming from cities like Guayaquil (Ecuador) and Panama City. The School of Medicine recommended to the Ministry of Justice, Worship, Education and Charity to mandate a quarantine in the Callao Port area. However, this policy motivated international businessmen and traders to pressure local authorities, who cancelled the measure.8 At the moment of the outbreak, the capital was going through an unprecedented population growth, and in just a few years its population went from 58,236 in 1836 to 105,167 in 1862.9 The demographic boost was not accompanied, however, with proper sanitary improvements; housing was scarce and people lived in crowded spaces with poor living conditions. The lack of proper health centers also affected the well-being of Limeños and newcomers to the city. Lima only had three hospitals: Santa Ana, San Andrés, and San Batolomé, all of which were insufficient for the growing population.10 Thus, the city became the perfect breeding ground for the Aedes aegypti, the mosquito responsible for the transmission of yellow fever. The official response to combat the disease was late, insufficient, and contradictory. When the quarantine failed to prevent the arrival of yellow fever to

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the country, authorities established special facilities intended to isolate sick people. Nonetheless, the temporary measures were rapidly overwhelmed due to the increasing number of people with fever, and Lima’s mayor unsuccessfully attempted to use military barracks as improvised hospitals. Without large facilities to place infected individuals, they were sent to three hospitals, which collapsed soon after due to the increasing number of patients. Social life was also altered. Authorities sought to prevent large crowds of people form congregating and proceeded to close schools and suspend activities like plays in theatres, 11 with Holy Week experiencing a significant decrease of attendants at churches. Writing retrospectively—and adopting a moral tone—the author of a memoir on the impact of the epidemic in Tacna implied that yellow fever targeted those “places where the lack of spirit and abuse of alcohol” was more frequent.12 Other decisions, like the erection of a lazareto (quarantine station) and a modern hospital, were of little help since they were both finished long after the epidemic had faded. At a certain point, the epidemic triggered fear among the elite that the urban poor in need of attention, medicines, and food could not be contained and that the poor would “flood the capital [with] helpless people.”13 The first news about Chinese healers appeared in the press around May. They echoed information from the streets about, “a Chinese doctor who is doing wonder cures for victims.”14 Newspapers were key platforms to disseminate news, and these were read in several spaces, in silence and out loud.15 In a story run by a local newspaper, an “Asian dependent” got sick and went to a fellow national doctor who treated him. The Chinese healer “cut him with a proper instrument and to complement the treatment gave him some herbs for a concoction.” Not surprisingly, the dependent woke up the next morning “smiling and ready to get back to work.”16 The press reproduced similar stories that captured increasing rumors from the streets. In the capital, the expanding public in the urban sphere of the mid-nineteenth century helped these stories reach desperate individuals in search of a cure. What began as a rumor soon became a major theme for newspapers as well as a concern for the School of Medicine. In July 1868, doctor José María Macedo ventured himself to investigate what he expected to be just rumors amid a time of confusion. What he found instead was worse: hundreds of Limeños visiting the Chinese doctor and turning him into a “local savior.”17 Chinatown, the emergent Chinese hub in the heart of the Peruvian capital, became one of many crucial sites of medicine in the midst of that tragic moment.18 Patients allegedly rejected by physicians found among Chinese herbalists and other healers an alternative to alleviate their suffering.19 Herbal shops offered not

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only medicines but medical services, which “attracted a considerable number of clients, both Asian and from other nationalities.”20 They started to operate around September 1868, “selling their medicines in the same way as pharmacists with professional studies.”21 One of the most famous herbal shops was located on Puno Street and had a permit from the municipality, which was contested by the School of Medicine a few months later. A key appeal of Chinese healers included the less invasive treatments based on herbs, a healing practice already familiar in the Andean area and in Lima due to the robust presence of Indigenous migrants in the city.22 Chinese healers imported most of the medicinal herbs from China, California, and Japan. They also introduced the use of needles in the body, currently known as acupuncture. These treatments overtly contrasted to methods used regularly by Peruvian doctors, such as bleedings, leeches, mercury, and purgatives. The public also attributed Chinese healers as having more experience in treating yellow fever than local physicians, since they believed this disease was native to China.23 Those who had been treated did not hesitate to express their public support toward the newcomers. In an article sent to El Comercio, Carlos Yansen and Adolfo Birmen said that “the Chinese have only tried to fix with herbs the weakened bodies of Lima’s inhabitants caused by the high doses of quinine, mercury, calomel [mercury chloride], poison acids and other thousands of preparations,” administered to Limeños over the last decades by physicians.24 By the end of the year, when the epidemic was finally over and people were resuming their daily activities, it was evident that the School of Medicine’s reputation could be counted somehow among the casualties. Nevertheless, the Lima Charitable Society awarded four doctors in recognition of their efforts to fight the epidemic.25 The School of Medicine had lost a unique opportunity to show the efficacy of Western medicine and to gain legitimacy around the nascent entity. Instead, they had been displaced and “humiliated” by a group of newcomers who performed exotic and mysterious treatments unknown in the classrooms of the School of Medicine until then. Incapable of competing with the impending popularity and acceptance of Chinese healers, doctors called them “quacks” and the “other plague,” and accused the local population of “ignorance” and “naïveté.”26 Dr. Casimiro Ulloa, a prominent figure in the school, sought to discredit the positive view of Chinese healers circulating in the local press. He penned a harsh reply in La Gaceta Médica de Lima, where he attacked the “Celestial Hippocrates”—a nickname used by local reporters to refer to the anonymous Chinese healer who saved several lives during the 1868 epidemic outbreak, calling him a “false prophet of medicine.”27 Despite their numerous

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efforts to counter rumors about the efficacy of Chinese healers, the damage to the reputation of the school was done. As an editorial in a local newspaper stated regarding herbal treatments: “[I]t seems [to] reveal the triumph of Chinese science above the science we obey with so much faith.”28 Doctors were not going to stay quiet. The battle for the medical space was declared, and for the ensuing decades, they would not stop until they barred their most immediate competitors from the practice of medicine. To accomplish that objective, doctors from the School of Medicine changed their tactics and decided to take the confrontation to the next level: the municipality, the Congress, and the public sphere. FR AGILE BOUNDA R IES

Incapable of convincing the public opinion about the alleged harm caused by Chinese healers and their lack of professional degrees, the members of the School of Medicine appealed to the municipality of Lima and the Congress to contain the expansion of Chinese medicine in the country. In two specific moments the debates around this issue were particularly intense. The first occurred in 1876, when medical authorities aligned with the municipality to enforce legislation and regulate the opening and operation of pharmacies. Peruvian doctors sought to consider Chinese herbal shops as regular pharmacies and thereby force them to obtain a license from the municipality and to hire a professional pharmacist. Without a license, they could be closed. The second moment took place in 1888, when Congress debated the law about the legal practice of medicine and pharmacy in the country, which therefore determined the status of Chinese healers in the medicinal market. In both cases, each campaign’s ultimate goal was to delineate clear institutional and public boundaries between licensed doctors and untitled practitioners considered to be quacks by the medical guild. The proliferation of homeopaths, Chinese healers, and sellers of unauthorized pills and potions was the direct consequence of the circulation and adjustment of medical knowledge and the arrival of newcomers to Peru from Asia, Europe, and the United States. It also reflected the predisposition of the local population to other types of medicines and healers besides the physicians from the School of Medicine. Peruvian doctors resented the foreign competition and sought to discredit any other practitioner that was not under their vigilance. Although campaigns targeted this heterogeneous group of practitioners, Chinese healers were mostly attacked.

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The medical discourse against Chinese healing traditions exposed the social, cultural, and medical gap between the School of Medicine and the local population, given that for local patients these arguments against Chinese doctors did not matter at all. The legal immigration of Chinese laborers had stopped in 1874, but Chinese medicine kept growing. By the time the Congress discussed the bill that regulated professional medicine in 1888, Chinese healers had continued cementing their presence in the capital city and other regions since their participation in the epidemic. The boost from the 1868 juncture did allow Chinese healers to accumulate the necessary capital and open small businesses nationwide. Some of them amassed small fortunes that brought some suspicion from other fellow nationals who could not believe that a Chinese healer owning a botica china (Chinese herbal shop) and selling “a few herbs” might produce such significant revenue.29 Precisely, herbs did constitute a major lucrative business for Chinese healers as one of their most salient treatments. They paid custom fees, and one single shop could manage significant capital of more than twenty thousand soles only in herbs.30 Chinese healers did not hesitate to exploit the media in order to publicize their own services. The way they publicized themselves in the public sphere may have been an additional incentive for patients to seek someone to cure their ailments. It was not only that their practices were open from very early until very late, like Tam-Jing, whose doctor’s practice was open between 7 a.m. and 9 p.m. It is that they also announced the cure of “all kinds of diseases.” Communication and language barriers were not an issue any more. And to maintain their foreign status and appeal, they performed consultations “in the company of one or more distinguished interpreters.”31 Unlike their counterparts in California, who publicized themselves dressed in oriental garments, Chinese doctors in Lima adopted a more discrete image, and in ensuing years they would present themselves in Western clothes and suits.32 Even when reporters approached their establishments following a complaint, Chinese healers took advantage of the opportunity to “make [themselves] known to the public” and to reach a new audience.33 The School of Medicine contested the expansion of herbal shops by attempting to close such establishments, arguing that they required a license granted, of course, by the school itself to keep operating. This institution demanded that the municipality of Lima and its agents close herbal shops that were without the proper documentation. In practice, no botica china complied with the opening regulations, because to function they also needed a licensed pharmacist—a requirement that none of the Chinese herbalists fulfilled. In July 1876, police officers approached four boticas chinas, demanding to see the corresponding

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authorization. It is most likely that the officers expected to encounter resistance from their owners and would have had to close them down. Nonetheless, what they found was the opposite. José Díaz, one of the inspectors, shared his own perplexity and relief with his superiors: “I am pleased to inform to you, that at the moment of my notification they gladly complied with the orders.”34 Rather than opposing the closure of their establishments, Chinese herbalists opted for a different and more straightforward strategy: to question the concept of the botica china and demand that their establishments be defined as herbal shops rather than as pharmacies. To the School of Medicine, boticas were establishments that integrated several steps and procedures—from manufacturing to the commercialization of medicines in one single space, which fit the category of pharmacy. However, Chinese healers dissected this concept by arguing that their own intervention in processing the herbs imported from Asia was minimal. Thus, Chinese herbalists considered their shops commercial establishments destined for the trade of goods, not pharmacies or laboratories. In the middle of this debate, herbalists Juan Lechan, Si Tu Pon, and Lupan argued that they only offered teas, roots, and vegetables as merchants but not as drug manufacturers.35 Consequently, Chinese herbalists totally dismissed the arguments of professional doctors. And given that their shops were industrial establishments rather than medical facilities, the School of Medicine had no authority to intervene with them. In response, the pharmacies’ inspector of the School of Medicine claimed that given that the neighborhood perceived certain establishments as boticas, that was sufficient proof to consider them as “actual boticas.”36 This was a weak argument that favored owners of Chinese herbal shops. By defying the restrictive notion of boticas, Chinese healers employed a major rhetorical strategy to erode the the School of Medicine’s legitimacy. They took advantage of a heated national debate about the future of the national economy to argue that their herbal and medical knowledge were protected by the freedom of industry. While the guano boom (1845–1870) had produced economic growth in Peru, its reserves ran down, and the country lived in a crisis of the export exhaustion.37 During Manuel Pardo’s (1872–1876) government, the foreign debt rose considerably as the government implemented large-scale public investment projects, including the expansion of railways and the nationalization of the nitrate industry. Unfortunately, the expropriation of the oficinas salitreras (saltpeter mines) generated a depreciation of local currency, the increase of international loans and the external debt, and, ultimately, the war against Chile (1879–1884).38 During the 1870s, when the Peruvian government was attempting to increase its

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once hefty coffers, prohibiting the sale of Chinese herbs could have negatively affected trade and relations with China, whose companies shipped important volumes of products to Peruvian ports each year, including vegetables, roots, and medical herbs.39 In this climate of stagnation, the Peruvian state prioritized economic recovery over the interests of professional doctors. The debate finished with a triumph of the herbalist cause and the consolidation of their position in the country. In July of 1879, the Supreme Court announced that herbal shops were, in fact, industrial establishments and not pharmacies. A legal resolution declared legal “all sales of ‘Asian herbs’ in public and in private establishments called herbolerías.”40 This provision still required herbalists to obtain credentials from the School of Medicine, and while they did not need to hire a pharmacist anymore, they still did need to provide samples of all herbs to the School of Medicine. The 1879 law allowing the sale of herbal medicines was a victory for Chinese herbalists and merchants and also confirmed the limited political influence of the School of Medicine. In the years that followed, the school requested on several occasions the reconsideration of the 1879 government provision. In the discussion of an 1888 law regulating medical practice, congressional representatives criticized the School of Medicine’s attempts to establish a de facto monopoly by eradicating alternative medical practices. During the debate, Representative Meza stated that even though the legal reform was necessary, it was unfortunate that in the process, “the desire of doctors to ruin, persecute, and end with these men [Chinese healers] will be satisfied.” Congressman Terry, supporting the opinion of Representative Meza, added that with the law proposed by the School of Medicine, all of the herbal shops will disappear, leading to “a monopoly that sickens civilization.” The law would ensure that only those who held the title of doctor or pharmacist from the School of Medicine could practice medicine in the country.41 To calm the situation, the government issued a supreme resolution that reinforced the control of the School of Medicine in the opening of herbolerías and the sale of herbs.42 Although the School of Medicine claimed the relevance to understand the composition of each herbal potion, this information had little or no relevance to patients. Effectiveness was the most important asset in a milieu where patients sought Chinese healers for their claimed reputation curing diseases. For this reason, Chinese herbalists took care of their professional image and good presence, and they even excluded and denounced other Chinese healers who did not meet certain standards. That was the case of a healer called Asoy. He was denounced by other Chinese healers for committing fraud against Mr. Vicente García. Asoy

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performed a poor diagnosis of Mr. García, determining that he was sick because of alleged witchcraft and that the only way to expel the spiders in his belly was with pills. The medication, however, only made the patient feel worse.43 As a community, Chinese healers also cared about any rumor that might harm their prestige. For instance, once healer Tam Jing learned that another person was using his name to perform consultations and discredit his reputation, he immediately published an “important announcement” in the press consolidating his reputation.44 Chinese doctors adopted marketing techniques of their own, frequently advertising in local newspapers. They emulated the style of professional doctors, providing artifacts such as business cards and prescription books to their patients. This gave them a professional flavor that others local healers lacked.45 The press was ambiguous regarding unlicensed practitioners. While some articles criticized healers and, by extension the state for allowing them to practice, the advertisement sections continued to publish the healers’ paid ads. Physicians still refused to understand the preference of the local population for Chinese healers and authorities to support them. As historian Jorge Lossio has asserted, the population perceived Western medicine as “expensive, painful, contaminating, and ineffective.”46 Unlike physicians, some Chinese healers offered free consultations to attract potential clients since the profit was in the selling of herbs. 47 Physicians were caught in a self-denial bubble that posited the local population and patients as “ignorant,” “gullible people,” “simple people,” and therefore “victims” of Chinese healers while portraying themselves as “agents [of] science.”48 Chinese healers, on the other hand, strategically used the social capital they had built over a decade and openly questioned not only the flawed justification of the law but also the ultimate purpose of the School of Medicine: to eradicate the practice from any non-licensed healer, given that Chinese healers were one of the key targets. “Of course,” says a document submitted to the mayor of Lima by Juan Lechan, Si Tu Pon, and Lupan, “the Dean and the School of Medicine are wrong by making such claims.” Despite the complaints and efforts of the medical guild to curb their presence, herbal shops continued doing business—at least for a few more years. THE DECLINE OF CHINESE HER BA LISM

From 1900 to the 1910s, the Chinese community in Lima endured one of the harshest and most violent periods since their arrival to the country half a century

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earlier. The racial animosity toward them moved from rhetoric and subtle hostility to open attacks and aggressive harassment, in some cases fostered by authorities themselves. No other immigrant group, with the exception of the Japanese Peruvian community in the early 1940s, had to endure such hostility from various social groups. Since the 1860s, the media had disseminated information regarding the poor conditions of housing and food establishments of the Chinese community, feeding local prejudices against them.49 The participation of some Chinese coolies supporting Chilean troops during the War of the Pacific as a strategy to escape from the inhumane conditions in plantations marked a turning point in the already tense relationship between national Peruvians and Asian immigrants.50 Racism against the Chinese was exacerbated during the first decades of the twentieth century, coinciding with the 1903 bubonic plague epidemic and the 1909 economic crisis.51 The peak took place in 1912, when Lima’s mayor ordered the destruction of the Callejón Otaiza in Chinatown, a residence that provided affordable housing to many poor Chinese immigrants.52 Not all of the Chinese community, however, were exposed to these attacks to the same degree. The bulk of victims belonged to the lower classes of the community. By the turn of the twentieth century, the Chinese community exhibited a social and class diversification, with some members still working in plantations and waiting to make their own way to the cities, whereas an emergent elite group enjoyed benefits and sought to distance themselves from their rural counterparts. While poor Chinese were suffering riots and eviction, the local Chinese elite in Lima were discussing how to send their less affluent counterparts back to the mainland—partly to improve their own social image in the city. The crystallization of the new self-image that the local Chinese merchants and professional elite were desperately trying to build for themselves came in 1921 with the Centennial of Peruvian Independence. Like other immigrant communities that expressed their allegiance and gratitude to the host country with magnificent presents, the Chinese community of Lima regaled the city with an ornamental fountain. They also commissioned a photo album to introduce themselves to national Peruvians as a modern, affluent, and upper-class group. As historian Ana María Candela has put it, “The Álbum constituted the first effort by community elites to craft a self-fashioned image of a modern Chinese subject.”53 As prominent members of a nascent Chinese elite, healers remained immune to these ordeals. Over the years, they had amassed both the fortune and prestige necessary to avoid major attacks from the populace and authorities, yet as we have seen, they were exposed to the scrutiny of medical institutions. The 1920s

Figure 9.1. Portrait of Dr. Pun Luy-On in his office, dressed in Western-style clothing. According to the Álbum, his experience included “countless and prodigious cures.” Álbum de la Colonia China en el Perú. Instituciones y hombres representativos. Su actuación benéfica en la vida nacional (Lima: Sociedad Editorial Panamericana, 1924), 67.

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for Chinese healers were a period of growth and success before a new wave of attacks in 1931 banned their profession definitely. A decade of political stability and economic growth provided the context in which these doctors acquired a group identity and established a solid presence in the public sphere. To the dismay of their local counterparts, Chinese healers rapidly learned the necessary social and professional codes. Over those years, they gained a professional reputation by distancing themselves from their roots as healers and presenting themselves as professional doctors with medical degrees. Furthermore, they projected an image of respectability through ads in local newspapers, sometimes placing fullpage ads. They did not hesitate to include public testimonies of their patients, a strategy that proved extremely helpful in the ensuing difficult years. Dr. Pun Luy-On and Dr. A. M. Chion Len embodied the quintessential image of modern Chinese healers.54 They were two of only three doctors featured in the Álbum, all of whom had Chinese medical degrees. Dr. Pun had arrived in 1899 in Lima from Canton. He built a solid reputation as an efficient physician in his herbal shop located on Zavala Street. Like his previous colleagues, he played an important role during the outbreak of the Spanish influenza in the capital city in 1918. This may explain his nickname of “Miraculous Pun,” coined by his own patients. Soon after, his son Carlos arrived in Peru to continue a dynasty that extends to today.55 According to Oriental, a bilingual Spanish- and Chinese-language magazine established in Lima in 1931, Carlos Pun worked with prestigious patients, including Vice President Héctor Boza Aizcorbe (1950–1956) and President Augusto B. Leguía (1919–1930). No less popular than the Puns was Dr. Adrian Chion Len. He appeared frequently in magazines, promoting his healing methods. In 1921, he published four full pages of information and testimonies in the magazine Economista Peruano. The ads proudly claimed that between 1904 and 1912, Dr. Chion Len had imported more than 9,500 Lp (Peruvian pounds) of herbs from China. The publication included ten testimonies from white-collar patients and a full-body photograph of the aristocratic-looking doctor. During the 1910s and 1920s, Dr. Chion Len purchased advertisements in the most important newspapers and journals in the city. He also managed to publish an annual advertisement in the Almanaque de El Comercio— the most important commercial guide in Peru—between 1909 and 1914, presenting himself as the “inventor of the reform of Chinese Medicine.” In 1924, Mundial, a magazine that devoted space to working-class movements, published a full page on Dr. Chion Len. The page included three very graphic photos of one of Dr. Chion Len’s patients, Mr. Javier Angulo, under the headline of “gratitude to doctor Len.”

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In the 1920s, both Chinese and Peruvian elites embraced a modernizing project and became allies of the Peruvian state and the government of Augusto B. Leguía (1919–1930).56 This period was a golden age for Chinese merchants who had the resources to respond to Leguía’s ambitions and desire to form a national industrial bourgeoisie.57 However, tranquility would last just a few years and come to an end with the abrupt fall of President Leguía in 1930. Extremely dependent on foreign loans, the Leguía administration could not manage the advent of the economic crisis of 1929. Confronting growing social discontent, the government crumbled down after an obscure lieutenant, Miguel Sánchez Cerro, led a coup against Leguía. Leguía was captured when he tried to run abroad, dying in prison in 1932. His supporters were persecuted and expelled from public positions. The political vacuum and a new realignment of forces played against the Chinese community. Partisan press and pamphlets condemned Leguía’s support of Chinese immigration and urged the new government to cease those treaties. The newspaper El Pueblo blamed Leguía for the spread of gambling and the opium trade in Peru due to his promotion of Chinese commercial establishments.58 While Chinese herbalists had stayed away from xenophobic discourses, the fall of Leguía put them in a vulnerable position. Opponents of Leguía’s government portrayed Chinese doctors as allies of the overthrown regime. However, it is most likely that the ubiquitous presence of affluent Chinese doctors in the media and public sphere may have fed anti-Asian sentiments amid the economic crisis. The Union of Doctors took advantage of the moment to propose a new public health reform, which included the regulation of Chinese herbalism and the suppression of herbal shops.59 Shortly after Leguía’s fall, the Bureau of Public Health resolved to prohibit Asian herbal shops in the country, and they gave owners only thirty days to close their establishments. The dean of the School of Medicine, Dr. Guillermo Castañeda, wrote a public letter in support of the decision, praising the “accurate guidance” of the bureau. The medical guild aligned behind this decision as an opportunity to displace Chinese medicine once and for all. Doctors from the major hospitals of Lima (Dos de Mayo, Arzobispo Loayza) published letters of support in El Comercio praising the measure since it “guaranteed the practice of scientific medicine, benefited the community, and safeguarded the economy and the life of our population.”60 Doctors barely masked their political motivations and desires of revenge against the former regime and its Asian allies. They rushed to acknowledge President Sánchez Cerro’s new regime and praised the appointment of his brother Luis as the new head of the Bureau of Public Health.

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Doctors also claimed to allegedly benefit the people as the ultimate way to persecute Chinese healers. But this rhetorical strategy proved to be counterproductive. An organized group of fifteen hundred patients published a four-page letter of support to Chinese healers with their full names in El Comercio, the most important paper in the country.61 A close examination of their personal and professional information provides an insight to the profiles of these supporters. By gender, nearly 70 percent of the petitioners were male. What is more revealing is that a vast majority of them came from the working class. This only confirms the popular appeal of Chinese herbalists among the working class in the capital city and their distance from xenophobic propaganda against the healers. The bulk of the supporters were tailors, painters, carpenters, and shoemakers. Unlike California, where as Haiming Lu has demonstrated, Chinese herbalists built their clientele among wealthy individuals, the grassroots component of their Peruvian counterparts is evident in this petition.62 It is also important to note that these particular professions were the most harmed with the economic crisis. The petition was probably the largest display of public support to a nonpolitical group in the country so far. What is clear from this statement is that they were not defending just the Chinese doctors themselves but what they came to represent to the supporters: an affordable alternative to the treatment provided by Western-trained doctors, who used to sometimes charge 250 percent more than herbalists.63 Amid the economic effects of the Great Depression, petitioners were determined to defend the scarce resources they and their families had to gain access to health care. But the public support was not confined just to the petition and signatures. In the following days, other Limeños, perhaps encouraged by the petition, shared their positive experiences with Chinese healers in the same newspaper. Thus, Mrs. María Scotti vouched for Dr. Pun, saying that he “is not a simple herbalist, but a Chinese professional doctor.”64 Local newspapers were convinced that the government would stop its decision given the overwhelming support to the herbalists. Public pressure was not sufficient to put a halt to the ban. The pressure from the medical sector was very strong since they had been waiting for decades for an opportunity like this. Chinese herbalists highlighted various legal loopholes to defend their case hoping that this strategy could at least allow them to mitigate the impact of the decision. Lee Kuang requested that the Bureau of Public Health release 131 crates of Chinese medicinal herbs detained by customs officials in El Callao, arguing that the herbs had entered to the country before the Supreme Resolution of December 10. However, the bureau denied the request

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to circumvent the law.65 Despite other petitions from herbalists and Limeños to overturn the Supreme Resolution, the government supported the opinion of the Bureau of Public Health and rejected all of the requests. In the following months after the resolution, the police intensified their persecution, arresting Chinese and other herbal healers. The 1931 Supreme Resolution meant a resounding victory for the School of Medicine in a long and exhausting battle that attempted to contain and suppress Chinese medicine from the medical scene. In February 1931, Dr. Pun Kan and Carlos Pun, on behalf of other herbalists, sent a long letter to the most important newspapers, contesting accusations that they had taken advantage of vulnerable patients. Given the government’s refusal to listen to them and considering the racially hostile environment, Chinese herbalists adapted again to the current situation. They adopted a low profile and stopped advertising in newspapers, making them nearly invisible to researchers after that. Nonetheless, many operated discretely with loyal clientele that continued seeking their services. Owners of legally opened pharmacies aware of the lucrative business started to import Chinese herbs on their own, securing this healing system in Peru. An era came to an end. Throughout the six decades between the 1868 yellow fever epidemic and the 1931 Supreme Resolution, Chinese healers openly defied the medical establishment and challenged the nature of Western medicines through a careful repertoire of strategies that included repurposing their appearance for commercial purposes, establishing alliances with political figures such as President Augusto B. Leguía, and participating in national debates in order to undermine their opponents’ claims. Overwhelmed by recurring waves of epidemics, insufficient health services, and affordable physicians in Peru, Peruvian patients relied heavily on newly arrived Chinese immigrants for access to treatment and medicines. As demonstrated, the popular support exhibited by Chinese healers exposed the School of Medicine’s conception of public health as a restrictive practice that did not benefit the majority of Peruvian citizens. The defeat of the Chinese healers was, nonetheless, only just a part of a broader process carried out by the School of Medicine in what they deemed as the pursuit of the medical professionalization of the Peruvian health system and the hegemony of Western medicine over any other kind of medical knowledge. Therefore, while in places like Lima—which was the larger site of Chinese settlement in the country—the School of Medicine repressed Chinese practitioners

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until they were confined to obscurity. In the highlands, the repression targeted Indigenous healers. Other practitioners, like homeopaths, were also persecuted in Lima by the time Chinese healers were defending themselves in Congress against the School of Medicine’s accusations.66 Yet it is evident that the 1931 juncture marks the transformation of a vast alternative expanded on by Chinese healers to a nonexistent one. We still need to learn what happened to patients and how they replaced the use of Eastern medicine during a moment of crisis like the Great Depression. The Great Depression in Peru was also a turning point in the relationship between the national government and public health because of the expansion of professional medicine and the development of health facilities in the capital city and elsewhere. The creation of the Ministry of Public Health, Labor and Social Foresight in 1935 was a major step in this direction.67 The advent of military populist governments in the following years pushed the Peruvian state to actively embrace public health as a national duty, centralizing the provision of health care and addressing it especially toward vulnerable populations with clientelistic purposes. Nonetheless, the transfer of health duties from the School of Medicine to the Peruvian state did not necessarily bring full coverage of medical attention to the population. The Peruvian state proved not to have the capacity to provide universal health care, in particular outside of major urban centers along the coastal areas. So how did a vast majority of Peruvians cope with the vanishing alternative? The answer came sooner than expected. Beginning in the 1940s, a massive new wave of migrants, this time escaping from rural poverty in the highlands, moved to Lima and posed a major challenge to national and local authorities when they rapidly surpassed health infrastructures developed by the state in what anthropologist José Matos Mar dubbed the “popular flood.”68 Bringing their own traditions and medical healing practices to old-time Limeños and the next generations, Indigenous migrants actively reconfigured the “gray area” left by the Chinese community just a decade earlier and created a new approach of their own. Given the existence of a large, complex, and long-term pluriverse of healing practices, a “gray area” approach is relevant in countries like Peru to better understand how local populations managed to obtain health care from a changing repertoire of both “formal” and “informal” medical practitioners, remedies, and procedures in settings informed by enduring precariousness, political instability, and social, ethnic, and gender inequalities.

{ 10 } Stepping through a Looking Glass The Haitian Healer Mauricio Gastón on the Romana Sugar Mill in the Dominican Republic in 1938

Alberto Ortiz Díaz

In the early to mid-twentieth century, the US government, its military, and associated interests helped create the modern Dominican state by centralizing its government and improving the country’s infrastructure. Starting in the 1910s in La Romana, in the eastern part of the Dominican Republic, the New York-based South Porto Rico Sugar Company of New Jersey contributed to these efforts by establishing a sugar mill complex. By the 1930s, the Romana sugar mill’s ties to dictator Rafael Leónidas Trujillo Molina afforded it substantial autonomy in managing labor disputes and organizing its medical system. During these early decades of the twentieth century, thousands of so-called cocolos (Blacks from the non-Hispanic Caribbean), Haitians, and others toiled on the mill in some capacity.1 A Haitian named Mauricio Gastón served there as a “medical practitioner” providing emergency health care to mill workers. Gastón did so at a sensitive time, following the October 1937 parsley massacre, a Trujillo regime-ordered genocide of Haitians living on the Hispaniolan borderlands. Dominican police and military officers investigated accusations against Gastón in early 1938. These suggested he was an untrained curandero (healer), and careless and discriminatory toward Dominicans. Whereas at the time, the Dominican state surveilled and prosecuted healers like Gastón for practicing “illegal medicine,” Romana administrators recruited them as medical practitioners. 155

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The sugar mill, then, represented an interstitial gray zone in this regard, one that granted Gastón liberties and privileges in his interactions with high power that would otherwise be diminished or nonexistent in Dominican society at large. Considering Gastón’s story in a Dominican, Hispaniolan, and circum-Caribbean context shows that non-titular health care providers were not only anchored in but also fluctuated between different categories of healers, depending on social, cultural, political, and economic factors. Indeed, examining an individual offers more than a straightforward biography. Doing so weaves together a collective biography that, in this case, follows Gastón’s life to tell a broader story about health and healing during a particularly volatile historical moment. Place-based epistemic entanglement characterized the craft of healing and how it was perceived in the Dominican Republic in the 1930s. Healing itself was as much about politics and subjective exchange as it was about strictly corporeal approaches to disease, medicine, and public health. HISPA NIOLA N FAULT LINES

The Caribbean island of Hispaniola is split into two countries—to the west, Haiti, and to the east, the Dominican Republic. Given the forking paths linking the two countries, Hispaniola has been called “an island in the mirror,” meaning that both nations’ historical experiences are distinct yet interconnected and have resembled one another over time.2 Before the arrival of Spanish conquistadors and colonists, the Indigenous Taíno Arawak people called Hispaniola Hayti (pronounced Ayiti, the land of high mountains). When the Spanish took possession of the island in the aftermath of 1492, they referred to it as Española. Between the seventeenth and nineteenth centuries, European colonial powers consolidated outposts on each side of Hispaniola and guided the formation of each place—the French in Saint Domingue and the Spanish in Santo Domingo. Although sugar became king in Saint Domingue, and a cattle economy eventually prevailed in Santo Domingo, imperial competition, piracy, contraband, plantation slavery, and resistance to slavery left an indelible mark on the political economies, social relations, and cultures of both societies.3 In French Saint Domingue specifically, enslaved healers treated the infirmities of other slaves, people of European descent, and even animals. They contributed to the plantation economy and colonial prosperity. However, they also helped inspire revolution, topple the slave system, and destroy one of the New World’s most productive and profitable colonies.4 Healers were at the center of

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Hispaniolan history before, during, and after the Haitian Revolution, a successful insurrection by self-liberated slaves against French colonial rule that reverberated across Hispaniola, the broader circum-Caribbean world, and beyond.5 Haitian independence in 1804 and reunification of the northern and southern parts of the country into a republic under President Jean-Pierre Boyer in 1820 altered the trajectory of Spanish Santo Domingo. During the tail end of the Spanish American wars of independence, in 1822, Boyer annexed Santo Domingo, and the entire island of Hispaniola was unified. Haitian control of the Dominican side of the island lasted for at least a generation, officially through 1844, with major incursions and skirmishes continuing until the mid-1850s.6 Late president of the Dominican Republic, Joaquín Balaguer, the intellectual backbone of the Trujillo regime in the middle decades of the twentieth century, cast this early Haitian rule as a form of imperialism. In one of his seminal works, La isla al revés, he underscored the “dangers” posed by the fusion of Hispaniola’s disparate parts into an incompatible, strained union.7 This view has since been challenged. In recent years, scholars have uncovered that many nineteenth-century Haitians and Dominicans fostered a common commitment to the abolition of slavery, freedom, and popular democracy. A shared anticolonial political culture in which many Haitians and Dominicans dreamed and acted together developed in Hispaniola and resonated throughout the circum-Caribbean world and wider Americas.8 But while scholars now downplay narratives of conflict in favor of more integrated and successful nineteenth-century histories of Hispaniola and Haiti, it is essential to recognize that early national Dominican-Haitian interaction was not exclusively seamless or utopic either.9 Notwithstanding the shared anticolonial and antislavery political culture stressed by a new generation of scholars, by the mid-nineteenth century the relationship between Dominicans and Haitians became increasingly antagonistic. In 1844, a secret society founded several years earlier by Juan Pablo Duarte, Francisco del Rosario Sánchez, Matías Ramón Mella, and others, and backed by Pedro Santana, a wealthy cattle rancher from El Seibo who commanded a private army, declared independence from Haiti.10 Simultaneously, sizable Black and mulatto peasantries specific to each society took form. In 1861, Santana returned the Dominican Republic to Spain, but a national war of restoration began in the northern city of Santiago by 1863. This war lasted until 1865, when annexation was annulled.11 Thereafter, Dominicans once again forged their own national path. By the late nineteenth and early twentieth centuries, however, both countries were pulled into the emerging imperial orbit of the United States,

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especially economically.12 Extended periods of political instability rocked both sides of Hispaniola through the arrival of US marines in the mid-1910s. US marines occupied the Dominican Republic from 1916 to 1924 and Haiti from 1915 to 1934. In both countries, US military governments advanced the work of state-building by centralizing governance, founding military and police forces (which became the pillars of future dictatorships), and developing infrastructure, including criminal-legal and health care systems. Peasant insurgencies and rebellions in response to the US presence (pursued by outlaw guerrilla groups, Haitian cacos and Dominican gavilleros, respectively), compulsory disarmament, and coercive labor extraction jolted Hispaniola during the respective occupations. US empire-building had analogous effects on local land tenure patterns and this, too, begat challenges from below.13 Despite the instability and uncertainty prevailing in peripheral parts of the Dominican Republic during the occupation years, the New York-based South Porto Rico Sugar Company of New Jersey—an enterprise that combined German capital, technical personnel from Louisiana, Barbadian biotechnology and supervision, and pan-Caribbean labor—took a major investment risk and established a modern sugar mill complex in La Romana in the 1910s.14 The complex became one of the world’s largest and most productive sugar mills by the 1920s, with a capacity of 2,500 tons of sugar cane per day and aspirations for doubling or tripling this amount at a later date.15 Like other sugar complexes and towns around the Caribbean, eminently those located in neighboring Cuba, the Romana mill had its own electric plant, wireless station, hospital, police force, railroad, school, clubs, sporting events, stores, and workers’ living quarters, among other modern paraphernalia.16 The hospital, in particular, was operational by 1920. The sugar mill grounds were subdivided into multiple departments (at least sixteen), each of which included a batey (outbuilding, settlement, or housing for workers) and a “sick bay.”17 Sick bays were urgent care areas, modern manifestations of slavery-era sick houses or rooms where plantation masters, mistresses, overseers, and trusted slaves monitored the conditions, medical care, and recuperation of patients.18 More broadly, the town of La Romana overlooked the Caribbean. Railroad tracks divided the town from the sugar mill. Yet, the boundaries between the town and the mill were porous, and the two practically overlapped.19 As for Romana’s labor force, it was diverse from the beginning. Thousands of Dominicans, cocolos, Puerto Ricans, and Haitians worked there between the 1910s and 1930s.20 A similarly layered labor tapestry was reproduced elsewhere in the Caribbean in the early twentieth century.21 Middle-class medical

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professionals also contributed to the Romana labor makeup. For example, a Dominican physician named Frank Gonzalvo, born of Puerto Rican parents, worked there alongside US nurses in the 1920s.22 In 1930, the US marine-trained and commander in chief of the Dominican armed forces, Trujillo, assumed power. His rule concluded in 1961, when he was assassinated by local dissidents equipped with US Central Intelligence Agency-supplied weapons. Today, Trujillo is known for having been a megalomaniacal, repressive dictator, but one who brought a considerable degree of law and order to the country and helped modernize it. During his tenure, Trujillo and his surrogates cultivated an ideology that exalted Hispanic and Indigenous culture while denigrating Haitians and Blackness.23 The rapid maturation of this ideology informed the Dominican-Haitian border crises of late 1937 and early 1938, which resulted in the deaths of anywhere between five thousand and fifteen thousand Haitians, although some liberal estimates put the number as high as thirty thousand casualties.24 These border crises strained Dominican-Haitian relations in high government circles, along the frontier, and within the confines of sugar mills as far east as La Romana. The case of Gastón, who was stationed on the Romana sugar mill in the late 1930s and who is the focus of the remainder of this chapter, throws this dynamic into sharp relief. The Trujillo regime actively distinguished between what it perceived to be legitimate and illegitimate health care practitioners. They inherited from previous governments (US and Dominican) the view that healers and sorcerers formed part of a misbelieving Black underground. However, healers were hidden in plain sight. Their abilities were more empirical, praxis-oriented, and less supernatural than was and still is generally believed to be the case.25 During the era of Trujillo, an internally differentiated community of healers surfaced and submerged in response to the socioeconomic, moral, and political crises of the time. Dominican authorities collapsed these disparate groups into one another because they found it more productive to address them in the singular rather than engage them as multiple moving targets. Trujillo and his collaborators sought to curb the medical power healers exercised, for they regarded them as culturally retrograde and, at worst, as conjurers of alternative, potentially threatening political utopias.26 But when healers like Gastón stepped through the looking glass into the more autonomous world of the Romana sugar mill, they were privy to possibilities that disrupted assumptions and expectations on multiple levels. There, they could shed their old skins and step into new, more empowered identities and roles.

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M AUR ICIO GASTÓN’S CASE FILE

Establishing this brief context is necessary to understand the case of Gastón, a Haitian medical practitioner based in the Cacata sector of the Romana sugar complex in the 1930s. Gastón drew the ire of Manuel Peña, an older, married private police officer stationed in the Higo Claro section of Romana. Peña had been working at the mill since at least 1931, largely on the strength of Trujillo’s endorsement. In a May 1938 letter, Peña recalled “the tyranny of the old [r]epublic,” praised his “friend” Trujillo, and asked the dictator to re-recommend him so that he might keep his job. Peña believed this would position him to overcome the regional politics of the east, where “planted trees” (local stakeholders) were firm in their ways. He hoped to retire in the near future, and these circumstances threatened his job security as well as the well-being of his young and adolescent children. In a note affixed to his letter, Peña denounced the perplexing, disturbing activities of Gastón, whom he called an “incapable” medical practitioner and deemed an earnest “threat.”27 Peña accused Gastón of holding onto grudges. He referenced “the border matter[s]” of October 1937 and early 1938 to explain what he meant.28 The Trujillo government had green-lighted the parsley massacre—an exercise in anti-Haitian, Hispanophile nation-building and internal colonialism—in October 1937. Under the Trujillo regime’s orders, and using shibboleths as an identification tool, army troops purged Haitians by the thousands in the northwestern frontier and in parts of the Cibao region—the white heartland of the country. Subsequently, in early 1938, Trujillo ordered a new campaign against Haitians, this time in the southern frontier region. Although mostly an eviction, the second campaign also resulted in death. Unlike the parsley massacre in the north, some witnesses recalled Dominican civilians cooperating with the killing in the south.29 These episodes, Peña asserted, shaped Gastón’s attitude toward Dominicans and his medical work at Romana. He exhibited disdain for Dominican “braceros [farmhands or day laborers]” by refusing to treat their injuries and conditions. Gastón reportedly dismissed braceros from the medical unit he administered in Cacata when he learned that they were Dominicans. Peña concluded his note by announcing the names and testimonies of two people in particular: a local agriculturalist named Marcelino Abreu, and another from Puerto Rico, a mill mayordomo (steward or manager) named Victor Santos Ramos. The two men had gotten injections from Gastón in the recent past but had to follow up with “competent Doctors” thereafter “to save their lives” because the injections

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triggered additional health problems for them.30 In the end, Peña wanted the Trujillo government to replace Gastón with a Dominican practitioner. It is unclear exactly who medically administered Romana’s other sectors and sick bays, although one of the cover pages in Gastón’s case file refers to medical practitioners in the plural. This raises the possibility that other Haitians may have been active there in a similar capacity. As soon as Dominican authorities based in Santo Domingo (then Ciudad Trujillo) caught wind of the charges against Gastón in early June 1938, they cast him as a curandero. Meanwhile, they deemed Peña a known and willing state partner.31 Between the 1930s and early 1940s, the Trujillo regime was in the midst of a nationwide “anti-superstition” campaign, one that focused on the Dominican-Haitian frontier but that also stretched east into La Romana and broader El Seibo province.32 Trujillo-era scholar Manuel A. Machado Báez observed that, as of the mid-1930s, there were more than fifty thousand Haitians in the country. Haitians had been involved in more than twenty-four hundred crimes against people, property, and morals on Dominican soil since 1910, including livestock theft, smuggling, vagrancy, and health and immigration violations; several of these crimes were long-standing problems that dated to the nineteenth century. Through 1937, Haitians were responsible for eighty-seven cases of “witchcraft” and a share of 269 cases related to “cadaver profanation” and “curandería” (healing).33 According to the Anuario Estadístico, a Dominican government statistics publication, hundreds of Haitians continued to pass through the criminal-legal system for a variety of offenses in the late 1930s and early 1940s.34 The yearslong anti-superstition campaign, chronicled in mainstream Dominican newspapers and government correspondence, targeted healers and other nonconforming or otherwise unlicensed health care providers, including luá and vodou (spirit, deity, and mystery) practitioners.35 The campaign coincided with the articulation and implementation of laws designed to rein in these individuals and to consolidate titular medicine in rural parts of the country. This was not a novel pursuit, however. Since the late nineteenth and early twentieth centuries, successive Dominican and US governments had been trying to exorcise the country of healing heterodoxies. Chief among the most worrisome politicized health movements of the time was the one led by the iconic and well-documented Black healer Olivorio Mateo (or Papá Liborio, 1876–1922), the “living saint” of San Juan de la Maguana, a municipality located in the interior southwest close to the border with Haiti.36 Officer Peña had roots in San Juan de la Maguana. The reference made to

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his age by Dominican police authorities (that he was older) suggests that Peña would have been familiar with Mateo’s movement and other borderland happenings and histories. In part, this historical memory elucidates why Peña, and subsequently government officials, projected Gastón the way they did. Labeling Gastón a “healer” made investigating the charges against him a pressing issue. After receiving Peña’s initial communication, executive authorities opened a case and relayed the relevant data to Secretary of the Interior and Police, Agustín Aristy, who ordered a meticulous inquiry. Within a week, the case descended the national police chain of command, landing in the hands of First Lieutenant Manuel Batlle.37 Years earlier, in 1917, marine officials arrested Batlle for having approved payrolls corresponding to inactive police personnel, apparently generating some wealth for himself in the process.38 By 1938, however, he seems to have cleared his name. Batlle’s investigation into the Gastón affair lasted three days. He interviewed all the key players involved: Abreu, Santos Ramos, Gastón, and Peña. As had been the case in the late nineteenth and early twentieth centuries, police and legal authorities like Batlle tried to restrict understandings of healers to the law. A consequence of such ascription was that they minimized healers’ medico-religious work and its significance in the communities they served. Abreu, who had been working at Romana since at least 1932, revealed to Batlle that he was treated by Gastón sometime in 1937, receiving an injection from the practitioner. However, the needle broke. Gastón could not excise the needle stuck in Abreu’s flesh, so the primary physician of the sugar mill hospital, Dr. Vélez, intervened. When Vélez himself struggled to remove the broken needle, he took Abreu to see Dr. Janer, a physician based in La Romana city. There, the patient completed treatment. Batlle also inquired whether Gastón treated sick workers poorly. As far as he knew, Abreu transmitted, Gastón gave them “all his good help and cooperation.” The same day, Batlle briefly interrogated Santos Ramos. The sugar mill steward of Puerto Rican descent, who was also based at Romana since at least 1932, confirmed that Gastón had treated him in the past as well, giving him “quinine injections” and “saline purgative” to combat malaria and constipation. These ailments, alongside hard labor–related injuries, were common conditions at the mill. Further, Santos Ramos clarified that he never paid for any of the medications Gastón prescribed him, nor did the injections cause him harmful or debilitating effects.39 Batlle finished the day interviewing Gastón, who also had been working at Romana since at least 1932. His line of questioning was direct yet subtle, and one must read between the lines and consider the case file’s subtext in order to

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excavate certain patterns. Although Batlle did not openly refer to curanderismo medicines, he strived to ascertain the kinds of medicines Gastón employed and whether these were sanctioned by the state. Answers to these questions would, in turn, expose whether the Haitian was in fact a healer. For example, at the time, healers were known for prescribing botellas, or bottled herbal-liquid mixtures consisting of plant parts from different species, culinary spices, and other ingredients like urine. The resulting “juices” could be nausea-inducing and worsen the conditions of those who ingested them, but they also frequently proved efficacious.40 Gastón insisted that he did not “prescribe medications to anyone” unless mill doctors told him to do so, and in the case of Abreu, Vélez had only ordered injections. It was true that Abreu’s injection site got “infected,” producing a pus-filled “abscess,” but “that happens all the time with quinine injections,” Gastón affirmed.41 Bottles were not literally mentioned in the exchange between Batlle and Gastón. Given the dynamics of this specific interrogation, the wider anti-superstition campaign, and historical precedent, however, Batlle was certainly aware that they might come up in conversation; if this happened, he could probe deeper. Similarly, Batlle asked Gastón if he charged for his services, which was then a common practice among healers. Charging clientele beyond their means, though, could earn healers the reputation of hustlers and swindlers. A judge named M. R. Cruz Díaz from the north-central part of the country dubbed such healers “primitive physicians.” He divided them into five types: (1) those who believed in the efficiency of their cures, (2) those who believed in their efficiency in dialogue with supernatural forces, (3) those who cured exclusively with superstitions, (4) those who believed they were divinely anointed, and (5) those who did not believe in anything but sought to exploit people gullible enough to entrust their health to them. These latter healers were out for personal financial gain. They were “delinquent prototypes” and usually ended up in prison.42 Gastón denied charging his patients for services rendered, let alone acknowledge that he took advantage of them. This would have made him, in his words, “repulsive.” Rather, he treated all his patients “equally.”43 In one fell swoop and using the rhetoric of equality, Gastón worked around two of the criteria that would have confirmed his healer identity and status: the prescription of alternative, suspicious medicines and disproportionately charging patients for services rendered. A few days later, Batlle questioned Peña, the guard from San Juan de la Maguana who had originally denounced Gastón. In his testimony, Peña provided Batlle with a list of people who solicited the practitioner’s services. One of two

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things happened to these individuals. Gastón either failed to respond to their entreaties, or if he did, he engaged them in a “bad manner.” Besides Abreu and Santos Ramos, Peña referenced several other workers of humble origins and their stewards. Gastón cured Celestino Wilamó of a scab, but because it was reoccurring, he decided to stop treating the man. Another worker suffering from “malarial fevers,” named Emiliano Montilla, contacted the practitioner at least four times via telephone to no avail. In another case, a young laborer named Cleto Mateo had been injured by an animal, likely an ox, given the nature of sugar cane work. Gastón rejected the man’s appeal for treatment. What is more, Gastón purportedly declared, “if [the patient] was Dominican, [then] he was not going to treat him.” Even when mill officers accompanied Mateo to consult Gastón, the healer articulated other excuses so that he would not have to respond. A “peon” with a severe foot condition named Andrés Castillo, who would have lived in impoverished, cramped, secluded quarters like those visually conveyed in figure 10.1, also had to contend with the practitioner’s alleged ethno-racial bias.44 If true, these latter anecdotes indicated that Gastón inverted the direction in which discrimination and power relations more broadly were supposed to travel in Hispaniola.45 In an economic vein, he practically went on labor strike due to the border crises of 1937–1938. It is unclear, however, if Gastón continued to treat Haitians, Puerto Ricans, and cocolos. Personal friction also distorted Peña’s impression of Gastón. The healer had recently declined to transfer Peña’s sick wife to the town hospital. Gastón agreed to authorize her transport by ambulance but reneged. When the couple tried to board the ambulance, it rushed off and left them standing in a cloud of dust. Gastón could have stopped the driver but failed to do so, despite having heard Peña’s emotional plea directly. Peña concluded his testimony by stressing that all the people he listed would ratify his statements. He mentioned them in the first place only because he had heard them at one point or another express dissatisfaction with Gastón. Overall, Batlle attempted to navigate conflicting accounts of the urgent care provided by the healer. Peña insisted that if Abreu and Santos Ramos had changed their tune, it was because they now favored Gastón for some reason. They could not deny, however, that they were hospitalized due to his injections.46 The national police’s investigation of Gastón illustrates that sugar mills had some autonomy in managing their internal medical regimes. The professional opportunity afforded to Gastón by Romana administrators was more difficult to come by elsewhere in the Dominican Republic proper. Major General José

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Figure 10.1. A woman examines rudimentary living quarters for peon workers near Romana cane fields while a man watches, c. 1920, from Humberto García Muñiz, Sugar and Power in the Caribbean: The South Porto Rico Sugar Company in Puerto Rico and the Dominican Republic, 1900–1921 (San Juan: La Editorial, Universidad de Puerto Rico, 2010).

García reached out to Romana officials upon conclusion of the inquiry and encouraged them to take measures that would preempt Gastónesque cases in the future.47 In addition, that the mill kept only a single resident titular physician and several medical practitioners on the payroll, some of whom may have been Haitian healers like Gastón, demonstrates the mill’s inability or aversion to investing in health care for its workers. The circumstances are also indicative of poor health care infrastructure in general, which made it difficult for the mill to adequately staff its medical facilities. Indeed, the demand for services clearly dwarfed personnel and resources. To understand the context in which Gastón lived and worked, it is of paramount importance to take material infrastructure and social exchange into account. In the middle decades of the twentieth century, the Trujillo government played a key role in modernizing the country in this regard. A congressional project proposed in December 1930 and a law passed in 1938 punished unsanctioned healers with fines and prison time. Sanitary laws passed in 1941 limited the practice of medicine to “capable” hands. These culminated in another 1941 law that expanded an emerging national network of hospitals and dispensaries, and obligated medical students to serve at least six months in a commune or rural area upon graduation. By 1943, a law punished occult approaches to healing with corrections.48 The timing of these regulations confirms that cases like Gastón’s helped spur state bureaucrats to clamp down on healers of all nationalities and

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persuasions. The collective body of laws put on the books in the 1930s and beyond also speaks to the sparse health care options into which mill laborers, rural denizens, and other marginalized people could tap. These individuals looked to healers as their primary sources to ameliorate health issues, just as they had done before the advent of modern medicine. Additionally, healers continued to “plague” Dominican society in the late 1930s and 1940s because Trujillo himself sent mixed messages. He was a spiritually ambiguous figure. On the one hand, he was a model secularist. On the other hand, locals deemed him invulnerable thanks to a muchachito (spiritual guide) who visited him in his sleep, told him how to invest, and revealed plots against him—at least until Trujillo lost confidence in his muchachito, which precipitated his downfall. The figure of the muchachito was a Hispaniolan cultural artifact, the product of cross-pollination between Haitian vodou and Dominican vodú.49 Many Dominicans perceived of the Trujillo-spirit guide duality as dangerous, and its instability was indeed made manifest in the repression of healers who were oftentimes cut from similar cloth. The centralizing Dominican state’s measured construction of sturdy health care and sanitary infrastructure allowed healers to carry on as providers. According to Trujillo-era scholar Luis Emilio Gómez Alfau, modern medical science in the form of laboratory research and surgical intervention, for example, slowly penetrated Dominican society in the first half of the twentieth century. A stark rural-urban divide eventually became visible in terms of the location of cutting-edge medical services. In cities like Ciudad Trujillo, physicians trained in Paris or originally based elsewhere in the circum-Caribbean world (such as Venezuela) increasingly played prominent and respected roles as the century unfolded. Their miniscule overall number, in conjunction with the city’s primitive transportation, sewer, and health systems, however, limited their reach and impact. Meanwhile, in rural areas, Gómez Alfau asserted, “shameless” healers predominated. They often prescribed home remedies to their patients, and recommended plant-based prescriptions, purgatives, emetics, poultices, plasters, body rubs, baths, and so on. Some practiced bloodletting or used leeches to extract contaminated blood, while others concocted salt-based potions. Since rural areas still generally lacked titular physicians and well-administered and well-stocked pharmacies, many peasants entrusted their health to “charlatan” healers. Thus, the country’s mortality rate was abysmally high in remote areas.50 As Trujillo’s regional surrogates and lieutenants legally pursued healers, the state itself made sanitary progress. While Dominicans and Haitians alike laid

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the groundwork for developed and sophisticated medical cultures before World War I, Trujillo built on the flurry of modern public health work advanced by US marines during the 1916–1924 occupation.51 Novel publications chronicling this growth appeared in the 1940s and 1950s, when several new health institutions and hospitals opened.52 Concurrently, nursing and social work flourished, bringing convenient supplemental health care, tertiary services, and social medicine to previously isolated corners of the country.53 Through it all, healers remained “enemies” of the state and national health.54 Writers for the Boletín de Sanidad y Asistencia Pública periodical, for instance, regretted the perseverance of healers well after the peaks of campaigns designed to vanquish them. In 1949, an article published in this bulletin railed against “medical sorcerers.” These “theatrical” and “intuitive psychologists” maintained laboratories replete with magical books, dissected animals, curative plants, skulls, candles, and religious artifacts—in sum, all those things meant to impress the sensibilities of the “ingenuous and ignorant.” The modernization project of the Trujillo dictatorship, which emphasized “proper” health care and hospitalization, sought to save “humble people” (by and large Dominican peasants) from the “damaging and useless medicines” propagated by healers, which often led to death.55 Trujillo himself recalled in the early 1950s that 1930, the first year of his reign, marked the start of “the great sanitary crusade to be undertaken if the diseases [biomedical and otherwise] that beset the populace and hamstrung the country’s progress were to be wiped out, or at least brought under control.” By midcentury, the Dominican Republic was “among the most advanced countries [in the world] in the field of sanitary legislation.”56 Annulling the value of healing went a long way in allowing Trujillo to make this claim with confidence. Despite the Trujillo regime’s intended extirpation of healers from the Dominican body politic and goal to delegitimize and replace them in medical circles, healers still had much to offer receptive audiences. To defend themselves against the most pernicious diseases and conditions of the time—tuberculosis, leprosy, bubo, scabies, and ringworm—impoverished rural and urban Dominicans depended on not only a growing modern medical class but also traditional healers. In fact, peasants themselves often appeared to external observers as healers by default, for they frequently drew from vast knowledge that included natural and supernatural therapeutics to resolve health problems.57 And when it came to the basic care associated with the onset of illness, first responders were usually located in the home anyway, especially in secluded or poorly medicalized spaces like the ones under consideration in this chapter.

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SH A DES OF GR AY

The resilient Gastón wore many hats and was aware of where he stood on the chessboard of Dominican-Haitian relations. The conflictual history of modern Hispaniola and local power struggles are buried in the overlapping narratives that comprise his case file. Gastón exercised consequential medical power in a gray interstitial space between official and unofficial medicine within the confines of the Romana sugar mill. This was the opposite of reality for many of the healers then circulating and providing services in the Dominican Republic. A cursory glance at additional government correspondence and the mainstream newspapers of the era corroborate this assertion to a considerable degree.58 The Dominican state targeted Gastón for allegedly practicing “illegal medicine,” whereas Romana administrators recruited him as a “medical practitioner.” Romana was among the few sugar operations (if not the only) on Dominican soil not taken over by the Trujillo regime. This in part explains why, in this instance at least, Gastón was able to sidestep corrections. Despite his being entrenched in a cog of imperial racial capitalism, the mill enjoyed a certain autonomy and shielded him. By the time the investigation into his discriminatory behavior was over, the new Secretary of the Interior and Police, Major General García, concluded that Gastón had indeed mistreated Dominican workers. However, no criminal charges were filed. When Gastón stepped through the looking glass into Romana, which mimicked Dominican-Haitian relations at large but also gave him opportunities he could not access in the same way beyond the mill’s borders, he navigated a parallel world where the class and race hierarchies associated with exploitative sugar production and urgent health care, as well as understandings about disease and well-being, were destabilized if not entirely defaced or inverted. The legal and intellectual binaries typically associated with curanderismo did not firmly apply on Romana grounds. Yet, back on the other side of the mirror in the Dominican nation, the apparent prestige and privileges Gastón reaped at Romana could slip from his grasp like water through a clenched fist. Non-titular health care providers like Gastón fluctuated between different categories of healer depending on factors like place, the autonomy of private enterprise, historical memory, and who got to narrate volatile situations and how they did so (via rumor or testimony, for instance). Complex social interactions and tensions permeated perceptions of healing as much as biomedical notions. Still, certain bodies proved to be more vulnerable than others, whether those of fragile day laborers or the racialized Gastón, in the eyes of rivals and

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the Dominican state. Gastón himself was considered useful in an urgent care capacity but not as a real doctor. These realities were no mystery to him, and he discerned and acted accordingly. The world and structural nuance that existed through the looking glass on Romana grounds presented everyone involved with intricate, inconvenient truths about Dominican-Haitian relations and the perpetual impact of healers on Hispaniolan history. Gastón’s story is therefore a collective story, and the meanings associated with it—and by extension health and healing—were subject to controversy, contested and in flux in multiple registers.

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{ 11 } Jesús Pueyo The “Modern Argentine Pasteur” of the 1930s and 1940s

Diego Armus

After Robert Koch’s discovery of the tubercle bacillus as the cause of tuberculosis in the early 1880s, advances in modern bacteriology enthused doctors and scientists searching for specific, effective treatments for this disease. However, during the following six decades, biomedical uncertainty dominated the history of tuberculosis, including not only unsuccessful vaccines and serums but also failed therapies based on a myriad of resources that influenced the biomedical efforts aimed at producing a sound cure. Antibiotics and the Bacillus CalmetteGuérin (BCG) vaccine would finally begin to change this uncertain scenario. However, even in the 1950s, some of these biomedical novelties—particularly the vaccine—continued to be regarded with some skepticism. This long-standing disbelief was present in both Paris and Berlin—in those decades, cities at the center of modern capitalism and science—as well as in Buenos Aires, a city in one of the many peripheries. The so-called Pueyo vaccine is a local example—very Argentine but with influences in neighboring countries—of the biomedical uncertainties that saturated the global history of tuberculosis in modern times. It is a story ensuing in the late 1930s and early 1940s that reveals a complex web of public and individual feelings and behaviors displayed by medical doctors and the state when dealing with a vaccine that the sick welcomed and believed in as an answer to their 170

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sufferings. It is also a story, of course, of the eventually ostracized microbiologist Jesús Pueyo. Time and again, Pueyo had defended his discovery as a scientific achievement. However, after an initial hesitant reception among some doctors, the Argentine medical establishment rejected the vaccine. Pueyo, whom popular printed media and many individuals with tuberculosis referred to as “the modern Argentine Pasteur,” ended up labeled as a charlatan by numerous professional voices speaking on behalf of scientific medicine.1 YEA RS OF BIOMEDICA L UNCERTA INTY

Between the 1880s and late 1940s, people with tuberculosis in Buenos Aires, regardless of economic status, could either accept their condition with resignation or access a cure even when its effectiveness was questionable. There were a great number of alternatives—from tonics, serums, vaccines, and surgery to rest, good diet, fresh air, crushed eggshells, garlic, and herbs—offered both by medical doctors as well as healers. In the first half of the twentieth century, advances in modern bacteriology generated enthusiasm among doctors and scientists searching for specific, effective treatments for tuberculosis. In 1890, after isolating the bacillus, Robert Koch attempted to find a treatment by using tuberculin, a lymph resulting from filtering bacillary cultures. In 1903, the Italian scientist Edoardo Maragliano injected human beings with a vaccine made from dead bacillus. During the first two decades of the twentieth century, other vaccines were developed, among them, by Henri Vallé in France, Hideyo Noguchi in Japan, Friedrich Loffler in Germany, and Alessandro Bruschettini in Italy. Through various techniques ranging from heat to chlorine, they all attempted to destroy the tuberculosis bacillus. Others, like Friedrich Friedmann, created vaccines from strains of bacteria taken from animals with strains of tuberculosis that were not virulent in humans. Emil von Behring, Koch, and Fred Neufeld worked on vaccines made from living bacilli taken from virulent human and bovine strains that were then attenuated through chemical and physical processes. The Spanish scientist Jaime Ferrán i Clúa created a preventative vaccine that attempted to immunize against the bacteria he believed later transformed into Koch’s bacillus. These serums and many others, as well as curative and preventative vaccines, gave rise to intense debate within European scientific circles. Developed by Albert Calmette and Camille Guerin, what is now the widely accepted Bacillus Calmette-Guérin (BCG) vaccine was also part of this atmosphere of debate. In fact, starting in the 1920s

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and continuing well into the 1950s, this vaccine was received with open hostility in some places and great enthusiasm or mistrust in others. Scientific circles in Buenos Aires published these developments and debates in the pages of medical journals and occasionally did clinical research on the effectiveness of vaccines and serums. In 1941, the story of the challenges of this process that had been underway since the beginning of the twentieth century appeared in an article in the professional journal La Semana Médica in which the author, Daniel Priano, discussed the fruitless efforts of biomedicine to find an effective vaccine. Priano commented on and criticized many of these efforts, among them the BCG vaccine. Interestingly, if Priano’s article mentioned the Friedmann vaccine only in passing —in spite of the fact that this vaccine received unusual attention among members of the Argentine Congress—it blatantly ignored others that made headlines in the Buenos Aires printed media, particularly the Villar serum at the beginning of the twentieth century and the Pueyo vaccine in the late 1930s and early 1940s.2 Revealing how long periods of scientific uncertainty can become tightly bound to social and cultural questions that go far beyond biomedicine, both the Villar serum and the Pueyo vaccine turned out to be public matters. The absence of a cure for tuberculosis in the first half of the twentieth century encouraged people living with the disease to embrace any sort of therapy, even when its effectiveness was dubious. Doctors, who were interested in overcoming the impotence they felt, and the sick, driven by the hope of recovery, could fall into this peculiar enthusiasm. Information about treatments circulated in the semipublic world of hospitals and medical wards as well as in the much more private world of doctors’ offices. Some remedies were only fleeting presences in the arsenal of tuberculosis treatments suggested by the medical profession. Others lasted longer. If the immediate prognosis for the infected individual wasn’t terminal, therapy often began at home, entailing some form of self-medication, followed by treatments offered by health care-givers, be they neighborhood pharmacists; professional doctors at hospitals, clinics, and local medical wards; or healers, herbalists, and quacks. There was no preestablished therapeutic trajectory, so each person did it his own way, and every instance meant very different experiences.3 At official medical institutions, the sick with tuberculosis became a patient and circulated in a sphere where the professionalized expertise of the doctor tended to dominate. The book entitled Lo que todo tuberculoso debe saber (All What the Tubercular

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Ought to Know), written by Juan José Vitón, a professor at the University of Buenos Aires School of Medicine, clearly laid out the subordinate role of the patient: “To become healthy, the sick person must contribute to organizing a ‘fight plan’ by submitting unconditionally to the orders of the doctor in charge, whose every suggestion must be seen as an obligation. The doctor is a guide and also a dictator, though a generous and kind one, since all he wants for himself is to triumph by curing his patient.”4 This rigid division of roles was part of a scenario laden with uncertainties about biomedical treatments for tuberculosis. One of these uncertainties is more than apparent in Ulises Petit de Murat’s 1943 novel El Balcón Hacia la Muerte (Balcony towards the Death). At the doctor’s office, in response to the recommendation of a specific therapy, the patient cynically says, “Who will demonstrate the lack of usefulness of what you’re giving me?”5 This sense of uncertainty also appears in the recollections of Elma M., who grew up in a boardinghouse for tubercular patients: “Many times the doctors were not sure if a remedy could actually cure us; they tested the remedies on the sick people who had been abandoned by their families. They used them as guinea pigs.”6 Even some doctors not only assumed these uncertainties but also warned about their sociocultural effects. In the 1940s, the lung specialist Antonio Cetrángolo wrote about “fooling the person with tuberculosis.” He estimated that “every five years, what I call the tide phenomenon takes place, that is, the irruption of a new medication that, with the aid of the press, stirs up hope but only for a little while.”7 In this context, every tuberculosis treatment was part of an uneasy scenario involving doctors’ inclination to offer patients solutions, explanations of how the recommended therapies had won public favor, and the enduring hope of those suffering from the disease. Patients’ responses varied greatly, from adaptation to acceptance, resignation, and protest. This tangle of reactions was particularly evident at sanatoriums and hospitals. Some patients tried to follow their doctor’s advice as closely as possible. Others attempted to devise alternative therapies, resisted treatments they felt were not trustworthy, rejected those that went against what they perceived to be their individual liberties, and demanded the right to try treatments—among them vaccines and serums that had not been approved by doctors or health authorities.8 Conflicts arose when these treatments produced headlines in the press and were closely covered for months. The impact of such reporting on the public varied according to each medium’s reaction to a treatment. A story that produced headlines in one newspaper or weekly magazine might be barely mentioned or totally ignored by others. In truth, the treatments—and, along with them, the

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sick—became news when they provided stories that suited a certain journalistic style. That was the case of the Pueyo vaccine, an incident in the history of tuberculosis in Buenos Aires in which the resistance of the academic establishment to a new therapy that originated from outside recognized medical circles became bound up in modern journalism, revealing the limited but real role of the sick in looking for effective cures, and unveiling how a context of biomedical uncertainties facilitated the use and abuse of the charlatan label. A BACTER IOLOGIST, A CH A R LATA N, A DISCOVER ER OF A N AUTHOR IZED VACCINE, A QUACK

Born in Spain, Jesús Pueyo emigrated to Argentina with his mother and brother at the age of fifteen. After finishing his secondary education, he began his studies at the University of Buenos Aires School of Medicine. According to a book he wrote, first published in 1942 in which he narrates his career, by the time he joined the laboratory of the medical school microbiology department around 1932 or 1933, he already had three years of experience working on “pharmaceutical chemistry” as a “bacteriologist.”9 His records at the medical school, however, do not contain any register of his previous laboratory work. In any case, it is quite probable that Pueyo had joined the laboratory of the Centro Gallego for a period time. At this mutual aid society of the Galician Spaniards in Buenos Aires, he could have met the well-respected Roberto Novoa Santos, who had been a professor of pathology at the medical school in Santiago de Compostela and Madrid but who was not an expert in either tuberculosis or infectious diseases. In 1932, Novoa Santos visited Buenos Aires through an invitation from the Spanish Cultural Institution. He lectured at the schools of philosophy and medicine of the University of Buenos Aires and visited social organizations of the Spanish community, among them the Centro Gallego where Pueyo might have requested from Novoa Santos a recommendation for Professor Alois Bachman, the microbiology chief at the University of Buenos Aires School of Medicine. Bachman was a specialist on immunization processes, not on the Koch bacillus. His work and that of his colleagues in the 1930s reveal the existence of an active group of researchers and professors that had been involved in research with the department of bacteriology at the medical school since 1897. Pueyo’s time as a medical student was not particularly notable; he had to repeat the examination twice to be accepted into the medical school and struggled with most of the eight courses he took. He failed the last one in 1937 and never

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graduated. In his third year at the school, he passed the microbiology course and was hired by the microbiology department as an unpaid laboratory assistant first and then as a paid employee between 1934 and 1940.10 In that capacity, and under the supervision of doctor Alois Bachman, Pueyo continued the line of research he had started on his own in 1929, experimenting with animals at the Centro Gallego laboratory, namely, the deactivation of infectious processes and the chemical substances potentially capable of making some microorganisms non-virulent. In his book as well as in several articles, Pueyo writes that it was in 1936 when he made the first trial of his antituberculosis treatment with humans. Soon to be known as the “Pueyo vaccine,” the treatment consisted of twenty applications over a four-month period. Later, Pueyo began to refer to his vaccine as preventative. He was also looking for vaccines and serums against several microorganisms such as gonococcus, staphylococcus, and streptococcus that he believed were associated with blennorrhagia, typhoid fever, and carbuncle. In a 1940 article, Pueyo indicates that he was applying some of these vaccines and serums to the medical school staff as well as to patients with tuberculosis sent to him by university faculty.11 By then, Pueyo had already formally requested to the school authorities that his vaccine be tested in order to probe its efficacy and be available free of charge to the sick.12 None of these serums and vaccines were presented to the National Department of Hygiene in order to pursue the tests that would officially approve their use. In the case of the antituberculosis vaccine, Pueyo did not formalize the sanitary registration. Even more, he systematically avoided revealing its components and deactivation procedures of the bacillus. Instead, when asked about the ingredients of his vaccine, he kept referring time and again to a “substance X.” The motives of Pueyo’s decision to withhold this information are not clear. They could have been efforts to defend the “authorship” of his discovery—at a time when there was not intellectual property legal protection—or to secure the material rewards that a successful vaccine might lend when tuberculosis had a tremendous impact on morbidity and mortality of the population. Pueyo’s reticence to both reveal the “substance X” as well as his decision to test his vaccine only with animals under the supervision of a special commission at the Tuberculosis Research Institute precipitated a series of events that culminated with the cessation of his position at the microbiology department laboratory in 1941. Initially, Pueyo rejected the preconditions defined by the institute’s tuberculosis specialists: that the testing should be first conducted in

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animals. However, and as a conciliatory gesture, he later made clear he was open to include animals but not as a first step to test the vaccine with humans. By November 1940, the lack of agreement on how to proceed motivated the demise of the special commission. While this happened, authorities from the School of Medicine discussed the issue in closed and secret sessions but did not participate publicly in the debate. Even Bachmann, the head of the Microbiology Department at the medical school who certainly knew what Pueyo was working on (and also at that time was in charge of vaccine production at a Buenos Aires pharmaceutical company), remained silent. By the early 1940s the vaccine had become a public issue and some printed media nicknamed Pueyo as “the modern Argentine Pasteur.” In 1941, the magazine Ahora and the newspaper Crítica, both with large readerships, were actively supportive of the vaccine, a novelty in which patients with tuberculosis had already found some hope. The health magazine Viva Cien Años, on the other hand, offered readers the very critical opinions of professors, doctors, and government officials. Some of them voiced their reservations by speaking in the name of the patients whose “hopes are resuscitated by this press campaign; they think there’s a life raft they can cling to, but when it sinks, it will bring down with it their dreams, and this, in the end, is very dangerous to their weakened spirits and bodies.” Others questioned Pueyo for having flouted academic rules and scientific ethics. They said: “The author of a discovery must prove [his findings] with scientific evidence. A vaccine is not something spiritual that must be accepted as a dogma. It’s something material, with a given physical reality; thus, in order to believe in the vaccine, it is necessary to know it. And, until now, the information given about its composition has not been adequate.”13 Once the issue had gone public, the vaccine’s effectiveness, and particularly its harmlessness, entered the purview of the National Department of Hygiene. In order to reach his verdict, the director of the department invited Pueyo to do the necessary testing at the department’s laboratory. The results were a long time in coming, however. Along with Ahora and Crítica, Pueyo blamed the delay on a bureaucracy that kept slowing down his work. Meanwhile, government officials accused Pueyo of keeping the composition of the vaccine a secret and refusing to report to the laboratory where it was to be tested. The minister of internal affairs tried to restart the dialogue. He spoke with Pueyo in January of 1941 and issued a resolution authorizing the application of the treatment to two hundred people with tuberculosis as well as to three hundred animals. Nonetheless, the tests never took place because the director

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of the National Department of Hygiene and the director of the Bacteriological Institute wanted to impose standardized preconditions for approval that Pueyo found unacceptable.14 In 1941 Pueyo was accused of illegal medical practice according to Law 4687 that established the sale or free distribution of vaccines, serums, and toxins must get the approval of the National Department of Hygiene. The trial lasted until 1945, when Pueyo was acquitted on the basis that patients who requested the inoculation of the vaccine did so after getting the approval of a licensed physician. In other words, the claim that Pueyo may have been practicing medicine illegally when prescribing or administering his vaccine could not be demonstrated. On April 12th, 1946, and under a military regime, the vaccine obtained authorization. The fifth and last edition of Pueyo’s book, published in 1947, details the story. Lucha Antituberculosa, a short-lived journal supportive of the Pueyo vaccine, and Revista de la Asociación de Farmacias, the professional magazine for drugstore pharmacists, also highlighted the novelty. The explanations of why the vaccine was granted authorization underscored its safety and sterility, ignoring, as was standard in most Western countries at that time, the issue of its efficacy. On August 7, 1946, a recently elected government ratified the authorization of the vaccine but clearly defined the accessibility to it around two points: one, patients were required to provide a signed informed consent in their medical record stating that they agreed to receive the vaccine; and two, patients had to pay for the vaccine out of their own pocket. This was a departure from medicines provided in public hospitals in that the vaccine would not be free.15 In 1947 a group of distinguished tuberculosis experts at the National University of Córdoba underwent an exhaustive study of the vaccine’s characteristics along with its clinical effects in guinea pigs and fifty female patients. The study concluded that the vaccine was not a curative or preventive medicine for tuberculosis and that in certain conditions was not innocuous.16 That same year, a study concluded that the antibiotic streptomycin was quite effective for the treatment of tuberculosis.17 Both, but particularly the latter, accelerated the demise of the Pueyo vaccine and all expectations associated with it. From then on, Jesús Pueyo’s journey in the gray zones of Argentine medicine remained a matter of the past. Historians of medicine and pharmacy would return to him and his vaccine early in the twenty-first century, indicating that the putative vaccine was essentially an attempt to obtain easy money from seriously ill patients and bordered on quackery: “We can agree that established medicine did not offer a better option, and probably, that beliefs and preconceptions of

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doctors were an important part of the refusal of academic medicine to accept Pueyo, but we cannot consider him as a scientist (indeed, his behavior was the negation of scientific standards), nor his putative vaccine as an appropriate approach to tuberculosis treatment.”18 THE M A K ING OF THE “MODER N A RGENTINE PASTEUR”

By the 1920s, it was clear that Buenos Aires was undergoing important changes—the diversification of its large, literate, and rapidly Argentinized immigrant population and the rise of a mass consumer culture figured among these transformations. As literacy rates in Buenos Aires rose to near universal numbers (though reading levels varied) in the first decades of the twentieth century, new or renovated newspapers and magazines abounded as interpreters of international, national, and local events. Print media exhibited an important level of autonomy with respect to the state and became a diverse and quite plural forum of ideas about modern life. Their prints were massive. By 1930, Crítica sold 350,000 copies, publishing photographs and illustrations alongside strong headlines. Crítica and most of the print media ran stories about soccer, tango, jazz, horse racing, crime, politics, and melodramas, as well as scientific and technical novelties. When news about the Pueyo vaccine leaked from the laboratory, it was received with excitement by people with tuberculosis and some newspapers and magazines. Among doctors, the reception was mixed. According to Pueyo, some doctors based in Buenos Aires and the Argentina interior invited their patients to try the vaccine, a hopeful attempt to find an effective cure that deserved serious attention. Other doctors were more cautious, requesting more information. Still others were suspicious and rejected it from the start. At the laboratory where Pueyo worked, the necessary evaluations were being put off, he averred, because of his marginal position in the world of researchers fighting tuberculosis. These delays were hindering access to the vaccine. “Convinced by the insistent offers of journalism,” Pueyo decided to go public with his discovery.19 Some magazines and newspapers made Pueyo’s vaccine a hot story.20 Crítica and the biweekly Ahora were decisive in their efforts at turning the vaccine into a public issue. Between 1940 and 1942 Crítica printed more than eighty articles on the case, including two-page stories, big headlines, interviews, and photographs. Ahora reported on the case seventy times, and its sophisticated graphic coverage included reproductions of tubercular patients’ letters,

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x-ray images, pictures of Pueyo in the laboratory and at the editorial offices, drawings of the bacillus, and photographs of patients at hospitals petitioning to the authorities and demonstrating in the street. Ahora used pictures to build the news, and every issue presented the reader with a shocking visual story followed by big headlines and short texts. Undoubtedly, the Pueyo vaccine had all the ingredients for a juicy story. It voiced the anxiety of people with tuberculosis, questioned the authority of high-ranking doctors, and fed the curiosity of an audience used to reading both scientific and pseudoscientific articles. Indeed, both Crítica and Ahora subtly intertwined the coveted cure for tuberculosis, its accessibility for the common person, and the story of the humble microbiology lab assistant who, despite the attacks of the medical establishment, was determined to save desperate people with tuberculosis. Pueyo was never introduced to the readership as a quack or a healer who offered alternative cures to the poor and the ignorant. On the contrary, pictured in the lab surrounded by microscopes, pipettes, and test tubes, he was described as being a worthy researcher, devoted to his work, and unfairly ignored by the medical establishment.21 Pueyo’s own public presentation always underscored his character as both a hardworking scientist to whom the media had turned in order to inform the people and as a researcher not involved in any sensationalistic yellow journalism campaign. This characterization is clearly apparent in his book La burocracia de la medicina contra la tuberculosis. Síntesis documentada y antecedents reales de mi vacuna antituberculosa (The Medical Bureaucracy against Tuberculosis: A Documented Synthesis and True Antecedents about My Anti-Tuberculosis Vaccine). It includes a compilation of letters he had sent to doctors and government officials who refused to seriously consider his findings. In each of the letters, which were written over the course of three years, Pueyo positioned himself as a member of the scientific community fighting against his marginalization, which had been orchestrated by the interests of the “medical bureaucracy.” The book, published by an “Editorial Científica” (Scientific Publisher), emphasized that the vaccine was not a panacea, like the treatments offered by charlatans and quacks. And while he criticized what he regarded as the unfair and unyielding resistance of certain powerful figures in academic circles and in public health agencies, Pueyo stressed again and again the enthusiastic support he had received from prestigious doctors active in the clinical care of people with tuberculosis. Regarding the press that followed him so closely, Pueyo said, “I use it only to let the people know about the current research.” He claimed his

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relationship with the press was an “instrument for progress and a spur against academic paralysis.” Craftily, he distanced himself from Ahora and Crítica. He said he let those media and the people “do the talking,” while he delivered papers to the “most competent personalities so that they might then make their verdict with due seriousness and serenity.”22 Crítica and Ahora transformed the medical establishment’s rejection of Pueyo into his main virtue. The “modern Argentine Pasteur,” as Ahora called him in its December 27, 1940, issue, quickly saw that his professional biography could be interpreted as an example of the life of a scientist who had not been corrupted by power. When interviewed by a magazine that had a poor opinion of his credentials, Pueyo didn’t hesitate to state that his exclusion from reputable academic circles was the price he had been forced to pay for “not accepting the scientific patronage” of powerful interests.23 In his view his career was a clear example of the twin struggles against a lack of resources and a needlessly complicated bureaucracy that ordinary people, “people without contacts,” often had to face.24 Considering this portrait, it wasn’t hard for Crítica and Ahora to conclude that Pueyo embodied science as it should be: removed from lavish funding and luxuriously equipped labs, and firmly committed to people’s needs. Other newspapers and magazines in Argentina and abroad also paid attention to the Pueyo vaccine. On February 1941 El Litoral, published in Santa Fe, reported about a Rosario city visit of the “bacteriologist Pueyo” organized by a local committee that promoted the vaccine. Earlier, on December 1940, the New York Times reported a story about the vaccine, its transformation into a public affair, and the role Crítica had been playing for quite some time in that process. In 1945, when Pueyo was still under trial and the vaccine without approval for commercialization, La Vanguardia, published in Barcelona, reported about the popular reception of this so-called vaccine in a country where quackery had a perdurable presence.25 But the intense media coverage of the early 1940s vanished as the decade advanced. Interestingly, and in a surprising and difficult to explain editorial change, the Argentine media outlets that actively supported the pro-Pueyo movement, namely, Crítica and Ahora, were almost silent when dealing with the marketing approval of the vaccine in 1946. Years later, in 1952, when chemotherapy in the treatment of tuberculosis was received with the high expectation many other previous novelties received, La Crónica of Lima, Peru, invited its readers to remember the long history of recurrent failed therapies, among them the Pueyo vaccine and the subsequent widespread discredit of its discoverer.26

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PUEYO A ND THE SICK

The detailed coverage in Crítica and Ahora and the delays in the paperwork required to study the vaccine’s innocuousness and effectiveness only served to heighten the despair of individuals with tuberculosis. In reaction to these postponements, they rallied. In November 1940 Crítica reproduced a pamphlet signed by patients inviting the general public to support them in their fight to get the vaccine. It warned the casual reader that “anybody, you or one of your relatives,” could be “the victim of this calamity.”27 In December the newspaper reported on a march of sick people in Plaza de Mayo, in front of the seat of the national government. In early 1941 the headlines in Ahora ominously declared, “A revolt of people with tuberculosis [is] about to break out across the nation.” In the same issue, an article entitled “Doctors Accused of Conspiring against Science” placed the Pueyo vaccine case in the realm of science and official medicine. By then, pamphlets and manifestos were circulating in tuberculosis medical wards, hospitals, and sanatoriums. One of those pamphlets hailed the “humanitarian decree” signed by the minister of Internal Affairs, who by then was more open-minded than the heads of the National Department of Hygiene. The last line of the pamphlet read, “Pueyo has vanquished, and he will continue to vanquish. Time is up for the people’s blood suckers.”28 Occupying a third of a page, a manifesto reproduced in Ahora voiced the agenda of the tubercular activists: “To the people of the Argentine Republic!!! The time has come to take to the street and demand what we deserve, what no man can take away from us. The medical professionals and defenders of official science conspire against us and against Pueyo, and they are willing to do everything they can to keep our nation from getting the tuberculosis vaccine that its discoverer has offered, free of charge, to the national government.”29 The manifesto questioned “the attitude of those professionals who make a living from their patients: an attitude that was publicly unmasked by Pueyo, who [in several letters] has clearly established that doctors seek to preserve their economic interests and their plentiful State funding.” It called for action: “The people have already chosen their way in this notable crusade [ . . . ] It’s just a matter of time before we leave hospitals, leave the beds where our lives are consumed, and undertake a caravan through the city streets towards the government house and . . . request and demand before our government that justice be done and the people receive the vaccine.” The manifesto ended by saying, “Enough! The world will soon know how a people sick and tired rallies behind the man

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who made the anti-tuberculosis vaccine possible, the man who unmasked the Philistines at the sacred temple of medicine. With Pueyo and for Pueyo. Against the capitalist bureaucracy of medicine!!!.”30 Contrary to the arrogance of the powerful figures of official medicine, Pueyo embodied the figure of the humble bacteriologist who had not only given out his cure for free but had also exposed those who profited from the disease. The therapy the tubercular patients were defending was not part of the home medicine tradition. Neither were they seeking access to the solutions offered by alternative or popular medicines. They were, rather, reaffirming their right to try a treatment that was on the margins of academic science. Their indignation was not untimely, considering that the vaccine’s harmlessness had already been proven. On these grounds, a patient stated, “If a remedy is not harmful, even if its benefits are still unknown, the logical thing to do would be to give it to the people who want it. Especially in the field of tuberculosis, where so far nothing really effective has been found, despite the fuss over the preventive merits of the Calmette Guerin vaccine, whose obstinate enemies include eminences such as León Taxier, in Paris, Professor Otolenghi in Rome, Doctors Tucunouva and Larinouva in Moscow, and Doctor Olbretch in Brussels.”31 By then it was evident that Crítica and Ahora had become enmeshed in the tubercular patients’ movement. Ahora’s editorial office turned into a sort of general headquarters where patient activists gathered to plan future actions. In a style that had been cultivated by Crítica in the 1930’s, Ahora established itself as a publication sensitive to the dramas of the needy. It even offered a mailing address at which doctors and sick people who were interested in the treatment could reach Pueyo. Largely because of the commotion created by the patients with tuberculosis and the actions of Pueyo himself, the minister of Internal Affairs ordered that tests to establish the harmlessness and effectiveness of the vaccine be accelerated. Meanwhile, in neighboring Uruguay, health authorities had already certified its innocuousness, and the authorities in Brazil, Peru, Bolivia, and Chile were studying it as well. This news started to circulate in Buenos Aires at the same time that the National Department of Hygiene affirmed its opposition to the vaccine, pointing out, among other things, that Pueyo had not performed the appropriate tests at the appropriate time. In response to this, tuberculosis patients wrote dozens of letters to the Hygiene and Medical Assistance Commission at the National Congress and again took to the streets. In early winter 1941, individuals with tuberculosis from Buenos Aires and other parts of the country

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Figure 11.1. Patients with tuberculosis and people in general in a street demonstration demanding access to the Pueyo vaccine. Ahora, 1941, 643.

marched to the National Congress shouting, “We want the Pueyo vaccine!” The photographic coverage of the protest in Ahora, which reproduced enlarged copies of images of massive events of people with tuberculosis and their families demanding the vaccine during the first part of the year, depicted a morose scene: sick people wrapped in hospital blankets and their sullen relatives, skinny mothers carrying their children. There were signs identifying neighborhood and regional associations that supported Pueyo, and many banners with a large V in reference to the vaccine. There were also confrontations. The police intervened, and some patients were detained.32 Nevertheless, the National Department of Hygiene didn’t change its policy. Indeed, the minister of Internal Affairs, who early on had been receptive to the demands of the patients, sided in this instance with the medical establishment— as did the National Congress, largely owing to the initiative of a legislator who happened to be a doctor. As a result, Pueyo was fined and sued for malpractice. This led to a spontaneous outpouring of contributions from sick people, which were sent to the Ahora editorial office. In less than forty-eight hours, twice the sum of the fine had been raised. But Pueyo didn’t accept the help. This reinforced

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his virtuousness and humility in the eyes of the public, demonstrating once again a position—according to him—diametrically opposed to that of doctors interested in profiting from people’s ill health. The trial and the fine didn’t do much to stop Pueyo because he had already distributed his treatment free of charge with the permission of the ministry of Internal Affairs. Furthermore, he had also distributed it to the doctors who had requested it, that is, doctors with patients eager to test whether the vaccine could restore their health. On July 11, 1941, Pueyo accepted the official decision, and from then on patients’ activism declined, as did media attention to the controversy. At the end of the year, in reporting that Uruguay had recognized the vaccine’s innocuousness and that Brazil was using it on an experimental basis at several hospitals, Crítica pointed out how irrationally Argentine authorities had dealt with the issue.33 In any case, the issue continued to appear sporadically in the newspapers, usually in the form of warnings to the public of fake Pueyo vaccines for sale. People with tuberculosis, their relatives, and even some doctors were apparently still interested in trying out the treatment in spite of the official condemnation of it. Oscar O. vividly recalled how he got the injection in the early 1940’s: “I was admitted to the hospital. When I met a doctor who administered it for ten pesos at his private office, I decided to go ahead and try it, without mentioning anything to my doctors at the hospital. The doctor was very kind; he gave me hope and convinced me that the cure was effective.”34 In Cosquín, a town in the Córdoba foothills with plenty of sanatoriums and rest cure hotels and pensions, Pueyo’s treatment was greeted with hostility by many doctors, though there were exceptions. Oscar F., the son of a nurse who worked for several decades at one of the most expensive sanatoriums, recalled that on an occasion in which Pueyo was visiting the foothills sanatoriums, the doctors denied him entrance to the building in spite of the fact that patients wanted to try the vaccine.35 And Ricardo H., a tubercular patient who arrived in the Córdoba foothills to pursue a rest cure in the mid-1940s before the trial against Pueyo, would indicate that the vaccine was innocuous. However, after the vaccine was not authorized to circulate, he recollected that sick people’s interest in the vaccine resulted from their desperate will “to try anything that might save them.”36 In those years it is not clear what kind of Pueyo vaccine was circulating, if one was produced somewhat by Pueyo himself or by others who found a lucrative opportunity selling something they called Pueyo vaccine. Once the vaccine got marketing authorization and Pueyo was acquitted of

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illegal exercise of medicine in 1946, tubercular patients were lobbying to obtain the approval of public funds that would make the production, commercialization, and access to the vaccine easy. That was the agenda of Lucha Antituberculosa, a monthly publication that described itself as the “first South American voice for the human, scientific and social crusade for the Pueyo vaccine.” In that year, and perhaps foreseeing an increasing demand given the new legal scenario, a laboratory in the Flores neighborhood of the city of Buenos Aires was already producing the vaccine.37 However, on August 7 the secretary of Public Health made clear that patients were supposed to pay for the vaccine. JESÚS PUEYO AS A GR AY ZONE HEA LTH CA R E PR ACTITIONER

From 1870 to 1950—in a similar fashion to what happened during the first three-quarters of the nineteenth century before the bacteriological revolution— herbalists, pharmacists who recommended medicines, empiricists, healers, swindlers, charlatans, midwives, fortune tellers, and quacks were mainstays of health care for vast social sectors. This heterogeneous group, according to its opponents (generally medical doctors) constituted a legion of dangerous, perverse, and illegal pseudo-providers of panaceas who were taking advantage of the sick in their despair and ignorance. This critical view ended up producing a certain stereotype of the healer: a character associated with a quack who could skillfully combine herbs, magic-wand medicines, and religion in his curing styles, who was an expert at communicating with the sick, a practitioner of orally transmitted knowledge, and a believer that all illnesses resulted from the disordered condition of the fluids or humors of the body. This stereotype of the healer as a quack contrasted with another stereotype, the image of the university doctor as a solid professional whose judgments were inevitably grounded on rational, secular, and biomedical knowledge. Whether in a private office or at the hospital, this doctor was always committed to a professional practice marked by reasonable material interests and humanitarian responsibilities and obligations. Articles in newspapers and magazines as well as in medical journals reinforced both stereotypes; thus, plenty of doctors were portrayed as having supposedly impeccable careers. On the other hand, healers were depicted as quacks whose treatments were pure suggestion, or strange, irrational, and irresponsible machinations. Needless to say, there were doctors who were not completely different than

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the celebrated stereotype of a dedicated physician. As for the healers, there were those who behaved like quacks. However, very few of the healers who advertised cures for tuberculosis resembled the quack stereotype. In fact, it seems that most of those who publicly presented themselves as capable of dealing with the disease were gray zone healers. Instead of radically alternative practices and visions, these healers combined popular healing traditions, official medicine, and even biomedicine. Their actions were part of a health care style that offered services outside the boundaries imposed by professional medicine and, in doing so, both obstructed the medicalization of society at large and also facilitated the presence and use of some biomedical knowledge and practices in the world of popular and home medicines.38 Healers like Pueyo sought to gain a place in the health services market by displaying many and varied resources, from announcing exceptional former successes to publicizing the infallible effectiveness of a cure, and from publishing articles in newspapers to writing short books and brochures that included the testimonials and letters of gratitude sent by their healthy former patients. These healers circulated quite freely at the margins of a world increasingly marked by professional medicine and the offering of over-the-counter remedies. Although there were reports of the negative and even lethal effects that some treatments or remedies had on people with tuberculosis, the herbs, medicines, and simple drinks supplied by healers were by and large innocuous, perhaps even less dangerous than some of the therapies used by biomedicine. Healers seem to have had a much more empathetic, supportive relationship with the sick than many licensed doctors. Without doubt, there were sensitive doctors capable of dealing with tuberculosis by means of biomedical resources while also providing the sick with affection and respect. And there must also have been unscrupulous, irresponsible, and money-driven healers. However, and interestingly, doctors were the ones to notice the way that most healers were able to relate to the sick. An article published in Archivos de Psiquiatría, Criminología y Ciencias Afines in 1905 recognized that “quacks have more ability to explain how, when, and where an illness was contracted.”39 Almost forty years later, in a tone that hadn’t changed significantly, a popular magazine stressed the “consideration, respect, and love” that characterized most healers’ practices and, in 1939, La Semana Médica pointed out, “the contagious optimism of the quack,” his or her direct talk free of “technical terms and convoluted words,” speaking a language that was similar to “that of the sick, from whom they even accept opinions about the disease.”40 These elements were not always present in the relationship between hospital

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doctors and their tubercular patients; hence, some explained the persistent presence of healers as the inevitable effect of academic medicine’s disregard for emotional factors in the life of tubercular patients. Consulting a healer allowed people with tuberculosis to regain some hope that a cure was possible—which, in the end, was what every sick person wanted to hear. In this way, and in times of medical uncertainty, healers’ promises were as instrumental as the recurrent and ineffective cures prescribed by doctors. The patient with tuberculosis may have simultaneously, successively, or alternatively gone to get help from doctors, pharmacists, and the array of healers and quacks. This sort of random therapy was also in part a result of the fact that the medical profession had yet to define its area of legitimate competence. It was in this context that a sort of gray zone characterized by overlapping and vagueness emerged. Both groups—healers and doctors—contributed to it. On the one hand, healers deliberately avoided an open confrontation with medical doctors. But in so doing, they imitated postures, practices, and terminology firmly anchored in diplomate medicine and biomedicine. As for doctors, some endorsed non-materialist vitalist notions, that is, the conviction that the functions of a living organism are regulated by a vital principle distinct from chemical and physical forces. This world of ill-defined jurisdictions was also apparent in the way healers and doctors practiced. If in 1867 the medical journal Revista Médico Quirúrgica reported that some doctors “declared they were quacks” in order to avoid paying professional matriculation fees, in the 1880s and 1890s it was said that certain quacks, after being pursued by the law, worked comfortably with professional doctors. In the late 1930s Viva Cien Años reported that there were doctors who worked alongside “healers and quacks with a curious enthusiasm.”41 Jesús Pueyo’s roaming is the wandering of a gray zone health practitioner. Dr. Santos Sarmiento, who had a long career as a lung specialist working in the Córdoba foothills’ public and private sanatoriums as well as in his own practice, recalls trying to dissuade patients who were demanding the Pueyo vaccine: “Time and again I explained to them that it’s nothing but water, it won’t do any harm or any good. But they didn’t care at all.”42 Dr. Santos Sarmiento’s statement clearly reveals a number of crucial issues in any history of disease, health, medicine, and science. First, the relevance of the sick person’s belief when dealing with their maladies and diseases in times of biomedical uncertainty. It is this belief and the desire to find an effective cure at any cost that at least in part explains the resilient

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presence of gray zone practitioners in general and the enthusiastic reception of the Pueyo vaccine in particular. Second, the limitations of the process of medicalization present during the last decades of the nineteenth century and the first decades of the twentieth bears the obvious but frequently forgotten fact that the so-called medical power and its institutions had a modest presence in the Argentine urban world of those years and even more so in the countryside. Third, the medicalization of society is always an incomplete process because the relationships between society, culture, the environment, and disease are unstable. Consequently, times of biomedical uncertainty abound as a result of changing collective immunities, changing microorganisms that can become more or less resistant, and specific treatments and preventative responses that, as in the case of tuberculosis, were not quick and effective. Fourth, while the medicalization process does produce plenty of historical evidence, both material and discursive, that tend to celebrate biomedical triumphs, the healing initiatives generated in its margins or outside its realm of knowledge do not. Hard to find, these fragmentary evidences reveal that when dealing with diseases—and with more intensity in times of biomedical uncertainties—people use whatever is available in order to get some kind of relief. These considerations are some of the reasons for underscoring that a history of tuberculosis in Argentina, and for that matter any history of a given disease in any place, needs to deal with medical doctors as well as healers and health practitioners of any sort, even quacks. The trajectory of Jesús Pueyo and his vaccine is just one of the many episodes that populate both the history of tuberculosis and of the gray zones of Argentine medicine.

{ 12 } Doña Hermila Diego Zapotec Healer, Entrepreneur, Social Activist, Media Star in Modern Mexico

Gabriela Soto Laveaga

Though nearly seven decades have passed, Doña Hermila still describes in hushed tones when she walked into a small hut and saw a dead woman on the f loor. Hermila was seventeen—the same age as the young woman who for more than two days had been in painful labor. Now that woman lay splayed on the dirt floor surrounded by bloodied rags. Word had spread in the village that she was dead or very close to dying and still her child was “unable to come out.”1 Hermila had never delivered a baby; in fact, she had never seen someone give birth, but the town midwife, on the pretext that she was needed faraway, had refused to treat this particular woman, for, if the patient died while in her care, the midwife was responsible for her death. Hermila Diego did not know this—she simply saw someone who needed help. Gingerly, she leaned over the woman and heard the faintest of moans. It was 1949 and her first patient was still alive, barely. Twenty-first-century rates of Indigenous maternal death in Mexico are still alarming. One of the nation’s most comprehensive studies on maternal death in Oaxaca reported that “two of every three women (64 percent) who died in Indigenous municipalities did not receive any medical attention before their deaths.” These statistics are especially troubling because Indigenous maternal care was not headed in this direction.2 These numbers are more impactful because these were deemed preventable deaths. In short, the majority of these women died 189

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because they did not have access to primary care or they died in transit to a distant clinic or hospital. Some professionals have long argued that trained Indigenous midwives could bring these numbers down. In 1949 a teenaged Hermila did not yet know that her neighbor’s experience with labor that evening was typical for a poor, uneducated, Indigenous pregnant woman in Mexico. Yet that moment impacted the rest of her life and led her decades later to fight for the rights of traditional healers and midwives to practice their profession in modern Mexico. Surrounded by glass jars brimming with dried plants that cure fright, evil eye, diarrhea, and infertility, one of Oaxaca’s most famous healer-midwives tells the story of that day and finishes by reflecting that it has not been easy to be an Indigenous midwife in Mexico. Hermila Diego Gonzalez, eighty-five, better known as Doña Hermila, sits surrounded by two boxes that seem to contradict that statement. The boxes overflow with diplomas, conference programs, and newspaper clippings that attest to years spent conducting her own radio show and frequent television spots, as well as lectures given in Hawaii, Oregon, California, New Mexico, various Mexican states, and other Latin American countries, like Colombia. In addition, her modest living room walls are tightly packed with framed pictures and diplomas from international organizations, such as Doctors Without Borders. What can the focus on the life, struggles, and successes of an especially renowned midwife and herbalist tell us about healers whose existence is celebrated as part of the cultural wealth of Mexico but whose role as healers remains problematically (and rigidly) outside official health centers? Today, enveloped by the evidence of both national and international success, she nonetheless adds that it has been weeks since she saw a patient, that Mexico’s recent health reforms again disparage midwives, and, she repeats, her normally animated hands now limp and heavy on her lap, that she is tired, that her life—“ha sido dura”—has been hard. Indeed, while traditional healers, herbalists, bonesetters, and midwives remain the pivotal backbone of twenty-first-century rural health care, they continue to exist independent of officially sanctioned care. This essay traces Doña Hermila’s life as a touchstone to understand Mexico’s complicated and seemingly erratic attitude—equally shunned by official state medicine and revered as repositories of Indigenous knowledge—toward midwives and traditional healers. Before delving into Doña Hermila’s practice as a traditional healer, the use of the term “traditional” merits a fuller explanation. Medicina tradicional is the official term used by the Mexican Ministry of Health to designate practices and

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knowledge related to health and illness held by “pueblos indígenas originarios” (native Indigenous people).3 If one refers to the official Ministry of Health page it emphasizes “corporal equilibrium” and “vital force” as well as different elements that restore a balance between an individual’s hot-cold equilibrium as the means to explain the broad gamut of sanctioned healing beliefs. Yet it is not only the Mexican state that uses this term. Doña Hermila and her colleagues proudly and purposefully use the terms medicina tradicional (traditional medicine) and médico tradicional (traditional doctor) as well as curandero (healer) to differentiate their practice and approach to the human body as different yet at times complementary to Western medicine. Medicina tradicional as used by Doña Hermila and other Indigenous healers acknowledges differences in medical practice, and they have been fighting to ensure that this difference does not translate as inferior to official medicine. For some Western-trained physicians, however, the term traditional holds a negative connotation. In this essay I use traditional doctor and healer interchangeably and as intended by the healers themselves. LEA R NING TO HEA L

Wearing a traditional Zapotec huipil, a tunic embroidered in vibrant colors, and two cream-colored sweaters, one on top of the other, to fight off the unseasonably cold January weather in Oaxaca City, Doña Hermila sat down at her dining table in early 2018 and recalled that fateful day when she thought that a fellow villager, Susana, had already died in childbirth.4 She was still in her teens when the parish priest sent a small child to her house with the urgent message that Susana still had not, after two full days of labor, given birth. The town’s midwife was staying away in another town and the priest, called by the husband to perform the last rites, instead sent for Hermila. She tried to explain to him that she was not a midwife, she was not even a healer, that she simply helped rural health promoters translate from Spanish to Zapotec during vaccination campaigns, but the priest refused to listen. Community members had seen her with the outsiders—the visiting doctor and his attendant—had observed her giving injections, and had heard her repeat a memorized script about the importance of vaccination and hygiene. For the priest, this may well have been enough, or he may have implicitly understood that Hermila, like her aunt, was born with the gift of healing. He marched her over to Susana’s hut and, announcing that he had found someone to replace the midwife, thrust her into a life of healing.

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There are certainly different ways to become a midwife, yet there is only one way to be certified a healer. The state is the arbiter of who can legitimately practice medicine and, more important, what type of healing is officially sanctioned. The registry of medical practitioners, for example, mentions licensed midwives for the first time in independent Mexico in 1852. In that year seven midwives were registered in Mexico City. A few years later, in 1866, that number increased to twenty-four. Yet these numbers are not conclusive, nor do they reveal the extensive use of midwives.5 They do, however, reveal the formation of a new health care provider in the mid-nineteenth century—professional midwife—created to wrest medical power from Indigenous midwives.6 The creation of a licensed midwife, or partera titulada, was not the first attempt by medical authorities to regulate midwifery among the Indigenous population. In 1750 the Royal Protomedicato ruled that in Spain and all of its territories, any midwife who faced a complicated birth must call upon the expertise of a surgeon.7 Moreover, colonial medical authorities defined midwives as those who had apprenticed at least four years with an “approved teacher,” had a pureza de sangre certificate, could provide references to her good conduct, and, additionally, deposit 63 pesos.8 Not surprisingly, until 1831, when the Protomedicato was abolished, only two women in Mexico managed to meet those requirements.9 Yet the majority of births in colonial and nineteenth-century Mexico were overseen by midwives. In Bernardino de Sahagún’s sixth edition of his General History of the Things of New Spain (1582), a work that details the broad gamut of cultural and social Nahua practices as conveyed by native informants, the many duties of the Aztec tlamatlquiticitl, or midwife, are described. These duties spanned pregnancy—when the midwife monitored the mother—up until the child was two years old and could finally be weaned. In addition to preparing herbs, giving massages, and communing with the gods, Nahua midwives prepared a temazcalli, known as a “house of heat,” during which they skillfully palpated and repositioned the fetus if needed.10 While other health professions initially dominated by women have diversified (i.e., nursing) parteria tradicional remains solidly a feminized profession, one of practitioners often passing on knowledge from one generation of women to the next. That night in the small hut, a young Hermila had yet to learn how to use her rebozo to lightly sway the patient’s hips back and forth and then slowly palpitate the fetus while gently guiding it to the correct position for childbirth. There were two additional women in the room that night, relatives of the pregnant woman, and both were clearly frightened and exhausted. Hermila instinctively

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put them to work, asking one to boil water while sending the other to get cold water. Meanwhile she began to speak to the young woman, who continued to faint from pain. Between contractions, she turned to Hermila and told her that they should let her die. Hermila recalls saying in a loud voice that startled her and the patient, “Only the lazy wish to die and you are not lazy.”11 For Doña Hermila, growing up in San Melchor Betaza, a speck of a town in Villa Alta in the Zapotec region of Oaxaca, was precarious, and laziness was a luxury no one could afford. Doña Hermila’s early years before she became a midwife were full of poverty and strife. Focusing on some of her personal details before she became a healer permits us to understand her initial attitude toward healing: mainly a support to other forms of income. Only decades later would she embrace traditional medicine as her true calling. As a child, there was never enough food, and violence both within her family and in her village was common. Oaxaca has a long history of violent land disputes that have often frayed a community’s social fabric. In fact, one of the most impactful memories from childhood occurred when her grandparents were run out of town at gunpoint. She was seven, too young to understand the exact details of the events leading to her grandparents’ ouster from the village but old enough that it left an impression. They left their home with only the clothes on their backs, and they never returned. Little Hermila, whom they had raised as their own daughter, was left behind, along with all her grandparents’ belongings and the fields that they had worked for decades. The abandoned home, within view of Hermila’s parent’s front door, was never inhabited again. Though it was frequently ransacked, the village people took care to stay away, considering it a cursed space. The grandparents’ move was especially hard for Hermila, who had long sought refuge from her mother’s temper in their home. Shortly thereafter, Hermila began a new, somewhat rootless life in which she was shuttled between her parents’ home and her grandparents’ new home in a distant village. This peripatetic lifestyle affected her schooling. Indeed, she would not learn Spanish until she was fourteen, although she understood much earlier that speaking Zapotec branded her and her schoolmates. She recalls a teacher in Villa Alta punishing her and her friends by rapping them on the head if they responded in Zapotec or spoke to each other in their language. For, the teacher explained, there simply was “no place for Zapotec in school.” The implication that Zapotec culture was neither welcome nor worthy was an attitude that she would later find especially problematic in health settings. A young Hermila observed these reactions and earnestly studied

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Spanish. It was her ability to speak Spanish that put her in contact with Mexico’s rural public health campaigns.12 Mexico has a long tradition of vaccination campaigns. Doctors or nurses from urban spaces would fan out across rural, Indigenous Mexico and line up children and adults to vaccinate them against smallpox, polio, tetanus, and other diseases.13 In areas where Spanish was not dominant, doctors relied on local people for aid. It was on such an occasion that the village priest recommended Hermila as a translator, who, while not fluent, could understand Spanish better than her peers. Locals, long cheated out of land and crops, distrusted outsiders, including physicians. Most rural Indigenous Mexicans rarely saw a doctor. There were few rural health facilities, and in an emergency, if the patient managed to stay alive long enough to arrive at the clinic, there was seldom enough money to pay the doctor. Moreover, the overt racism Indigenous Mexicans faced—and still experience—in health centers often kept many away. So locals relied on healers, bonesetters, midwives, and an assorted collection of folk remedies passed on from family to family. Also, everyone prayed to never get sick. Because of the villagers’ distrust, Hermila explained how vaccination campaigns were often composed of three essential members: the doctor (or nurse), the local interpreter, and a policeman. The role of the policeman was to stand visibly to the side as a reminder that adults who refused to vaccinate their children would be thrown in jail. Hermila’s role was pivotal. Speaking in Zapotec she would explain to concerned parents that vaccinations were a preventive measure, and she would gently cajole unwavering parents, and, if needed, gesture toward the policeman, attentive and watching from the sidelines—always staying within their line of sight. If parents resisted, the doctor would then step in and, through Hermila, tell them that they had no choice. If parents did not comply with the vaccination campaigns they could be thrown in jail. In a likely attempt to give her more perceived power, the doctor taught her to vaccinate. It helped that she was a local girl. It helped tremendously that she spoke Zapotec. It may have surprised the locals to watch her deftly inject waiting arms with the approval of the doctor. Despite this, when they returned to give booster shots she was occasionally met by angry, shouting parents who vehemently refused to have her children vaccinated again. They blamed the vacuna for the fever and general malaise that babies and young children often experienced after getting their first shots. In spite of these occasional bursts of anger, by age seventeen her reputation as a “promotora de salud” (health promoter) was cemented among the townsfolk. That fateful night when Hermila was thrust into her first role as midwife,

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Susana, who was likely familiar with her neighbor’s role as a health promoter, turned to Hermila and asked her for something to stop the pain. Hermila was at a loss. She was decades away from learning the language of plants, the gentle communication of flora that rely on conduits, like Hermila, to let their healing properties be known. On one of the many occasions when journalists interviewed an older Doña Hermila, she explained how this communication with plants “worked.” She explained that when she closed her eyes and concentrated on a patient, she saw moving images, as in a film, of the plants that could heal the individual.14 The plants “came to her” and she could feel how they guided her. On her travels she sought to expand her knowledge and acquaint herself with the information of local herbalists and so “when I went to Hawaii and to New Mexico healers there took me to meet their plants.” While she certainly learned about different species from colleagues, a sort of instinct took over and she “simply knew” which plant to pick and how to prepare them. Plants, she explained in an interview, are sacred because they are alive, yet in order to heal, plants must die. Thus, before each healing session she asks permission and forgiveness of mother Earth. With closed eyes and hands lightly extended she prays in Zapotec before switching to Spanish. She asks Earth for help in aiding her brother (or sister) who is ailing from “x,” adding that she is a mere humble servant, a channel to help them heal. She then prays to the Virgin Mary so that her hands may only perform good deeds and adds a special request to el niño Jesus, her patron. Finally, she again thanks her “sister plants” for their sacrifice. That night with Susana she had neither plants nor an understanding of the rituals that transform them into healing poultices or teas. She also had little knowledge of the female body. At seventeen, she had not yet gotten her period. Hermila’s delayed onset of puberty may be linked to her lack of nutrients. Hermila was nineteen and already married when she got her first period, well past the median age for menarche. When asked if she saw a doctor or was concerned about her period’s delay, she said that no one noticed. At the time, she explained, no one spoke about the body, especially the female body, most certainly not periods, or the “dirty” (sucio) act of childbirth. After a fellow student stained her skirt with menstrual blood, Hermila asked her grandmother what happened to the girl. Her grandmother responded that one “did not speak about such things,” so she never asked again.15 Though she had never witnessed a birth before being asked to help Susana, years earlier she had heard her aunt through the walls tell a woman in labor to gently breathe. That night with Susana she demonstrated what she herself had

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only heard through wood slats. But Susana was too exhausted to listen. Instead she again weakly asked Hermila for a shot to make the immense pain go away. In her bag, Hermila had an ampule of vitamin B-complex given to all health promoters. She made a show of pulling it out of her bag and instead of gently injecting her, as she had been taught, she rammed the injection in Susana’s arm, making her shriek in pain. It was this action—the involuntary push when Susana arched her back in pained reaction to the needle—that, Hermila surmised, expelled the baby. MIDW IVES A ND THE MEXICA N STATE

At the beginning of the twentieth century it was increasingly difficult to be a midwife in Mexico. In 1911 a new prerequisite established that future midwives must first become nurses, and so the profession of “enfermeras parteras” (nurse-midwives) was created.16 To obtain a license, a student spent two years studying nursing and the following two years she learned obstetrics. By 1918 the medical profession conferred an inferior status on these nurse-midwives until all duties formerly performed by midwives were taken over by obstetricians and gynecologists.17 Meanwhile, as pregnancy and labor became more institutionalized, the role of the independent, licensed midwife diminished as most began to work within the hospital system. Indigenous midwives, however, continued to practice freely in rural areas, and by 1930 some began to receive courses given by the state, transforming them into “parteras capacitadas o adiestradas.”18 Yet reports from medical students writing from rural Mexico are teeming with depictions of midwives with “nails blackened by filth,” who were unkempt, malodorous, uneducated, and “dangerous.”19 As anthropologists increasingly documented the lives of Indigenous Mexicans for state institutions, such as the Instituto Nacional Indigenista (INI, or the state’s incursion into Indigenous communities), public health institutions steadily closed the door on Indigenous healing practices. Even films with mass appeal, such as The Forgotten Village (Pueblo Olvidado, 1941), often portrayed Indigenous healers, especially midwives, as unambiguous villains of modern medicine, fearful that physicians would displace them and their hold on the lives of villagers.20 For Indigenous midwives, it was progressively difficult to practice their profession. By the late 1940s when Doña Hermila encountered Susana in childbirth, Indigenous midwives were seen as detrimental to modern Mexico’s health

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goals. This was due in part to the emergence of new hospital centers, such as IMSS (Mexican Institute for Social Security) in 1943 and ISSSTE (Institute for Social Security and Services for State Workers) in 1959 that incorporated Western-trained, nurse-midwives into the state health care system. As others have pointed out, initially midwives’ “presence was essential for hospital births to be accepted.”21 Yet by 1962 the hospital midwife position was eliminated. At that time, Mexican health regulations ruled that birth was a “high risk action” for women, and health policy makers argued that because midwifery training did not include surgery nor did midwives have the right to issue death certificates they could no longer be sanctioned by health governing bodies.22 Furthermore, the emergence of specialized obstetrics and gynecology hospitals shut out midwives when it was deemed that only “physicians and obstetric surgeons”23 could work in these spaces. Then as now, however, hospitals were principally for urban-based Mexicans. Rural Mexicans, like Hermila, could and often did live a lifetime without encountering a state health official, let alone a clinic or hospital. In fact, Hermila encountered a doctor for the first time in her village as a teenager when the vaccinators came to town. With limited access to health centers, it is thus not surprising that maternal and infant mortality in rural Mexico was high.24 Returning to that pivotal night, the baby, the first newborn Hermila had ever seen, was blue. The other women in the room told her to focus on the mother since the baby had, sadly, died. But Hermila felt she needed to focus on the child. Not knowing what to do, Hermila asked for hot water and dunked the tiny body in the water. She felt him drape “like a limp rag” over her arms, so she asked for cold water instead. It was when she dunked him in cold water that she saw the newborn move slightly. Rubbing her bloody hands on her clothes, she stuck her index finger in the baby’s mouth and he let out a weak whimper. She had never seen a placenta and when this started to fall out she turned, puzzled, to the older women, one of whom explained that this was the baby’s casita, its home. But it was stuck. Susana was dying and the placenta needed to come out.25 THE BUSINESS OF HEA LING

Though Hermila had an instinct for healing, it was not what she wanted to do. She loved learning and desperately wanted to become a village teacher but there was little continuity to her studies. She somehow completed grade school at sixteen, not uncommon for both boys and girls in her village who often went

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without a proper village teacher for months or even years. Yet she was bright and especially good at math, so when she finally finished grade school, her teacher encouraged her to take the entrance exam for a teacher’s college in Oaxaca City. Nervous about taking the exam, she convinced two friends to study with her and also take the test. Though they all passed, Hermila was the only one who did not continue her studies. Although room and board were included, she needed fifty pesos (about four dollars at the time), a fortune for a poor, rural family to make it to the city and pay the initial fees. Her father refused to lend her the money and, though it had been her goal, she instead watched as her two friends headed off to live the life she had imagined for herself. Nearly seventy years later, it was still one of her major life disappointments, “For fifty pesos. Imagine. For the lack of fifty pesos I did not become a teacher.” Disheartened, she did not consider midwifery again until a few years later when her own sister Irene, then twenty-four, bled out and died during labor, leaving two small children behind.26 Hermila decided that she had had enough of death, especially maternal death. If she couldn’t be a teacher, she would become a midwife. But, again, life intervened and she would have to wait nearly four decades to practice healing. By the mid-1940s, rural to urban migration was on the rise in Mexico. At nineteen, now married but still poor, Hermila and her new husband migrated to Oaxaca City, joining the thousands of Mexican rural poor who traveled to urban centers in search of employment. Though she was circumspect about how she initially learned to heal, she definitely learned from her father how to sell goods, medications, and herself as a healer. Her father, an itinerant salesman, traveled the Chinantla—the rainforest region sandwiched between the states of Oaxaca and Veracruz—from village to village selling his wares. From the age of eight, Hermila often accompanied him on his rounds. They traveled for as long as a month, walking all day, stopping in villages and sleeping in the woods at night. They carried a bundle of local, dried, long tortillas (tlayudas) smeared with black bean paste, and drank from streams. On his travels, locals often asked her father for remedies for persistent aches and pains, and especially a treatment for malaria, endemic in the region. Always looking to sell, he taught himself how to prepare teas and ointments from local herbs and would prescribe them to his customers. Though he did not consider himself a healer, he learned which plants heal susto—fright—and villagers requested more remedies for mal de pinto—a disease endemic in southern Mexico that can cause changes in skin pigmentation—as well as treatments for tuberculosis, another common ailment in the area. Hermila never forgot that regardless

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of where they went, people seemed to desire the same thing: they always asked for cures, and rural people were always in need of a healer. For Hermila, a growing understanding of how the consequences of poverty and health care inequities in rural Mexico—as with her sister’s preventable death—more than an initial desire to cure others pushed her to become a healer. Ambitious, and with a keen intellect, her gender and ethnicity, however, limited her opportunities. Just as she embraced her calling as a healer, major changes began to happen in Mexico’s rural health care systems. GLOBA L HEA LTH A ND IMSS-COPLA M A R

Doña Hermila was almost forty when in 1974 the World Health Organization declared that the participation of “traditional practitioners was needed in community health activities because it was operationally impossible for academic medicine to treat all the population of the developing world, especially those living in rural areas.”27 In Mexico this global dictate to include traditional healing methods translated into a major national health initiative known as IMSSCoplamar and a more regionally focused project built on existing INI, programs.28 IMSS-Coplamar was an especially noteworthy health initiative because it focused on local health needs and scaled up from the community level. This meant that local causes of infection, death, and morbidity were addressed directly and with local solutions involving the inclusion of traditional doctors and healers in an official capacity. Anecdotally the program was welcomed in rural communities accustomed to plural forms of healing and a broad roster of healers. Official numbers support the enthusiastic memories linked to IMSS-Coplamar. For example, in 1983, 11.5 million rural users were linked to the program and a mere two years later, in 1985, there were 13.7 million.29 Health initiatives linked to the program zeroed in on states with a meaningful Indigenous population. In Oaxaca, Doña Hermila, who by the mid-1980s had become a well-known and respected healer in Oaxaca, played a significant role in both health projects. But before examining her participation it is important to pause to ask: what happened in the two decades between her sister’s death in labor and the arrival of health reforms to Oaxaca that transformed a reluctant healer into a well-known herbalist and midwife? As mentioned above, Hermila moved to Oaxaca City with her new husband. Hers, however, was not a happy marriage. Plagued by poverty and lack of opportunities, her husband drank too much and was often physically violent.

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Moreover, he controlled their finances, and when he went on drinking binges, she often had an empty pantry. Later, with three small children and needing to provide for a growing family, she began to sell cooked meals from outside her home. With time she incorporated small trinkets to sell and discovered that she, like her father, had a knack for commerce. Her children were still young when she learned that her husband was building a house for his second family. Infuriated, she left him and took her, by then, five small children and moved in to what was meant to be the lover’s home. It was this rupture in her family life that set the ground for her to fully embrace traditional healing. As an Indigenous, single mother living in Oaxaca City in the 1970s, Hermila needed to make a living. Her decision to pursue healing at this time allows one to appreciate how she merged her entrepreneurial spirit with a demand for rural health services, a pursuit that eventually led to personal fame. Hermila noticed that people in remote villages paid a bit more for goods if they were transported to their doorstep, so she started a transportation company. From one borrowed old car her business grew to five vehicles with several drivers traveling rural Oaxaca on her payroll. Though she always traveled with one driver to keep tabs on the business, she felt her time was wasted when the driver was out making deliveries in each town. She instead came up with the idea to have her drivers advertise that in their next delivery a curandera (healer) would be traveling with them. The driver would drop off Hermila in one town, continue on his route, then loop back in the afternoon to pick her up. In the interim the sick and ailing would have time to consult with her. Within a short amount of time she was traveling with medicinal plants and homemade lotions and creams to sell in the various towns. Her fame grew to such a degree that rural patients started traveling to Oaxaca City to have her treat them. It was not long before anthropologists also came to her door, keen on recording her knowledge. Indeed, federally funded projects (primarily INI and IMSS-Coplamar) of the early 1980s focused on health in rural Oaxaca. These were short-lived programs yet remarkably successful. Recalling these inclusive health initiatives, Doña Hermila spoke of a state “embrace of traditional healers” as an optimistic period in which government funds brought traditional doctors together to organize, and, most importantly, learn from each other. Influenced by global health dictates, these health programs incorporated Mexico’s multiple healing beliefs. IMSS-Coplamar, for example, encouraged the construction of community herbal gardens filled with traditional healing plants, relied on midwives to teach family planning, and issued identification cards to

Figure 12.1. Working with candles after performing a limpia, a spiritual cleansing ritual, Doña Hermila Diego stands in her home office surrounded by plants, tinctures, and Western medicine used to heal both spiritual and bodily ills. Photo credit: Gabriela Soto Laveaga.

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traditional healers, certifying them as traditional doctors of the state. Yet what was happening outside the state-led initiatives at the same time was perhaps more significant: A collective of traditional doctors came together to legally seek protection for their healing practices. It was no longer the state setting the limits to define who was a healer in Mexico; it was traditional healers themselves who were collectively defending their medical knowledge while redefining the parameters of acceptable health provision in the state. In dozens of meetings, healers from across various states came together to first deliberate what they wanted and then determine how they would achieve it. The early 1980s public health scene seemed to be one of genuine optimism for traditional Indigenous healers, a new era where plural healing practices would be acknowledged as equally valid.30 It is at this time that small organizations of Indigenous healers begin to crop up, usually near places where there was an INI office or near where state-sponsored traditional healer workshops had taken place. Their assembly became a space not only for the exchange of ideas but also from where they produced new definitions of what constituted a healer in Oaxaca. Doña Hermila and many of her Oaxacan colleagues were caught up in this moment. Ironically, Hermila, who had long eschewed a life as a healer and midwife, found herself front and center in this move to legitimate traditional healing practices in the state of Oaxaca. When Doña Hermila was named president of the local association of traditional doctors, she became a healer-activist in the process. A 1983–1984 census overseen by the IMSS-Solidaridad program found that there were 13,034 traditional doctors in 3,132 communities where the program was in place. In other words, there were 4.1 traditional doctors for every physician in a rural clinic—and as many as 8.2 in places such as Tabasco.31 Despite being primary care providers for the vast majority of rural Mexicans, most traditional doctors were not seen as legitimate healers. Today, nearly every single constitutional reform linked to traditional medicine in Oaxaca is the result of community action on behalf of midwives, healers, herbalists, etc.—individuals such as Doña Hermila. By the 1990s, Doña Hermila was a locally acknowledged cultural authority who as a leader was shaping the state’s view of traditional medicine—“La sabia de Oaxaca,” or the sage of Oaxaca, as a local paper would later describe her. While she was certainly not the only healer to be featured in the Oaxacan press, she was often the one speaking at events. Moreover, she wrote and published her experiences as a healer, cementing her authority. For example, as part of the memoir of the founding of an organization for traditional healers that she helped organize,

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the INI published her particular memories of that event. It is from these writings that we know that during four years (1984–1988) traditional Indigenous healers and midwives came together more than forty times in the Mixe and Chatino regions and that these local meetings finally culminated in a state-wide reunion of healers and herbalists in Temascal.32 Shortly thereafter, in a 1988 assembly, traditional Indigenous healers voted to move beyond regional organizations and seek national representation for “respect and recognition” of their medical knowledge. A first regional organization of Indigenous doctors from the Mixteca Alta (Omima) emerged from these talks in 1989, as did shortly thereafter, in 1994, the national organization Cemito or the State Council for Indigenous Traditional Doctors (Consejo Estatal de Médicos Indigenas Tradicionales). Doña Hermila was voted the first president of Cemito. Doña Hermila recalls feeling that there was genuine support from the state, including financial backing for traditional doctors. Indeed, among her personal papers, she saved an undated letter from the INI that initially accompanied a check for $137, 465 pesos to the Consejo Estatal de Medicos Indigenas Tradicionales de Oaxaca. Many of the initial meetings were to determine what to do with unexpected state funds. All healers agreed that they needed a space to meet and treat patients and for visiting healers to find a place to stay that was independent of the state’s health centers, which, despite programs such as the one they were currently a part of, continued to exclude Indigenous doctors. Hermila and her board of directors voted to buy a plot of land in Santa Rosa, near Oaxaca City, with plans of eventually building a space for traditional doctors to come together to meet and treat patients. Using state funds and donations from neighboring communities, Cemito broke ground. Pictures of the event show Doña Hermila holding a shovel staring solemnly at the camera. Cemito’s founding documents reveal the ambition and vision of this group of traditional healers. In addition to “strengthening Mexico’s real health system,” the organization’s goals echoed some of Hermila’s early experiences with poverty by seeking to end “the financial insecurity of Indigenous traditional healers so they may enjoy a dignified life that allows them to strengthen state and national health systems.”33 While Cemito sought to “better the health of Mexicans,” it also sought to reduce inequality among “urban zones and rural and Indigenous communities.” Through Cemito, Hermila, who had long-harbored dreams of studying in the big city (Oaxaca City), joined other healers to emphasize the inequality of the urban/rural divide. As the founding document emphasized more than autonomy, they sought legitimacy and recognition. Citing the dire

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conditions in Indigenous communities—“lack of water, sewage, schools, doctors, food, etc.”—and how these led to higher rates of chronic diseases, high incidences of disease that had been eradicated elsewhere in Mexico (i.e., onchocerciasis) as well as “traditional diseases such as evil eye, fright, empacho,” traditional doctors began to demand more than a passing show of support. The INI had created platforms—workshops, conferences, teach-ins—where healers from different states came together and learned from each other. Despite the conviction to assemble healers to commemorate Mexico’s long and rich history of Indigenous healing practices, these celebrations did not translate into permitting healers to practice their craft in state-led health institutions. The idea to form an organization independent of the state slowly began to take hold at these official reunions. “We struggled a lot to define what it is we wanted but we agreed that if we were going to be a group we needed to be recognized by the Ministry of Health. We wanted [the Ministry] to grant us the right to practice in the clinics and small hospitals of the comunidades.”34 In conversations with Doña Hermila, she made clear that she did not plan on becoming a defender of the rights of traditional healers or ensuring that the government would see them as equals to their Western-trained counterparts. Yet her ability to communicate and her restless ambition again placed her in an unexpected position of power, this time as president of the first Indigenous-led organization of traditional doctors and midwives. Organizing was not easy, in part because none of these midwives, healers, bonesetters, sobadores (those who heal thru massage) and hierberos (those who can heal with plants) had belonged to such a group before. As with most social reformers, healers discovered that a simple desire to have something happen was not enough. They learned that they needed to schedule reunions, vote to have representatives and delegates from different communities, select their leadership, and have consensus about their goals. Most important, in order to seek financial support, they needed to be a legitimate organization, a civil association. “So we got our seals, our name,” Doña Hermila explained, stating that the desire to belong to a larger representative body was such that within a matter of months, twenty local organizations of traditional healers emerged. As president of Cemito, by the 1990s and early 2000s Doña Hermila could be heard on the radio speaking about medicinal plants and traditional medicine. Locals would call in and explain their ailments, and Doña Hermila would offer a diagnosis and treatment. The radio show was a hit and ran until 2006 when, according to her, APPO protesters took over and destroyed the local radio station.35 Most often cures consisted of teas brewed with plants readily available

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in Oaxaca’s central market for a few pesos. If a case was more complicated, say, an empacho36 or susto37 or mal de ojo38 she recommended patients consult her in person at her home. The number of patients increased to the point that she transformed her carport into a waiting room with several chairs to accommodate the demand. In each radio segment, she spoke at length about a particular plant, explaining its properties, or speaking about her experience as an herbalist and midwife, educating the listening public in sixty-minute segments about traditional ways of healing. Her personal papers show that she also appeared quite a bit in print at this time, for example, in an undated newsletter with a special section “El Rincón de Doña Hermila” (Doña Hermila’s Corner) where she wrote a column about medicinal plants. Academics also took note. Medical anthropologists from the regional CIESAS (Centro de Investigaciones y Estudios Superiores en Antropología Social), the state university, and foreign researchers documented Doña Hermila’s knowledge about midwifery and medicinal plants for articles and books on traditional healing.39 In addition, she appeared in several television segments on traditional healers, including on the popular El y Ella, which took on couples’ issues. Hermila’s personality—a nimble storyteller, soft-spoken yet firm with a quick mind—came thru via radio and television. Not surprisingly, her name recognition and her reputation as a dependable healer soared.40 Crucial to her rise in popularity was the West’s embrace for alternative healing practices and Mexico’s own changes in the health care system that appeared to engage with traditional healers in new, respectful ways. At this time, Doña Hermila also embarked on a series of international appearances across the southwestern Unites States and Hawaii. At the age of sixty-six, Doña Hermila, who initially rejected a life of healing, had become the representative of Mexican Indigenous healers, as described in official letters of introduction from the INI. In August of 1998, for example, she traveled to give a workshop in New Mexico accompanied by written permission to travel with herbs, “ceremonial instruments,” “medicines made in the home,” and “other objects to practice medicine.” As the director of Oaxaca’s INI wrote, “She travels representing the Indigenous people of Mexico and of Oaxaca.”41 In the following two decades she gave workshops on traditional midwifery and Indigenous herbs (“honoring diversity in midwifery”) in San Diego, San Francisco, Maui, Albuquerque, and Park, Colorado. A handwritten letter of appreciation from a midwife—“Shannon from Maui”—excitedly reported how Doña Hermila’s teachings had impacted her own practice. The midwife from Maui had tried the rebozo technique on a

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difficult pregnancy to “sway the mother’s hips,” and safely delivered “a big baby boy.” She was deeply grateful to Doña Hermila and sought to put her in touch with an herbalist friend, Rosemary Gladstar, whose beginner’s guide to medicinal herbs is a staple for home remedies. Doña Hermila’s network was expanding as she spread Zapotec traditional healing methods well beyond the confines of Oaxaca. Not all her colleagues were pleased with her accomplishments, though. Tensions arose between Doña Hermila and some traditional healer colleagues who may have interpreted her success as personal ambition. And not all health professionals welcomed incorporating healers into the nation’s health services. Hermila recalled countless example of being snubbed or ostracized by medical personnel. Yet there is one case in particular that stood out to her—a young doctor at IMSS who openly questioned her practice and her knowledge, telling her, “You didn’t study. I burned the midnight oil (me quemé las pestañas) for seven years and what have you done?” She explained that she too had spent years learning about plants and ways to best heal an injured or ailing body. But the doctor scoffed at her and dismissed her practice as “cosas que no sirven”—things that do not work. It was such interactions, however, that pushed the group of Oaxacan traditional doctors, their preferred term, to renew their efforts to seek legal recognition. As they explained, it was not simply Indigenous healers who were mistreated by state health officials, doctors, and nurses, but the lives of Indigenous patients were often put at risk because of racist treatment in Mexican medical centers.42 After years of efforts they were successful in changing the Oaxacan constitution. In 2001 Oaxaca’s constitution was amended to explicitly mention health for Indigenous communities and Indigenous healing systems, specifically articles 68 and 69 guarantee that “health services must be planned in conjunction with and with feedback from interested communities, taking into account the financial geographic, social and cultural conditions, including their traditional medicine.” In addition, article 69 insured that state funds would be used to research traditional medicine and provide jobs for its practitioners.43 Despite these successes, constitutional reforms did not translate into significant changes in practice. In 2004 Mexico rolled out Seguro Popular, a universal access to health insurance program. The main targets for inclusion to Seguro Popular were the unemployed, the poor, and rural inhabitants who were not covered by Mexico’s extensive and already existing health care systems (primarily IMSS and ISSSTE, which provided coverage via work). Previous health programs, such as the popular IMSS-Coplamar in the 1980s, were designed to incorporate Mexico’s plural

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healing systems into already fragmented national health programs, and yet these faced financing difficulties and were defunded by new presidential regimes. While Seguro Popular increased access to health care, it also standardized care by providing a menu of covered care.44 Traditional doctors and midwives were not part of the established covered care. According to Doña Hermila, by not including Indigenous healers as part of these health reforms, it was “teaching new generations that we have no value (que no valemos).” In the years since the rollout of the new health program, anecdotal evidence suggests that Oaxaca’s traditional healers and midwives saw a steady decline in patients. Undaunted, the state’s healers continued to meet and sought to educate others about their ways of healing. For example, in 2008 Doña Hermila and other healers set up a stand in one of the busiest tourist corridors in Oaxaca City as part of the first Foro Estatal para el Fortalecimiento preservación y Difusión de la Medicina Tradicional en Oaxaca (state-wide forum for the strengthening, preservation, and diffusion of Oaxaca’s traditional medicine). As a blogger who covered the event reported, their intent was to show people that they could trust traditional medicine, and by extension, healers who used traditional healing methods such as plants. “This [healing with plants] is not new but people have tried to hide it,” Doña Hermila is cited as clarifying, “Thankfully we are now retaking what our ancestors taught us.”45 As part of that day’s teachings were the properties of specific plants, for example, albahaca or basil. “Albahaca is used to heal with other herbs and we use that to do a limpia, to extract air, the bad energy that one might have with them. If I put a little bit of this plant on your heart [press it on the heart] the plant feels you and you feel her and with this we make an exchange. We then offer prayers to Mother Earth to ask for forgiveness for all that we have done. Plants are born to give life, and they gather all of the bad [in one’s body] and then they die.”46 Today Oaxaca’s Ministry of Health representatives regularly drive Doña Hermila to remote Indigenous communities (about a seven-hour drive) so she can help train a new generation of Indigenous midwives. The ministry employees are concerned that traditional ways of healing are being lost—while concurrently denying these healers access to their healing centers. Now well into her eighties, a breast cancer survivor with a heart condition and glaucoma, a frail Doña Hermila continues to travel to these small towns giving lectures in a profession that she insists chose her. Sitting surrounded by regional, national, and international recognition for her “immemorial healing knowledge,” she seems far removed from the frightened teenager who delivered her first baby decades ago. Though

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now a respected healer, she acknowledges that life for Mexico’s thousands of traditional healers continues to be dura, hard, and that in rural Mexico not much has changed in terms of maternal care offered to Indigenous women. FINA L THOUGHTS

Doña Hermila Diego’s path to become a respected, internationally renowned Indigenous healer did not follow a linear path. In fact, much of her life story calls attention to the challenge of practicing Indigenous medicine in modern Mexico. In the fall of 2017 Oaxaca’s Ministry of Health awarded Doña Hermila the prestigious Mujer del Año (Woman of the Year award) for a lifetime spent ensuring the preservation and recognition of Mexico’s traditional medical practices. In so doing, it was explicitly acknowledging the role of Indigenous healers in the state. Yet Hermila’s financially precarious position in old age—and steady decline in patients seeking traditional cures—illustrates how despite a rhetoric of inclusion, many Mexican traditional healers (even those as famous as Doña Hermila) remain solidly outside institutional medicine and the protection of the state. In 2018 the Ministry of Health published a pamphlet explaining that Indigenous traditional midwives could practice their profession “under supervision,” and that their practice was in fact covered by Mexico’s articles 6 and 93 of the Ley General de Salud as well as the Mexican constitution.47 The pamphlet went on to explain that despite constitutional support, Mexicans, including representatives of the secretary of health, as well as traditional healers, did not know that traditional medicine is included and protected under Mexican health law. 48 As Doña Hermila’s experience illustrates, however, in the twenty-first century, legal inclusion does not mean acceptance. In this short essay, the life of Doña Hermila Diego serves as a touchstone from which to examine a series of health initiatives and public health campaigns and their impact on the practice of traditional medicine in Mexico—from Hermila’s first encounter with health care via her aunt and grandmother, a healer and a midwife, respectively, into her teenage years when she first saw a Western-trained physician and surprisingly was selected to work as part of a vaccination campaign. She was also present when the INI began to make inroads in seeking to preserve the knowledge of traditional healers and again in the 1980s when the innovative IMSS-Coplamar sought to incorporate healers into Mexico’s health care system. From the Indigenous-led efforts to legally recognize traditional

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healers in various Mexican states to the successful inclusion of traditional doctors in Oaxaca’s constitution to becoming president of Cemito, Hermila had a prominent role. Yet despite the triumphs of local healers, she acknowledges that there is still much to be done to guarantee that Mexico’s multiple healing practices receive equitable representation. The National Institute of Public Health reported that in Mexico there are more than fifteen thousand traditional midwives, one hundred professional midwives with degrees (PP or parteras profesionales) and 16,684 individuals with degrees in nursing and obstetrics (LEO or licenciadas en enfermería y obstetricia), according to 2016 numbers.49 Yet according to published evidence-based studies, 80 percent of all deliveries in Mexico are overseen by medical personnel in training who demonstrate less ability than midwives made up of PPs and LEOs.50 Today, for example, there is only one midwifery training school in Mexico that is certified by Mexico’s Ministry of Education.51 Established in 1981, CASA is based in San Miguel de Allende in the state of Guanajuato. While CASA is the only official school recognized by Mexico’s Ministry of Education, it is not, however, the only program. Programs in Oaxaca, Michoacan, and Guerrero face significant challenges, including finding hospitals or clinics where students can intern and, once they have graduated, work. In some ways, the current panorama in Mexico is not so different from the years when Doña Hermila was seeking recognition to forge a community between medical peers. Yet there are some signs to be optimistic. For example, in Chalchihuitán, a small village in Chiapas in southern Mexico, a group of midwives came together to educate women about oral contraceptives, reproductive rights, and neonatal care via puppets, workshops, and teach-ins.52 As a group they reiterate what Doña Hermila has long repeated: Indigenous midwives have long been—and can continue to be—the successful first line of care in predominately Indigenous, rural Mexico. COV ID-19 PA NDEMIC EPILOGUE

On April 3, 2020, the Movement of Indigenous Midwives of Chiapas Nich Ixim put out a statement. The declaration proclaimed that during this pandemic, the Nich Ixim midwives would continue to provide prenatal care, deliver babies, and take care of their postpartum patients. Moreover, the organization acknowledged that as it became harder to access health care institutions, either because women were afraid to go to health centers because of the ongoing pandemic or because

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these were already overflowing, Indigenous midwives would continue to care for women and infants as they had for hundreds of years. Indeed, the organization reassured existing and potential patients that between them—more than five hundred midwives from nearly thirty municipalities—they had delivered more than seven thousand live births in less than two years. They also had a warning. Aware of the risks involved in continuing to treat patients without protection, they, however, were wholly unsuccessful in attaining “alcohol, masks, gloves, hand sanitizer, and liquid soap,” none of which are available in their communities. Local health providers, already concerned with their own supplies, were reluctant to offer any to Indigenous midwives. It was not simply the lack of supplies but also, as the midwives explained, an age-old delegitimization of their knowledge and medical worth in rural areas. In fact, midwives were instructed to stop practicing and direct their patients to local clinics and hospitals. Yet, as fear of infection in rural areas spread, reports of Indigenous women being turned away from hospitals are already surfacing. These women, at arguably one of the most vulnerable stages of their lives, are caught between decades-old battles about who has the right to provide care and where they, poor women, can go for care. These (in)decisions may likely lead to an increase in maternal mortality during the pandemic. It is easy to read the Nich Ixim statement as something wholly foreign to us. Indeed, the demand that Indigenous midwives be recognized as formal health providers speaks to a particularly specific struggle within Mexico. It also speaks to the problems of an unequal health care system that has left the rural, often Indigenous, poor without access to nearby medical services. Yet the statement also highlights problems not limited to a southern-Mexican context: disparity between rural and urban care and how expanding maternal mortality is a disturbing barometer for public health failings made more apparent during a crisis such as the pandemic.

NOTES Introduction 1. Archivo Histórico Nacional de España, Madrid, Spain. Inquisición, L. 1022, Fol. 101v. 2. Ann Zulawski, “New Trends in Studies of Science and Medicine in Latin America,” Latin American Research Review 34, no. 3 (1999): 241–51. 3. In fact, only four years after the article in Latin American Research Review was published, the first collection of essays in English focused on the history of diseases in modern Latin America anticipated a trend that over time would gain strength and enhance its agenda. See Diego Armus, ed., From Malaria to AIDS: Disease in the History of Modern Latin America (Durham, NC: Duke University Press, 2003). 4. For overviews of the long period before the arrival of modern bacteriology, see Linda Newson, “Medical Practice in Early Colonial Spanish America: A Prospectus,” Bulletin of Latin American Research 25 (2006): 367–91; Diego Armus and Adrián López Denis, “Disease, Medicine and Health,” in The Oxford Handbook of Latin American History, ed. José Moya (New York: Oxford University Press, 2011); Pablo F. Gómez, “Afro-Caribbean Healers,” in The Oxford Research Encyclopedia of Latin American History, ed. William Beezley (New York: Oxford University Press, 2015). For an overview including scholarship in English, Spanish, and Portuguese focused on the period starting with the arrival of modern bacteriology, see Diego Armus, “History of Health and Disease in Modern Latin America,” Oxford Bibliography Online—Latin America, 2013, doi:10.1093/obo/97801997665810094. For a survey of the subfield, see Marcos Cueto and Steven Palmer, Medicine and Public Health in Latin America: A History (New York: Cambridge University Press, 2014). 5. Diego Armus, “Disease in the Historiography of Modern Latin America,” in From Malaria to AIDS. 6. Marcos Cueto, Excelencia científica en la periferia: Actividades científicas e investigación biomédica en el Perú, 1890–1950 (Lima: Tarea, 1989); Noble David Cook and W. George Lovell, eds., Secret Judgments of God: Old World Disease in Colonial Spanish America (Norman: University of Oklahoma Press, 1991); Simone Petraglia Kropf, Doença de Chagas, doença do Brasil: ciência, saúde e nação (Rio de Janeiro: Editora Fiocruz, 2009); Nancy Leys Stepan, “‘The Only Serious Terror in These Regions’: Malaria Control in the Brazilian Amazon,” in From Malaria to AIDS; Jorge Márquez Valderrama, Ciudad, miasmas y microbios: La irrupción de la ciencia pasteuriana en Antioquia (Medellín: Editorial Universitaria de Antioquia, 2005). These examples and those in the following three footnotes are meant to illustrate these new historiographical approaches. They do not in any way present an exhaustive list; consequently, they are only indicative of a growing and very dynamic scholarship. 7. John Tate Lanning and John Jay Tepaske, The Royal Protomedicato: The Regulation of the Medical Profession in the Spanish Empire (Durham, NC: Duke University Press 1985); Jaime Benchimol and Luiz Antonio Texeira, Cobras, lagartos e otros bichos: Uma historia comparada dos Institutos Oswaldo Cruz e Butantan (Rio de Janeiro: UFRJ/Casa Oswaldo Cruz, 1993); María Angélica Illanes,

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“En nombre del pueblo, del estado y de la ciencia, (…)” Historia de la salud pública en Chile, 1880–1973 (Santiago: Colectivo de Atención Primaria, 1993); Claudia Agostoni, Monuments of Progress: Modernization and Public Health in Mexico City, 1876–1910 (Calgary: University of Calgary Press, 2003); Susana Belmartino, La atención médica argentina en el siglo XX: Instituciones y procesos (Buenos Aires: Siglo XXI Editores, 2005); Anne-Emanuelle Birn, Marriage of Convenience: Rockefeller International Health and Revolutionary Mexico (Rochester, NY: University of Rochester Press 2006); Adam Warren, Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms (Pittsburgh: University of Pittsburgh Press, 2010); Raúl Necochea López, A History of Family Planning in Twentieth-Century Peru (Chapel Hill: University of North Carolina Press, 2014); Martha Few, For All of Humanity: Mesoamerican and Colonial Medicine in Enlightenment Guatemala (University of Arizona Press, 2015); Gilberto Hochman, The Sanitation of Brazil: Nation, State, and Public Health, 1889–1930 (Urbana: University of Illinois Press, 2016); Nora Jaffrey, Reproduction and Its Discontents in Mexico: Childbirth and Contraception from 1750 to 1905 (Chapel Hill: University of North Carolina Press, 2016). Paul Ramírez, Enlightened Immunity: Mexico’s Experiments with Disease Prevention in the Age of Reason (Stanford, CA: Stanford University Press, 2018). 8. Suzanne Austin Alchon, Native Society and Disease in Colonial Ecuador (Cambridge: Cambridge University Press, 1991); José Pedro Barrán, Medicina y sociedad en el Uruguay del novecientos (Montevideo: Ediciones de la Banda Oriental, 1994); Sidney Chaloub, Cidade febril: Cortiços e epidemias na Corte Imperial (São Paulo: Companhia das Letras, 1996); María Emma Mannarelli, Limpias y modernas. Género, higiene y cultura en la Lima del novecientos (Lima: Flora Tristán, 1999); Sherry Fields, Pestilence and Head-colds: Encountering Illness in Colonial Mexico (New York: Columbia University Press, 2009); Mariola Espinosa, Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878–1930 (Chicago: University of Chicago Press, 2009); Diego Armus, The Ailing City: Health, Tuberculosis, and Culture in Buenos Aires, 1870–1930 (Durham, NC: Duke University Press 2011); Liane Maria Bertucci, “Para a saúde da criança. A educação do trabalhador nas teses médicas e nos jornais operários (São Paulo, início do século XX),” Mundos do Trabalho, 7, no. 13 (2015): 27–42; Pablo Gómez, The Experiential Caribbean: Creating Knowledge and Healing in the Early Modern Atlantic (Chapel Hill: University of North Carolina Press, 2017). 9. For examples of practitioners outside of the medical realm or in the gray zone of Latin American medicine, see, among others, María Eugenia Módena, Madres, médicos y curanderos: Diferencia cultural e identidad ideológica (México City: CIESAS, 1990); Joseph Bastien, Drums and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia (Salt Lake City: University of Utah Press, 1992); Libbet Crandon-Malamud, From the Fat of Our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia (Berkeley: University of California Press, 1993); David Sowell, The Tale of Healer Miguel Perdomo Neira: Medicine, Ideologies and Power in the Nineteenth-Century Andes (Wilmington, DE: Scholarly Resources, 2001); Steven Palmer, From Popular Medicine to Medical Populism: Doctors, Healers and Public Power in Costa Rica, 1880–1940 (Durham, NC: Duke University Press, 2003); Joan D. Koos-Chioino, Thomas Leatherman, Christine Greenway, eds., Medical Pluralism in the Andes (London: Routledge, 2003); Johan Wedel, Santería Healing: A Journey into the Afro-Cuban World of Divinities (Gainsville: University Press of Florida, 2004); Gabriela dos Reis Sampaio, Nas trincheras da cura: As diferentes medicinas no Rio de Janeiro Imperial (São Paulo: Unicamp, 2005); Karol Weaver, Medical Revolutionaries: The Enslaved Healers of Eighteenth- Century Saint Domingue (Urbana: University of Illinois Press, 2006); James H. Sweet, Domingos Álvares, African Healing, and the Intellectual History of the Atlantic World (Chapel Hill: University of North Carolina Press, 2011); João José Reis, Divining Slavery and Freedom: The Story of Domingos Sodré, an African Priest in Nineteenth-Century Brazil (New York: Cambridge University Press, 2015); Iri-

NOTES TO PAGES 8–13

na Podgorny, “Charlatans and Medicine in 19th-Century Latin America” in The Oxford Research; Sheila Cosminsky, Midwives and Mothers: The Medicalization of Children on a Guatemalan Plantation (Austin: University of Texas Press, 2016); Jethro Hernández Berrones, “Homeopathy ‘for Mexicans’: Medical Popularisation, Commercial Endeavours, and Patients’ Choice in the Mexican Medical Marketplace, 1853–1872,” Medical History 61, no. 4 (Oct 2017); Mauro Vallejo, El Conde de Das en Buenos Aires (1892–1893): hipnosis, teosofía y curanderismo detrás del Instituto Psicológico Argentino (Buenos Aires: Biblos, 2017); Patricia Palma and José Ragas, “Enclaves sanitarios: Higiene, epidemias y salud en el Barrio Chino de Lima (1880–1910),” Anuario Colombiano de Historia Social y de la Cultura 45, no. 1 (2018): 159–90; Gómez, The Experiential Caribbean; Victoria Estrada and Jorge Márquez, “Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905–1950),” História, Ciências, Saúde—Manguinhos 26, no. 4 (2019), 1355–72; Alberto Ortiz Díaz, “Pathologizing the Jíbaro: Mental and Social Health in Puerto Rico’s Oso Blanco (1930s to 1950s),” The Americas 77, no. 3 (July 2020): 409–41. 10. Peter Burke, Cultural Hybridity (Cambridge: Polity, 2009), 34. 11. Similar discussions about the problems of traditional categories and epistemes are shaping the study of technology and histories of knowledge production; see Gabriela Soto Laveaga and Pablo F. Gómez, “Introduction,” History and Technology, 34 (2018), 5–10. 1. Domingo de la Ascensión and the Criollo Healing Culture of the Seventeenth-Century Caribbean 1. This chapter, in part, draws from evidence examined in Pablo F. Gómez, The Experiential Caribbean: Creating Knowledge and Healing in the Early Modern Atlantic (Chapel Hill: University of North Carolina Press, 2017) chaps. 3 and 6. 2. Archivo Histórico Nacional de España (hereafter AHN), Inquisición, L. 1022, Fol. 443r. 3. See, Gómez, Experiential Caribbean, especially introduction and chaps. 1 and 2. 4. For works on colonial Latin-American non-European healers outside urban spaces, see Martha Few, Women Who Live Evil Lives: Gender, Religion, and the Politics of Power in Colonial Guatemala (Austin: University of Texas Press, 2002); Ryan Kashanipour, “A World of Cures: Magic and Medicine in Colonial Yucatán,” (PhD diss., University of Arizona, 2012); James H. Sweet, Domingos Alvares, African Healing, and the Intellectual History of the Atlantic World (Chapel Hill: University of North Carolina Press, 2011); Gómez, Experiential Caribbean. 5. See Pablo F. Gomez, “The History of Public Health and Hospitals in the Sixteenth-Century Caribbean,” in The Spanish Caribbean and the Atlantic World in the Long Sixteenth Century, ed. Ida Altman and David Wheat (Lincoln: University of Nebraska Press, 2019). 6. See David Wheat, Atlantic Africa and the Spanish Caribbean, 1570–1640 (Chapel Hill: University of North Carolina Press, 2016); Gómez, Experiential Caribbean, chaps. 1–3. 7. For disease in the Caribbean, see J. R. McNeil, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (New York: Cambridge University Press, 2010); Noble David Cook, Born to Die: Disease and New World Conquest, 1492–1650 (Cambridge: Cambridge University Press, 1998), 15–60, 166–200. Gómez, Experiential Caribbean, chap. 1. For death statistics related to the African diaspora, see Joséph. C. Miller, Way of Death: Merchant Capitalism and the Angolan Slave Trade, 1730–1830 (Madison: University of Wisconsin Press, 1988), 105–39; Linda Newson and Susie Minchin, “Slave Mortality and African Origins: A View from Cartagena, Colombia in the Early Seventeenth Century,” Slavery & Abolition 25, no. 3 (2004): 18–43; Vincent Brown, The Reaper’s Garden: Death and Power in the World of Atlantic Slavery (Cambridge, MA: Harvard University Press, 2010).

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8. AHN, Inquisición, L. 1022, Fol. 429v. 9. See Archivo General de Indias (hereafter AGI), Santa Fe, 73, “Carta que el Capitan Duarte de Leon Marques escribio al Rey a travez del contador Pedro Guiral. 5 julio 1621.” For data on the demography of the slave trade, see the Trans-Atlantic Slave Trade Database at http://www. slavevoyages.org. See also Alejandro de la Fuente, “Esclavos africanos en La Habana: Zonas de procedencia y denominaciones étnicas, 1570–1699,” Revista Española de Antropología Americana 20 (1990): 135–60; David M. Stark, “A New Look at the African Slave Trade in Puerto Rico through the Use of Parish Registers: 1660–1815,” Slavery and Abolition 30, no. 4 (2009): 491–520; David Wheat, “The First Great Waves: African Provenance Zones for the Transatlantic Slave Trade to Cartagena de Indias, 1570–1640,” Journal of African History 52, no. 1 (2011): 1–22. 10. See Wheat, Atlantic Africa. 11. AHN, Inquisición, L. 1022, Fol. 443r. 12. Gómez, Experiential Caribbean, chap. 2. 13. See Alejandro de la Fuente, Havana and the Atlantic in the Sixteenth Century (Chapel Hill: University of North Carolina Press, 2008). 14. See, Gómez, Experiential Caribbean. See also Linda M. Rupert, Creolization and Contraband: Curaçao in the Early Modern Atlantic World (Athens: University of Georgia Press, 2012); Wheat, Atlantic Africa; de la Fuente, Havana. 15. Gomez, Experiential Caribbean, chap. 2. 16. AHN, Inquisición, L. 1022, Fol. 430r. 17. AHN, Inquisición, L. 1022, Fol. 431v. 18. See Gomez, Experiential Caribbean, chaps. 2–3. 19. For instance, in the case of the licensed surgeon, Diego López, who was born a slave in Cartagena. AHN, Inquisición, 1010. For surgeons and barbers of African descent in other colonial Latin American spaces, see Adam Warren, Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms (Pittsburgh: University of Pittsburgh Press, 2010). 20. AHN, Inquisición, L. 1022, Fols. 428r–429r. In colonial Latin American spaces, ético was a term associated with pulmonary disorders and “consumptive diseases.” However, authors like Vilanova use the term to refer to liver diseases. Arnau de Vilanova, Libro de medicina llamado Tesoro de los pobres con un regimiento de sanidad (Sevilla: Juan Cromberger, 1540). 76. 21. AHN, Inquisición, L. 1022, Fols. 428r–429r. 22. AHN, Inquisición, L. 1022, Fols. 431r, 435v. 23. See, for instance, Timothy Walker, Doctors, Folk Medicine and the Inquisition: The Repression of Magical Healing in Portugal during the Enlightenment (Leiden: Brill, 2005). 24. María Tausiet, “Healing Virtue: Saludadores Versus Witches in Early Modern Spain,” supplement, Medical History, no. 29 (2009): 40–63. 25. See, among others, Benjamin Breen, “The Flip Side of the Pharmacopeia?: Sub-Saharan African Medicines and Poisons in the Atlantic World,” in Drugs on the Page: Pharmacopoeias and Healing Knowledge in the Early Modern Atlantic World, ed. Matthew J. Crawford and Joséph M. Gabriel (Pittsburgh: University of Pittsburgh Press, 2019). 26. AHN, Inquisición, L. 1022, Fols. 431r, 435v. 27. AHN, Inquisición, L. 1023, Fols. 428r-429r. 28. AHN, Inquisición, L. 1023, Fols. 430r-431v. 29. AHN, Inquisición, L. 1023, Fol. 431v. 30. AHN, Inquisición, L. 1022, Fols. 436r–v. 31. AHN, Inquisición, L. 1022, Fol. 436v.

NOTES TO PAGES 18–23

32. Bernardo Ortiz de Montellano, Aztec Medicine, Health, and Nutrition (New Brunswick, NJ: Rutgers University Press, 1990), 129–61. 33. Pablo F. Gómez, “The Circulation of Bodily Knowledge in the Seventeenth-Century Black Spanish Caribbean,” Social History of Medicine 26, no. 3 (August 1, 2013): 383–402. 34. AHN, Inquisición, L. 1022, Fol. 439r. 35. AHN, Inquisición, L. 1022, Fol. 433v. 36. AHN, Inquisición, L. 1022, Fol. 433v. 37. AHN, Inquisición, L. 1022, Fols. 434r–v. 38. AHN, Inquisición, L. 1022, Fol. 434r. 39. AHN, Inquisición, L. 1022, Fol. 437r. 40. AHN, Inquisición, L. 1022, Fol. 434r. 41. AHN, Inquisición, L. 1022, Fols. 438r–439v. 42. See, for example, AHN, Inquisición, L. 1021; AHN, Inquisición, L. 1022; AHN, Inquisición, L. 1023; AGN, Colonia, Negros y Esclavos; AGI, Contaduria, 243; AGI, Justicia, 74. 43. See Juan Méndez Nieto (1611), Discursos medicinales (Salamanca: Universidad de Salamanca, Junta de Castilla y León, 1989). 44. See Gómez, Experiential Caribbean, chap 5. Also, for materia medica that did make it to Europe, see Nicolás Monardes, Dos libros. El uno trata de todas las cosas que traen de nuestras Indias Occidentales, que sirven al uso de medicina. . . . (Sevilla, 1565); Nicolás Monardes, Segunda parte del libro, de las cosas que se traen de nuestras Indias Occidentales, que siruen al vso de medicina (Sevilla, 1571); Antonio Barrera-Osorio, Experiencing Nature: The Spanish American Empire and the Early Scientific Revolution (Austin: University of Texas Press, 2006); Matthew J. Crawford and Joséph M. Gabriel, eds., Drugs on the Page: Pharmacopoeias and Healing Knowledge in the Early Modern Atlantic World (Pittsburgh: University of Pittsburgh Press, 2019). 45. For a similar take on this issue, see Carla Nappi, “The Global and Beyond: Adventures in the Local Historiographies of Science,” Isis 104, (2013): 102–10. 46. AHN, Inquisición, L. 1022, Fol. 436v. 47. AHN, Inquisición, L. 1022, Fol. 429r. 48. See, for example, John K. Thornton, “Afro-Christian Syncretism in the Kingdom of Kongo,” Journal of African History 54, no. 1 (2013): 53–77. 49. AHN, Inquisición, L. 1022, Fol. 427v. 50. For an analysis of Caribbean stones as spiritual technological artifacts, see Pablo F. Gómez, “Caribbean Stones and the Creation of Early-Modern Worlds,” History and Technology 34, (2018): 11–20. 51. AHN, Inquisición, L. 1022, Fol. 435r. 52. Among others, see Luke E. Demaitre, “The Art and Science of Prognostication in Early University Medicine,” Bulletin of the History of Medicine 77, no. 4 (2003): 765–88. 53. AHN, Inquisición, L. 1022, Fol. 434v. 54. See Marcy Norton, Sacred Gifts, Profane Pleasures: A History of Tobacco and Chocolate in the Atlantic World (Ithaca, NY: Cornell University Press, 2008). 55. AHN, Inquisición, L. 1022, Fol. 429v. 56. AHN, Inquisición, L. 1022, Fols. 434v-435r 57. AHN, Inquisición, L. 1022, Fol. 429v. 58. AHN, Inquisición, L. 1022, Fol. 430r-v. 59. AHN, Inquisición, L. 1022, Fol. 435v. 60. AHN, Inquisición, L. 1022, Fols. 431v–432r.

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61. Among others, Heather M. Kopelson, “‘One Indian and a Negroe, the First Thes Ilands Ever Had’: Imagining the Archive in Early Bermuda,” Early American Studies: An Interdisciplinary Journal 11 (2013): 272–313; Sweet, Domingos Alvares. 62. Among others, see Harold Cook and Timothy D. Walker, “Circulation of Medicine in the Early Modern Atlantic World,” Social History of Medicine 26 (2013): 337–51; Jürgen Renn, “The History of Science and the Globalization of Knowledge,” in Relocating the History of Science, ed. Theodore Arabatzis, Jürgen Renn, Ana Simoes (Boston: Boston Studies in the Philosophy and History of Science, 2015), 241–52; Lissa Roberts, “Situating Science in Global History: Local Exchanges and Network of Circulation,” Itinerario 33 (2009): 9–30; James Secord, “Knowledge in Transit,” Isis 95 (2004): 654–72. 2. The Curing World of María García, an Indigenous Healer in Eighteenth-Century Guatemala 1. The information about María García comes from Archivo General de la Nación, Mexico City, Ramo de Inquisición (hereafter cited as AGN, Inq.), vol. 729, exp. 4, fols. 330r–43v. In the colonial period, the Audiencia of Guatemala stretched from what is today Chiapas (in Mexico) through much of modern day Central America. I follow the racial-ethnic designations used by notaries to describe those who appear in inquisition cases, such as Indian (yndio/a), Spaniard (español/a), and Black (negro/a). In colonial Central America, mestizo/a referred to a person of mixed Spanish and Indigenous parentage and mulato/a to a person of mixed Spanish, Indigenous, and/or African parentage. I have updated spellings of names, places, and other words and added accents in the main text, but I retain the original orthography in quotes and archival citations found in the footnotes. 2. Testimony of Phelipa de Xerez, May 19, 1706, AGN, Inq., vol. 729, exp. 4, fols. 330r–43v, especially fols. 337r–39v. 3. In María García’s case, sources include letters written to and from inquisition authorities in Guatemala and Mexico City, as well as testimonies from García’s patient Felipa Jérez, two of Jérez’s adult sisters, and Jérez’s employer, her employer’s cousin, and her employer’s neighbor—all of them women. For a discussion of these issues for the sixteenth century, see Martha Few, “‘Speaking with the Fire’: The Inquisition Confronts Mesoamerican Divination to Treat Child Illness in Sixteenth-Century Guatemala,” in “Medicine and the Inquisition in the Early Modern World,” special issue, Early Science and Medicine 23, nos. 1–2 (2018): 159–76. 4. Christopher H. Lutz, Santiago de Guatemala, 1541-1773: City, Caste and the Colonial Experience (Norman: University of Oklahoma Press, 1994. 5. “Por arte del demonio por maleficio encantamiento, [o] hechiso.” Testimony of María García, November 20, 1713, AGN, Inq., vol. 729, exp. 4, fols. 330r–43v, especially 342v–43v. 6. For the history of the Inquisition, see for example, Solange Alberro, Inquisición y sociedad en México, 1571–1700 (Mexico City: Fondo de Cultura Económica, 1988); Jorge E. Traslosheros and Ana de Zaballa Beascoechea, eds., Los indios ante los foros de justicia religiosa en la hispanoamérica virreinal (Mexico City: Universidad Nacional Autónoma de México, 2010); Kimberly Lynn, Between Court and Confessional: The Politics of Spanish Inquisitors (Cambridge: Cambridge University Press, 2013); John F. Chuchiak IV, ed. and trans., The Inquisition in New Spain, 1536–1820: A Documentary History (Baltimore, MD: Johns Hopkins University Press, 2012). 7. Where possible I distinguish among these medical cultures, but often the sources available do not allow such fine-grained distinctions. 8. Testimony of María García, AGN, Inq., vol. 729, exp. 4, fols. 342fv–43fv. All of the information in these paragraphs comes from this section of the case.

NOTES TO PAGES 29–33

9. Martha Few, Women Who Live Evil Lives: Gender, Religion, and the Politics of Power in Colonial Guatemala (Austin: University of Texas Press, 2002). 10. For more on the Inquisition and the politics of Indigeneity, see Few, Women Who Live Evil Lives. 11. Between 1704 and 1821, the University of San Carlos conferred bachelor’s degrees in medicine to thirty persons, licentiates to twelve, and doctorates to twelve. John Tate Lanning, The Eighteenth-Century Enlightenment in the University of San Carlos de Guatemala (Ithaca, NY: Cornell University Press, 1956), 211. 12. The information on hospitals in the paragraph comes from “Fundación del hospital San Lázaro, en la ciudad de Guatemala,” Archivo General de Centro América, Guatemala City (hereafter cited as AGCA), A1–7205–314299, transcribed in Boletín del Archivo del Gobierno 10, no. 4 (1945): 270–76; and J. Joquín Pardo, Pedro Zamora Castellanos, and Luis Lujan Muñoz, Guía de Antigua Guatemala, 2nd ed. (Guatemala City: Editorial José de Pineda Ibarra, 1968), 191–99. 13. For the definitive work on the town’s history, see Laura E. Matthew, Memories of Conquest: Becoming Mexicano in Colonial Guatemala (Chapel Hill: University of North Carolina Press, 2012). 14. Francisco Hernández, Rerum medicarum Novae Hispaniae thesaurus, seu, Plantarum animalium mineralium Mexicanorum historia (Rome: Ex typographeio Vitalis Mascardi, 1651), 193. I am grateful to Edward Polanco for his help in identifying this plant in personal communications on April 1–2, 2018. Polanco pointed me to a further reference to what is likely this same plant in the Florentine Codex, book 11, p. 144 (whose authors describe the plant as being used to reduce swelling, including from sprains). 15. Testimony of María García, AGN, Inq., vol. 729, exp. 4, fols. 342fv–43fv. 16. “Preguntada que como dio un remedio a una negra paraq[ue] abortasse un niño.” Testimony of María García, AGN, Inq., vol. 729, exp. 4, fol. 342v. 17. “Dixo que a poco tiempo que d[io] una bebida a una negra pero dha negra no le di[xo] que estaba embarasada dha niña sino que estaba hidropesiada y por hidropesia dio dha bebida hecha de dha yerva de tesumpate.” Testimony of María García, AGN, Inq., vol. 729, exp. 4, fol. 342v. 18. For more on abortifacient knowledge in the Atlantic World, see the work of Londa Schiebinger, especially Plants and Empire: Colonial Bioprospecting in the Atlantic World (Cambridge, MA: Harvard University Press, 2007). 19. I discuss in depth the issue of botanical knowledge and abortifacients in colonial Central America in Martha Few, For All of Humanity: Mesoamerican and Colonial Medicine in Enlightenment Guatemala (Tucson: University of Arizona Press, 2015). For the extensive and significant historiography of state-sponsored expeditions and imperial collecting of plants, animals, and other materials from the colonial Americas, see, for example, Paula De Vos, “Research, Development, and Empire: State Support of Science in the Later Spanish Empire,” Colonial Latin American Review 15, no. 1 (2006): 55–79; Antonio Barrera-Osorio, Experiencing Nature: The Spanish American Empire and the Early Scientific Revolution (Austin: University of Texas Press, 2006); Helen Cowie, Conquering Nature in Spain and Its Empire, 1750–1850 (Manchester, UK: Manchester University Press, 2011); Patrick Manning and Daniel Rood, Global Scientific Practice in an Age of Revolutions, 1750–1850 (Pittsburgh: University of Pittsburgh Press, 2016). 20. This bark was also called cocomecatl, palo de la vida, or palo de china. Edward Polanco, personal communication, October 2012. See Francisco Hernández, Quatros libros de la naturaleza y virtudes medicinales de las plantas, trans. Francisco Ximénez (1615; repr., Morelia, Mexico: José Rosario Bravo, 1888), 111. 21. Francisco Ximénez, Historia natural del reino de Guatemala (1722; repr., Guatemala: José

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Pineda Ibarra, 1967), 246, 248. Ximénez continued to experiment with the bark to see “if in some way, as they say, that it brings back the dead from their graves” (si de alguna cosa se puede decir que levanta muertos de la sepultura). Ximénez, Historia natural, 247. 22. Ximénez, Historia natural, 247. 23. Gazeta de México, February 22, 1785, 241. This periodical also reported that flecha or arbol de la Margarita, used to treat typhus, reputedly cured rabies and smallpox as well. 24. “Relación de las raices y yervas medicinales,” n.d., Archivo General de Indias, Seville, Indiferente General 1550, n.p. 25. “En obedecimiento y cumplimiento de despacho y supremas ordenas y con arreglo a instruccion que ellas se cita y he hallado en este archivo, yo Dn. Francisco Geraldino alc. mayor por S. M. y Teniente de Capitan Gral. de esta Prov.s de Guegue. y Toto[nicapán] formó un cajón con las producciones medicinales,” Huehuetenango, February 2, 1784, AGCA, A1–6088–55135, fols. 35r–39v. 26. “Una mulata llamada Phelipa ciega de la garganta quebrada.” Testimony of Ysabel Sánchez de León, AGN, Inq., vol. 729, exp. 4, fols. 331fv–32fv, especially fol. 331f. 27. For colonial Guatemala, see Few, Women Who Live Evil Lives. For contemporary practices of assault sorcery, see Neil L. Whitehead, Dark Shamans: Kanaima and the Poetics of Violent Death (Durham, NC: Duke University Press, 2002). 28. Few, Women Who Live Evil Lives, 31–33, 40. 29. All the material in this paragraph comes from testimony of María García, AGN, Inq., vol. 729, exp. 4, fols. 342fv–43fv. 30. Testimony of Ysabel Sánchez de León, AGN, Inq., vol. 729, exp. 4, fols. 331fv–32fv, especially fol. 331f. 31. Testimony of Xerez, AGN, Inq., vol. 729, exp. 4, fols. 337fv–39f. 32. Richard P. McBrien, gen. ed., The HarperCollins Encyclopedia of Catholicism (San Francisco, CA: HarperCollins, 1995), 798. 33. Testimony of María García, AGN, Inq., vol. 729, exp. 4, fol. 343v. 3. Calundu 1. For slaves’ mastery of the waterways of the Atlantic World, see Kevin Dawson, Undercurrents of Power: Aquatic Culture in the African Diaspora (Philadephia: University of Pennsylvania Press, 2018). 2. Arquivo Nacional da Torre do Tombo (ANTT), Inquisição de Lisboa, Processos No. 12658. 3. ANTT, Inquisição de Lisboa, Processos No. 12658. 4. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 59, Livro 256, ff. 130–130v. 5. Crucially, at the same time calundu proliferated in Brazil, Portuguese Jesuit Pedro Dias composed a Kimbundu grammar in Salvador, Brazil, in which malundo translates as “hills” (oiteiros). Thus, proto-Bantu overlapped with innovations even in Brazil. Pedro Dias, Arte da Lingua de Angola, oferecida a Virgem Senhora N. do Rosario, Mãy, & Senhora dos mesmos Pretos (Lisbon: Oficina de Miguel Deslandes, 1697), 7. 6. Bantu lexical reconstructions 3 / Reconstructions lexicales bantous 3, Yvonne Bastin, André Coupez, Evariste Mumba, and Thilo Schadeberg, eds. (Tervuren, 2002), www.africamuseum. be/collections/browsecollections/humansciences/blr. One can chart the innovations in dund through the derivations in BLR3. According to the database, the proto-Bantu dund was distributed across language zones C, F, G, H, J, K, L, M, N, P, R; dundu as “hill,” derived from dund was distributed across zones H, K, L, M, R; and finally, dundu as “antheap,” as an innovation of dundu as “hill” was distributed across zones G, H, L, and M. 7. Kairn Klieman, The Pygmies Were Our Compass: Bantu and Batwa in the History of West Central

NOTES TO PAGES 42–48

Africa, Early Times to c. 1900 (Portsmouth, NH: Heinemann, 2003), 70, 151, 160. Also see Neil Kodesh, Beyond the Royal Gaze: Clanship and Public Healing in Buganda (Charlottesville: University of Virginia Press, 2010), 184. 8. The more accurate rendering is actually “Zambi’s Mountain,” with Zambi being the supreme deity in Mbundu regions. Also note the change from dundu to lundu here, “mulundu” meaning hill or mountain. 9. Jean Baptiste Douville, Voyage au Congo et dans l’intérieur de l’Afrique équinoxiale: fait dans les années 1828, 1829 et 1830, vol. 2 (Paris, 1832), 228–30. 10. Angolans reported that Moulondu Zambi previously had destroyed entire forests and villages, but “serenity replaced this moment of fury.” Since that time, the spirits of the volcano only “scolded from time to time” with lightning bolts aimed at men. These spirits were also said to control the firearms that white men used against Africans. Douville, Voyage au Congo, 228. 11. The root lung is possibly a phonological innovation on lund. See the continuing research of Kathryn de Luna. On malungu/o, see the various works of Robert Slenes, most recently, “Metaphors to Live By in the Diaspora: Conceptual Tropes and Ontological Wordplay among Central Africans in the Middle Passage and Beyond,” in Tracing Language Movement in Africa, ed. Ericka A. Albaugh and Kathryn M. de Luna (Oxford: Oxford University Press, 2018), 343–64. 12. A. J. R. Russell-Wood, The Portuguese Empire, 1415–1800: A World on the Move (Baltimore, MD: Johns Hopkins University Press, 1988), 61–62. 13. Estimate Table, “Assessing the Slave Trade,” Voyages: The Transatlantic Slave Trade Database, http://www.slavevoyages.org/assessment/estimates. From 1600 to 1700, estimates suggest 314,029 Africans arriving in Bahia; 244,570 of these came from West Central Africa. 14. ANTT, Inquisição de Lisboa, Livro 784, ff. 65–66v, 81–82v. Also see the description of a Guiné woman in the Recôncavo of Bahia, who spoke to “the devil” in her chest and gave answer to future things. ANTT, Inquisição de Lisboa, Livro 784 ff. 102v.103v. 15. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 18, ff. 305–13. 16. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 67, ff. 311–20v. For more on Caterina, see James H. Sweet, “Reimagining the African-Atlantic Archive: Method, Concept, Epistemology, Ontology,” Journal of African History 55 (2014): 147–159. 17. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 59, ff. 130–130v. 18. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 81, ff. 239–48. 19. Obras de Gregório de Matos, ed. Afranio Peixoto, Satírica, IV, vol. 1 (Rio de Janeiro: Publicações da Academia Brasileira, 1930), 186. Nuno Marques Pereira, Compendio Narrativo do Peregrino da America (1728), 6th ed., 2 vols. (Rio de Janeiro: Publicações da Academia Brasileira, 1939), vol. 1, 123–26. 20. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 68, ff. 176–83v. 21. I count nine denunciations that explicitly mention calundu (or some variation) between 1692 and 1708. Many cases that fit the choreography and description of calundu but are not referenced as such, appear in the years before 1692. 22. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 80, ff. 32–32v. 23. ANTT, Cadernos do Promotor, No. 83, f. 202. 24. Documentos Históricos: Portarias, 1715–1718, vol. 44 (Rio de Janeiro: Ministério da Educação e Saúde/Biblioteca Nacional, 1941), 188. 25. Le Gentil de la Barbinais, Nouveau voyage autour du monde. . . . T. 3 (Amsterdam, 1728), 149–52. For more on this case, see Sweet, “Reimagining the African-Atlantic Archive.” 26. ANTT, Inquisição de Lisboa, Processos, No. 3723. See also Laura de Mello e Souza, O diabo e

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a terra de Santa Cruz: feitiçaria e religiosidade popula no Brasil colonial (São Paulo: Companhia das Letras, 1986), 263–64. Likewise, some African healers claimed that they could not remove Brazilian spirits. For example, Domingos Pinto Ferrás called on an African healer to remove the malevolent spirits his wife and mother-in-law put in him; however, the healer revealed that they were “caboclo” spirits, which he didn’t have the power to cure. 27. Estimate Table, “Assessing the Slave Trade. Between 1700 and 1740, estimates suggest that 105,514 Africans arrived in Bahia from West Central Africa. Meanwhile, 230,727 arrived from the Bight of Benin. A further 41,437 arrived from other regions of Africa—Bight of Biafra, Gold Coast, Senegambia, etc. 28. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 110, ff. 41–41v. 29. ANTT, Inquisição de Lisboa, Cadernos do Promotor, No. 115, ff. 203–13. 30. For a detailed study of this case, see João José Reis, “Magia Jeje na Bahia: A invasão do Calundu do Pasto de Cachoeira, 1785,” Revista Brasileira de História 8 (1988): 57–81. 31. ANTT, Inquisição de Lisboa, Cadernos do Promotor, 129. 32. For greater detail on the diffusion of calundu in Bahia in the second half of the eighteenth century, see Elisangela Oliveira Ferreira, “O santo de sua terra na terra de Todos os Santos: Rituais de Calundu na Bahia colonial,” Afro-Ásia 54 (2016): 103–50. 33. José Ramos Tinhorão, Pequena história da música popular: da modinha ao tropicalismo (São Paulo: Arte Editora, 1986), 19. 34. As quoted in Tinhorão, Os negros em Portugal: uma presença silenciosa (Lisbon: Caminho, 1988), 362–63. 35. D. Francisco de S. Luiz, Glossario de vocabulos Portuguezes derivados das linguas orientaes e africanas (Lisbon: Academia das Sciencias de Lisboa, 1837), 64. 36. James H. Sweet, “The Evolution of Ritual in the African Diaspora: Central African Kilundu in Brazil, St. Domingue, and the United States,” in Diasporic Africa: A Reader, ed. Michael A. Gomez (New York: New York University Press, 2006), 70. 37. Machado de Assis, Dom Casmurro (1899), chap. 46. Assis had earlier described this kind of catatonic malaise as “Calundutico” in his História de Quinze Dias (1877). 38. Diccionario Brazileiro da Lingua Portugueza (1875–1888), 138 in Annaes da Bibliotheca Nacional do Rio de Janeiro, vol. 13, part 2 (Rio de Janeiro, 1889), 138. 39. Even today, there are streets called Estrada do Calundu in both Salvador and Rio de Janeiro. 40. Visconde Henrique Beaurepaire-Rohan, Diccionario de Vocabulos Brazileiros (Rio de Janeiro: Imprensa Nacional, 1889), 28. 41. For yet a third, similar, definition of calundu, see Pacheco da Silva and Lameira de Andrade, Noções de grammatical portugueza (Rio de Janeiro: J. G. de Azevedo, 1887), 515. 42. José Alvares Amaral, Resumo chronologico e noticioso da Provincia da Bahia: desde o seu descobrimento em 1500 (Bahia: Imprensa Oficial do Estado, 1922), 34. 43. According to the Michaelis Dicionário Brasileiro da Lingua Portuguesa, calundu is a “state of animus characterized by bad mood, irritability; emotional instability; nostalgia, boredom: ‘He spoke well; but when he was silent, it was for a long time; it was said that these were his calundus,’” http://michaelis.uol.com.br/busca?id=Do3a. 4.Dorotea Salguero and the Gendered Persecution of Unlicensed Healers in Early Republican Peru 1. Manuel Cayetano de Loyo, Defensa hecha a favor de Da. Dorotea Salguero, en la causa criminal que se le ha formado a moción del protomedicato por haberse curado contra sus prohibiciones, y las del

NOTES TO PAGES 56–59

juez de primera instancia. En recurso a la representación nacional (Lima: Imprenta de José, María Masías, 1831), 34. 2. Loyo, 34. 3. Loyo, 50. 4. Loyo, 50. 5. Hermilio Valdizán, Crónicas médicas del doctor Valdizán (Lima: Talls. Grafs. del Asilo Colonia “Víctor Larco Herrera,” 1929), 35–61. 6. Juan Lastres narrated Salguero’s persecution to illustrate tensions between licensed and unlicensed healers during a period of post-independence political upheaval; Juan Lastres, Historia de la medicina peruana, vol III: La medicina en la república (Lima: Universidad Nacional Mayor de San Marcos, 1951), 153–55, 321. José R. Jouve Martín, on the other hand, traces Salguero’s conflicts with the protomédico and connects her persecution, imprisonment, and trial to larger questions about the protomédico’s legal status, authority, and legitimacy after independence. Moreover, he reconstructs how debates over her work played out in Lima’s newspapers, creating a spectacle of published accusations that this chapter also examines; José R. Jouve Martín, The Black Doctors of Colonial Lima: Science, Race, and Writing in Colonial and Early Republican Peru (Montreal: McGill-Queens University Press, 2014), 101–10. Lissell Quiroz mentions Salguero in studies of the history of obstetrics and the field’s professionalization in Peru; Lissell Quiroz, “Circulación de saberes científicos en el espacio transatlántico y el nacimiento de la obstetricia peruana (siglo XIX),” Revista de Crítica Literaria Latinoamericana 42, no. 84 (2016), 127–45; Lissell Quiroz, “Del hogar al espacio público: las obstetrices peruanas del siglo XIX,” in Género y mujeres en la historia del Perú: Del hogar al espacio público, ed. Claudia Rosas Lauro (Lima: Pontificia Universidad Católica del Perú, 2019), 297–316. 7. Quiroz, “Del hogar al espacio público.” 8. Loyo, Defensa hecha a favor, 8. 9. Valdizán, Crónicas médicas, 36. 10. Dorotea Salguero was listed first as the wife of Francisco Ascoitia and the mother of Manuel Ascoitia; the latter was baptized in the parish of San Pedro, Lambayeque, on June 28, 1798. Subsequent records exist for a Dorotea Salguero who married another man, Francisco Polo, in the same village of San Pedro, on January 30, 1813. Together they had at least one child, a son named Manuel Agustín de la Rosa Polo, who was baptized in Lima’s parish of Santa Ana on September 9, 1820; “Dorotea Salguero,” Family Search, http://www.familysearch.org. 11. Mercurio Peruano, March 5, 1831. This daughter was most likely Juana Salguero Chiquisonga, who married Pedro José Alayón in the parish of San Pedro, Lambayeque, on October 31, 1822. Dorotea Salguero was listed as her mother; “Dorotea Salguero,” Family Search, http://www.familysearch.org. 12. Mercurio Peruano, February 18, 1831. 13. Pablo Gómez, The Experiential Caribbean: Creating Knowledge and Healing in the Early Modern Atlantic (Chapel Hill: University of North Carolina Press, 2017). 14. Valdizán, Crónicas médicas, 51. Years later, others referred to Salguero’s trial as an “auto de brujas,” or witches trial; Mercurio Peruano, April 12, 1831. 15. The association of midwifery with the use of magic comes across most clearly in Benita Paulina Cadeau Fessel’s critiques of the profession in Lima before the founding of a midwifery school. As will be discussed later, Cadeau Fessel was a French midwife who sought to professionalize midwifery in Lima. See Adam Warren, “Between the Foreign and the Local: French Midwifery, Traditional Healers, and Vernacular Knowledge about Childbirth in Lima, Peru,” História, Ciências, Saúde–– Manguinhos 22, no. 1 (2015), 179–200.

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16. Examples include “Recetario eficaz para las familias, medicamentos caseros,” in La medicina popular peruana, vol. 3, ed. Hermilio Valdizán and Ángel Maldonado (Lima: Imprenta Torres Aguirre, 1922), 107–317; “El médico verdadero,” in La medicina popular peruana, 417–87; Martín Delgar, “Libro de medicina y cirugía,” Ms. D59C, Biblioteca Nacional del Perú; Martín Delgar, “Nuevo tesoro de pobres,” Ms. D12936, Biblioteca Nacional del Perú. 17. Alberto Flores Galindo, La ciudad sumergida: Aristocracia y plebe en Lima, 1760–1830 (Lima: Ed. Horizonte, 1991), 83. 18. Loyo, Defensa hecha a favor, 40. 19. Mercurio Peruano, April 18, 1831. 20. Mercurio Peruano, March 5, 1831. 21. Loyo, Defensa hecha a favor, 30, 38. 22. Loyo, 32. 23. Quiroz, “Circulación de saberes científicos”; Quiroz, “Del hogar al espacio público.” 24. Mercurio Peruano, March 2, 1831. 25. Mercurio Peruano, March 2, 1831. 26. Loyo, Defensa hecha a favor, 32. 27. Loyo, 33. 28. Loyo, 35, 36, 37. 29. Loyo, 39, 31. 30. Loyo, 4. 31. Loyo, 5. 32. Loyo, 5. 33. Loyo, 6. 34. Jouve Martín, Black Doctors of Colonial Lima, 103. 35. Loyo, Defensa hecha a favor, 9. 36. Loyo, 10. 37. Loyo. 12. 38. Loyo, 17, 18. 39. Loyo, 19. 40. Loyo, 21. 41. Loyo, 49. 42. Loyo, 51, 53. 43. Loyo, 59. 44. Loyo, 60. 45. Mercurio Peruano, January 19, 1827, quoted in Valdizán, Crónicas médicas, 37. 46. Mercurio Peruano, July 15, 1828. 47. Mercurio Peruano, February 18, 1831. 48. Mercurio Peruano, February 22, 1831. 49. Mercurio Peruano, February 25, 1831; February 26, 1831. 50. Mercurio Peruano, February 22, 1831. 51. Mercurio Peruano, October 25, 1830; March 28, 1831; April 15, 1831; April 18, 1831. 52. Mercurio Peruano, April 14, 1831. Salguero’s defenders presented similar challenges in La Floresta, March 18, 1831. 53. Mercurio Peruano, April 14, 1831. 54. Merurio Peruano, February 26, 1831. 55. El Telégrafo de Lima, January 11, 1837.

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56. El Telégrafo de Lima, January 11, 1837. 57. El Telégrafo de Lima, February 14, 1837. 58. Jouve Martín, Black Doctors of Colonial Lima, 101–10; Lastres, Historia de la medicina peruana, 153–55, 321. 5. Pai Domingos 1. This chapter is largely based on João José Reis, Divining Slavery and Freedom: The Story of Pai Domingos, an African Priest in Nineteenth-Century Brazil (New York: Cambridge University Press, 2015), especially chaps. 4 and 5. 2. For an overview of nineteenth-century Candomblé in Bahia, see Rachael E. Harding, A Refuge in Thunder: Candomblé and Alternative Spaces of Blackness (Bloomington: Indiana University Press, 2000); Luís Nicolau Parés, A formação do candomblé: história e ritual da nação jeje na Bahia (Campinas: Editora da UNICAMP, 2006). On the participants in Candomblé, see João José Reis, “Candomblé in Nineteenth-Century Bahia: Priests, Followers, Clients,” in Rethinking the African Diáspora, ed. Kristin Mann and Edna G. Bay (London: Frank Cass, 2001), 116–34. 3. See Joseph Miller, Way of Death: Merchant Capitalism and the Angolan Slave Trade, 1730–1830 (Madison: University of Wisconsin Press, 1988), 389, 413; Marcus Rediker, The Slave Ship: A Human History (New York: Viking, 2007) 266–67; John Thornton, “Cannibals, Witches, and Slave Traders in the Atlantic World,” William and Mary Quarterly, 60, no. 2 (2003): 273–94. A personal account about the fear of white cannibalism is offered by Olaudah Equiano, The Life of Olaudah Equiano (Essex, England: Longman, 1989 [orig. 1789]), 22, 31. 4. A good read on withcraft/sorcery in the lusophone Atlantic is Luis Nicolau Parés and Roger Sansi, eds., Sorcery in the Black Atlantic (Chicago: University of Chicago Press, 2011), especially the editors’ introduction. 5. Mind, however, that the term Yoruba had not yet been established at the time of the slave trade to designate the people we know as such nowadays. On Yoruba ethnogenesis in the nineteenth century, see J. D. Y. Peel, “The Cultural Work of Yoruba Ethnogenesis,” in History and Ethnicity, ed. E. Tonkin, M. McDonald, and M. Chapman (London: Routledge & Kegan Paul, 1989), 198–215; Bíódún Adédiran, “Yoruba Ethnic Groups or a Yoruba Ethnic Group? A Review of the Problem of Ethnic Identification,” África: Revista do Centro de Estudos Africanos da USP, 7 (1984), 57–70; Andrew Apter, “Yoruba Ethnogenesis from Within,” Comparative Studies in Society and History 55, no. 2 (2013): 356–87. 6. Domingos Sodré’s will in Arquivo Público do Estado da Bahia (APEB heretofore), Judiciária. Testamentos, no. 07/3257/01. Given the Christian names of Domingos’s alleged parents, they were baptized as slaves in Bahia, and by claiming he was a legitimate son, they had married in the Catholic Church. 7. On this conflict, see Robin Law, “The Career of Adele at Lagos and Badagry, c. 1807–c.1837,” Journal of the Historical Society of Nigeria 9, no. 2 (1978): 35–59; Kristin Mann, Slavery and the Birth of an African City: Lagos, 1760–1900 (Bloomington: Indiana University Press, 2007), 34–37. 8. Robin Law, The Oyo Empire, c. 1600–c. 1836: A West African Imperialism in the Era of the Atlantic Slave Trade (Oxford: Claredon, 1977). 9. David Eltis, “The Diaspora of Yoruba Speakers, 1650–1865: Dimensions and Implications,” in The Yoruba Diaspora in the Atlantic World, ed. Toyin Falola and Matt D. Childs (Bloomington: Indiana University Press, 2004), 24, 31, 38. 10. On the growth of Nagô influence on Bahian Candomblé in the nineteenth century, see Luís Nicolau Parés, “The Nagôization Process in Bahian Candomblé,” in Yoruba Diaspora, 185–208. That

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almost 80 percent of African slaves in Salvador were Nagôs, see João José Reis, Ganhadores: a greve negra de 1857 na Bahia (São Paulo: Companhia das Letras, 2019), 219. 11. Mario Torres, “Os morgados do Sodré,” Revista do Instituto Genealógico da Bahia, 5 (1951): 9–34; APEB, Matrícula dos engenhos, livro no. 632, registros no. 424 (engenho Trindade) and 643 (engenho Cassucá). 12. On the Bahian slave revolts, see João José Reis, Slave Rebellion in Brazil: The Muslim Uprising of 1835 in Bahia (Baltimore, MD: John Hopkins University Press, 1993). 13. On the recruitment of slaves during the war of independence, see Hendrik Kraay, “‘Em outra coisa não falavam os pardos, cabras, e crioulos’: o recrutamento de escravos na guerra da independência na Bahia,” Revista Brasileira de História 22, no. 43 ( 2002 ): 109–28. 14. APEB, Livro de notas do tabelião, 282, fl. 19. For manumission prices, see Katia Mattoso, Herbert Klein, and Stanley Engerman, “Notas sobre as tendências e padrões dos preços de alforrias na Bahia, 1819–1888,” in Escravidão e invenção da liberdade, ed. João José Reis (São Paulo: Brasiliense, 1988), 66. For his discharge from the army and hospitalization, see Domingos’s affidavit of 1853 in APEB, Policia, maço 6315. 15. Chief of police João Antonio de Araújo Freitas Henriques to subdelegado of São Pedro parish, July 25, 1862, Arquivo Público do Estado da Bahia (APEB heretofore), Polícia. Correspondência expedida, 1862, vol. 5754, fl. 214v. This incident was also discussed by Harding, A Refuge in Thunder, 50–51, 93–96 and a sample of the sources transcribed in pp. 193–204. 16. On the population of Salvador, see Katia M. de Queirós Mattoso, Bahia: a cidade de Salvador e seu mercado no século XIX (São Paulo: HUCITEC, 1978), 134, 138. 17. For more details see Reis, Divining Slavery and Freedom, 145–48. On Delfina’s marriage with Sodré, see Arquivo da Cúria Metropolitana de Salvador (ACMS heretofore), Livro de assentos de casamentos. São Pedro Velho, 1844–1910, fl. 128v 18. Subdelegado Pompílio Manuel de Castro to Chief of Police of Bahia province, July 26, 1862, APEB, Polícia. Subdelegados, 1862–63, maço 6234. 19. See William Bascom, Sixteen Cowries: Yoruba Divination from Africa to the New World (Bloomington: Indiana University Press, 1980). 20. Chief of Police Henriques to the director of the War Arsenal, July 26, 1862, APEB, Polícia. Correspondência expedida, 1862, vol. 5750, fl. 326v. 21. Diário da Bahia, July 28, 1862, 170. 22. Pierre Verger, Notes sur le culte des Orisa et Vodun à Bahia, la Baie de Tous les Saints, au Brésil, et l´ancienne Côte des Esclaves en Afrique (Dacar: IFAN, 1957), 120–22, reproduces passages of European travel narratives in West Africa that associated Es�u, Elegbara, or Legba (the last two an equivalent god in Dahomey) with the devil. One such commentator, Pruneau de Pommegorge, who lived in Whydah between 1743 and 1765, described Legba just as the 1862 Bahian newspaper had, as “a Priapus god . . . with his main attribute, which is enormous and exaggerated in comparison with the rest of the body” (Verger, Notes, 120). US baptist missionary Thomas Bowen also associated Es�u with Satan. See T. J. Bowen, Adventures and Missionary Labours in Several Countries in the Interior of Africa from 1849 to 1856 (London: Frank Cass, 1968 [1857]), 317. On Brazil, see Antonio da Costa Peixoto, Obra nova da língua geral de mina (Lisbon: Agência Geral das Colônias, 1943–1944 [1741]), 32, where the author identifies “Leba” (Legba) with the “Demônio” (devil). 23. See Wande Abimbola, Ifá: An Exposition of Ifá Literary Corpus (Ibadan: Oxford University Press Nigeria, 1976). Thomas Bowen and William Clarke, US baptist missionaries who visited Yorubaland in the 1850s, noted the extraordinary popularity of Ifá divination everywhere they went. Bowen, Adventures and Missionary Labours, 317; William W. Clarke, Travels and Explorations in Yorubaland, 1854–1858 (Ibadan: Ibadan Universisty Press, 1972), 279.

NOTES TO PAGES 79–84

24. Subdelegado Pompílio Manuel de Castro to Chief of Police of Bahia province, July 27, 1862, APEB, Polícia. Subdelegados, 1862–1863, maço 6234. 25. Michka Sachnine, Dictionaire usuel yorùbá-français (Paris: Karthala/IFRA, 1997), 69, 73. In Brazil, male leaders of Afro-Brazilian religions are addressed as pai de santo (father of the saint) and female leaders as mãe de santo (mother of the saint). 26. A. B. Aderibigbe, “Early History of Lagos to about 1850,” in Lagos: The Development of an African City, ed. A. B. Aderibigbe (Lagos: Longman Nigeria, 1975), 16–17. 27. Abimbola, Ifá; Bascom, Sixteen Cowries; Samuel Johnson, The History of the Yorubas (London: Routledge, 1921 [1897]), 33: “As he [the first babalawo] advanced in age, he began to practice sorcery and medicine,” according to a tradition about S�etilu, a Nupe migrant who would have introduced Ifá to Yorubaland. 28. Chief of Police João Antonio de Araújo Freitas Henriques to subdelegado of São Pedro parish, July 25, 1862, APEB, Polícia. Correspondência expedida, 1862, vol. 5754, fl. 215. 29. José Manuel de Macedo, As vítimas-algozes, 3rd ed. (Rio de Janeiro: Scipione/Casa de Rui Barbosa, 1991). 30. Mary Karasch, Slave Life in Rio de Janeiro,1808–1850 (Princeton, NJ: Princeton University Press, 1987), 61. 31. Macedo, As vítimas-algozes, 77. 32. Posturas da Câmara Municipal da Cidade de S. Salvador, capital da Província da Bahia (Bahia: Typ. de Manoel Agostinho Cruz Mello, 1860), 26. 33. José Teixeira Bahia, subdelegado of Brotas, to the chief of police, November 8 and December 1, 1860, APEBa, Polícia. Subdelegados, maço 6233. 34. Tribuna 4, no. 67 (October 18, 1979): 3. 35. Amansa-senhor is found in the classic Houaiss Portuguese dictionary, which associates it with both guinea weed and the coral shrub. 36. Quoted from José Flavio Pessoa de Barros and Eduardo Napoleão, Ewé Òrìsà: uso litúrgico e terapêutico dos vegetais nas casas de candomblé jêje-nagô, 3rd ed. (Rio de Janeiro: Bertrand Brasil, 2007), 197. 37. Quoted from Maria Cristina Wissenbach, “Ritos de magia e de sobrevivência. Sociabilidades e práticas mágico-religiosas no Brasil (1890–1940),” (PhD diss., Universidade de São Paulo, 1997), 172–73. 38. Manoel Joaquim Ricardo’s probate records, APEB, Inventários, maço 04/1457/1926/18. 39. Carlota Leopoldina de Mello to the police chief, March 13, 1857, APEB, Polícia, maço 6322. 40. A. L. de Figueiredo Rocha to the vice president of the province, June 4, 1859, APEB, Polícia. Correspondência expedida, 1859, vol. 5734, fl. 20v. 41. See several letters by the police chief to the jailer at the correctional house between July 26 and 31, 1862, APEB, Polícia. Correspondência expedida, 1862, vol. 5756, fls. 140v-149. APEB, Polícia. Termos de fiança, 1862–67, vol. 5651, fl. 88v. See also Reis, Divining Slavery and Freedom, 152–66, for example. 42. Diário da Bahia, July 28, 1862. 43. O Alabama, September 2, 1868. 44. O Noticiador Catholico 2, no. 89 (1850): 365. 45. O Alabama, September 29, 1868. 46. O Alabama, March 6, 1867. This newspaper waged a fierce compaign against Candomblé. See Dale Graden, “‘So Much Supersticion among These People’: Candomblé and the Dilemmas of Afro-Bahian Intellectuals, 1864–1871,” in Afro-Brazilian Culture and Politics: Bahia, 1790s to 1990s, ed. Hendrik Kraay (Armonk, NY: M. E. Sharpe, 1998), 57–73.

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47. APEB, Judiciária. Tribunal da Relação, 1860, 26A/921/16, maço 3537. 48. About Yorubaland, see Johnson, The History of the Yorubas, 119. 49. Mercantil, July 15, 1848, for a contemporary description; Reis, Divining Slavery and Freedom, 205–25, for a longer discussion of African credit societies in Bahia and Domingos’s role in one of them. 50. APEB, Livro de notas do tabelião, vol. 295, fls. 134–134v (Esperança’s bill of purchase); APEB, Livro de notas do tabelião, vol. 319, fls. 165v-166 (Esperança’s manumission); APEB, Livro de notas do tabelião, vol. 320, fl. 72 (Theodoro´s manumission); APEB, Índice de cartas de liberdade, maço 2882 (Umbelinda’s manumission). On slave manumission in nineteenth-century Bahia, see Mieko Nishida, “Manumission and Ethnicity in Urban Slavery: Salvador, Brazil, 1808–1888,” Hispanic American Historical Review 73, no. 3 (1993): 361–91. On African ex-slaves who owned slaves, see João José Reis, Rebelião escrava no Brasil: a história do levante dos malês em 1835 (São Paulo: Companhia das Letras, 2012), 33, 367–370; Maria Inês C. de Oliveira, O liberto, seu mundo e os outros (Salvador: Corrupio, 1988); Mieko Nishida, Slavery and Identity: Ethnicity, Gender, and Race in Salvador, Brazil, 1808–1888 (Bloomington: Indiana University Press, 2003). 51. On attitudes toward death as viewed through wills, see João José Reis, Death Is a Festival: Funeral Rites and Rebellion in Nineteenth-Century Brazil (Chapel Hill: North Carolina University Press, 2003), esp. chap. 4. 52. APEB, Judiciária. Testamentos, no. 07/3257/01 (Domingos’s will); “Cópia do Auto de busca e achada,” APEB, Polícia. Subdelegado, 1861–62, maço 6234 (police report); for a different interpretation, see Harding, A Refuge in Thunder, 50–51. 53. There is evidence of a Pai Domingos active in Candomblé after 1862, as reported by O Alabama, September 14, 1864; August 12, 1865; and July 23, 1870. For a good example of an itinerant healer in colonial Rio de Janeiro, see James Sweet, Domingos Álvarez, African Healing, and the Intellectual History of the Atlantic World (Chapel Hill: North Carolina University Press, 2011), esp. chap. 4. 54. APEB, Judiciária, 07/3000/08. 6. Mystic of Medicine, Modern Curandero, and “Médico improvisado” Epigraph: Bruno Traven, “The Third Guest,” Fantastic 2, no. 2 (1953): 19. I want to thank Dorothy Porter and Gabriela Soto Laveaga, who commented on a first version of the manuscript, and the attendants of the workshop “The Gray Zones of Medicine(s)” whose valuable insight made this a better text. The Consejo Nacional de Ciencia y Tecnología in Mexico and the University of California Institute for Mexico and the United States supported this research. 1. Madero’s clinical booklet in Archivo de la Secretaría de Hacienda y Crédito Público, Fondo Histórico Francisco I. Madero (FHFIM), 48. 2. Julián González, Tratado de homeopatía y guia de las familias (México: Viuda e hijos de Murguía, 1871), 128. 3. October 6, 1902, in Francisco Ignacio Madero, Epistolario (1900–1909), vol. 1, Archivo de don Francisco I. Madero (Mexico: SHCP, 1985), 55. 4. Isabel Kelly, Folk Practices in North Mexico: Birth Customs, Folk Medicine, and Spiritualism in the Laguna Zone (Austin: University of Texas Press, 1965), 22. 5. Marcos Cueto and Steven Palmer, Medicine and Public Health in Latin America: A History (New York: Cambridge University Press, 2015), 1–57 and 90–95. 6. Christopher M. Moreman, The Spiritualist Movement: Speaking with the Dead in America and around the World (Santa Barbara, CA: Praeger, 2013); Robert Jütte, Guenter B. Risse, and John

NOTES TO PAGES 91–94

Woodward, Culture, Knowledge, and Healing: Historical Perspectives of Homeopathic Medicine in Europe and North America (Sheffield, England: European Association for the History of Medicine and Health Publications, 1998); Robert Jütte, The Hidden Roots: A History of Homeopathy in Northern, Central, and Eastern Europe (Stuttgart: Institute for the History of Medicine of the Robert Bosch Foundation, 2006). 7. Sandra Kuntz Ficker and Elisa Speckman Guerra, “El porfiriato,” in Nueva historia general de México (México: El Colegio de México, 2010), 134–95. 8. Luz María Hernández Sáenz, Carving a Niche: The Medical Profession in Mexico, 1800–1870, (Montreal: McGill-Queen’s University Press, 2018), 113–224; Francisco de Asís Flores y Troncoso, “Enseñanza de la medicina en el período positivo,” in Historia de la medicina en México desde la época de los indios hasta la presente, vol. 3 (México: Oficina tipográfica de la Secretaría de Fomento, 1886), 203–21; Ana María Carrillo and Juan José Saldaña, “La enseñanza de la medicina en la Escuela Nacional durante el Porfiriato,” in La casa de Salomón en México: Estudios sobre la institucionalización de la docencia y la investigación científica, ed. Juan José Saldaña (México, D. F.: FFyL, DGAPA, UNAM, 2005), 257–71; Ladislao Kusior Carabaza, “Breve reseña histórica de la salubridad en el estado de Coahuila,” in Fuentes para la historia de la medicina en Saltillo, 1717–1940 (Saltillo, Coahuila: Presidencia Municipal, Archivo Municipal, Universidad Autónoma de Coahuila, 2001), 223–56. 9. Mílada Bazant, “La República restaurada y el Porfiriato,” in Historia de las profesiones en México, ed. Lilia Cardenas Treviño (México, D. F.: El Colegio de México, 1982), 129–222. 10. El consultorio médico (México: Antonio Vanegas, ca. 1889–1918). 11. Flores y Troncoso, “Del ejercicio de la medicina en este periodo,” in Historia de la medicina, 253–60. 12. Claudia Agostoni, “Médicos científicos y médicos ilícitos en la ciudad de México durante el Porfiriato,”, Estudios de Historia Moderna y Conemporánea 39, no. 58 (2019): 13–31. 13. For Coahuila see Kelly, Folk Practices in North Mexico. 14. Jennifer Koshatka Seman, “Laying-on Hands: Santa Teresa Urrea’s Curanderismo as Medicine and Refuge at the Turn of the Twentieth Century,” Studies in Religion 20, no. 10 (2017): 1–23; Paul J. Vanderwood, The Power of God against the Guns of Government: Religious Upheaval in Mexico at the Turn of the Nineteenth Century (Stanford, CA: Stanford University Press, 1998), 159–84; Claudia Agostoni, “Ofertas médicas, curanderos y la opinión pública: El niño Fidencio en el México posrevolucionario,” Anuario Colombiano de Historia Social y de la Cultura 45, no. 1 (2018): 215–43; Jennifer Koshatka Seman, “‘How Do I Know  . .   .  Prayers Don’t Do More Good Than . . . Pils’: Don Pedrito Jaramillo, Curanderismo, and the Rise of Professional Medicine in the Rio Grande Valley, 1881–1900,” Journal of the West 54, no. 1 (2015): 15–28; Brett Hendrickson, Border Medicine: A Transcultural History of Mexican American Curanderismo (New York: New York University Press, 2014), 19–36. 15. Luz María Hernández Sáenz, Learning to Heal: The Medical Profession in Colonial Mexico, 1767– 1831 (New York: Peter Lang, 1997), 247–55; Mark Allan Goldberg, Conquering Sickness: Race, Health, and Colonization in the Texas Borderlands (Lincoln: University of Nebraska Press, 2016), 67–97. 16. Claudia Agostoni, “Enfermedad y persistencia de la medicina doméstica (1810–1910),” in México en tres momentos: 1810–1910–2010, ed. Alicia Mayer (México, D. F.: UNAM, Instituto de Investigaciones Históricas, 2007), 77–89; Jethro Hernández Berrones, “Homeopathy ‘for Mexicans’: Medical Popularisation, Commercial Endeavours, and Patients’ Choice in the Mexican Medical Marketplace, 1853–1872,” Medical History 61, no. 4 (Oct 2017): 568–89. 17. William Meyers, Forge of Progress, Crucible of Revolt: Origins of the Mexican Revolution in La Comarca Lagunera, 1880–1911 (Albuquerque: University of New Mexico Press, 1994), 145–74.

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18. Friedrich Katz, “Labor Conditions on Haciendas in Porfirian Mexico: Some Trends and Tendencies,” Hispanic American Historical Review 54, no. 1 (1974): 1–47. 19. Pedro Lamicq, Madero. Por uno de sus íntimos (Mexico: Azteca, 1915), 10. 20. Enrique Krauze, Francisco I. Madero. Místico de la libertad, Biografía del poder (Mexico: FCE, 1987). 21. Mauro Sebastián Vallejo, “Early Attitudes to X-Rays in Buenos Aires, 1896–1897: Medicine, Esotericism and Popular Fantasies,” História, Ciências, Saúde—Manguinhos 26, no. 2 (2019): 555–72; Richard Noakes, “Thoughts and Spirits by Wireless: Imagining and Building Psychic Telegraphs in America and Britain, circa 1900–1930,” History and Technology 32, no. 2 (2016): 137–58; Clément Chéroux et al., The Perfect Medium: Photography and the Occult (New Haven, CT: Yale University Press, 2004). 22. John Warne Monroe, Laboratories of Faith: Mesmerism, Spiritism, and Occultism in Modern France (Ithaca, NY: Cornell University Press, 2008), 95–112; José Mariano Leyva, El ocaso de los espíritus: El espiritismo en México en el siglo XIX (México: Cal y arena, 2005), 19–62. 23. Leyva, El ocaso de los espíritus. 24. Jean Pierre Bastian, “Protestants, Freemasons, and Spiritists: Non-Catholic Religious Sociabilities and Mexico’s Revolutionary Movement, 1910–1920,” in Faith and Impiety in Revolutionary Mexico, ed. Matthew Butler (New York: Palgrave Macmillan, 2007), 75–92; Keith Brewster and Claire Brewster, “Ethereal Allies: Spiritism and the Revolutionary Struggle in Hidalgo,” in Faith and Impiety, 93–110. 25. Francisco Ignacio Madero, Cuadernos espíritas, 1900–1908, vol. 6, Obras completas de Francisco Ignacio Madero, ed. Alejandro Rosas, (México: Editorial Clío, 2000), 20–23. 26. Francisco Ignacio Madero, Memorias, vol. 1 Obras completas, 34–35. 27. Ana María Carrillo, “¿Indivisibilidad o bifuración de la ciencia?: La institucionalizacion de la homeopatía en México,” in Continuidades y rupturas. Una historia tensa de la ciencia en México, ed. Francisco Javier Dosil Mancilla and Gerardo Sánchez Díaz (Morelia, Michoacán: Instituto de Investigaciones Históricas, UMSNH; Facultad de Ciencias, UNAM, 2010), 277–310. 28. See Manuel Eulogio Carpio’s comments in Fernando Martínez Cortés, La medicina científica y el siglo XIX mexicano (México, D. F.: FCE, 1997); Gabino Barreda, La homeopatía o juicio critico sobre este nuevo medio de engañar a los cándidos (Mexico: Nabor Chavez, 1861). 29. Flores y Troncoso, “Terapéutica,” in Historia de la medicina, 642–49. 30. Hernandez Berrones, “Homeopathy ‘for Mexicans.’” 31. Agostoni, “Enfermedad y persistencia de la medicina doméstica (1810–1910).” 32. The story was very popular in the last decades of the nineteenth century and throughout the twentieth century. Vanegas captured it in a theatrical play. Bruno Traven wrote a version titled “The Third Guest” that was translated as “Macario,” the healer’s name in Traven’s version, in the mid-twentieth century. Filmmaker Roberto Gavaldón carved the character in the modern popular Mexican imaginary in the homonymous film. El doctor improvisado (México: Antonio Vanegas, ca. 1889–1918); Bruno Traven, “The Third Guest;” Bruno Traven, Macario (México: Compañía General de Ediciones 1960); Macario directed by Roberto Gavaldón (Clasa Films Mundiales, 1960). 33. Madero bought La salud de los niños, Medicina veterinaria y homeopática y Manual de la madre de familia with Julián González Sucs. Krauze, Francisco I. Madero, 5. He purchased books on medical magnetism, such as Delaye’s Instrucción práctica de magnetismo animal and Derville’s Aplicación del imán al tratamiento de las enfermedades, Procedimientos magnéticos, Leyes físicas del magnetismo, and El magnetismo humano, from foreign providers. Madero, Epistolario (1900–1909), 18, 22, 41–42, 213, 332. 34. To J. González Sucs., October 21, 1900, Madero, Epistolario (1900–1909), 18.

NOTES TO PAGES 100–109

35. González, Tratado de homeopatía, 399. 36. Francisco Ignacio Madero, “Manual Espírita,” in Escritos sobre espiritismo. Doctrina espírita, 1901–1903, vol. 7;; Obras completas, 75–157. 37. Madero, “Manual espírita,” 79–80. 38. Madero, “Manual espírita,” 96–97. 39. August 18, 1901, in Madero, Cuadernos espíritas, 1900–1908, 271. 40. January 9, 1901, in Madero, 35. 41. May 9, 1901, in Madero, 41. 42. December 2, 1901, in Madero, 65. 43. March 9, 1902, in Madero, 79. 44. I used patients’ names in Madero’s clinical notes to find sex ratios. I could not identify one percent of the patients’ sex using this method. 45. November 4, 1901, in Madero, 56. 46. March 20, 1902, in Madero, 86. 47. Madero’s clinical booklet, see note 1, 57, 56. 48. Arturo Palmero, Elementos de obstetricia para la enseñanza de las señoras (México: Oficina Tip. De la secretaría de fomento, 1897), 62; Nancy Leys Stepan, The Hour of Eugenics: Race, Gender, and Nation in Latin America (Ithaca, NY: Cornell University Press, 1996). 49. González, Tratado de homeopatía, 172, 244–49. 50. March 16, 1902, in Madero, Cuadernos espíritas, 1900–1908, 84. 51. November 26, 1901, in Madero, Epistolario (1900–1909), 38. 52. Correspondence in Madero, Epistolario (1900–1909), 58, 49, 178, 99, 213, 320, 32. 53. Ricardo E. Manuell, “Discurso pronunciado por su autor en la sesión celebrada en el anfiteatro de la Escuela Preparatoria el 6 de marzo de 1912,” Gaceta médica de México, 49, no. 3 (1912): 121–30. 54. Juan Antiga Escobar, “El progreso de la homeopatía en México, 1850–1911,” La homeopatía 15, no. 8 (1911): 113–16. 55. Jorge F. Hernández, Setenta aniversario de Similia. Una sombra luminosa (México: Farmacia Homeopática Nacional, 2006). 56. Mariano Villalba, “Arnold Krumm-Heller, la Revolución Mexicana y el esoterismo en América Latina,” Revista de estudios históricos de la Masonería latinoamericana y caribeña 10, no. 2 (2018): 227–58. 57. Pablo González Casanova, “La magia del amor,” Mexican folkways 1, no. 1 (1925): 19–20. 7. Herbs, Roots, Amulets, and Prayers in the Practices of “Saint” Vicente and other Healers in São Paulo in the 1910s 1. Frederico Carlos Hoehne, O que vendem os hervanários da cidade de São Paulo (São Paulo: Casa Duprat, 1920), 5. 2. See Barbara J. Hawgood, “Pioneers of Anti-venomous Serotherapy: Dr Vital Brazil (1865– 1950),” Toxon 30, no. 5–6 (1992): 573–79. 3. Ariel de A. Molina and Luiz Antonio C. Norder, “A contribuição de F. C. Hoehne (1882–1959) para o pensamento agroambiental brasileiro,” Revista Brasileira de História da Ciência 7, no. 1 (2014): 70–80. 4. Carlos J. F. dos Santos, Nem tudo era italiano (São Paulo: Annablume, 1998). 5. Potion, liquid medication prepared by a “specialist” doctor, pharmacist, or healer. 6. Arthur Neiva and Belisario Penna, Viagem científica pelo norte da Bahia, sudoeste de Pernambuco, sul do Piauí e de norte a sul de Goiás (1916), (facsimile ed. Brasília: Senado Federal, 1999).

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7. Arthur Neiva, Relatorio da Directoria do Serviço Sanitario do Estado de São Paulo, January 5, 1917, item 3, and Arthur Neiva, Relatorio da Directoria do Serviço Sanitario do Estado de São Paulo, April 16, 1918, item 2. 8. Pedro Luiz Napoleão Chernoviz, Diccionario de medicina popular e das sciencias accessorias para uso das famílias, 2nd ed. (Rio de Janeiro: Laemmert, 1851), vol. 1, 336–38; vol. 2, 73, 301; Carmen Maria K. Barguil, O lugar e o valor da fisioterapia na terapêutica médica: A medicina prática nos primeiros trinta anos do século XX (PhD diss., Casa de Oswaldo Cruz, Fiocruz, 2011). 9. “Impotencia,” O Combate, January 20, 1918; “Hernia,” O Estado de S. Paulo, September 21, 1918. 10. In the 1910s, two situations led to an increase the number of so-called charlatans: (1) the requirement, not always obeyed, for the revalidation of a medical diploma from a foreign university and (2) the practice of medicine and pharmacy by students in the last months of courses at universities that were closed in the country by the national higher education legislation of 1915. 11. Arthur Neiva, Relatorio da Directoria do Serviço Sanitario do Estado de São Paulo, October 1, 1917, item E. 12. “Pascoal de Luca,” O Parafuso 72 (1917): 11. 13. “O professor Pasqual de Luca,” A Gazeta, December 7, 1917; cf. “Gabinete de Massagem,” A Gazeta, December 16, 1918. 14. Michel de Certeau, The Practice of Everyday Life (Berkeley: University of California Press, 1984). 15. Regarding “benzedeira,” see Carlos Alberto Steil, “Traditional Popular Catholicism in Brazil,” in Handbook of Contemporary Religions in Brazil, ed. Bettina E. Schmidt and Steven Engler (London: Brill, 2017), 69–70. 16. Laura de Mello e Souza, O diabo e a terra de Santa Cruz (São Paulo: Companhia das Letras, 1995), 154–56. 17. Tânia S. Pimenta, “Terapeutas populares e instituições médicas na primeira metade do século XIX,” in Artes e ofícios de curar no Brasil, ed. Sidney Chalhoub, Vera R. B. Marques, Gabriela dos R. Sampaio, and Carlos R. Galvão-Sobrinho (Campinas: Editora da Unicamp 2003), 307–30. 18. Maria Regina C. Guimarães, Civilizando as artes de curar (Rio de Janeiro: Editora Fiocruz, 2016). 19. “V. Excia já visitou–Ervanaria Paulista,” A Capital, May 29, 1923. 20. Scientific names: Jataí bee: Tetragonisca angustula; bravo lemon: Seguieria langsdorffii; soft elephant’s foot: Elephantopus scaber; punarnava: Boerhavia difusa; American ginseng: Panax quinquefolium; catuaba: Anemopaegma mirandum. See advertisements: A Platéa, January 9, 1917; Diario Popular, January 7, 1918; O Estado de S. Paulo, December 21, 1920. 21. Orishas: Yoruba (ethnic and linguistic groups from West Africa) deities, linked to ancestors and the forces of nature, which are worshiped in Afro-Brazilian religions. For further information on these cults and their transformations, see Reginaldo Prandi, Segredos guardados: Orixás na alma brasileira (São Paulo: Companhia das Letras, 2005). 22. Figa: amulet made of wood or other material in the shape of a hand with fingers placed in a specific position (the thumb between two other fingers), used to ward off bad luck, etc. 23. See advertisements in A Platéa, January 9, 1917; Diario Popular, January 7, 1918; O Estado de S. Paulo, December 21, 1920. 24. Edward P. Thompson, Introduction: Custom and Culture, in Customs in Common (London: Penguin, 1993), 1–15. See Aldrin M. de Figueiredo, A cidade dos encantados: Pajelanças, feitiçarias e religiões afro-brasileiras na Amazônia—1870–1950 (Belém: Editora da UFPA, 2008); Fernando S. D. dos Santos and Stephane G. S. de Souza, “Processos de cura em Casas de Santo do Rio de Janeiro,”

NOTES TO PAGES 114–117

in  Uma história brasileira das doenças, 6, ed. Sebastião P. Franco, Dilene R. do Nascimento, and Anny J. T. Silveira (Belo Horizonte: Fino Traço, 2016), 335–59; Gabriela dos Reis Sampaio, Juca Rosa: um pai-de-santo na Corte imperial (Rio de Janeiro: Arquivo Nacional, 2009). 25. “Aleluia! . . . Aleluia! . . . ,” O Estado de S. Paulo, April 9, 1924. 26. “Praga de urubu!. . . Não mata cavalo,” O Estado de S. Paulo, December 11, 1923. 27. Francisco Bethencourt, O imaginário da magia: Feiticeiras, adivinhos e curandeiros em Portugal no século XVI (São Paulo: Companhia das Letras, 2004), 73–74. 28. Neiva and Penna, Viagem científica pelo norte da Bahia, 161. 29. Hoehne, O que vendem os hervanários, 10–15. 30. Hoehne, 214–15. 31. Hoehne, 7. 32. Certeau, Practice of Everyday Life. 33. Hoehne, O que vendem os hervanários, 23–24. 34. “A praga dos curandeiros,” A Capital, May 10, 1917; “Feitiçaria campeia,” A Capital, August 7, 1919; “No reino dos curandeiros,” O Parafuso 43 (1919): 16. 35. “A praga dos curandeiros,” A Capital, May 10, 1917; “Feitiçaria campeia,” A Capital, August 7, 1919; “A charlatanice, a impostura, a cartomancia, a nigromancia e o vegetarianismo de feira,” A Gazeta, October 23, 1918; “Os charlatões,” A Nação, July 29, 1918; “Outra do mesmo tipo,” A Rolha, 18 (1918): 14. 36. “Mais um curandeiro preso,” A Capital, May 14, 1918. Belém is part of the São Paulo outskirts. 37. “Os charlatões,” A Nação, July 29, 1918. Scientific name Aconite: Aconitum napellus. 38. Chernoviz, Diccionario de medicina popular, vol. 1, 16–17; vol. 2, 110. 39. “Outra do mesmo tipo,” A Rolha, 18 (1918): 14; “Os charlatães,” A Nação, July 29, 1918. 40. Peter Burke, Popular Culture in Early Modern Europe (London: Routledge, 2009), 142. 41. Bethencourt, O imaginário da magia, 77. 42. Márcia M. Ribeiro, A ciência dos trópicos: A arte médica no Brasil do século XVIII (São Paulo: Hucitec, 1997), 71–72. 43. Maria Clementina P. Cunha, O espelho do mundo: Juquery, a história de um asilo (Rio de Janeiro: Paz e Terra, 1986), 57–80. 44. Maria Cristina C. Wissenbach, Práticas religiosas, errância e vida cotidiana no Brasil (Finais do século XIX e inícios do XX), (São Paulo: Intermeios, 2018). 45. Henri-Jacques Stiker, “Nova percepção do corpo enfermo,” in História do corpo, ed. Alain Corbin, Jean-Jacques Courtine, and Georges Vigarello, 2nd ed. (Petrópolis: Vozes, 2008), vol. 2, 366. 46. Stiker, “Nova percepção do corpo enfermo,” 366–67. 47. Lilia M. Schwarcz, O espetáculo das raças (São Paulo: Companhia das Letras, 1993); Márcia Regina C. Naxara, Estrangeiro em sua própria terra: Representações do brasileiro 1870/1920 (São Paulo: Annablume, 1998). 48. Gilberto Hochman, A era do saneamento (São Paulo: Hucitec, 1998); Nísia Trindade Lima, and Gilberto Hochman, “Condenado pela raça, absolvido pela ciência,” in Raça, ciência e sociedade, ed. Marcos C. Maio and Ricardo Santos (Rio de Janeiro: Editora Fiocruz, 1996), 23–40. 49. Nancy Leys Stepan, “The Hour of Eugenics”: Race, Gender, and Nation in Latin America (Ithaca, NY: Cornell University Press, 1991). 50. Renato Kehl, Eugenia e medicina social (1920), 2nd ed. (Rio de Janeiro: Francisco Alves, 1923), 20–21. 51. Kehl, Eugenia e medicina social, 50–51.

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NOTES TO PAGES 117–120

52. Kehl, Eugenia e medicina social, xii. 53. Jair de S. Ramos, “Como classificar os indesejáveis?,” in Antropologia Brasiliana: Ciência e educação na obra de Edgard Roquette-Pinto, ed. Nísia T. Lima and Dominichi M. de Sá (Belo Horizonte: Editora da UFMG, 2008), 179–211; Priscila B. Peixoto, Até que a eugenia nos separe: raça, saúde e a proposta de exame médico pré-nupcial no Brasil (1918–1936) (master’s thesis, Universidade Estadual Paulista, 2017). Vanderlei Sebastião de Souza, “Brazilian Eugenics and Its International Connections: An Analysis Based on the Controversies between Renato Kehl and Edgard Roquette-Pinto, 1920–1930,” História, Ciências, Saúde—Manguinhos, supplement, 23, (2016): 93–110. 54. The doctor and anthropologist Edgard Roquette-Pinto contested the theory of racial hierarchy, claiming that the Brazilian race was mixed and that eugenic teaching and encouraging marriage between healthy individuals would be the best way to avoid degenerates and strengthen the Brazilian race. Souza, “Brazilian Eugenics”; Giralda Seyfertb, “Roquette-Pinto e o debate sobre raça e imigração no Brasil,” in Antropologia Brasiliana: Ciência e educação na obra de Edgard Roquette-Pinto, ed. Nísia T. Lima and Dominichi M. de Sá (Belo Horizonte: Editora da UFMG, 2008), 147–77. 55. This resolution was maintained in the 1937 Brazil Constitution. Ramos, “Como classificar os indesejáveis?,” 197–98. Regarding discussions of these themes in other Latin American countries, see Diego Armus, “Eugenics in Buenos Aires: Discourses, Practices, and Historiography,” História, Ciências, Saúde—Manguinhos, supplement, 23 (2016): 149–69; Abel Fernando Martínez Martin, “Trópico y raza: Miguel Jiménez López y la inmigración japonesa en Colombia, 1920–1929,” Historia y sociedade 32, (2017) 103–38; Alexandra Stern, “Madres conscientes y niños normales: eugenesia y el nacionalismo en el México pos-revolucionario 1920–1940,” in Medicina, ciencia y sociedad en México, século XIX, ed. Laura Cházaro C (Zamora: Universidad Michoacana de San Nicolás Hidalgo, 2002), 293–336. 56. “No domínio da magia,” A Capital, March 29, 1917, and April 2, 1917. 57. In the anarchist ideas that spread throughout Latin America at the time, science (including medical science) and education were often presented as fundamental with regard to the formation of conscious and revolutionary people. See Álvaro Sierra-Girón, “Eugenics and Anarchism in Early Libertarian Neo-Malthusianism in Barcelona, 1896–1915,” História, Ciências, Saúde—Manguinhos, supplement, 25 (2018): 87–103; Diego Armus, The Ailing City: Health, Tuberculosis, and Culture in Buenos Aires, 1870–1950 (Durham, NC: Duke University Press, 2011); Liane Maria Bertucci, “Para a saúde da criança. A educação do trabalhador nas teses médicas e nos jornais operários (São Paulo, início do século XX),” Mundos do Trabalho 7, no. 13 (2015): 27–42. 58. “Através da cidade—Uma mulher fugindo da vida,” A Plebe, September 9, 1919. 59. Bentinho is a kind of scapular with two small squares of holy cloth with religious images or signs (usually of Catholic saints) that is hung around the neck on a cord or chain. 60. “No reino dos curandeiros,” O Parafuso 43 (1919): 16. 61. “Feitiçaria campeia,” A Capital, August 7, 1919. 62. Barbara Weinstein, The Color of Modernity: São Paulo and the Making of Race and Nation in Brazil (Durham, NC: Duke University Press, 2015). 63. “A impunidade de um curandeiro,” O Parafuso 132 (1919): 11–12. 64. Ademir Medici, Migração e urbanização (São Paulo: Editora Hucitec, 1993), 411. 65. Medici, Migração e urbanização, 414–16. 66. Medici, 411–20. 67. Medici, 416. 68. Medici, 407–11.

NOTES TO PAGES 120–127

69. “Mais um processo contra O Parafuso,” O Parafuso 71 (1917): 13. 70. Medici, Migração e urbanização, 409. 71. Steil, “Traditional Popular Catholicism in Brazil”; Wissenbach, Práticas religiosas. 72. Medici, Migração e urbanização, 410. 73. “Mais um processo contra O Parafuso,” O Parafuso 71 (1917): 13. 74. “Mais um Processo,” O Parafuso 72 (1917): 8–10; “Charlatão Processado,” O Combate, April 4, 1918; “Queixa crime,” O Estado de S. Paulo, January 4, 1918. 75. “Cortando . . . ,” A Rolha, 6 (1918): 6. 76. Medici, Migração e urbanização, 414–15. 77. Medici, 415, 418. 8. Recognition without a Diploma 1. “Patent medicines” were brand-name drugs whose formula was protected by an unofficial license, as was even the brand itself. Not to be confused with what is currently known as a “patent” in international trade and industrial innovation. See Jorge Márquez, “Medicamentos, médicos y boticarios en el siglo xix en Colombia,” Poder y saber en la historia de la salud en Colombia, dir. Jorge Márquez and Víctor García (Medellín: Universidad Nacional de Colombia, 2006), 127–53. 2. José Antonio Osorio, “Aventuras del indio Rondín: El vendedor de específicos más famoso del país—Cómo salió del Putumayo y llegó hasta Nueva York,” Novelas y crónicas (Bogotá: Instituto Colombiano de Cultura, 1979), 461–64. This chronicle was also published in El Tiempo [Bogotá]: May 7, 1939. 3. In Colombia, a “culebrero” (literally “snakeman”) is a vendor who exhibits a snake in promoting his ointments and balms, flaunting an unusual verbosity to attract customers with hyperbolic speeches and stories. 4. Eduardo Santa, Recuerdos de mi aldea (Bogotá: Kelly, 1990), 111–12. 5. Leonidas Arango, “Boticarios, farmacias y doctores,” Relatos y retratos (Bogotá: Códice, 2010), 102. 6. Santa, Recuerdos de mi aldea, 113–14. 7. Mario Hernández, La salud fragmentada en Colombia, 1910–1946 (Bogotá: Universidad Nacional de Colombia, 2002), 47. 8. República de Colombia, “Ley 83 de 1914, por la cual se reglamenta el ejercicio de las profesiones médicas,” Diario Oficial 5350 [Bogotá]: November 23, 1914. 9. República de Colombia, “Ley 12 de 1905, por la cual se autoriza la reglamentación del ejercicio de la medicina y de la abogacía,” Diario Oficial 12.327 [Bogotá]: April 14, 1905. 10. República de Colombia, “Ley 0035 de 1929, por la cual se reglamenta el ejercicio de la profesión de medicina en Colombia,” Diario Oficial 21.253 [Bogotá]: November 28, 1929. 11. Victoria Estrada and Jorge Márquez, “Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905–1950),” História, Ciências, Saúde—Manguinhos 26, no. 4 (2019), 1355–72. 12. Throughout the nineteenth century, university medicine in Colombia operated under precarious conditions, and the medical occupation, among others, was framed within a fierce defense of liberality in industry, commerce, trades, and professions. See Jorge Márquez, Víctor García, and Piedad Del Valle, “La profesión médica y el charlatanismo en Colombia en el cambio del siglo XIX al XX,” Quipu 14, no. 3 (2012), 331–62. Several historians agree in stressing the precariousness and empty nominalism of medical studies throughout most of the nineteenth century in Colombia; for example, Quevedo et al., Café y gusanos, mosquitos y petróleo: El tránsito de la higiene hacia la medici-

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NOTES TO PAGES 127–130

na tropical y la salud pública en Colombia 1873–1953 (Bogotá: Universidad Nacional de Colombia, 2004), 57–71; Edwin Hernández and Patricia Pecha, La universidad bogotana y la enseñanza de la medicina en el siglo xix:, entre la precariedad, la inestabilidad política y la miseria de las guerras civiles (Bogotá: Círculo de Lectura Alternativa, 2003). 13. Virginia Gutiérrez de Pineda and Patricia Vila de Pineda, Medicina tradicional de Colombia: Magia, religión y curanderismo, vol. 2 (Bogotá: Presencia, 1985). 14. Victoria Estrada, “La valeur des chiffres: la production et les usages des statistiques démographiques et de santé publique en Colombie, 1886–1947,” (PhD diss., École des Hautes Études en Sciences Sociales, Paris, 2015), 284, 330–32. 15. Victoria Estrada, “La valeur des chiffres,” 282–84. 16. The CEF was created by Law 11 of 1920, pertaining “to the importation and sale of drugs that generate pernicious habits,” but it was only enforced as of late 1926, when some of its members were made public officers. Its most important regulatory actions commenced in 1931. See Víctor García, “Hábitos perniciosos y especialidades farmacéuticas: la legislación del medicamento en Colombia durante la primera mitad del siglo xx,” Historia social y cultural de la medicina y de la salud en Colombia, siglos XVI–XX, comps. Javier Guerrero, Luis Wiesner, and Abel Fernando Martínez (Medellín: UPTC / La Carreta, 2010), 223–40. 17. Pereira, Manizales, Chocontá, Salamina, Montenegro, Marsella, Anolaima, and Facatativá. AGN, c. 3190, ff. 48–51. 18. AGN, c. 3190, f. 49. 19. Called “the forefather of syphilography,” he was the founder and first president of France’s Société de prophylaxie sanitaire et morale, whose primary goal was to protect society from syphilis outbreaks. 20. AGN, c. 3190, f. 66. 21. AGN, c. 3190, f. 48. 22. AGN, c. 3190, f. 59. 23. AGN, c. 3190, ff. 61–63. 24. In 1917, Cundinamarca’s departmental sanitary authority ratified Rondín’s unofficial participation in vaccinating various people in Nemocón. It seems his help was accepted due to his “condition as a traveling drug vendor”; it was not unusual for people with certain types of instruction to perform vaccinations without being physicians; AGN, c. 3190, f. 80. 25. According to official documents, Rondín probably did present himself as a culebrero and a healer. In Líbano, perhaps the town he visited most often, officials tried to suppress culebrero practices. AGN, c. 3190, f. 53. 26. AGN, c. 3190, f. 1. 27. El Progreso 1.6 [Bogotá], June 21, 1925. [Rondín Pharmacy / Carrera 13, Number 173 / (San Victorino Square) / Dispensation of formulas. Practitioner services. The latest drugs from the best German houses. Rondín’s famous patent medicines for sale: / Veterino Child-Saver, Rondin, Antidol, USAR Tropical Wine, Mentholatum, Molarina, etc. / Dispensation until 10 p.m. Mail: / USCATEGUI, SALAZAR & Co. / Telegrams: Likewise. Phone: 36–52]. 28. AGN, c. 3190, ff. 1–2. 29. See James Harvey Young, The Medical Messiahs: A Social History of Health Quackery in 20th Century America (Princeton, NJ: Princeton University Press, 1992). 30. Leonidas Arango, “Los específicos: un prodigio en cada frasco,” Poder y saber en la historia de la salud en Colombia, dir. Jorge Márquez and Víctor García (Medellín: Universidad Nacional de Colombia, 2006), 99–126. 31. Víctor García, “La inspección de farmacias y el control de los medicamentos en Medellín a

NOTES TO PAGES 130–134

comienzos del siglo xx,” Poder y saber en la historia de la salud en Colombia, dir. Jorge Márquez and Víctor García (Medellín: Universidad Nacional de Colombia, 2006), 155–89; Márquez, García, and Del Valle, “La profesión médica,” n331–62. 32. AGN, c. 3190, f. 1. 33. AGN, c. 3190, f. 7. 34. AGN, c. 3190, f. 6. 35. Drugs, which started to be regarded as narcotics or as “substances that generate pernicious habits.” According to Article 1 of Law 11 of 1920, “heroic drugs” included cocaine or its salts; eucaine, alpha or beta; opium or its official variants, such as laudanum, concentrated opium, anodine balm, codeine, morphine, or its salts or derivations; heroin; belladonna; atropine or its salts; cannabis indica; and any other substance of this kind. See García, “La inspección.” 36. AGN, c. 3190, f. 6. 37. AGN, c. 3190, f. 1. 38. AGN, c. 3190, f. 88. 39. Antidol, Agua India, Bálsamo Indio, Crema La Reina, Coty Cura (gotas y ungüento), Capilina, Contra Caspa (jabón y loción indio), Callicida, Gotas Antisifilíticas, Gotas Epáticas, Hielol (remedio mágico), Jabón Blampiel, Jarabe Quitatos, Linimento, Mentolata Verde, Mata Callo, Molarina, Palusan, Panacea Sublime, Pasta Chocoana, Rondín (remedio indio), Reumaticura (unguento y jarabe), Salva Niños (vermífugo indio), Sanagono, Sanador de Rondín, Usarine (dentífrico la Reina), Vino Tropical de Usar y Veterino. Diario Oficial LXII. 20137 [Bogotá], 339: March 3, 1926. The same page shows invention patent No. 2145. It corresponds to Veterino, a vegetable laxative intended for livestock. 40. AGN, c. 3190, f. 12. 41. AGN, c. 3190, f. 10. 42. Sublime Panacea (No. 811); Cough Syrup (No. 1932); Children’s Drops (No. 1931); Internal Antidol (No. 1734); External Antidol (No. 1735); Indian Balm (No. 1930); Green Mentholatum (No. 1934); Rondín Indian Remedy (No. 1933); Savior Vermifuge (No. 316); and San Antonio Restorative (No. 780). AGN, c. 3190, f. 71. In 1929, Rondín was authorized to sell his patented medicines in four municipalities in Valle del Cauca; AGN, c. 3190, ff. 71–72. 43. In 1925, Líbano’s city council tried to stiffen controls over the sale of patent medicines and banned “the exhibition of snakes in public markets within the Municipality.” AGN, c. 3190, f. 53. 44. Víctor García, Remedios secretos y drogas heroicas: historia de los medicamentos en Antioquia, 1900–1940 (Medellín: Universidad Nacional de Colombia, Facultad de Ciencias Humanas y Económicas, 2008), 122–26. 45. These names are puns that refer explicitly to the effects of the drugs: Quita-tos (cough-stopper) and Anti-dol is short for anti-dolor (anti-pain). 46. Jorge E. Orozco, Legislación farmacéutica colombiana: disposiciones vigentes sobre escuela de farmacia y títulos farmacéuticos; drogas heroicas, Comisión de especialidades farmacéuticas, farmacias, droguerías y laboratorios, policía sanitaria nacional (Bogotá: Talleres Gráficos Mundo al día, 1940), 159–225. 47. Such difficulties were not exclusive to Colombia. In 1938, the US Congress passed a set of laws that authorized the Food and Drug Administration as the supervisor of food, medicine, and cosmetic safety, given the boom of panaceas. This struggle remained an ongoing public health problem in the 1940s, both in the United States and in Colombia; James H. Young, The Medical Messiahs, 260–95. 48. AGN, c. 3190, f. 16–17.

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49. AGN, c. 3190, f. 40. 50. Signed by the patient and thirty-three witnesses to the events; AGN, c. 3190, f. 18. 51. AGN, c. 3190, f. 22–23. 52. Jorge Bejarano, El Estado y las medicinas de patente, ante la Federación Médica Colombiana (Bogotá: Imprenta Nacional, 1936), 28–32. 53. Roy Porter, Quacks: Fakers & Charlatans in Medicine (London: Tempus, 2003). 54. Jorge Márquez, “El médico de oficio en Colombia en las décadas de 1920 y 1930,” Mundos do Trabalho 7, no. 13 (2015): 85–104. 9. The Miraculous Doctor Pun, Chinese Healers, and Their Patients in Lima, 1868–1930 1. José María Macedo, Informe del Dr. José María Macedo sobre la fiebre amarilla y sus particularidades. Lima, July 20, 1868. Archivo Histórico Municipalidad de Lima (AHML). Sección Higiene y Vacuna. Caja 1 (1857–1869). f. 4. 2. “Crónica Local: Médico Chino,” El Nacional, May 12, 1868. 3. Throughout this chapter, we use the original terms as they appear in primary sources (“Chinese healer,” “Chinese doctor,” and “Chinese herbalist”) to refer to those Chinese nationals who performed health treatments in Peru during the years examined. 4. The literature on nineteenth-century Chinese migration is extensive. See, for example, Watt Stewart, Chinese Bondage in Peru. A History of the Chinese Coolie in Peru, 1849–1874 (Durham, NC: Duke University Press, 1951); Humberto Rodríguez Pastor, Hijos del Celeste Imperio, Lima (Lima: Sur Casa de Estudios del Socialismo, 1989); Isabelle Lausent-Herrera. Pequeña Propiedad, Poder y Economía de Mercado, Acos (Lima: IEP- IFEA, 1983). 5. On Chinese herbalism in the United States, see Haiming Liu, “The Resilience of Ethnic Culture: Chinese Herbalists in the American Medical Profession,” Journal of Asian American Studies 1, no. 2 (1998): 173–91; Tamara Venit, “Curiosity or Cure? Chinese Medicine and American Orientalism in Progressive Era California and Oregon,” Oregon Historical Quarterly 114, no. 3 (2013): 266–91; Tamara Venit, Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace (New Haven, CT: Yale University Press, 2019). 6. See Diego Armus, ed. Entre médicos y curanderos: Historia, cultura y enfermedad en la America Latina moderna (Buenos Aires: Grupo Editorial Norma, 2002). 7. Patricia Palma and José Ragas, “Desenmascarando a los impostores: Los médicos profesionales y su lucha contra los falsos médicos en Perú,” Salud Colectiva 15 (2019): 1–14. 8. Gabriel Ramón, La Muralla y los Callejones: intervención urbana y proyecto político en Lima durante la segunda mitad del siglo XIX (Lima: SIDEA, 1999), 154. 9. Paul Gootenberg, Población y etnicidad en el Perú republicano (siglo XIX): algunas revisiones (Lima: IEP, 1995), 8. 10. Carlos Bustíos, Cuatrocientos años de la salud pública en el Perú 1533–1933 (Lima: Fondo Editorial UNMSM, 2004), 322. 11. Jorge Lossio, “Fiebre Amarilla, Etnicidad y Fragmentación Social,” Socialismo y Participación 93 (2002): 82. 12. Lossio, “Fiebre Amarilla,” 85. 13. Ramón, La Muralla, 161. 14. “Crónica Local: Médico Chino,” El Nacional, May 12, 1868. 15. José Ragas, “Leer, escribir, votar: Literacidad y cultura política en el Perú,” Histórica 31, no. 1 (2007): 107–34. 16. Lossio, “Fiebre Amarilla,” 84.

NOTES TO PAGES 141–146

17. Patricia Palma, “Unexpected healers: Chinese medicine in the age of global migration (Lima and California, 1850–1930),” História, Ciências, Saúde—Manguinhos 25, no. 1 (2018): 6. 18. Patricia Palma and José Ragas, “Enclaves sanitarios: Higiene, epidemias y salud en el Barrio Chino de Lima (1880–1910),” Anuario Colombiano de Historia Social y de la Cultura 45, no. 1 (2018): 159–90; Isabelle Lausent-Herrera, “The Chinatown in Peru and the Changing Peruvian Chinese Community(ies),” Journal of Chinese Overseas 7 (2011): 69–113. 19. “Crónica Local: Médico Chino,” El Nacional, May 12, 1868. 20. “Crónica de la Capital: Boticas de Chinos,” El Comercio, September 10, 1868. 21. “Crónica de la Capital: Boticas de Chinos,” El Comercio, November 13, 1868. 22. José Ragas, Lima Chola: Una historia de la Gran Migración Andina (Lima: Random House, forthcoming). 23. Palma, “Unexpected Healers,” 7. 24. “Comunicados. Intereses generales. El protomédico y los chinos,” El Comercio, December 11, 1868. 25. Ramón, La Muralla, 164–65. 26. José María Macedo, Informe del Dr. José María Macedo, f. 4. 27. José Casimiro Ulloa, “Empirismo y charlatanismo,” La Gaceta Médica de Lima, 12, no. 273 (1868): 231. 28. “Crónica Local: Médico Chino,” El Nacional, May 12, 1868. 29. Archivo General de la Nación (AGN), Criminal Records, Leg. 305, started on May 22, 1871, f. 4. 30. AHML. Higiene y Vacuna. Caja 2 (1870–1884). “Inspección de Higiene. Expediente seguido para clausurar las boticas de chinos establecidas en esta capital.” Started July 3, 1876, f. 7–9. 31. “Anuncio. Médico Chino,” El Comercio, October 2, 1877. 32. For more about the differences between Chinese medicine in California and Peru, see Palma, “Unexpected Healers.” 33. “Botica China,” El Nacional, April 11, 1877; Cited in AHML, “Inspección de Higiene,” f. 22. 34. AHML, “Inspección de Higiene,” f. 3. 35. AHML, “Inspección de Higiene,” f. 4–6. It is most likely that some Chinese newcomers decided to adopt a Spanish stylized name, presumably for commercial purposes. For instance, the famous Dr. Pun added “Juan” to his original Chinese family name, being known as “Juan” Pun Luyon. His son Pun San-yin, also a doctor, continued this tradition by adding “Carlos” to his family name. See “Cuatro generaciones de médicos en la familia Pun,” Oriental 69, no. 806 (1999). 36. AHML, “Inspección de Higiene,” f.15. 37. Paul Gootenberg, Imagining Development: Economic Ideas in Peru’s “Fictitious Prosperity” of Guano, 1840–1880 (Berkeley: University of California Press. 1993), chap. 5. 38. Carlos Contreras and Marcos Cueto, Historia del Peru Contemporáneo (Lima: IEP, 1999), chap. 3. 39. The Chinese commercial activities in Peru can be explored in Isabelle Lausent-Herrera, “The Chinatown in Peru and the Changing Peruvian Chinese Community(ies),” Journal of Chinese Overseas 7 (2011): 69–113 and Evelyn Hu, “Chinos comerciantes en el Perú: Breve y preliminar bosquejo histórico (1869–1924) in Actas Primer Seminario sobre poblaciones migrantes. Tomo II (Lima: CONCYTEC, 1988). 40. El Peruano, October 7, 1879. 41. Diario de Debates de la H. Cámara de Diputados (Lima: Imprenta del Comercio, 1888), 292–94. 42. Archivo Histórico de la Facultad de Medicina de Lima (AHFML), Enviados y Recibidos. Lima, July 21, 1888.

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NOTES TO PAGES 147–153

43. AGN, Criminal Records, Leg. 428, started on April 10, 1886. 44. El Comercio, September 28, 1877. Cited in Alejandro Salinas, Publicidad gráfica en la prensa limeña, siglo XIX (Lima: Seminario de Historia Rural Andina, 2010), 103. 45. Palma and Ragas, “Desenmascarando a los impostores.” Other non-licensed health practitioner groups, like “empíricos” and ethnic traditional healers from Andean and Afro-Peruvian descent in Lima, did not appeal to potential clients through advertisements in newspapers as Chinese healers did. Although there is a robust literature on the Chinese diaspora to Peru (see note 4), the specific profile and previous professional background of the Chinese newcomers still remains obscure. Yet it is safe to say that most of the Chinese healers in Peru came from a rural background with no professional training. The first documented Chinese healer with a medical degree was Dr. Pun Luy-on, who opened his medical practice in Chinatown in the turn of the twentieth century. 46. Jorge Lossio, Acequias y gallinazos: salud ambiental en Lima del siglo XIX (Lima: Instituto de Estudios Peruanos, 2003), 79. 47. “Anuncio. Wan Chay Jan,” El Comercio, January 4, 1910. 48. AHML, “Inspección de Higiene,” 10vta-11 and 19–21. 49. Palma and Ragas, “Enclaves sanitarios.” 50. Heidi Tinsman, “Rebel Coolies, Citizen Warriors, and Sworn Brothers: The Chinese Loyalty Oath and Alliance with Chile in the War of the Pacific,” Hispanic American Historical Review 98, no. 3 (2018): 439–69. 51. Palma and Ragas, “Enclaves sanitarios,” 174–79; Marcos Cueto, The Return of Epidemics: Health and Society in Peru during the Twentieth Century (Aldershot, NY: Ashgate, 2001), chap. 1. 52. Adam McKeown, Chinese Migrant Network and Cultural Change: Peru, Chicago and Hawaii, 1900–1936 (Chicago: University of Chicago Press, 2001), 150–51. 53. Ana María Candela, “Nation, Migration And Governance: Cantonese Migrants to Peru and the Making of Overseas Chinese Nationalism, 1849–2013” (PhD diss., University of California, Santa Cruz, 2013), chap. 3. 54. Álbum de la Colonia China en el Perú. Instituciones y hombres representativos. Su actuación benéfica en la vida nacional (Lima: Sociedad Editorial Panamericana, 1924), 66–68. Ana María Candela kindly shared with us a digital copy of the Álbum. 55. “Cuatro generaciones de médicos en la familia Pun,” Oriental 69, no. 806 (1999), 45–47. 56. Paulo Drinot, ed., La Patria Nueva. Economía, sociedad y cultura en el Perú, 1919–1930 (Raleigh, NC: Editorial A Contracorriente, 2018). 57. McKeown, Chinese Migrant Network, 163. 58. “Durante los tres últimos meses ingresaron al país 54 chinos y salieron 126, ”El Pueblo Dic 3, 1930, 5. 59. “Importante memorial que presenta a la Junta de Gobierno el presidente del Sindicato de Médicos de Perú,” La Crónica, November 30, 1930, 6. 60. El Comercio, December 23, 1930; La Crónica, December 24, 1930. 61. “Memorial que presentan al Sr. Presidente de la República numerosas personas que testimonian la benéfica acción curativa de las hierbas medicinales chinas,” El Comercio, Dic. 31, 1930, 3–8. 62. Haiming Liu, The Transnational History of a Chinese Family (New Brunswick, NJ: Rutgers University Press, 2005), 58–59. 63. “Los herbolarios y el precio de las drogas,” Libertad: Diario depurador y revolucionario (January 2, 1931), 3. 64. “Comunicados,” El Comercio, January 3, 1931, 13. 65. “Herbolerías asiáticas; denegatoria de una solicitud,” Resolución Suprema, April 21, 1931.

NOTES TO PAGES 154–158

66. Patricia Palma, “George Deacon and the circulation of homeopathic therapies in Lima (1880–1915),” História, Ciências, Saúde–Manguinhos 26, no. 4 (2019): 1263–80.  67. Paulo Drinot, The Allure of Labor: Workers, Race, and the Making of the Peruvian State (Durham, NC: Duke University Press, 2011). 68. José Matos Mar, Desborde popular y crisis del Estado: El nuevo rostro del Perú en la década de 1980 (Lima: Instituto de Estudios Peruanos, 1984). 10. Stepping through a Looking Glass 1. Michiel Baud, “Sugar and Unfree Labor: Reflections on Labor Control in the Dominican Republic, 1870–1935,” Journal of Peasant Studies 19, no. 2 (January 1992): 301–25; Humberto García Muñiz and Jorge L. Giovannetti, “Garveyismo y racismo en el Caribe: El caso de la población cocola en la República Dominicana,” Caribbean Studies 31, no. 1 (January–June 2003): 139–211. 2. Pedro L. San Miguel, “An Island in the Mirror: The Dominican Republic and Haiti,” in The Caribbean: A History of the Region and Its Peoples, ed. Stephan Palmié and Francisco A. Scarano (Chicago: University of Chicago Press, 2011), 553–69. See also his The Imagined Island: History, Identity, and Utopia in Hispaniola, trans. Jane Ramírez (Chapel Hill: University of North Carolina Press, 2005). 3. Pedro Mir, “Acerca de las tentativas históricas de unificación de la isla de Santo Domingo,” in Problemas domínico-haitianos y del Caribe, ed. Gérard Pierre-Charles, et al. (México D. F.: Universidad Nacional Autónoma de México, 1973), 145. 4. Karol K. Weaver, Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue (Urbana: University of Illinois Press, 2006). 5. Julius C. Scott III, The Common Wind: Afro-American Currents in the Age of the Haitian Revolution (New York: Verso, 2018). 6. Alberto Despradel and Miguel Reyes Sánchez, La guerra domínico-haitiana: Las cinco campañas de separación, 1844–1856 (Santo Domingo: Ediciones Senderos del Mundo, 2011); Frank Moya Pons, La dominación haitiana, 1822–1844 (Santiago: Universidad Católica Madre y Maestra, 1973). 7. Joaquín Balaguer, La isla al revés: Haití y el destino dominicano, Cuarta edición (1983; repr., Santo Domingo: Editora Corripio, 1987). 8. Anne Eller, We Dream Together: Dominican Independence, Haiti, and the Fight for Caribbean Freedom (Durham, NC: Duke University Press, 2016); Andrew Walker, “All Spirits Are Roused: The 1822 Antislavery Revolution in Haitian Santo Domingo,” Slavery & Abolition 40, no. 3 (July 2019): 583–605. 9. An insightful history of Haitian “success” in the early nineteenth century is Johnhenry González, Maroon Nation: A History of Revolutionary Haiti (New Haven, CT: Yale University Press, 2019). On internal diversity and dissent in Haiti in the aftermath of the revolution, see Chelsea Stieber, Haiti’s Paper War: Post-Independence Writing, Civil War, and the Making of the Republic, 1804-1954 (New York: New York University Press, 2020). 10. José María Serra, Apuntes para la historia de los trinitarios (1887; repr., Santo Domingo: Comisión Permanente de Efemérides Patrias, 2009). 11. Francisco Febres-Cordero Carrillo, Entre estado y nación: La anexión y la guerra de restauración dominicana, 1861–1865, una visión del caribe hispano en el siglo XIX (Santo Domingo: Academia Dominicana de la Historia, 2016). 12. Ellen D. Tillman, “Imperialism Revised: Military, Society, and US Occupation in the Dominican Republic, 1880–1924” (PhD diss., Urbana: University of Illinois, 2010). 13. Bruce J. Calder, The Impact of Intervention: The Dominican Republic during the US Occupation of 1916–1924 (1984; repr., Princeton, NJ: Markus Wiener, 2006); Hans Schmidt, The United States

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Occupation of Haiti, 1915–1934 (1971; repr., New Brunswick, NJ: Rutgers University Press, 1995); Humberto García Muñiz, “Sugar Land and Gavillero Warfare in Eastern Dominican Republic: The Case of Central Romana, 1910–1924,” Historia y Sociedad 12 (2000–2001): 3–47; Roger Gaillard, La guérilla de Batraville, 1919–1934 (Port-au-Prince, Haiti: Le Natal, 1983); Yveline Alexis, Haiti Fights Back: The Life and Legacy of Charlemagne Péralte (New Brunswick, NJ: Rutgers University Press, 2021); San Miguel, “Island in the Mirror.” 14. Biotechnology meaning the exploitation of biological processes for industrial purposes. 15. Humberto García Muñiz, Sugar and Power in the Caribbean: The South Porto Rico Sugar Company in Puerto Rico and the Dominican Republic, 1900–1921 (San Juan: La Editorial, Universidad de Puerto Rico, 2010), x, xii, and 282. 16. Oscar Zanetti, Alejandro García, et al., United Fruit: Un caso del dominio imperialista en Cuba (Havana: Editorial de Ciencias Sociales, 1976); Ariel James, Banes: Imperialismo y nación en una plantación azucarera (Havana: Editorial de Ciencias Sociales, 1976); Gillian McGillivray, Blazing Cane: Sugar Communities, Class, and State Formation in Cuba, 1868–1959 (Durham, NC: Duke University Press, 2009). 17. Frank Moya Pons, et al., El batey: Estudio socioeconómico de los bateyes del consejo estatal del azúcar (Santo Domingo: Fondo para el Avance de las Ciencias Sociales, 1986); Margarita Vargas Canales, Del batey al papel mojado: Campesinos cañeros y vida cotidiana en Puerto Rico (México D. F.: Universidad Nacional Autónoma de México, 2011). 18. Glenda Sullivan, “Plantation Medicine and Health Care in the Old South,” Legacy 10, no. 1 (2010): 22–23. 19. García Muñiz, Sugar and Power, 274. 20. García Muñiz, Sugar and Power, 242–48, 274–76, 313, 336, 446, and 451; García Muñiz and Giovannetti, “Garveyismo y racismo en el Caribe.” 21. Philip A. Howard, Black Labor, White Sugar: Caribbean Braceros and Their Struggle for Power in the Cuban Sugar Industry (Baton Rouge: Louisiana State University Press, 2015); Jorge L. Giovannetti, Black British Migrants in Cuba: Race, Labor, and Empire in the Twentieth-Century Caribbean, 1898–1948 (Cambridge: Cambridge University Press, 2018). 22. García Muñiz, Sugar and Power, 245. 23. Franklin J. Franco, “Antihaitianismo e ideología del Trujillato,” in Problemas domínico-haitianos y del Caribe, 96–97; Franco, Sobre racismo y antihaitianismo y otros ensayos (Santo Domingo: Impresora Vidal, 1997); Silvio Torres-Saillant, Introduction to Dominican Blackness (New York: CUNY Academic Works, 2010), 25–30. 24. Rafael Darío Herrera, “La matanza de haitianos de 1937,” Revista Clío 86, no. 194 (July-December 2017): 257–59; Michele Wucker, Why the Cocks Fight: Dominicans, Haitians, and the Struggle for Hispaniola (New York: Hill and Wang, 1999), 50–51. 25. Carlos Esteban Deive, Vodú y magia en Santo Domingo (Santo Domingo: Fundación Cultural Dominicana, 1988), 329. 26. Alberto Ortiz, “Redeeming Bodies and Souls: Penitentiary Science and Spirituality in Twentieth-Century Puerto Rico and the Dominican Republic” (PhD diss., University of Wisconsin–Madison, 2017), chap. 2. 27. “Denuncia contra el haitiano Mauricio Gastón, por ejercer la profesión médica indebidamente,” May 18, 1938–July 4, 1938, Ref. Antigua de Caja 2082, Secretaría de Estado de Interior y Policía, Fondo Presidencia, Archivo General de la Nación (hereafter AGN). 28. “Denuncia contra el haitiano Mauricio Gastón.”

NOTES TO PAGES 160–166

29. Richard Lee Turits, Foundations of Despotism: Peasants, the Trujillo Regime, and Modernity in Dominican History (Stanford, CA: Stanford University Press, 2003). 30. “Denuncia contra el haitiano Mauricio Gastón.” 31. “Denuncia contra el haitiano Mauricio Gastón.” 32. Ortiz, “Redeeming Bodies and Souls,” chap. 2. 33. Manuel A. Machado Báez, La dominicanización fronteriza, vol. 3 of La era de Trujillo: 25 años de historia dominicana (Ciudad Trujillo: Impresora Dominicana, 1955), 210–11 and 224–25. 34. Anuario estadístico de la República Dominicana (Santiago: Editorial El Diario, 1937), 538; Anuario estadístico de la República Dominicana (Ciudad Trujillo: Editorial La Nación, 1940), “Justicia” sections. 35. Brendan Jamal Thornton, Negotiating Respect: Pentecostalism, Masculinity, and the Politics of Spiritual Authority in the Dominican Republic (Gainesville: University Press of Florida, 2016); Martha Ellen Davis, La otra ciencia: El vodú dominicano como religión y medicina populares (Santo Domingo: Editora Universitaria, UASD, 1987); Kate Ramsey, The Spirits and the Law: Vodou and Power in Haiti (Chicago: University of Chicago Press, 2011). 36. “Liborism” is a form of folk Catholicism based on intense devotion to Liborio, who was a fence maker and day laborer before becoming a messianic healer. He grew in stature as Dominicans attempted to escape the yoke of strongman politics and inched closer to modern capitalism in the early twentieth century. Liborio’s followers believed he was an incarnation of Jesus Christ. Liborism was repressed by the US marine government and their creole collaborators but resurfaced and submerged during the era of Trujillo and is perhaps best known for its revival in the Palma Sola movement of the early 1960s. See Jan Lundius and Mats Lundahl, Peasants and Religion: A Socioeconomic Study of Dios Olivorio and the Palma Sola Movement in the Dominican Republic (New York: Routledge, 1999); Martha Ellen Davis, ed., La ruta hacia Liborio: mesianismo en el sur profundo dominicano (Santo Domingo: Secretaría de Estado de Cultura, UNESCO, 2004); Lauren Derby, The Dictator’s Seduction: Politics and the Popular Imagination in the Era of Trujillo (Durham, NC: Duke University Press, 2009), chap. 7. 37. “Denuncia contra el haitiano Mauricio Gastón.” 38. “Discharge of Manuel Batlle,” June 7, 1917, Legajo 1700234, Fondo Gobierno Militar de Santo Domingo, AGN. 39. “Denuncia contra el haitiano Mauricio Gastón.” 40. Ian Vandebroek, et al., “The Importance of Botellas and Other Plant Mixtures in Dominican Traditional Medicine,” Journal of Ethnopharmacology 128, no. 1 (March 2, 2010): 20–41. 41. “Denuncia contra el haitiano Mauricio Gastón.” 42. M. R. Cruz Díaz, Supersticiones criminológicas y médicas: apuntes folklóricos (Santo Domingo: Editora Caribe, 1965), 144–57. A deeper consideration of this judge’s work is in Ortiz, “Redeeming Bodies and Souls,” chap. 2. 43. “Denuncia contra el haitiano Mauricio Gastón.” 44. “Denuncia contra el haitiano Mauricio Gastón.” 45. Trenita Brookshire Childers, In Someone Else’s Country: Anti-Haitian Racism and Citizenship in the Dominican Republic (Lanham, MD: Rowman & Littlefield, 2020). 46. “Denuncia contra el haitiano Mauricio Gastón.” 47. “Denuncia contra el haitiano Mauricio Gastón.” 48. Ortiz, “Redeeming Bodies and Souls,” chap. 2. 49. Derby, Dictator’s Seduction, chap. 6.

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NOTES TO PAGES 166–174

50. Luis Emilio Gómez Alfau, Ayer o el Santo Domingo de hace 50 años (Santo Domingo: Poll Hermanos Editores, 1944), 52–57 and 60. 51. Francisco E. Moscoso Puello, Apuntes para la historia de la medicina de la isla de Santo Domingo, vols. 1–6 (San Pedro de Macorís: Universidad Central del Este, 1983–1985); Calder, The Impact of Intervention, 40–54; Matthew Davidson, “The Medical Journals of US-Occupied Haiti,” Books, Health, and History: The New York Academy of Medicine, May 29, 2019, https://nyamcenterforhistory.org/2019/05/29/the-medical-journals-of-u-s-occupied-haiti/. 52. See, for example, “Primer Instituto de Salud Pública,” Boletín de Sanidad y Asistencia Pública 2, no. 4 (October–December 1946): 5–137; “Inauguración del Laboratorio de Salud Pública,” Boletín de Sanidad y Asistencia Pública 3, no. 1 (January–March 1947): 33–39; “Inauguración del Sanatorio Antituberculoso Infantíl El Santo Socorro,” Boletín de Sanidad y Asistencia Pública 5, no. 1 (January–March 1949): 17; “El nuevo hospital Padre Fantino de Monte Cristi,” Boletín de Salud Pública 10, no. 2 (July–December 1954): 1–6; “Inauguran en San Juan de la Maguana moderno hospital Santomé,” Boletín de Salud Pública 12, no. 1 (January–March 1956): 35–39. 53. Carmen Adoltina Henríquez Almánzar, “La trabajadora médico social y sus actividades,” Boletín de Sanidad y Asistencia Pública 3, no. 3 (July–September 1947): 144–50; Neici M. Zeller, “‘Fighting for Its Rightful Place’: Nursing, Dictatorship, and Modernization in the Dominican Republic, 1930–1961,” Nursing History Review 26, no. 1 (2018): 172–96. 54. “El curandero, enemigo de la salud,” Boletín de Sanidad y Asistencia Pública 5, no. 4 (October– December 1949): 293. 55. “El curandero, enemigo de la salud,” 293. 56. Rafael Trujillo, “Rehabilitation Program of the Dominican Republic,” Dominican Republic: A Bulletin of the Dominican Embassy 174 (August 16, 1953): 4. 57. Gómez Alfau, Deive, and others have catalogued dozens of remedies used by ordinary people in their homes to showcase this point. See Gómez Alfau, Ayer, 57–72; Deive, Vodú y magia, 331–44. 58. Ortiz, “Redeeming Bodies and Souls,” chap. 2. 11. Jesús Pueyo 1. Ahora, December 27, 1940. 2. La Semana Médica,1941. 3. See a detailed discussion of sociocultural aspects of tuberculosis in Buenos Aires in Diego Armus, The Ailing City: Health, Tuberculosis and Culture in Buenos Aires. 1870–1950 (Durham, NC: Duke University Press, 2011). 4. Juan José Vitón, Lo que todo tuberculoso debe saber. Anotaciones y consejos que ayudan a curar la tuberculosis y enseñan a evitarla (Buenos Aires: El Ateneo, 1928), 83–87. 5. Ulises Petit de Murat, El balcón hacia la muerte (Buenos Aires: Lautaro, 1943), 57. 6. Interview with Elma M. This and the rest of the in-depth interviews mentioned hereafter were conducted by the author. 7. Antonio Cetrángolo, Treinta años curando tuberculosis (Buenos Aires: Hachette, 1945), 194. 8. I am using the word “right” as a general entitlement. Individuals with tuberculosis in the 1940s used it with this meaning, definitively more vague than the current definition and discussion of “patients’ rights.” In Argentina, the late 1930s and the 1940s were years of enhancement of social and political citizenship. On patients’ individual demands, see Cetrángolo, Treinta años curando tuberculosis. On patients’ collective demands, see Armus, Ailing City, chap. 3. 9. Jesús Pueyo, La burocracia de la medicina contra los tuberculosos: Síntesis documentada y antecedentes reales de mi vacuna antituberculosa: Yo acuso (Buenos Aires: Editorial Científica, 1942).

NOTES TO PAGES 175–187

10. Details about his life are very fragmentary; see Pueyo, La burocracia de la medicina; Estela Quiñones, “El caso de la vacuna Pueyo: análisis e implicancias de los estudios de eficacia de 1946– 47,” XII Jornadas Interescuelas/Departamentos de Historia. Universidad Nacional del Comahue, San Carlos de Bariloche, 2009, http://www.aacademica.org/000-008/88. 11. Jesús Pueyo, “La tuberculosis y su cura definitiva. Vacuna y suero anti-tuberculoso,” Boletín Científico Internacional, Buenos Aires, 1940, Año I, No. 1, p. 6; Ahora, 1941, 578. 12. Quiñones, “El caso de la vacuna Pueyo,” 11. 13. Viva Cien Años, 1941, 213. 14. “Sobre el pretendido descubrimiento para la cura de la tuberculosis,” Actualidad Médica Mundial, Buenos Aires, 1940, Tomo X, Año X, 339–47; Crítica, October 21, 1940; Crítica, January 3, 1941; Ahora 1941, 14; Pueyo, La burocracia de la medicina, 23–28, 73–103; Viva Cien Años 9, 1941, 254. 15. Quiñones, “El caso de la vacuna Pueyo,” 18. 16. Santos Sarmiento, Ludueña Funes, and P. Manavella, “Estado actual de los conocimientos sobre la vacuna Pueyo. Estudio experimental clínico, radiológico y bacteriológico,” Revista de la Facultad de Ciencias Médicas de la Universidad Nacional de Córdoba, Córdoba 5 (1947): 313–49. 17. Raúl Vaccarezza and Alberto Raimondi, “Fístulas Bronco Pleuro Cutáneas de origen tuberculoso tratadas con éxito por la estreptomicina,” Revista de la Asociación Médica Argentina, Buenos Aires, 1947, 61, 615–16, 713–15. 18. Estela B. Quiñones, Lucas Goldin, Inés M. I. Bignone, and Roberto A. Diez, “A Critical View of ‘On TB Vaccines, Patients’ Demands, and Modern Printed Media in Times of Biomedical Uncertainties: Buenos Aires, 1920–1950,’” Journal of Bioethical Inquiry 15 (2018): 19–22. 19. Viva Cien Años, 1941, 208. 20. Diego Armus, “On TB Vaccines, Patients’ Demands, and Modern Printed Media in Times of Biomedical Uncertainties: Buenos Aires, 1920–1950,” Journal of Bioethical Inquiry 12 (2015): 4. 21. Ahora, 1941, 560, 591, 624, 645, 719. 22. Pueyo, La burocracia de la medicina, 25. 23. Viva Cien Años, 1941, 364. 24. Ahora, 1941, 645, 561. 25. La Vanguardia, September 27, 1945. 26. La Crónica, March 12, 1952. 27. Crítica, November 8, 1940. 28. Ahora, 1941, 578. 29. Ahora, 1941, 578. 30. Ahora, 1941, 578. 31. Ahora, 1941, 580. 32. Ahora,1941, 642. 33. Crítica, October 14, November 2, November 17, December 25, 1941; January 12, 1942. 34. Interview with Oscar O. 35. Interview with Oscar F. 36. Interview with Ricardo H. 37. I am grateful to Roberto Diez, who provided this information. 38. See a detailed discussion of these healers in Armus, Ailing City, chap. 1. 39. Archivos de Psiquiatría, Criminología y Ciencias Afines, November–December 1905, 4, 708. 40. Ahora, 1941, 639; La Semana Médica, September 21, 1939. 41. Revista Médico-Quirúrgica, 1867, 4, 83; Las Calamidades de Buenos Aires, April 18, 1883; Viva Cien Años, 1938, 6, 39.

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42. Interview with Dr. Santos Sarmiento. 12. Doña Hermila Diego 1. Unless otherwise noted, all quotes attributed to Hermila Diego González are based on over ten hours of oral history over the span of four days in January 2018. In addition to these 2018 interviews, dozens of informal conversations have taken place since first meeting Doña Hermila more than fifteen years ago. I am deeply grateful to her for her time and generosity sharing her memories and life experiences. I am additionally grateful to her children, Cipatli and Álvaro, who helped coordinate my visits. 2. Paola Sesia, “Quince años de investigaciones en la prevención y la reducción de la muerte materna en Oaxaca” in Salud y mortalidad materna en México. Balances y perspectivas desde la antropología y la interdisciplinariedad, ed., Graciela Freyermuth Enciso (México: CIESAS, 2017), 234–35; Roman Rodriguez-Aguilar, “Maternal Mortality in Mexico, beyond Millennial Development Objectives: An Age-Period-Cohort Model,” Salud y mortalidad materna. 3. For the Mexican state’s definition of traditional medicine, see https://www.gob.mx/salud/ acciones-y-programas/medicina-tradicional. 4. In the time I have known Doña Hermila I heard the story of Susana’s delivery multiple times— virtually a verbatim retelling each time. In researching newspaper articles and other sources to verify this oral history I found two published versions of Hermila’s story. It is Doña Hermila’s origin story, and yet small details are different in each telling. Given the nature of oral history, age, memory, and circumstances in each telling (i.e., interviewer, space where the interview is taking place, etc.), this is not unusual. See Judy Gabriel, Touching Bellies, Touching Lives: Midwives of Southern Mexico Tell Their Stories (Long Grove, IL: Waveland Press, 2016), chap. 1. 5. Luz María Hernández Sáenz, Carving a Niche, The Medical Profession in Mexico 1800–1870 (Kingston, Ontario: McGill-Queens University Press, 2018), 75. 6. Ana María Carrillo, “Nacimiento y muerte de una profesión. Las parteras tituladas en México,” Dynamis:acta hispanica ad medicinae scientiarumque 19 (1999): 168. 7. Graciela Freyermuth et al., Los caminos para parir en México en el siglo XXI: experiencias de investigación, vinculación, formación y comunicación (México: Centro de Investigaciones y Estudios Superiores en Antropología Social, 2018), 13. 8. Carrillo, “Nacimiento y muerte de una profesión,” 168. 9. Freyermuth, Los caminos para parir, 13. 10. Nora E. Jaffrey, Reproduction and Its Discontents in Mexico: Childbirth and Contraception from 1750 to 1905 (Chapel Hill: University of North Carolina Press, 2016), 45. 11. Author interview, Hermila Diego Hernández, Oaxaca City, Mexico, January 2018. 12. Author interview, Hermila Diego Hernández, January 2018. 13. In describing the smallpox vaccination campaigns of the mid-twentieth century, Claudia Agostoni describes the wide array of individuals who took part in the efforts: “doctors, vaccinators, epidemiologists, auxiliary vaccinators, Indigenous intermediaries, teachers and nurses, among others.” Moreover, she explains that critical aspect of their work was to “provide health education to men, women and children in rural Mexico in order to establish a true culture of prevention.” See Claudia Agostoni, “Control, Containment and Health Education in the Smallpox-Vaccination Campaigns in Mexico in the 1940s,” in História, Ciencias, Saúde—Manguinhos, Rio de Janeiro 22, no. 2 (April–June 2015); Médicos, campañas y vacunas:la viruela y la cultura de prevención en México 1870–1952 (Mexico: UNAM/Instituto de Investigaciones Dr. José María Luis Mora, 2016). 14. Author interview, Hermila Diego Hernández, January 2018.

NOTES TO PAGES 195–202

15. Author interview, Hermila Diego Hernández, January 2018. 16. Rosalinda Jiménez Botello, “Elementos histórico-antropológicos acerca de la partería en México. Entre la subordinación y la autonomía,” in Adame Cerón and Miguel Ángel, eds. (Ecosalud y antropología de las medicinas alternativas y tradicionales, México: Ediciones Navarra, 2013), 150. 17. Graciela Freyermuth, et al., Los caminos para parir en México en el siglo XXI: experiencias de investigación, vinculación, formación y comunicación (México: Centro de Investigaciones y Estudios Superiores en Antropología Social, 2018), 16. 18. Jiménez Botello, “Elementos histórico-antropológicos,” 150. 19. Starting in 1938 all Mexican medical students had to complete what came to be known as “social service,” giving back to the community. Furthermore, to receive their medical license they had to complete a thesis examining their time in their community. I examined hundreds of these theses from the 1930s to the 1950s for a different project, and medical students often wrote about traditional healers, usually in pejorative terms. See Gabriela Soto Laveaga, “Seeing the Countryside through Medical Eyes: Social Service Reports in the Making of a Sickly Nation,” Endeavor 37, no. 1 (January 2013).  20. Soto Laveaga, “Seeing the Countryside.” 21. Jiménez Botello, “Elementos histórico-antropológicos,” 150–51. 22. Jiménez Botello, “Elementos histórico-antropológicos,” 151. 23. Freyermuth, Los caminos para parir en México,15–16. 24. Frausto, ed. Mortalidad Materna en México (México: Instituto Mexicano del Seguro, 1994), 31. 25. Author interview, Hermila Diego Hernández, January 2018. 26. Maternal mortality is often used as a nation’s indicator of both development and inequality because most maternal deaths are preventable. Recent twenty-first-century studies show Mexico’s startling numbers for Indigenous maternal death, which place it among nations with the highest maternal death in the world. 27. Francisco Guerra, Las medicinas marginales. Los sistemas de curar prohibidos a los médicos (España: Alianza Editorial, 1976), 7. 28. IMSS, or Instituto Mexicano de Seguro Social, is Mexico’s agency that regulates pensions, social security, and public health for the majority of Mexico’s workers. Since its start in 1943 the IMSS was primarily urban based and excluded agricultural workers from its care. With its rural focus, IMSS-Coplamar sought to change that. 29. Alvarado A. Flores and J. Morin Zenteno, “Efectos del modelo de atención en a la salud del Programa IMSS-COMPLAMAR sobre el estado de la salud de la población rural marginada de México,” Salud Publica 31 (1989): 745–56. The pilot project to bring in traditional healers as part of state-sanctioned health care took place in Chiapas (1973–1979) before launching as a national program (1983–1984) and becoming part of the massive, national health conglomerate IMSS under the name IMSS-Coplamar (1985–1987). Graciela Freyermuth, Médicos tradicionales y médicos alópata: Un encuentro difícil en los Altos de Chiapas (Mexico City: CIESAS, 1993), 61–63; Margaret Sherrard Sherraden, “Policy Impacts of Community Participation: Health Services in Rural Mexico,” Human Organization 50, no. 3 (1991): 256–63; Julio Boltvinik, “Treinta Años De Medición De La Pobreza En México: Una Mirada Desde Coplamar,” Estudios Sociológicos 30, (2012): 83–110; Kenyon Rainier Stebbins, 30. Margaret Sherrard Sherraden, “Policy Impacts of Community Participation: Health Services in Rural Mexico,” Human Organization 50, no. 3 (1991): 256–63; Julio Boltvinik, “Treinta Años De Medición De La Pobreza En México. Una Mirada Desde Coplamar,” Estudios Sociológicos 30 (2012):

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83–110; Kenyon Rainier Stebbins, “Politics, Economics, and Health Services in Rural Oaxaca, Mexico,” Human Organization 45, no. 2 (1986): 112–19; Oscar Javier Cárdenas Rodriguez, “Poverty Reduction Approaches in Mexico since 1950: Public Spending for Social Programs and Economic Competitiveness Programs,” Journal of Business Ethics 88 (2009): 269–81. 31. Roberto Campos Navarro, Nadie nos puede arrebatar nuestro conocimiento . . . Proceso de legalización de las medicinas indígenas tradicionales en México y Bolivia (México: UNAM, 2015), 83. 32. The INI publication that I saw in her records was a photocopy of a larger volume. Hermila Diego Hernández, Personal Papers, n.d. Oaxaca City, Oaxaca. 33. Hermila Diego Hernández, Personal Papers, n.d. 34. Author interview, Hermila Diego Hernández, January 2018. 35. Initially a teachers’ protests against low salaries, the 2006 conflict grew to a takeover of the city; known as APPO or the Popular Assembly by the People’s of Oaxaca, it eventually pitted protestors against the state governor, whom they accused of abuse of power and repression. It lasted seven months and led to nearly twenty deaths. 36. Empacho is what used to be referred to as a culturally specific ailment that consists of intestinal malaise, a bloated feeling, and either constipation or diarrhea. The origin is often linked to overeating or eating greasy food or, for children, swallowing chewing gum. The cure is a back massage with oils made with medicinal plants and a pulling of the skin of the lower back which “snaps” the intestines back into shape. 37. Susto, or fright, sometimes called soul loss, happens when someone is startled by, for example, bad news, a near-miss car accident, or a wild animal on a foot path. 38. Mal de ojo, or evil eye, happens when, say, your good fortune causes envy in another person. A bouquet of medicinal plants and/or a raw egg are passed over the body. The healer absorbs this “heaviness” from the patient’s body and releases them via burps, leaving the patient cleansed of bad feelings. 39. To focus on just one, Judy Gabriel’s Touching Bellies, Touching Lives: Midwives of Southern Mexico Tell Their Stories details Doña Hermila’s first delivery, although some key elements are missing. 40. In the late 1990s when conducting research for my PhD dissertation I asked two different medical anthropologists if they could recommend a healer so I could verify the local medicinal properties of a wild yam, barbasco. Without hesitation, they both mentioned Doña Hermila. 41. Hermila Diego Hernández, Personal Papers, Oaxaca City, Oaxaca. 42. Though racism in Mexico’s public health institutions is not new, the 2013 case of Irma, an Indigenous woman forced to give birth on the lawn in front of a clinic became international news; see https:// www.proceso.com.mx/354510/irma-la-indigena-mazateca-que-pario-en-el-patio-de-un-hospital. 43. Artículo 69 de la Constitución de Oaxaca. El Estado otorgará asistencia técnica y financiamiento para la investigación y desarrollo de la medicina tradicional indígena en el Estado, así como para la formación y el empleo de sus practicantes and Artículo 68: Los servicios de salud deberán planearse en cooperación con los pueblos interesados y tomando en cuenta sus condiciones económicas, geográficas, sociales y culturales, así como su medicina tradicional. Adicionado,15 de Septiembre de 2001. 44. Carly Strouse et al., “Mexico’s Seguro Popular Appears to Have Helped Reduce the Risk of Preterm Delivery among Women with Low Education,” Health Affairs 35, no. 1, (2018). 45. “Hermila Diego González partera tradicional habla del beneficio de la herbolaría,” El blog de Frida (blog), December 11, 2008, https://fridaguerrera.blogspot.com/2008/12/hermila-diego-gonzlez-partera.html.

NOTES TO PAGES 207–209

46. “Hermila Diego González partera tradicional habla del beneficio de la herbolaría.” 47. The figure of the midwife has rights to practice under article 64 of Ley General de Salud. Guía para la autorización de las parteras tradicionales como personal de salud no profesional. Mexico: Secretaría de Salud, 2018, https://www.gob.mx/cms/uploads/attachment/file/38480/GuiaAutorizacionParteras.pdf. 48. Guía para la autorización de las parteras tradicionales como personal de salud no profesional, Mexico: Secretaría de Salud, 2018, https://www.gob.mx/cms/uploads/attachment/file/38480/ GuiaAutorizacionParteras.pdf. 49. La partería professional ¿Hacia dónde va? https://www.insp.mx/avisos/4315-seminario-parteria-insp.html. 50. National Institute of Public Health, “Proyecto Marco: Modelo Integral de Partería desarrollado por el INSP buscar legitimar esta actividad,” Instituto Nacional de Salud Pública, https:// www.insp.mx/avisos/4315-seminario-parteria-insp.html. 51. CASA A.C., https://casa.org.mx/. 52. Video on Parteras Chiapas, https://www.youtube.com/watch?v=2GXytrwBLMg, last accessed on Youtube in September 2019. Also worth noting is Compañeras en Salud’s (Partners in Health) use of midwives in the community of Revolución, Chiapas. See Carolina Menchú, “A Midwife is Changing How Women Give Birth in Mexico, One Baby at a Time.” STAT, July 31, 2017.

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SELECTED BIBLIOGRAPHY This selected bibliography includes scholarly work related to healers and health practitioners in the gray zones of medicine. It is not a bibliography of the broader history of health and disease in Latin America. Agostoni, Claudia. “Médicos científicos y médicos ilícitos en la ciudad de México durante el Porfiriato.” Estudios de Historia Moderna y Contemporánea 39, no. 58 (2019): 13–31. Armus, Diego, ed. Entre médicos y curanderos. Salud, cultura y sociedad en América latina. Buenos Aires: Norma, 2002. Armus, Diego. The Ailing City: Health, Tuberculosis, and Culture in Buenos Aires, 1870–1930. Durham, NC: Duke University Press, 2011. Austin Alchon, Suzanne. Native Society and Disease in Colonial Ecuador. Cambridge: Cambridge University Press, 1991. Barrán, José Pedro. Medicina y sociedad en el Uruguay del novecientos. Montevideo: Ediciones de la Banda Oriental, 1994. Bastien, Joseph. Drums and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia. Salt Lake City: University of Utah Press, 1992. Breen, Benjamin. “The Flip Side of the Pharmacopoeia: Sub-Saharan African Medicines and Poisons in the Atlantic World.” In Drugs on the Page: Pharmacopoeias and Healing Knowledge in the Early Modern Atlantic World, edited by Matthew J. Crawford and Joséph M. Gabriel. Pittsburgh: University of Pittsburgh Press, 2019. Campos Navarro, Roberto. Nadie nos puede arrebatar nuestro conocimiento . . . Proceso de legalización de las medicinas indígenas tradicionales en México y Bolivia. Mexico City: UNAM, 2015. Carrillo, Ana María. “Nacimiento y muerte de una profesión. Las parteras tituladas en México.” DYNAMIS: Acta Hispanica ad Medicinae Scientiarumque Historiam Illustrandam 19 (1999): 167–90. Cosminsky, Sheila. Midwives and Mothers. The Medicalization of Children on a Guatemalan Plantation. Austin: University of Texas Press, 2016. Crandon-Malamud, Libbet. From the Fat of Our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia. Berkeley: University of California Press, 1993. Di Liscia, María Silvia. Saberes, terapias y prácticas médicas en Argentina (1750–1910). Madrid: CSIC, 2002. Dos Reis Sampaio, Gabriela. Nas trincheras da cura: As diferentes medicinas no Rio de Janeiro Imperial. São Paulo: Unicamp, 2005. Dos Santos, Fernando S. D., and Stephane G. S. de Souza. “Processos de cura em Casas de Santo do Rio de Janeiro.” In Uma história brasileira das doenças.  6,  edited  by  Sebastião P. Franco, Dilene R. do Nascimento, and Anny J. T. Silveira. Belo Horizonte: Fino Traço, 2016.

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Deive, Carlos Esteban. Vodú y magia en Santo Domingo. Santo Domingo: Fundación Cultural Dominicana, 1988. Estrada, Victoria and Jorge Márquez. “Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905–1950).” História, Ciências, Saúde—Manguinhos 26, no. 4 (2019): 1355–72. Few, Martha. For All of Humanity: Mesoamerican and Colonial Medicine in Enlightenment Guatemala. Tucson: University of Arizona Press, 2015. Few, Martha. Women Who Live Evil Lives: Gender, Religion, and the Politics of Power in Colonial Guatemala. Austin: University of Texas Press, 2002. Fields, Sherry. Pestilence and Head-colds: Encountering Illness in Colonial Mexico. New York: Columbia University Press, 2009. Fleitas, Mirta. “!Queremos a Mano Santa!: Actores y significados de una revuleta popular acontecida en 1929 en San Salvador de Jujuy,” Salud Colectiva 3, no. 3 (2007): 301–13. Freyermuth, Graciela. Médicos tradicionales y médicos alópatas. Un encuentro difícil en los Altos de Chiapas. Mexico City: CIEASAS, 1993. Freyermuth, Graciela et al. Los caminos para parir en México en el siglo XXI: experiencias de investigación, vinculación, formación y comunicación. Mexico City: CIESAS, 2018. Gabriel, Judy. Touching Bellies, Touching Lives: Midwives of Southern Mexico Tell Their Stories. Long Grove, IL: Waveland, 2016. Gómez, Pablo F. “Incommensurable Epistemologies? The Atlantic Geography of Healing in the Early Modern Black Spanish Caribbean.” Small Axe: A Caribbean Journal of Criticism 44 (2014): 95–107. Gómez, Pablo F. The Experiential Caribbean. Creating Knowledge and Healing in the Early Modern Atlantic. Chapel Hill: University of North Carolina Press, 2017. González Leandri, Ricardo. Curar, persuadir, gobernar. La construcción de la profesión médica en Buenos Aires, 1852–1886. Madrid: CSIC, 1999. Guimarães, Maria Regina. Civilizando as artes de curar. Rio de Janeiro: Editora Fiocruz, 2016. Hendrickson, Brett. Border Medicine: A Transcultural History of Mexican American Curanderismo. New York: New York University Press, 2014. Hernández Berrones, Jethro. “Homeopathy ‘for Mexicans’: Medical Popularisation, Commercial Endeavours, and Patients’ Choice in the Mexican Medical Marketplace, 1853–1872.” Medical History 61, no. 4 (2017): 568–89. Jaffrey, Nora. Reproduction and Its Discontents in Mexico: Childbirth and Contraception from 1750 to 1905. Chapel Hill: University of North Carolina Press, 2016. Jiménez Botello, Rosalinda. “Elementos histórico-antropológicos acerca de la partería en México. Entre la subordinación y la autonomía.” In Ecosalud y antropología de las medicinas alternativas y tradicionales, edited by Adame Cerón and Miguel Ángel. México: Ediciones Navarra, 2013. Jouve Martín, José R. The Black Doctors of Colonial Lima: Science, Race, and Writing in Colonial and Early Republican Peru. Montreal: McGill-Queens University Press, 2014. Mannarelli, María Emma. Limpias y modernas. Género, higiene y cultura en la Lima del novecientos. Lima: Flora Tristán, 1999. Márquez Valderrama, Jorge. “Medicamentos, médicos y boticarios en el siglo XIX en Colombia.” In Poder y saber en la historia de la salud en Colombia, edited by Jorge Márquez and Víctor García. Medellín: Universidad Nacional de Colombia, 2006. Módena, María Eugenia. Madres, médicos y curanderos: Diferencia cultural e identidad ideológica. México City: CIESAS, 1990.

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251

CONTRIBUTORS Diego Armus is professor of Latin American history at Swarthmore College. He is the author of, among other works, The Ailing City: Health, Tuberculosis, and Culture in Buenos Aires (Duke University Press, 2011; Spanish editions, 2007, 2013). Liane Maria Bertucci is associate professor of history of education, and history of education and health at Federal University of Paraná (Curitiba, Brazil). She is the author of Influenza, a medicina enferma: Ciências e práticas de cura na época da gripe espanhola em São Paulo (Universidade Estadual de Campinas, 2004). Victoria Estr ada is a biologist and historian affiliated with the Red de Producción, Circulación y Apropriación de Conocimiento Research Network of the Universidad Nacional de Colombia. She is the author of “Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905–1950),” História Ciências Saúde-Manguinhos 26, no. 4 (2019), with Jorge Márquez. Martha Few is professor of Latin American history and gender, women’s, and sexuality studies at Pennsylvania State University. One of her recent books is For All of Humanity: Mesoamerican and Colonial Medicine in Enlightenment Guatemala (University of Arizona Press, 2015). Pablo F. Gómez is associate professor in the Department of Medical History and Bioethics, and the Department of History at the University of Wisconsin, Madison. He is the author of, among others, The Experiential Caribbean: Creating Knowledge and Healing in the Early Modern Atlantic (University of North Carolina Press, 2017). Jethro Hernández Berrones is associate professor of history at Southwestern University. He is the author of A Revolution in Small Doses: Homeopathy, the Medical Profession, and the State in Mexico, 1893–1942 (University of North Carolina Press, forthcoming). Jorge Márquez Valderr ama teaches in the Departamento de Filosofía y Estudios Culturales at the Universidad Nacional de Colombia, Medellín campus. He is the author of “Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía

253

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CONTR IBUTORS

en Colombia (1905–1950),” História Ciências Saúde-Manguinhos 26, no. 4 (2019), with Victoria Estrada. Patricia Palma is assistant professor in the Department of Historical and Geographic Sciences at Universidad de Tarapacá, Chile. She is the author of “Sanadores inesperados: medicina china en la era de migración global (Lima y California, 1850–1930),” História Ciências Saúde-Manguinhos 25, no. 1 (2018). José R agas is assistant professor in the Instituto de Historia at the Pontificia Universidad Católica de Chile. He is the author of, among others, “Science and Technology in Modern Latin America,” Oxford Bibliographies (2020). Joāo José R eis is professor of history at the Universidade Federal da Bahia (Salvador, Brazil) and the author of, among other books, Divining Slavery and Freedom: The Story of Domingos Sodré, an African Priest in Nineteenth-Century Brazil (Cambridge University Press, 2015; Portuguese edition, 2008). Gabriela Soto Laveaga is Professor of the History of Science and the Antonio Madero Professor for the Study of Mexico at Harvard University. She is the author of, among others, Jungle Laboratories: Mexican Peasants, National Projects and the Making of the Pill (Duke University Press, 2009; Spanish Edition, 2020). Alberto Ortiz Díaz is assistant professor of history at the University of Texas-Arlington. He is the author of “Pathologizing the Jíbaro: Mental and Social Health in Puerto Rico’s Oso Blanco (1930s to 1950s),” Americas 77, no. 3 (2020). James H. Sweet is the Vilas-Jartz Distinguished Professor of History at the University of Wisconsin. He is the author of, among others, Domingos Álvares, African Healing, and the Intellectual History of the Atlantic World (University of North Carolina Press, 2011). Adam Warren is associate professor of Latin American history in the Department of History at the University of Washington, Seattle. He is the author of Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms (University of Pittsburgh Press, 2010).

INDEX

abortion, 32

Bacteriological Institute, 177. See also institutions

abortifacients, 18, 32–33, 217

Bahia, 41, 74, 76

acupuncture, 142

biomedicine, 6–9, 168, 170, 172–73, 185–86

abolition, 81–82

African, 15, 20, 27, 47, 51, 59, 75; Central, 48; dance, 50–51; enslaved, 10, 13, 43–44, 49, 58, 75; freed, 85, 87; healing practices, 17, 24, 40, 50; health specialist, 3; knowledge, 40, 109, 112, 114, 120; medicinal experts, 82; medicine, 83; music, 50; practitioners, 12; rituals, 50; West, 13, 21, 78; West Central, 21, 42 African diaspora, 24 allopathy, 92, 126, 129, 135–36 Amerindian, 20, 21, 24. See also Indigenous amulet, 109, 114, 122 anthelmintic, 132 antibiotics, 170 apothecary, 39, 93

biomedical uncertainty, 170, 174, 184, 188 biotechnology, 158, 240n14 bloodletting, 93, 166 body/bodies, 7, 18–19, 21–22, 26, 37, 40, 49, 54, 90, 100; corporeality, 49; female, 195 Bogotá, 10, 124, 127–29 botanical knowledge, 31 botanist, 55, 114, 122 bottles/botellas, 163 Buenos Aires, 10, 170–85 Bureau of Public Health, 151–53. See also institutions Butantan Institute, 108. See also institutions

appropriation, 8 Argentine ministry of Internal Affairs, 184. See also institutions auto de fé, 24

calundu, 9, 41–42, 44–54, 218n5. See also Kilundu Candomblé, 74, 77–81, 84

255

256

INDEX

Catholic Church, 48–49, 96, 105, 120–21; and Candomblé, 87; and the Inquisition, 27, 32, 46. See also institutions

degeneracy, 116–17

Catholicism, 40, 80–81, 86; popular, 120; unorthodox, 93

divination, 74–75, 79–88

Caracas, 3 Cartagena de Indias, 11 Central Board of Medical Degrees, 128. See also institutions Central Gallego laboratory, 175. See also institutions charlatan, 9, 135–39, 171, 174, 179, 185, 230n10, 231n35; charlatanism, 109–10; healers and, 109–10, 115, 121, 166; legislation, 64, 66, 73, 131

devil, 28, 30, 32, 41, 45–46, 50, 79 diagnosis, 19–30, 83, 115–16, 123, 147, 204 doctor. See physicians Doctors Without Borders, 190 drops, 112, 131; anti-syphilitic, 131 drugs, 126, 131–32, 135, 138

Enlightenment, 33, 94 ensalmadores, 16 eugenics, 116–18 exorcism, 49

childbirth. See pregnancy Chinese: community, 148, 151, 154; doctors, 144; healers, 138–39, 141– 48, 150–53; herbs, 146; herbalists, 138, 140, 144–45, 151–52; herbal store, 141–43, 145, 151; laborers, 144; medicine, 143, 150

faith healing, 109–10, 116

Christianity, 20, 132–33

Galenic 9, 12, 19

científicos, 91–92

General Board of Medical Degrees, 127. See also institutions

cocolos, 155, 158, 164 Consejo Superior de Salubridad, 92. See also institutions

fetish, 41, 46, 52; fetishers, 42, 44 foot condition, 164

genocide, 155 Great Depression, 152, 154

constipation, 162 creole/criollo, 12, 24, 88 curandero/a, 9, 27–30, 91–106, 155, 161, 191–200

healer, 12, 22, 23, 109–11, 115, 118; African, 45, 81; Angolan, 46;

257

INDEX

benzedeira, 110–11; Black, 43–44, 48, 118, 161; Black female, 48; Chinese, 7, 138–39, 141–48, 150–53; creole, 8; enslaved, 156; female, 27, 56–57, 59, 74; folk, 55, 57, 74; itinerant, 127, 130; Indigenous, 27, 154, 196, 202, 207–8; licensed, 22; mixed-race, 118; popular, 40, 90; traditional, 190, 200–203, 208; unlicensed, 17, 55. See also sorcerer healing practices, 58, 74 health care, 94, 114–15, 154, 165–66, 206–10; rural, 198 herbs, 26, 32, 55, 108, 112–15, 186, 206– 7; abortifacients, 18; Amerindian, 20, 205; Chinese, 139–42, 144–47, 150–53; midwives, 192; purgatives, 19; religion, 36–37, 86, 109, 111; sellers of, 112–15, 122; slavery, 82–83; women, 17, 56, 59–62, 71 herbalists, 6, 20, 62, 172, 185, 199, 203; Black, 81, 83; Chinese, 138, 140–41, 144–45, 151–53, 236n3; female, 58–59, 61–62, 195, 205–6; healers and, 115; herbal store, 108–9, 114–15, 122; midwives and, 190, 199; traditional, 93 Hippocratic, 9, 12, 19, 103 Holy Office, 3, 11, 27, 29, 49. See also Inquisition hospitals, 140–41, 172; homeopathic, 97; Hospital de San Lázaro, 30; Hospital de San Pedro, 30; Hospital San Alejo, 30; Royal

Hospital of Santiago, 30. See also institutions homeopathy, 89–93, 95–107, 143 humors, 17, 185 hybrid, 6, 8 hygiene, 4, 117, 125, 127, 130–32, 191

idolatry, 28 Ifá, 78–80 ill. See sick india, 29. See also Indigenous Indian, 124. See also Indigenous Indigenous: healing, 59–60; knowledge, 60, 112,114, 190–91, 204; medical specialist, 27 injuries, 77, 160, 162 institutions: Argentine ministry of Internal Affairs, 184; Bacteriological Institute, 177; Bureau of Public Health, 151–53; Butantan Institute, 108; Catholic Church, 48–49, 96, 105, 120–21; Central Board of Medical Degrees, 128; Central Gallego laboratory, 175; Consejo Superior de Salubridad, 92; General Board of Medical Degrees, 127; Hospital de San Lázaro, 30; Hospital de San Pedro, 30; Hospital San Alejo, 30; Inquisition, 3, 11, 16–24, 26–39, 41–47, 80; Institute for Social Security and Services for State Workers, 197, 206;

258

INDEX

Instituto Nacional Indigenista, 196; laboratory, 106, 128–32, 166, 174–79, 185; Mexican Institute for Social Security, 197, 199–208, 245nn28–29; Mexican Ministry of Health, 190; municipality of Lima, 143–44; National Academy of Medicine, 105; National Department of Hygiene, 176–83; National Institute of Public Health, 209; National University of Colombia, 128; National Univeristy of Córdoba, 177; Orthopedic Institute, 110; Protomedicato, 65–66, 140, 192; Provisorato de Indios, 29; Rockefeller Foundation, 127; Royal Hospital of Santiago, 30; San Fernando School of Medicine (Lima), 139–45, 153–54; São Paulo Eugenics Society, 117; Spanish Cultural Institution, 174; State Council for Indigenous Traditional Doctors, 203; State Sanitation Service of São Paulo, 111; Tuberculosis Research Institute, 175; Union of Doctors, 151; University of Buenos Aires School of Medicine, 174 Inquisition, 3, 11, 16–24, 26–39, 41–47, 80; records, 20, 36. See also institutions Institute for Social Security and Services for State Workers, 197, 206. See also institutions

Instituto Nacional Indigenista, 196. See also institutions imperialism, 156–60

Kilundu, 42–44

laboratory, 106, 128–32, 166, 174–79, 185. See also institutions ladino, 88 liberalism, 57, 65, 126; liberals, 94 licensed medicine, 3, 6; license, 123–33. See also regulation limpia, 201, 207 limpieza de sangre, 30 Lisbon, 46, 49, 50 Lima, 55–59; Lima Charitable Society, 142 luá, 161

magazines: A Rolha, 116, 121; Ahora, 176, 178–83; Economista Peruano, 150; O Parafuso, 118, 120–21; Oriental, 150; Viva Cien Años, 176, 187 magnetism, 100–101, 103–4, 228n33 malaria, 162, 164, 198 manumission, 77, 81, 85 maroons, 12, 16 materia medica, 18

INDEX

maternal mortality, 189, 197–98, 210 Matos, Gregório de, 45 matriarchal/matriarchy, 47 Maya, 28, 33 measles, 16 medical cultures, 7–8, 27–28, 31, 39; African-originated, 24

Mexican Institute for Social Security, 197, 199–208, 245nn28–29. See also institutions Mexican Ministry of Health, 190. See also institutions Mexican Revolution, 90 Middle Passage, 43

medical degrees, 127

microbe, 16

medical establishment, 153, 171, 179, 183

microbiologist, 171 microbiology, 174–76

medical journals: La Gaceta Médica de Lima, 142; La Semana Médica, 172, 186; Lucha Antituberculosa, 177, 185; Revista de la Asociación de Farmacias, 177; Revista Médico Quirúrgica, 187

midwives, 6, 18, 30, 57, 61, 189–210, 247n52; health care and, 185; Indigenous, 190–92, 196, 207–10; traditional, 93; Western-trained, 197

medical knowledge, popular, 60

mixing, 7, 8, 88

medical marketplace, 56, 135, 139, 143

modernization, 90–92, 94, 107, 125, 151, 165–67

medical pluralism, 59, 60

miscegenation, 116

medical professionalization, 123–37, 172

modernity, 91, 119; medical, 95

medicine, 74; academic, 92, 97, 104, 199; Chinese, 150; domestic, 91, 94, 106; folk, 136; illegal, 155, 168; modern, 106; popular, 104; scientific, 171; traditional, 106, 190–91, 193, 202; Western, 138, 142, 147, 191. See also drugs

municipality of Lima, 143–44. See also institutions

medicinal plants, 190, 195, 200 menstruation, 33, 89, 195 mestizo/a, 29, 34, 123, 133 mestizaje, 8, 24, 25 Mexico City, 27, 36, 92–96, 104–6, 192

mulato/a, 35, 115, 118

mystic, 91

Nahua, 30 National Academy of Medicine, 105. See also institutions National Department of Hygiene, 176–83. See also institutions National Institute of Public Health, 209. See also institutions

259

260

INDEX

National University of Colombia, 128. See also institutions

agency, 173, 181–83; Indigenous, 93–94. See also sick

National Univeristy of Córdoba, 177. See also institutions

pardo, 51

newspapers; A Capital, 115, 118–19; A Gazeta, 110; A Nação, 116; A Plebe, 118; Boletín de Sanidad y Asistencia Pública, 167; Crítica, 178–84; El Comercio, 142, 150–52; El Litoral, 180; El Pueblo, 151; El Telégrafo de Lima, 57; La Crónica, 180; La Floresta, 57; La Vanguardia, 180; Mercurio Peruano, 57–58, 68, 71; New York Times, 180; O Alabama, 84; O Combate, 110; O Estado de S. Paulo, 110

partera, 196

nuns, 47–48

Oaxaca, 189–93, 198–99, 202 ointment, 112, 124, 131 official medicine, 6–7, 10, 181–82, 191 orthodoxy: Catholic, 121; medical, 90, 95; religious, 90 Orthopedic Institute, 110. See also institutions

Panacea, 131–32, 185 patent medicines, 129–32, 135, 137 patients, 102–4, 128, 134–37, 147;

parsley massacre, 155, 160 pharmaceutical, 129–32, 134, 174, 176; pharmacist, 123, 128, 131, 172; pharmacy, 112 pharmacopeia, 82; Indigenous, 93 physicians, 4, 17, 35, 39, 57–59; academically trained, 60, 91, 92, 94, 100, 105; allopathic, 92, 126; authorized, 123, 126; European, 8, 19–20; homeopathic, 92, 102; Indigenous, 203; improvised, 91; itinerant, 123; licensed, 10, 12, 55–56; professional, 139; tolerated, 126, 129, 136; traditional, 191, 202, 206; uncertified, 126; university, 125, 127–30, 135–36; Westerntrained, 191. See also medical establishment police, 132, 136 power, 40, 43, 47–48, 54; medical, 159, 168, 188 pregnancy, 18, 26, 31–33, 61, 190–92, 195–98 priests, 17, 24, 46–48, 74, 79, 191; African, 84 printed media, 171, 178–80. See also newspapers; magazines; medical journals prognosis, 21, 93

INDEX

Protomedicato, 65–66, 140, 192; protomédico, 56–58, 62. See also institutions

sanador, 9

Provisorato de Indios, 29. See also institutions

santiguadores 16–17

public health, 92, 104, 116–17, 125, 179, 194; public health officials, 10 purgatives, 19, 142, 162, 166

sanitation, 91–92, 105, 117, 125, 127, 136, 140 San Fernando School of Medicine (Lima), 139–45, 153–54. See also institutions San José del Cayo, 11, 13, 24 São Paulo, 10, 108–22 São Paulo Eugenics Society, 117. See also institutions

quack, 131, 139, 142, 172, 179, 185–86, 188 quarantine, 140–41 quinine, 162–63

science, 40, 91, 170, 180–81; academic, 182; Chinese, 143, 147; history of, 4–5, 9; Latin American, 4, 232n57; modern medical, 54, 93–94, 97, 105, 170; positivist, 95 scientist, 110

regulation, 55–57, 109–10, 126–27, 132–37, 151, 165, 197 religion, 30, 39; organized, 75; African, 50–52, 80, 87. See also calundu; Spiritism Rio de Janeiro, 10, 52–53, 81–84, 111 Rockefeller Foundation, 127. See also institutions reproductive health, 61, 189, 196–97, 209–10

secularization, 91, 166 sick; abandoned, 3, 56, 173; agency, 26, 31, 39, 63, 170, 173, 174, 183; beliefs, 7, 8, 187; children, 20; experiences, 9; illness narratives, 5; protestors, 181–83; relationship with health care givers, 7; sick houses/bays, 158–59; workers, 162. See also patients slavery, 11, 41, 47, 53, 54; abolition of, 87, 138, 157; Bahian, 75, 81–82; Caribbean, 15, 16, 24; as disease, 88; plantation, 156

saline, 162

smallpox, 16

saludadores, 16, 116

sorcerer, 11, 23, 24, 159, 166; African, 84; sorcery, 75

Salvador, 44–47, 50, 74, 76–79, 82, 87

261

262

INDEX

Spanish Cultural Institution, 174. See also institutions

Union of Doctors, 151. See also institutions

spirits, 53; possession, 45, 54, 74, 78, 84

University of Buenos Aires School of Medicine, 174. See also institutions

Spiritism, 90–107, 120 State Council for Indigenous Traditional Doctors, 203. See also institutions State Sanitation Service of São Paulo, 111. See also institutions

vaccine; innocuousness, 181–84; Pueyo vaccine, 170–78; vaccination, 191, 194, 208, 234n24, 244n13

sterilization, 117

vodun, 50, 52

sugar mill, 156, 158–59, 162, 164

vodú, 161

supernatural, 22, 26, 31–33, 35, 36–37, 40, 99 superstition, 41–42, 46, 75, 161, 163

witchcraft, 28, 38, 59, 75–84, 161

surgeon, 10, 22, 57, 93

witch doctor, 110, 115

syphilis, 128

women: African, 44, 58, 87; Africandescended, 47; benzedeira, 110–11; Black, 17, 48; elite, 36, 118; freed, 87; Indigenous, 27, 30, 208, 210; Jeje, 52

syncretism, 8, 105 syrup, 124, 131–34

technology, 6, 95

World Health Organization, 199

therapeutic market, 126, 136 Trujillo, Francisco de, 22–23, 155–68, 241n36

yellow fever, 138, 140, 153

tuberculosis, 170–88, 198; activists, 181–83; patients, 172–73, 182–83; sick beliefs, 185–87; vaccines, 170–88

Zapotec, 191–94

Tuberculosis Research Institute, 175. See also institutions typhoid, 103 typhus, 16, 33

Yoruba, 76–79