IN the late eighteenth century, public health formed an integral part of the Bourbon campaign to revitalize the Spanish colonial enterprise and reinstate Spain as one of Europe’s premier imperial powers. As frequent outbreaks of epidemic disease threatened the social, economic, and military well-being of the realm, colonial officials, medical experts, and members of the commercial elite struggled to find ways to counter and, ideally, to prevent the devastating effects of widespread illness. In doing so, they looked to the public health innovations gathering momentum throughout Europe.

Throughout the eighteenth century, intellectuals and policymakers across Europe paid increasing attention to the cameralist notion that a state’s wealth stemmed ultimately from its ability to ensure the health and continued growth of its population. Over time, this concept meshed with Enlightenment beliefs that nature exhibited an order capable of being understood and, eventually, manipulated by humanity. Because epidemics and other widespread disease outbreaks formed a part of this order, scientific inquiry promised to reveal the underlying causes of illnesses that threatened the welfare of the state and point the way to preventing their occurrence.1

These trends sparked initiatives to improve public health in capitals and major cities throughout Europe. Attention focused on controlling the spread of epidemics by restricting the movement of people and goods suspected of carrying contagious illnesses and eradicating theorized environmental causes of disease by improving sanitary conditions in crowded population centers. While most of the measures and the concepts of disease that underpinned them had existed for centuries, the aggressiveness with which European governments pursued their implementation reached new heights after 1750.2 As a result, some scholars point to these efforts as a major cause of the continent’s eighteenth-century population boom.3

How effectively did the new European emphasis on improving communal health carry over to New Spain? Where and to what extent did the ideas that crossed the Atlantic affect the lives of the viceroyalty’s inhabitants? Studies that have asked these questions have tended to focus on the implementation of public health measures in the viceregal capital, Mexico City.4 There, well-informed intellectuals and viceroys newly arrived from Europe struggled at times to introduce new regulations or, more often, simply to enforce centuries-old statutes designed to improve sanitary conditions in the crowded urban center and protect the city from the ravages of epidemic disease. Even in the late colonial period such efforts usually failed, falling victim to a populace with little interest in adhering to municipal sanitation codes and to the lack of a specific and effective regulatory body to establish and enforce public health standards.5 That failure has prompted the conclusion that New Spain as a whole proved unable to carry out reforms of the type that gathered momentum in European cities in the late eighteenth and early nineteenth centuries.6

Shifting attention away from the capital city to the port of Veracruz, however, yields a very different picture of the campaign to improve health conditions in New Spain. Concern over health conditions in New Spain’s most important link to the Atlantic resonated forcefully in Mexico City and Madrid as the town’s exponential growth in demographic, economic, and military importance in the late eighteenth century lent an unprecedented urgency to taming the region’s notoriously vicious disease environment. Widespread sickness in the port slowed the movement of goods across its docks, hurting commerce and depressing royal revenues. At the same time, the disease threat frustrated military planners forced to counter repeated warnings of an imminent British invasion but loath to condemn troops drawn mostly from the highlands to the ravages of ailments endemic to the coastal zone. The specter of illness in Veracruz also prompted fears that epidemics might surface in the well-trafficked port and from there engulf all of New Spain, devastating the viceroyalty’s economy in the process.

Aided by a medical community well versed in the emerging European public health innovations, government officials and the commercial elite in Veracruz implemented programs and erected an administrative structure designed to improve health conditions in the port. As a result, in the closing decades of the colonial period, Veracruz stood in the vanguard of the campaign to preserve communal health in New Spain.

Trade and Growth in a Warm Climate

For most of the colonial period, the lowlands edging New Spain’s Atlantic coast remained sparsely populated. The region’s Amerindian peoples were the first on the Mexican mainland to suffer the full effects of contact with Europeans advancing beyond their colonial toehold in the Caribbean in the first quarter of the sixteenth century. Consequently, the native population dwindled rapidly as once-prosperous communities succumbed to imported Old World pathogens or simply vanished as their inhabitants fled an unwanted but unstoppable Spanish colonial expansion.

Hot, humid, disease-ridden, and soon devoid of an exploitable Indian populace, the lowlands failed to attract a meaningful number of European settlers over the course of the next two-and-a-half centuries. Newcomers gravitated instead toward the more hospitable climes and brighter economic prospects of the central highlands. Still, the lowlands separated the more temperate, mountainous interior of the continent from the gulf and thus the sea routes that tied the viceroyalty to Spain and the Atlantic economy. As the region’s only serviceable port, Veracruz arose not as a desirable point of settlement for European immigrants, but as a necessary link between New Spain and the outside world.

This changed dramatically with the surge in Atlantic commerce sparked by Charles Ill’s liberalization of colonial trade laws and the declaration of comercio libre in 1778.7 Soaring trade levels in Veracruz in the following decades invigorated the town’s economy and gave rise to a new commercial elite. As early as 1781, leading comerciantes in Veracruz petitioned the crown for permission to establish a consulado, or merchant guild, for the port, a concession eventually granted by a royal cédula of January 17, 1795. Like its older counterpart in Mexico City, the Veracruz guild served as the judicial body in disputes involving commerce in the town and its surrounding rural districts. It financed its activities by collecting a half percent duty on all goods entering or leaving its jurisdiction, supplemented by fines imposed in judgments made by its tribunal. In return for these concessions, the crown expected the consulado to foment commerce in the region by publicizing new technologies, improving harbor facilities, and constructing and maintaining roads between Veracruz and the interior.8 Over the ensuing decades, furthermore, the consulado focused on public health as a matter vital to the port’s continued economic growth.

At the same time, comercio libre and the economic opportunities it bestowed on Veracruz attracted newcomers from both sides of the Atlantic in search of employment and the chance for profit. After 1778, thousands of comerciantes, petty traders and peddlers, artisans, day laborers, muleteers, and sailors from Spain, the interior of Mexico, and the surrounding coastal lowlands poured into the hot, mosquito-infested port. In 1784, the director of the Hospital de San Juan de Montesclaros complained that his facility— open to the poor of the town and financed primarily by community alms — was incapable of caring for a population that had expanded rapidly as a result of the liberalization of trade in the port.9

By 1791, the resident population of Veracruz numbered more than 8,000, more than double the census figure given for the town at midcentury.10 In 1800, cabildo officials pointed with alarm to the extreme overcrowding within the city walls and unsuccessfully petitioned the crown for funds to extend the town’s fortified perimeter.11 When Alexander von Humboldt visited the port in 1804, consulado and town officials informed him that more than 16,000 permanent residents lived in crowded conditions in the town or camped among the dunes and swamps beyond the city walls.12 By 1806, the Veracruz population had increased to 20,000, not including the estimated 7,500 muleteers, 3,230 sailors, and 5,500 miscellaneous travelers, merchants, visiting officials, and military personnel who had resided in the town temporarily during the previous year.13

A myriad of ailments crept into the daily lives of these newcomers to the gulf lowlands, but the febrile illnesses that claimed so many victims in the coastal zone year after year stood out as the region’s most serious disease threat. Sixteenth-century writers dubbed the port at Veracruz la tumba de los españoles. They identified the fevers that killed disproportionate numbers of recent immigrants to the coast while seemingly sparing those who had spent their lives in the lowlands with only the most general of descriptive terms, such as calenturas pútridas or fiebres malignas. By the eighteenth century, though, travelers and residents alike blamed one illness consistently for the deaths: vómito prieto, or, as it came to be known in the late colonial period, fiebre amarilla.

An acute viral illness, yellow fever is contracted via the bite of an infected mosquito—most commonly the female of the species Aedes aegypti. Many adults infected with the virus either show no symptoms at all or experience only mild fever, headache, and malaise. Among children, even greater percentages of those afflicted may escape with these minor manifestations of the illness. In such cases, those stricken usually recover unaware of having contracted yellow fever but afterward enjoy a lifelong immunity to the disease.14 Less fortunate victims, though, suffer the more life-threatening complications of the sickness recognized as classic yellow fever. High fever, chills, bodyaches, nausea, and severe headache usually signal the onset of the more serious form of the disease three to six days after the initial infection.

As the illness progresses, damage to the liver causes the two most distinctive manifestations of yellow fever: jaundice and hemorrhaging of the gums, nasal passages, and stomach lining exacerbated by the liver’s inability to produce factors essential to the body’s blood-clotting system. As gastrointestinal bleeding becomes more pronounced, frequent and at times violent hematemesis (vomiting of blood) follows, and in the colonial period it was this complication that earned the sickness the epithet of vómito prieto, or “black vomit.” Among these more severe cases mortality exceeds 50 percent, with death following the development of renal failure, convulsions, and cardiovascular collapse seven to ten days after the onset of symptoms.15

In tropical zones, yellow fever is a disease complex that involves virus, the mosquito vector, and both human and primate host populations. The offending pathogen—a small RNA virus of the family Flaviviridae—cannot pass directly between mammalian hosts and is therefore not contagious in the classical sense of spreading by person-to-person contact. Instead, victims contract the illness through the bite of an infected mosquito, which has usually acquired the virus by feeding on the blood of an afflicted human or monkey. Several species of mosquitoes can harbor the yellow fever virus, but in Latin America only Aedes aegypti and a few members of the genus Haemagogus play a significant role in transmitting the disease. A peridomestic mosquito, A. aegypti thrives in urban areas and, as a result, is the primary vehicle for the spread of yellow fever in areas of concentrated human settlement. In rural zones, Haemagogus predominates as the vector, passing the virus among susceptible primates and infecting any human victim who strays into this “jungle” or sylvan cycle of the disease (see figure 1).16

Each element in the life cycle of the yellow fever virus is essential to the survival and propagation of the microorganism, and the overall prevalence or absence of the illness in any given area depends on an intricate interplay of factors affecting the availability of every component of the disease complex. The vector population is far more susceptible to variations in environmental conditions than either human or primate hosts. Yellow fever is thus limited to those regions where ecology and weather patterns allow A. aegypti and, in the sylvan cycle of the disease, Haemagogus mosquitoes to thrive. A. aegypti breeds preferentially in small bodies and containers of water. The mosquito therefore flourishes in the urban centers of regions where heavy annual rainfall can form and frequently replenish the small ponds and street puddles essential to the insect’s multiplication.17 Temperature and altitude also limit the range of A. aegypti and therefore the potential spread of yellow fever: the mosquito rarely ventures above one thousand meters, and cooler temperatures kill both the adult arthropod and its larvae. A. aegypti prospers instead in low, tropical climes with little seasonal variation in temperature.18

Even in those areas where environmental conditions favor the existence of the vector population, however, the yellow fever virus does not in its normal life cycle pass directly from mosquito to mosquito. Transovarial passage of the pathogen from the adult female to her offspring can help to maintain the virus among successive generations of arthropods over the short term, but ultimately the long-term survival of the disease complex depends on the ready availability of susceptible human or other mammalian hosts. Once bitten by an infected vector, the yellow fever sufferer can then pass the virus on to uninfected mosquitoes that subsequently feed on the victim as the illness runs its course. In jungle areas, that survival is ensured by the wide variety of primate species that can harbor the disease.19

Among human population groups, though, yellow fever appears in specific regions or communities in patterns that depend as much on the immunological history of the people potentially at risk as on the seasonal prevalence of mosquitoes bearing the deadly virus. Communities inhabited predominantly by persons native to the region and situated in zones where yellow fever is prevalent are normally unlikely to see dramatic outbreaks of the disease, simply because most residents will have received exposure to the virus at some earlier time in their lives and will thus be immune to further infection. From year to year, newborns, the occasional visitor, or those indigenous inhabitants who have fortuitously escaped infection in previous seasons might host the virus and thereby contribute to its continued survival in the area. But because most of this relatively small number of cases will exhibit few or none of the more severe symptoms of the illness, the disease would attract little attention as a killer among the local populace.

Instead, a dramatic upsurge in the number of clinically apparent cases of yellow fever is likely only when a largely nonimmune population suddenly comes into contact with a disease-bearing mosquito population. Such a confluence generally occurs when one of three factors is present: a large number of nonimmune persons migrate into an endemic yellow fever zone from areas where the disease is rare or nonexistent; weather and migratory opportunities allow infected mosquitoes to spread into populated regions that otherwise rarely experience the illness; or ecological conditions in endemic areas depress the infected vector population for a period of years, allowing the number of nonimmune native children and immigrants to build to the point that a return of the virus touches off a high number of first exposures.20

The phenomenon that most native and long-term residents of endemic regions enjoy their immunity to the illness unaware of having been exposed to the virus earlier in life has colored historical perceptions of which sectors of a given populace are most susceptible to the disease. Southerners in the nineteenth-century United States called yellow fever the “stranger’s disease” because it seemed to strike newcomers from the northern states or Europe while inexplicably sparing many long-term white residents and, especially, the black population of afflicted communities.21 In doing so they echoed perceptions of vómito prieto that had predominated for centuries in Veracruz: only recent arrivals on incoming ships or highlanders descending to the coastal plain could contract the illness. Lifelong residents of the region had little to fear from the disease.22

Veracruz offered ideal conditions for the long-term survival of the yellow fever complex. The region’s heavy rainfall and warm year-round temperatures supported the large and highly varied mosquito population noted in the writings of observers in the lowlands from the time of Cortés onward.23Haemagogus species thrived in the rainforest extending across Central America, the Yucatán, and the coastal plains of the southern gulf.24 Veracruz itself provided the perfect breeding environment for Aedes aegypti. Drainage in the rain-soaked town was notoriously poor. Heavy showers left alleyways and plazas inundated with water for days, even weeks.25 Street puddles combined with household pots and vases and the large cisterns that stored drinking water in wealthier homes to give the peridomestic mosquito ample opportunity to spawn during the wet summer months. In July 1817, one visitor to the port noted after one soaking rain that in little more than a week, “such an abundance of mosquitoes resulted . . . that all the walls of the houses and those on the outside facing the street appeared black.” 26

At the same time, Veracruz’s central role in Atlantic commerce guaranteed a frequent infusion of people from Europe or central New Spain who lacked prior exposure to the yellow fever virus. Each flota and, later, each group of merchant vessels entering the port brought hundreds, even thousands of nonimmune sailors, comerciantes, and immigrants to the Indies. These newcomers and the cargadores, merchants, and other highland residents who descended to the coast to meet incoming or outgoing vessels provided a ready host population for the yellow fever complex. Even in years when little traffic passed through the port, the disease could smolder almost unnoticed among the newborns and young of the resident populace who had yet to catch the illness. In the early sixteenth century, for example, infants in the lowlands reportedly acquired fevers and died more frequently than those in the central plateau.27 Alternatively, the disease could retreat into nearby rural areas until conditions favored a resurgence of its urban cycle.

The confluence of yellow fever virus, mosquito vectors, and vulnerable human hosts followed a seasonal rhythm in Veracruz, one with which residents and visitors alike became all too familiar over the course of the colonial period. While isolated cases of yellow fever could and did appear in any month of a year in which the illness was active in the region, significant outbreaks of the disease usually occurred only after the onset of summer rains in May. A one-month maturation period for the new generation of mosquitoes, followed by more breeding and an average six-month lifespan, would push the yearly vector population peak into the late summer.

As a result, peak morbidity and mortality from yellow fever did not come until late summer and early fall (see figure 2). August and September marked the time not only when the Aedes infestation was worst, but also when commercial activity in the port and, therefore, the influx of newcomers to Veracruz was highest. Flota officials and, after the declaration of comercio libre, independent ship captains timed their arrival to avoid as much of the port’s cruel and disease-ridden summer as possible. But with October came prevailing northern winds (nortes) that made navigation in the gulf treacherous, so ships could not delay their entry into Veracruz for too long.28 The conjuncture of nonimmune newcomers and a large, infected Aedes vector population sparked horrific outbreaks of the disease, making August and September the months most feared by visitors passing through the port.29

As they gathered strength throughout the fall, the same winds that forced ships to dock at Veracruz in the deadly months of late summer literally swept the disease threat from the port altogether. Throughout the colonial period, observers on the coast marked the arrival of the nortes as the time when the number of vómito cases declined dramatically, and many averred that the winds transformed Veracruz into a town as healthful as any in the sierras during the winter months despite its continued warm temperatures.30 Modern understanding of the yellow fever complex explains the phenomenon: Aedes aegypti is a weak flier, and sustained winds can push the mosquito kilometers away from its preferred habitat.31 As northerly gusts prevailed every fall in Veracruz, high winds forced the vector population south and inland, away from the port community. At the same time, the tapering off of the rainy season kept breeding among any remaining mosquitoes at a minimum until a new cycle could begin the following spring.

As the colonial period wore on, each summer in Veracruz brought renewed fears as to whether and how severely the vómito would strike. In the early eighteenth century, respect for the illness prompted royal officials to choose the nearby mountain town of Xalapa over Veracruz as the site for the intercontinental trade fairs that took place between 1722 and 1778. Families in the port community who could afford to spend extended periods away from the coast flocked to Xalapa during the deadly months of August and September to escape the heat and humidity of the lowlands and the horrors of yellow fever’s assault on the town.32 But the disease proved unpredictable. Years, even decades could pass in which no apparent outbreak of yellow fever occurred in Veracruz. When such respites inevitably came to an end, though, any illusions of Veracruz as a healthful community quickly faded as summer death tolls from vómito prieto soared once again.

Not surprisingly, the years of highest mortality from the disease corresponded to those in which large numbers of Europeans or highland residents entered the port. In 1799, fears of a British effort to capture Veracruz prompted Viceroy Miguel José de Azanza to commit thousands of highland troops to the coastal town’s defense. In doing so, Azanza disregarded the advice of both his military advisers and his immediate predecessor, the Marqués de Branciforte: vómito prieto killed soldiers sent into the lowlands from the central plateau with a cold-blooded efficiency that no foreign invader could match.33

During the summer of 1799, more than half the 600 troops camped at Arroyo Moreno, a few kilometers outside Veracruz, reportedly died of yellow fever. Over the course of the year, 938 deaths among the 4,000 troops stationed in and around the port were attributed to the disease. Hundreds more chose to desert their units rather than risk contracting the horrifying illness.34

In 1802, deaths attributed to yellow fever peaked again, as record levels of trade brought unprecedented numbers of people affiliated with transatlantic trade into the port. The number of yellow fever cases quickly overwhelmed the city’s hospitals. As the death toll rose, the year’s especially heavy rains flooded the city’s cemeteries and allowed a distressing number of newly interred cadavers “to bloom to the surface” from their shallow and hastily dug graves.35 By summer’s end, the heavy mortality brought trade in the port to a complete standstill, as muleteers from the highlands refused to descend to the disease-infested lowlands until the vómito season had passed.36 In all, almost two thousand people perished from the illness, high-lighting the 1802 yellow fever season as the most vicious in the memories of resident Veracruzanos.37

Experience with the vómito and its predilection for newcomers discouraged settlement in the region and taught travelers to minimize their days spent on the coast. Those who arrived in Veracruz from overseas wasted little time in the town before setting out for the higher elevations and the recognized safety of the sierras. As they wound their way up the rugged, 75-kilometer trail that linked Veracruz to nearby Xalapa and the central Mexican plateau, travelers kept an anxious lookout for the two indications that they had at last ascended above the yellow fever zone: the appearance of mountain oaks marking the transition from the low, tropical environment to the more temperate air of the sierras; and the sign for the Hacienda del Encero, a longtime way station along the mountain road situated at an altitude of 928 meters.38

Often, however, those who reached this point believing that they had escaped the yellow fever threat fell ill nevertheless, from mosquito bites received days, even hours earlier during their passage through the lowlands. In Xalapa, some residents claimed the ability to divine which recent arrivals from the coast would develop the vómito even before its symptoms became manifest. At the turn of the nineteenth century, one Indian barber in the mountain town offered a rationale for his predictive power: 20 years of shaving Europeans and others en route from Veracruz to the interior had taught him that when the soapy lather he applied to his customer’s face dried immediately, the unlucky patron stood a three-in-five chance of falling ill with the disease before the end of the day.39

Those journeying from the sierras to Veracruz also recognized Encero as the last safe refuge before the yellow fever zone, and travelers often congregated there as they steeled themselves for the plunge into the disease-ridden tropical air. Muleteers, commercial agents, and others with business in the port often waited until nightfall before making the final descent in the hope that the lower temperatures of evening and early morning would ease their transition into the lowland environment and thereby lessen their chance of contracting the illness. Those planning to embark on ships leaving Veracruz adopted a similar strategy, but usually waited for word that their vessel would depart the following morning before striking out on the final leg of the overland voyage. As the disease-wary travelers arrived in the port early the next day, they boarded the ship directly as it made ready to sail, comfortable in the knowledge that they had limited their time in the coastal lowlands to less than a day.40

Public Health Initiatives in Veracruz

Thus, in the late colonial period, officials and citizens anxious to improve health conditions in Veracruz pointed to yellow fever as the port’s most serious disease threat. Yellow fever inflicted widespread suffering and death with distressing frequency, damaging the all-important movement of people and goods. It therefore stood as an obvious obstacle to economic growth on both sides of the Atlantic, forcing colonial officials and the commercial elite to look for means of preventing widespread outbreaks. Consequently, yellow fever played a fundamental role in shaping public health initiatives in New Spain’s most important port.

At that time, no effective therapies were in use to aid yellow fever sufferers. Hospitals had existed in the port since the sixteenth century, but they offered little more than food, shelter, and basic nursing care. The general prosperity of the revitalized settlement and its expanding resident population enticed more than a few European physicians and surgeons to settle in Veracruz, but in terms of direct efforts, these formally trained and licensed practitioners—known collectively as facultativos — contributed only marginally to improving health in the town. Few outside of the community’s elite looked on the facultativos’ proffered cures as anything more than impotent and expensive; in times of illness, most Veracruzanos turned to popular home therapies or the more affordable services of folk healers (curanderos). Alexander von Humboldt noted in 1804 that Veracruzanos shunned facultativos’ treatments for yellow fever, which included chinchona bark, mercurials, or Brownian drug therapies—mostly opium-based—designed to stimulate the body out of its diseased state. The curanderos, by contrast, pushed less aggressive regimens that often included pineapple juice, olive oil rubs, ice baths, and massaging the epigastric region to calm any irritation.41

But Veracruz’s licensed medical community exerted a crucial influence nevertheless. In the final decades of the colonial period, the majority of the town’s facultativos boasted training in one of Spain’s most innovative learning institutions, the College of Surgery in Cádiz. Many of these practitioners therefore possessed both a background and an ongoing interest in the ground-breaking medical concepts and techniques emanating from academic centers throughout Europe.42

The Cádiz-trained facultativos who settled in Veracruz turned the low-land community into a testing ground for innovative ideas and techniques imported into New Spain. In Mexico City, the editors of the Gazeta de México frequently touted the accomplishments of Veracruz practitioners as they successfully performed surgical procedures hitherto unattempted in the viceroyalty.43 At least one Cádiz graduate who practiced in Veracruz after 1799, Florencio Pérez y Comoto, actively translated European medical papers. A forum existed in Veracruz for presenting such literature in the Sociedad Médica de Emulación de Paris. Extracts of Comoto y Pérez’s work appeared from time to time in the Gazeta de México44 As yellow fever resumed its seasonal assault on the port in 1794, local practitioners conducted trials in the military hospital of San Carlos of therapeutic regimens bearing the latest endorsements of European academe.45

Colonial officials and the port’s commercial elite turned to this source of medical knowledge as they searched for the means to prevent yellow fever outbreaks in Veracruz. Both sectors, moreover, deemed it worth funding these tests of the latest European theories with significant amounts of money. Colonial officials knew that virtually all goods passing between Spain and New Spain had to move through Veracruz, and that widespread sickness impeding such movement could cost the crown dearly in lost revenue. They also knew that foreign enemies, frequently Britain, likewise recognized the importance of Veracruz; but respect for the vómito tempered the zeal with which strategists committed highland militia units to bolster the town’s defenses. Policymakers therefore faced a difficult decision: either find some way of improving health conditions in Veracruz or abandon the defense of the port altogether.46

Similar concerns motivated the commercial elite to support public health initiatives in and around the port. After its founding in 1795, the Veracruz consulado channeled political and financial resources into efforts to minimize the impact of disease on trade through the region. At the same time, the merchant guild’s members were keenly aware that the fertile soils and abundant produce of the tropical lowlands were valuable resources that had gone untapped for centuries. The region needed settlers to foment its agriculture and industry, but clearly few could be lured onto the coastal plain until its reputation as a disease-ridden zone had been reversed. Consulado secretary José María Quirós highlighted the problem in 1807 when he noted,

the principal cause of [the lowlands’] underdevelopment stems from underpopulation; without competent hands it will never progress. If one looks at the coastal expanse from the Rio Coatzacoalcos to Tampico, points that mark the northern and southern limits of this province [of Veracruz], one finds that over an expanse of 146 leagues there are no more than nine pueblos that merit the name.47

Still, despite the recognized need to improve health conditions in the port, opinions varied as to how best to achieve that goal. Among those concerned about public health in Europe and its colonial holdings circulated a plurality of views as to the best means of safeguarding communities from widespread sickness. Certain diseases—smallpox, for example —had for centuries been universally accepted as contagious entities, capable of spreading from person to person.48 Efforts to protect populations from such scourges in the late eighteenth century therefore centered on refining and strictly enforcing age-old policies of quarantine and isolation in hopes of restricting the movement of people and goods suspected of carrying infectious disease.49

Other febrile illnesses, most notably yellow fever, defied any clear understanding of causation and spread. Yellow fever appeared widely throughout afflicted communities, prompting some to label it, too, as a contagious illness, best contained by traditional quarantine and isolation. Other theorists, though, noted that simple contagion could not account for the puzzling way yellow fever struck only certain areas and individuals while sparing others in close proximity.50

Rejecting the idea of yellow fever as a simple contagious entity, these proponents fell back on the Hippocratic principle that sickness resulted from a disorder in the physiological balance between individuals and their surrounding environment. The answer to preventing outbreaks of yellow fever, the argument went, lay in discerning the nature of humanity’s relationship to the physical environment. As the Enlightenment gathered intellectual momentum over the course of the eighteenth century, the search for specific environmental factors responsible for outbreaks of deadly illnesses like yellow fever accelerated. Attention centered increasingly on the atmosphere because all life depended immediately on air, and air seemed a logical medium through which human victims could internalize the environment’s pathogenic influences.51

Opinions varied as to whether astrological factors, climatic patterns, or physical elements, such as particulate matter or vapors given off by decaying organic materials, explained how air could induce widespread sickness. By the latter half of the eighteenth century, though, many European medical theorists and policymakers shared the conviction that if the atmospheric source of epidemics could be pinpointed, steps could be taken to counteract the disease-causing influence and prevent the appearance of illnesses like yellow fever. Physicians and scientists collected detailed data on topography and weather patterns in specific regions and townships throughout Europe. They then compared that information with local case histories of illnesses and the timing of regional epidemic outbreaks in the hope that some discernible relationship between environment, atmosphere, and sickness would become apparent.52

Meanwhile, adherents of the environmental theory of disease eager to take concrete steps toward improving health conditions proceeded on the assumption that removing obvious sources of atmospheric contamination would ultimately lessen epidemic risk. After midcentury, cities across the continent devoted new energy to clearing their streets of filth, relocating cemeteries beyond town limits, draining nearby swamps, and widening streets to facilitate the movement of fresh air.53

In the late eighteenth century, many of these thoughts and trends surfaced in Veracruz as the port struggled to rid itself of yellow fever. As in Europe, theories on the nature of yellow fever and therefore the most appropriate means to prevent its outbreak in Veracruz were divided along contagionist versus environmental lines. These different approaches partly reflected the conflicting explanations for yellow fever’s appearance in the port. At the same time, however, and especially because science could provide no definitive answer to the dispute, the field remained wide open for those who provided funding for public health measures to dictate strategies for improving community health according to their particular social, political, and economic agendas.54

The environmental approach to public health gained wide acceptance among the intelligentsia and the commercial and political elite of Veracruz. By the 1780s, local residents had begun to keep careful records of temperature and barometric readings in and around the port in the hope that the collected data would explain long-term trends in the appearance of yellow fever in the area.55 Other citizens focused on removing atmospheric contaminants they thought were the source of yellow fever and other recurring ailments. As one consulado member argued,

if one examines the causes of the dominant illnesses in this port, . . . one finds no other that is more important than the impure air we breathe. . .. [Air] serves as the primary substance for all, or for the majority of the marvelous processes of nature. . .. But the cruel hardship of war has not sacrificed as many lives as air impregnated by the fumes of evaporated putrefaction. What sort of air can one breathe in a town like Veracruz, where the wastewater of each house is poured onto the streets to sit and ferment for lack of an incline to let it drain? I shudder when I pass through the city at the sight of the venomous particles that continually evaporate from these stagnant and foul pools. . .. This is a perpetual epidemic that we foment.56

Taking its cue from developments in Europe, this attitude focused public attention in Veracruz on cleaning up the city and removing potential sources of atmospheric contamination. Critics pointed to the dire need to improve public sanitation and keep streets clear of human waste and other fetid materials. The stink generated by the refuse left to rot in alleys and passageways was matched only by the stench of corpses buried under church floors and in shallow plots, prompting a push to establish a general cemetery beyond the town limits. Proposals to drain the brackish and stagnant ponds that ringed the community also won support among public health advocates because a number of the town’s medical practitioners believed that vapors given off by decaying vegetable matter in the swamps explained the local prevalence of yellow fever. Finally, some observers argued for the destruction of the town’s fortified perimeter, as this would allow purifying breezes to sweep alleys and narrow passageways clear of any remaining airborne elements capable of causing disease.57

The approaches to improving health conditions in the port differed little from environmental measures being proposed throughout Europe and even Mexico City, but a unique sense of urgency, coupled with strong financial and political backing, drove the environmental initiative in Veracruz. Epidemic disease could cause loss of revenue in the form of collected import and export duties; in addition, production in New Spain’s silver mines depended heavily on European mercury unloaded at the port. But the contagionist approach to preventing large-scale sickness in ports—namely, the quarantine of vessels suspected of carrying contagious illness—could halt the movement of goods as effectively as the worst epidemic. Measures such as improving public sanitation, altering burial practices, and draining nearby swamps, on the other hand, promised to improve health conditions in Veracruz without impinging on commerce. An improved environment, moreover, would enable the crown to station troops in Veracruz without fear of yellow fever, ending the dilemma of how to protect the vital lowland port.58

The earliest attempts to eradicate potential sources of atmospheric contamination and disease in Veracruz centered on removing the waste and filth generated in the daily life of the community and habitually dumped on its streets. For most of the port’s early history, municipal employees had collected such refuse and dumped it in the town’s harbor,

[a] nightly chore that employs a few negroes and other persons whose necessity . . . obliges them to it. This task, considered indecent and beneath the lowest class of people, is supported by the señores gobernadores, who include it among the many public obligations encompassed by the norms of good government.59

More often, though, garbage and the contents of emptied chamberpots simply collected on thoroughfares and in poorly ventilated alleyways until the next strong rain arrived to wash away the filth. By 1767, conditions in the port were unpleasant enough to draw the attention of Charles III, who ordered the viceroy, the Marqués de Croix, to allocate funds for two boats to cruise the harbor daily and clear waste from the waters.60

At the same time, a strong movement to improve street cleaning gathered momentum. Few effortseiforts survive, but in 1775 city officials announced that they had completed the paving of every major street in Veracruz, with curbside sluices to aid in sweeping away accumulated filth.61

Impressed with their accomplishments, the officials were quick to claim that the new emphasis on sanitation was responsible for yellow fever’s disappearance from the port between 1776 and 1793. Local comerciantes shared in the enthusiasm generated by the perceived public health victory and used the vómito’s subsidence to encourage potential investors and settlers to overcome their traditional fear of the port. By 1784, articles appeared regularly in the Gazeta de México stressing the success of recent cleanup efforts in Veracruz and, furthermore, reporting a moderating trend in average yearly temperatures. These could only be signs, port promoters argued, of the end of yellow fever’s centuries-old reign in the lowlands and “the [negative] impression commonly formed about Veracruz’s harsh climate that has had not a minor influence on the interests of the community and the royal treasury.” Port advocates even went so far as to predict that soon Veracruz “would become the healthiest city in all of New Spain.”62

The direct success of these efforts to lure investors, laborers, and settlers to Veracruz in the 1780s can never be gauged, but the port’s improved reputation undoubtedly contributed to its dramatic post-comercio libre population boom. By the end of the decade, though, that growth had effectively demolished many of the town’s hard-won improvements in public sanitation. The amount of garbage and human waste tossed onto city streets increased apace with the influx of newcomers, who crammed themselves into a settlement that had no way of expanding beyond the limits of its encircling fortifications. By 1791, municipal officials were complaining that the 32 city employees charged with clearing the streets and hauling collected refuse to be dumped into the harbor could no longer cope with the amount of filth generated daily.63

As yellow fever renewed its assault on the coastal community in 1794, local residents, crown officials, and leading comerciantes grew increasingly alarmed at the port’s now inadequate public sanitation efforts. In 1796, moreover, city officials complained that it had become next to impossible to find the unemployed drifters (vagos) who had always filled the ranks of the street cleaners. Press gangs eager to provide crews for warships in the port after the renewal of hostilities between Spain and Great Britain had effectively cleared the town of potential street-cleaning recruits.64

Conscious of the damage that decaying health conditions threatened to inflict on its recent economic gains, the town’s commercial elite stepped in to offer its guidance and financial support for a new public health initiative. In January 1797, consulado representatives presented the town council with a detailed proposal, formed in consultation with the town’s facultativos, on how best to attack the disease-inducing conditions in Veracruz. The plan advocated four steps: halting burials inside churches and establishing a general cemetery on land far removed from the city, closing the dilapidated and disease-infested hospital of San Juan de Montesclaros and building a new facility at the edge of town, draining the stagnant ponds surrounding the town, and installing water closets in every building in the city and constructing an underground sewage system to drain them. The consulado offered to pay for these measures if the town council granted it the authority to collect fines from building owners who did not maintain the water closets in working order and from residents caught pouring their waste onto the street.65

Over the next decade, the consulado applied money and political leverage to ensure that its proposed public health measures were carried out. In 1802, the merchant guild persuaded the Veracruz cabildo to set aside land on the plains surrounding the town as a general cemetery. By 1804, many of the town’s commercial elite had announced that they and their families would give up the tombs reserved for them in the city cathedral and take plots instead in the new cemetery in the hope that their example would spark imitation throughout the community.66 When Charles IV issued a general edict later that year mandating an end to burials within the limits of all cities in Spain and its overseas possessions, Veracruz complied with the order almost immediately.67 Also in 1804, the consulado won its campaign to close the city hospital of San Juan de Montesclaros and persuaded the cabildo to devote municipal funds to a new facility that would care exclusively for yellow fever sufferers connected to Atlantic commerce.

In 1801, the cabildo had given up its attempts to maintain adequate numbers of street cleaners in Veracruz, contracting instead with a local comerciante, Manuel Francisco Alegre, to provide the vital service.68 Alegre dealt with the task successfully, according to Alexander von Humboldt. The port’s age-old reputation as a filth-ridden community was undeserved, Humboldt noted in 1804; cabildo and consulado efforts to improve sanitation had been so successful that “Veracruz is now cleaner than many cities in southern Europe.”69

Other elements of the consulados campaign to eradicate environmental sources of disease in Veracruz proved less successful, however. Local comerciantes convinced the crown of the need to improve the town’s water supply, both to drive a new sewage and water closet system and to provide drinking water so that the surrounding swamps could be drained once and for all. By 1804, the royal treasury had provided more than five hundred thousand pesos in direct subsidies for the construction of a 25-kilometer aqueduct that would channel water from the nearby Río Xamapa into Veracruz. By 1815, however, only one thousand meters of the water system had been completed, and auditors in the Mexico City contaduria angrily denounced the Veracruz cabildo for having tapped money intended for the Río Xamapa effort to offset its deficit spending of almost two decades.70 When the city entered the national period in 1821, it did so without the long-hoped-for aqueduct.

The Debate over Quarantine

In the meantime, contagion theory also found advocates among those concerned with preventing yellow fever in Veracruz. As the viceroyalty’s busiest harbor, Veracruz was perceived by many as the most dangerous potential landing site for imported illness. Only the systematic inspection and, when deemed necessary, the isolation of newly arrived vessels in Veracruz, advocates argued, could protect “this vast continent from the deadly foreign contagions whose principal point of entry is the port of Veracruz.”71 Failure to take such precautions, they warned, would sooner or later precipitate an epidemic in the coastal township “capable of spreading throughout the realm, sacrificing the lives of thousands of persons [who are] of great use to the State and the Nation.”72

Although loath to instate contagionist public health measures, decision-makers in Mexico City found these arguments increasingly difficult to ignore after 1790. Smallpox outbreaks in Havana in 1790,1793, and 1796 prompted fears that the disease might strike the continent by way of Veracruz. As a result, successive viceroys, from the Conde de Revillagigedo on, would order the Veracruz cabildo and local military authorities to establish a temporary health inspection committee (junta de sanidad) and guidelines for ship quarantines whenever smallpox threatened.73 As the century drew to a close, calls increased dramatically for a permanent junta de sanidad in the town.

The resurgence of yellow fever only fed the growing interest in contagionist efforts. Many Veracruzanos rejected the contention that yellow fever was a noncontagious, endemic illness that emanated from the soggy terrain surrounding the town. Instead, they asserted that the vómito’s resurgence after an absence of almost 20 years had come via three infected sailors aboard the warship El Miño.

If the proper precautionary measures had been in place and executed on the arrival of the warship Miño, his majesty would have four thousand more subjects to man his armies and navy that have perished as a result of that fatal ship’s influence, and the Nation a great number of active arms that experienced a similar cruel fate.74

This belief not only gave added weight to the campaign for more rigorous inspections of ships entering Veracruz, but also fueled calls for an automatic quarantine on vessels coming from the yellow fever-plagued eastern seaboard of the United States.75 In 1801, knowledge that the disease was active in southern Spain prompted Viceroy Félix Berenguer de Marquina to order the establishment of permanent jantes de sanidad in every port in New Spain. Veracruz complied with the order, making systematic ship inspections standard practice for the remainder of the colonial period.76

The appearance of an inbound sail on the horizon was the signal for port officials to summon one of the town’s facultativos from a list compiled by the protomedicato’s representative in Veracruz.77 As the ship entered the harbor, a launch carried both the practitioner and a notarial clerk to meet the incoming vessel. From the launch, the facultativo queried the captain about the health of his crew and the places he had visited en route to Veracruz. If no immediate cause to suspect contagious illness existed, he then boarded the vessel and examined all hands. But if the captain’s answers raised suspicions of sickness, or if the inspection uncovered signs of disease, the ship entered quarantine at a site selected by the harbormaster. In such instances, all persons who had accompanied the launch washed their clothes with vinegar, sulfur water, or some other astringent substance on returning to shore. After 40 days had passed with no new appearance of disease on the isolated craft, crew members could disembark after similarly cleansing all clothing. The ship’s cargo was then unloaded onto a remote part of the docks, where it remained for several days to allow fresh air and sunlight to remove any lurking remnants of contagion.78

The efforts to implement ship inspections and isolation measures faced opposition and harsh criticism. In Veracruz, local comerciantes, agents of the large trading houses in Mexico City and Madrid, and, after 1795, members of the town’s consulado regularly attended meetings of the port’s junta de sanidad, where the merchants vocally denounced the quarantines as unnecessary and hurtful to commerce.79 Quarantining a vessel laden with valuable cargo not only lost weeks in transporting the merchandise but also placed it at considerable risk of loss or theft.

Health officials typically ordered quarantined ships to take up station off the nearby Isla de Sacrificios. Navigation between the harbor at Veracruz and the designated anchorage was treacherous, particularly for larger vessels with fully packed holds. The ships, moreover, enjoyed no military protection during their lengthy stay, making them tempting targets for British raiders and privateers. Debates between members of the junta de sanidad, the military, the merchants’ guild, the harbormasters, and the town council over the appropriate anchorage for quarantined vessels arose repeatedly during the crises of 1790, 1793, and 1796 and continued into the nineteenth century.80

These threats to commerce were in themselves irksome to those with a stake in the Atlantic trade, but critics also questioned the validity of the contagionist measures that exacted such a heavy price. As one colonial official pointed out after a 1793 reinstatement of the junta de sanidad in Veracruz, ship inspections were far from foolproof under the best of circumstances.

In addition to the malicious violation [of rules forbidding recovering smallpox victims from boarding ships leaving Havana] by some convalescent interested only in quick passage to this continent, some sufferers can embark without malice and [complete their] travel in the days between catching the illness and manifesting even the most minor of symptoms.81

Even without questioning the theoretical validity of quarantines, opponents argued that gross inadequacies and violations of the system as practiced in Veracruz rendered the measure worthless even as it impeded the flow of goods through the port. They pointed out that contacts between incoming vessels and persons from the shore occurred long before the inspecting facultativo began his interrogation, making any subsequent isolation superfluous. As ships neared Veracruz, for example, boys from the town habitually flocked into canoes, paddling out to intercept the new arrival and sell their services as guides. As the inbound vessel neared its designated slip, the young entrepreneurs would jump overboard and swim ashore long before the launch bearing the health inspectors left the docks. Similarly, the harbormaster and military officers frequently overruled the designated medical inspector’s authority when they accompanied him in the outgoing launch, forcing him to delay his interrogation and remain in the boat until after they had boarded and questioned the ship’s captain about the nature of his cargo, urgent documents, and military or political news from abroad.82

At the same time, colonial authorities often ignored violations of quarantine when the preventive measure impinged on activities considered vital to the state. Complaints frequently surfaced that ship captains and passengers claiming urgent business in the viceregal capital left quarantined vessels prematurely.83 Even Viceroy Revillagigedo, reinstating the junta de sanidad in 1793, stressed that while he understood the dangers of smallpox spreading from Havana, “nevertheless there are other matters both ordinary and extraordinary that concern the royal service at this moment that should be kept in mind as the mentioned junta carries out its tasks.”84 As the system evolved in subsequent years, mail ships and any messengers they carried were allowed to circumvent the quarantines, depositing cargo and passengers on the shore south of the port. There, the passengers remained in isolation at a designated hacienda for three or four days before being allowed to continue to the interior of Mexico.85

Criticism of the anticontagion measures, as well as complaints that they hindered commerce in the port, provided ready ammunition for the commercial elite as it promoted the competing environmental approach. No issue plagued the new junta de sanidad more than funding, a weakness that enabled opponents of the anticontagion steps to seriously limit the junta’s capabilities. In Mexico City, where no royally funded health committee functioned in the colonial period, debate over the allocation of money for the Veracruz junta de sanidad continued for more than a decade among the fiscales charged with advising the viceroy on the matter.86

Meanwhile, efforts to raise funds locally by increasing the duties on goods moving through the port met with unbending opposition from the consulado, whose members were loath to suffer added expenses for anticontagion measures they considered more damaging than helpful to commerce. Such tax hikes, they repeatedly and successfully argued, were better reserved for environmental programs like the Río Xamapa project, which would ultimately improve health conditions in Veracruz without impinging on the movement of goods through the port.87

Lasting Achievements

In spite of conflicting economic interests and theories on disease causation, Veracruz did make genuine advances in public health as the colonial period drew to a close. Efforts to improve public sanitation succeeded from time to time, and advocates of the environmental approach to disease prevention could claim major victories in their campaign to stop burials within the walled confines of the town and to close the hospital of San Juan de Montesclaros. After 1801, a permanent public health body, the junta de sanidad, functioned continuously in Veracruz, conducting ship inspections and, after 1804, overseeing the distribution of smallpox vaccine throughout the southeast corner of the viceroyalty. In 1816, moreover, viceregal authorities finally acknowledged the importance of the committee’s work by granting funds for a salaried médico de sanidad to head the organization, thereby creating the first and only royally funded public health office in New Spain.88

The public health effort in Veracruz stemmed from the threat that disease—most importantly, yellow fever—posed to the port and to New Spain’s position in an expanding Atlantic economy. The town’s emerging commercial elite and royal officials recognized sickness in Veracruz as bad for business and the interests of colonial government. Both sectors, therefore, proved willing to devote money to projects patterned after public health initiatives being carried out across Europe, particularly those that did not impinge on the movement of goods and people through the port. As a result, public health in Veracruz reached a level unequaled in the viceroyalty, placing the town in the vanguard of the effort to prevent widespread disease in New Spain.


George Rosen, A History of Public Health (New York: MD Publications, 1958), 107–14, and “Cameralism and the Concept of Medical Police,” in From Medical Police to Social Medicine: Essays on the History of Health Care (New York: Science History Publications, 1974), 120–41; Ann F. La Berge, Mission and Method: The Early Nineteenth-Century French Public Health Movement (New York: Cambridge Univ. Press, 1992), 12–13; James C. Riley, The Eighteenth-Century Campaign to Avoid Disease (New York: St. Martin’s Press, 1987), 8.


Rosen, History of Public Health, 128–34.


Roy Porter, “Cleaning Up the Great Wen: Public Health in Eighteenth-Century London,” Medical History, supplement no. 11 (1991), 74–75; Riley, Eighteenth-Century Campaign, xii-xiii, 115–38, 151–54.


Donald B. Cooper, Epidemic Disease in Mexico City, 1761–1813: An Administrative, Social, and Medical Study (Austin: Institute of Latin American Studies/Univ. of Texas Press, 1965); John Tate Lanning, The Royal Protomedicato: The Regulation of the Medical Professions in the Spanish Empire, ed. John Jay TePaske (Durham: Duke Univ. Press, 1985), 351–86. Other works on specific aspects of public health in the colonies include Pamela Voekel, “Peeing of the Palace: Bodily Resistance to Bourbon Reforms in Mexico City.” Journal of Historical Sociology 5:2 (June 1992), 183-208; Robin C. Price, “State, Church, Charity, and Smallpox: An Epidemic Crisis in the City of Mexico, 1797–98,” Journal of the Royal Society of Medicine 75 (May 1982), 356–67; Jean-Pierre Clement, “El nacimiento del la higiene urbana en la América española del siglo XVIII,” Revista de Indias 43:171 (1983), 77–95. Rare looks at developments outside of Mexico City include Michael C. Meyer, “Public Health in Northern New Spain,” Estudios de Historia Novohispana 11 (1991), 135–53; Angela Thompson, “To Save the Children: Smallpox Inoculation, Vaccination, and Public Health in Guanajuato, Mexico, 1797–1840,” The Americas 49:4 (Apr. 1993), 431–55.


Lanning, Royal Protomedicato 351–58; Cooper, Epidemic Disease, 16–46, 185–200.


Cooper, Epidemic Disease, 185–86, 198–99.


For an overview of the late eighteenth-century transformation of the Atlantic economy, see C. H. Haring, The Spanish Empire in America (New York: Oxford Univ. Press, 1947), 341–47; D. A. Brading, “Bourbon Spain and Its American Empire,” in The Cambridge History of Latin America, vol. 1, Colonial Latin America, ed. Leslie Bethell (Cambridge: Cambridge Univ. Press, 1984), 409–26; John R. Fisher, “Imperial ‘Free Trade’ and the Hispanic Economy, 1778–1796,” Journal of Latin American Studies 13:1 (May 1981), 21–56; Alexander von Humboldt, Ensayo político sobre el reino de la Nueva España, 5 vols. (Mexico City: Robredo, 1941 [1811]), 4:95–96; Javier Ortiz de la Tabla Ducasse, Comercio exterior de Veracruz, 1778–1821: crisis de dependencia (Seville: Escuela de Estudios Hispanoamericanos, 1978), 19–22.


Ortiz de la Tabla Ducasse, Comercio exterior, 69–84.


Archivo General de la Nación, Mexico City (hereafter AGN), Hospitales, vol. 3, exp. 1.


Veracruz, Archivo y Biblioteca Históricos de Veracruz (hereafter ABH-V), caja 40, fols. 422–513. This detailed, nonmilitary census of Veracruz is unfortunately incomplete, with only four of the eight returns for districts in the town mentioned elsewhere in the surviving municipal records (ABH-V, caja 41, fol. 96). The total population of the four reported districts was 4,154. This figure has been doubled to provide the citywide estimate offered in the text. For a discussion of the growth in the comerciante sector of the populace after comercio libre, see Jackie R. Booker, “The Veracruz Merchant Community in Late Bourbon Mexico: A Preliminary Portrait, 1770–1810,” The Americas 45:2 (Oct. 1988), 187–99.


José Antonio Calderón Quijano, Historia de las fortificaciones en Nueva España (Seville: Escuela de Estudios Hispanoamericanos, 1953), 168–71; ABH-V, caja 65, fol. 372.


Humboldt, Ensayo político, 3:309.


“Balanza de Comercio de Veracruz . . . 1805,” reprinted in Apuntes históricos de la heroica ciudad de Veracruz, by Miguel Lerdo de Tejada, 3 vols. (Mexico City: Imprenta de I. Cumplido, 1850–58), appendix, doc. 19.


Thomas P. Monath, “Yellow Fever,” in Infectious Diseases: A Modern Treatise of Infectious Processes, 4th ed., ed. Paul D. Hoeprich et al. (Philadelphia: Lippincott, 1989), 795.


Ibid.; Margaret Humphreys, Yellow Fever and the South (New Brunswick: Rutgers Univ. Press, 1992), 5–6; David K. Patterson, “Yellow Fever Epidemics and Mortality in the United States, 1693–1905,” Social Science and Medicine 34:8 (Apr. 1992), 855.


James S. Ward, Yellow Fever in Latin America: A Geographical Study (Liverpool: Centre for Latin American Studies, Univ. of Liverpool, 1972), 1–2; Jean Slosek, "Aedes aegypti Mosquitoes in the Americas: A Review of Their Interactions with the Human Population,” Social Science and Medicine 23:3 (1986), 249.


Ward, Yellow Fever in Latin America, 18.


Ibid., 11–18; Robert Shope, “Global Climate Change and Infectious Diseases," Environmental Health Perspectives 96 (Dec. 1991), 171–72.


Thomas P. Monath, "Yellow Fever: Victor, Victoria? Conqueror, Conquest? Epidemics and Research in the Last Forty Years and Prospects for the Future,” American Journal of Tropical Medicine and Hygiene 45:1 (July 1991), 26–28; idem., personal communication, Oct. 15, 1993; Slosek, “Aedes aegypti Mosquitoes,” 249.


Ward, Yellow Fever in Latin America, 6–9, 28–29.


Patterson, “Yellow Fever Epidemics,” 855–62; Humphreys, Yellow Fever and the South, 6–7.


Humboldt, Ensayo político, 4:137–41; AGN, Protomedicato, vol. 1, exp. 6, fol. 336.


See, e.g., Bernal Diaz del Castillo, Historia verdadera de la conquista de la Hueva España [1551], facsimile (Havana: Casa de las Américas, 1983), chap. 41, p. 93; Fr. Alonso de la Mota y Escobar, Memoriales del obispo de Tlaxcala: un recorrido por el centro de México a principios del siglo XVII [1609–23] (Mexico City: SEP, 1987), 51; Giovanni Francesco Gemelli Carreri, Viaje a la Nueva España [1700], ed. Francisco Perujo (Mexico City: UNAM, 1976), book 3, chap. 3; Miguel de Corral, “Relación de los reconicimientos [del sur de Veracruz] por el coronel . . . D. Manuel [sic] del Corral, Tlacotalpa, 1777," in “El sur de Veracruz a finales del siglo XVIII: un análsis de la relación de Corral,” by Alfred H. Siemens and Lutz Brinckmannn, Historia Mexicana 26:2 (Oct.–Dec. 1976), 292–324.


Ward, Yellow Fever in Latin America, 19–21.


Antonio de Herrera, Historia general de los hechos de los castellanos en las islas y tierra firme del mar oceano, 4 vols. (8 décadas) (Madrid, 1601–15), 4th década, book 9, chap. 6; Gemelli Carreri, Viaje a la Nueva España, 3:3; Informe del ingeniero Pedro Ponce, Nov. 15, 1764, Archivo General de Indias, Seville (hereafter AGI), México 2459.


“Veracruz en 1816–1817: fragmento del diario de Antonio López Matoso,” ed. Jim C. Tatum, Historia Mexicana 19:1 (July–Sept. 1969), 121.


Herrera, Historia general, 4th déc., 9:8.


Humboldt, Ensayo político, 1:371–72. For shipping patterns after the declaration of comercio libre, see Ortiz de la Tabla Ducasse, Comercio exterior, 57.


ABH-V, caja 48, fols. 141; AGN, Hospitales, vol. 3, exp. 33, fol. 424; Humboldt, Ensayo político, 4:133.


Herrera, Historia general, 4th déc., 9:6; Humboldt, Ensayo político, 4:133.


Ward, Yellow Fever in Latin America, 15.


AGN, Epidemias, vol. 10, exp. 11, fol. 435.


Instrucción del virrey Marqués de Branciforte a su sucesor, D. Miguel José de Azanza, Mar. 16, 1797, in Instrucciones que los virreyes de Nueva España dejaron a sus sucesores (Mexico City: Imprenta Imperial, 1867), 129–43.


AGN, Protomedicato, vol. 1, exp. 6, fol. 352; Christen I. Archer, “The Key to the Kingdom: The Defense of Veracruz, 1780–1810,” The Americas 27:4 (Apr. 1971), 438.


ABH-V, caja 70, fol. 418.


Humboldt, Ensayo político, 4:116–17; ABH-V, caja 67, fol. 7.


Humboldt, Ensayo político, 4:145–47.


Ibid., 2:300, 4:197; Alfred H. Siemens, “The Persistence, Elaboration, and Eventual Modification of Humboldt’s View of the Lowland Tropics,” Canadian Journal of Latin American and Caribbean Studies 14:27 (1989), 90.


Humboldt, Ensayo político, 4:143.


Ibid., 4:142.


Ibid., 4:149–52.


At least 6 of the town’s 11 licensed practitioners who presented their credentials to the Veracruz cabildo in 1809 had received their degrees at Cádiz and had settled in the gulf port after service in the Real Armada. AGN, Protomedicato, vol. 1, exp. 6, fols. 280–303. On the college of surgery at Cádiz and its progressive curriculum, see Michael E. Burke, The Royal College of San Carlos: Surgery and Spanish Medical Reform in the Late Eighteenth Century (Durham: Duke Univ. Press, 1977), 43–63.


See, e.g., Gazeta de México (Mexico City) (hereafter GM) 1:20 (Oct. 6, 1784), 170; 4:37. 38 (July 12. 26, 1791), 349–51. 357–60.


Von Humboldt presented a paper to the society when he passed through Veracruz in 1804. Pérez y Comoto’s translation appears in GM 12:16 (June 30, 1804), 134–36.


For trials of Spanish physician Tadeo de la Fuentes yellow fever therapy, which stressed massive dosing with chinchona bark in the early stages of the disease, see GM 12:56 (Dec. 18, 1805), 469–75; 13:69 (Aug. 23, 1806), 558–60. For earlier trials of yellow fever regimens, see ibid. 6:51 (Aug. 18, 1794), 422; 7:21 (Apr. 17, 1795), 183; 10:26 (Nov. 4, 1800), 207; 12:24 (Oct. 27,1804), 212. In 1804, the Veracruz medical community helped cabildo and vice-regal authorities introduce smallpox vaccination into New Spain. See Michael M. Smith, “The ‘Real Expedición Marítima de la Vacuna’ in New Spain and Guatemala,” Transactions of the American Philosophical Society 64 (1974), pt. 1.


For a detailed discussion of the military strategies employed in the defense of New Spain’s Atlantic coast, see Archer, “Key to the Kingdom,” 426–49.


“Memoria sobre el fomento agrícola de la intendencia de Veracruz,” Jan. 12, 1807, in Javier Ortiz de la Tabla Ducasse, ed., Memorias políticas y económicas del consulado de Veracruz, 1796–1822 (Seville: Escuela de Estudios Hispanoamericanos, 1985), 137. Three years earlier, von Humboldt had calculated the population density of the entire coastal plain, from Tampico to the Laguna de Términos, at 38 persons per square league. In comparison, Humboldt’s figures for the intendancies of Mexico and Puebla were 255 and 301 persons per square league, respectively. Humboldt, Ensayo político, 2:171.


Vivian Nutton, “The Seeds of Disease: An Explanation of Contagion and Infection from the Greeks to the Renaissance,” Medical History 27 (1983), 1–34.


For detailed discussions of the rise of these early European public health measures after 1347 see, among many sources, Carlo M. Cipolla, Fighting the Plague in Seventeenth-Century Italy (Madison: Univ. of Wisconsin Press, 1981), 16–50; Ann G. Carmichael, Plague and the Poor in Renaissance Florence (New York: Cambridge Univ. Press, 1986), 110–21.


See Erwin H. Ackerknecht, “Anticontagionism Between 1821 and 1867,” Bulletin of the History of Medicine 22:5 (1948), 570–75. For the European debate over yellow fever and its mode of spread, see La Berge, Mission and Method, 90, n. 16.


Riley, Eighteenth-Century Campaign, 12–19.


Ibid., 19–69; Rosen, History of Public Health, 154–56.


Riley, Eighteenth-Century Campaign, 89–112. On such efforts in London, see Rosen, History of Public Health, 128–32; Porter, “Cleaning Up the Great Wen,” 67–68. On Madrid, see Clement, “El nacimiento del la higiene urbana,” 83; Vicente Pérez Moreda, Las crisis de mortalidad en la España interior, siglos XVI–XIX (Madrid: Siglo Veintiuno de España, 1980).


See esp. Martin S. Pernick, “Politics, Parties, and Pestilence: Epidemic Yellow Fever in Philadelphia and the Rise of the First Party System,” in Sickness and Health in America: Readings in the History of Medicine and Public Health, ed. Judith W. Leavitt and Ronald L. Numbers (Madison: Univ. of Wisconsin Press, 1978), 241–56.


The earliest published recordings of Veracruz climatic data appear in GM 1:4 (Feb. 25, 1784), 28–29. For most of the ensuing decade, GM published yearly compilations of the readings collected in the port each February. For reports of data gathered in the 1790s and early 1800S by Veracruz resident Bernardo de Orta, see Humboldt, Ensayo político, 4:133–36.


“Memoria sobre la construcción de sumideros para purificar la atmosfera,” Jan. 9, 1797, in Ortiz de la Tabla Ducasse, Memorias políticas y económicas, 17–18.


Humboldt, Ensayo político, 4:159.


“Relación del señor Félix Berenguer de Marquina a su sucesor, don José de Iturrigaray,” Jan. 1, 1803, in Instrucciones y memorias de los virreyes novohispanos, 2 vols., ed. Ernesto de la Torre Villar (Mexico City: Porrua, 1991), 2:1418.


“Memoria sobre la construcción de sumideros,” 16.


AGN, Marina, vol. 27, exp. 71, fols. 168–71.


Humboldt, Ensayo político, 4:158–59.


See GM 1:4 (Feb. 25, 1784), 28–29; 2:3 (Feb. 15, 1786), 32; 2:28 (Feb. 13, 1787), 290–91. The laudatory articles usually appeared in February and included mortality statistics from the previous year for the Hospital Real de San Carlos as supporting evidence. Over the course of the 1780s and early 1790s, annual mortality in the hospital was touted as running between 2 and 3 percent. The authors noted that it would be hard to find another hospital in Europe or the Americas whose yearly mortality did not exceed 10 percent.


ABH-V, caja 37, fols. 140–52.


Ibid., caja 51, fols. 26–28.


“Memoria sobre la construcción de sumideros,” 19–20; Humboldt, Ensayo político, 4:152.


Humboldt, Ensayo político, 4:158–59.


Burial records for the Veracruz cathedral confirm this; listings for the cementerio general extramuros as the site of interment appear consistently beginning in 1805.


ABH-V, caja 48, f. 524.


Humboldt, Ensayo político, 4:132.


AGN, Epidemias, vol. 2, exp. 7, f. 318.


Ibid., f. 310.


Ibid., vol. 2, exp. 3, f. 40.


Ibid., vol. 7, exp. 2.


Ibid., vol. 2, exp. 3, fols. 39–43.


ABH-V, caja 77, f. 701; AGN, Epidemias, vol. 2, exp. 3, fols. 39–40.


AGN, Epidemias, vol. 2, exps. 3–5, fols. 41–179.


The facultativos shared the duty on a rotating basis without pay, endlessly bickering over and trying to escape the hated task. AGN, Epidemias, vol. 8, exp. 12, fols. 254–55; Lanning, Royal Protomedicato, 130–33. On several occasions after 1801, the subdelegado, with the cabildo’s support, threatened to revoke the prescription privileges of offending facultativos and to fine or close down local pharmacists who filled their orders. ABH-V, caja 77, fols. 695–97; AGN, Protomedicato, vol. 1, exp. 5, f. 160.


AGN, Epidemias, vol. 7, exp. 2, fols. 33–45.


See the attendance lists for meetings on Mar. 11, 1793, ABH-V, caja 27, f. 268; and Nov. 27, 1801, AGN, Epidemias, vol. 2, exp. 3, fols. 53–54.


AGN, Epidemias, vol. 7, exp. 2, fols. 72–75.


Ibid., vol. 7, exp. 8, f. 359.


Ibid., vol. 2, exp. 3, fols. 39–40; ABH-V, caja 51, fols. 78–81.


See, e.g., ABH-V, caja 27, fols. 289–90.


ABH-V, caja 27, fols. 287–88.


Ibid., fols. 268–74; AGN, Epidemias, vol. 2, exp. 3, f. 82.


See the opposition from Francisco Xavier Borbón, the supervising fiscal de lo civil, in AGN, Epidemias, vol. 2, exp. 3, fols. 46, 67; and his postponement of a decision in July 1802, ibid., vol. 2, exp. 7, f. 247. Soon afterward, the file on the matter disappeared, despite repeated searches by viceregal clerks in 1804 and 1814. ABH-V, caja 68, fols. 178–84; AGN, Epidemias, vol. 2, exp. 7, fols. 315–18.


In October 1802, the merchant guild blocked efforts by the junta de sanidad to acquire operating funds via a 1/8 percent increase in duties on goods passing through the port; AGN, Epidemias, vol. 2, exp. 3, fols. 85–86, and exp. 7, f. 262. In May 1804, the consulado derailed a similar proposal based on an increase in the per weight tax on water loaded onto outgoing vessels; AGN, Epidemias, vol. 2, exp. 3, fols. 114–16.


AGN, Epidemias, vol. 8, exp. 11, fols. 171–84.