This tightly constructed analysis of medical practice in New Spain (Gunter R. Risse), New France (Toby Gelfand), and New England (Eric H. Christianson) challenges the premise that the New World environment created a distinct genre of general practitioner, freed from the restraints of Old World methods and learning. In all three European societies, bonafide, licensed physicians and surgeons trained in Alcalá de Henares, Paris, or London, relying on Galen, Hippocrates, and Avicenna, transmitted their theories and practices virtually unchanged to colonies overseas. Because of severe shortages of physicians in the New World, however, homegrown practitioners, who learned as apprentices, emerged by default and were hierarchically arranged according to their specialty. With no local training ground available at all in New France and none in New England until the 1780s, the self-trained empiric became the rule. In Mexico, however, the Royal and Pontifical University began providing European-style, formal training in the late sixteenth century, two hundred years before Harvard, while the protomedicato led the way in licensing physicians. In New France, a nondegree-holding “king’s physician ” served somewhat the same function for the surgeons of the colony, but in New England private medical societies licensed doctors. Hospitals serving all levels of society dotted Mexico City, and Quebec could boast the Hôtel-Dieu. New England, however, had no hospitals at all until the nineteenth century, only temporary military hospitals and alms or poor houses. Medical practitioners in New England initiated medical innovations such as inoculation earlier than their counterparts in New France or New Spain, but by the late eighteenth century, doctors in Mexico were as quick as those in Boston to put in place new curative or preventive health measures.

Ably edited by Ronald Numbers, this piece of comparative history shows that medical practice in the Spanish empire in the New World compared favorably with methods and techniques used elsewhere. In fact, the Hispanic sense of public responsibility for the sick at all levels was more deep-seated, regulatory agencies better defined, university training for would-be physicians more readily available, and methods and techniques as advanced as those being used elsewhere in America. My only caveat concerns the authors’ general opinion that medical practice in the New World stagnated. In New Spain, at least, remarkable advancements occurred; witness the establishment of a College of Surgery in Mexico City, advocacy of the caesarean section, and the immediate adoption of a universal vaccination program, all in the last half of the eighteenth century. Depite this minor criticism, this work is a well-focused piece of comparative history which aptly illustrates that an analysis of medical practices can do much to reveal the texture of life and cultural levels of colonial societies.