Hernández Sáenz’s study of medicine and medical practitioners in late colonial Mexico has much to offer specialists both in the history of medicine and in Latin American social history. It traces the improvement in medical knowledge and training from 1767, when the first College of Surgery was established in Mexico City, until 1831, when the Royal Protomedicato was abolished and medicine and surgery were merged. Although the outlines of this story are evident in John Tate Lanning’s book on the Protomedicato in Spanish America, Hernández Sáenz adds new information culled from Mexican archives, presents technical advances clearly so that they can be understood by the lay-person, and provides a useful discussion of developments in contemporary Europe. The most original contribution of Learning to Heal is the author’s study of the lives of medical practitioners; it is one of the first prosopographies for any group of professionals in colonial Mexico.
This book is not a study of popular medicine, such as those by Gonzalo Aguirre Beltrán and Noemí Quesada. Hernández Sáenz focuses on the groups of health-care workers licensed by the Protomedicato. She examines their training, working conditions, patients, household arrangements, and family ties. She finds that medical professionals, though largely from the middle strata of colonial society, were far from a homogeneous group. At the top of the hierarchy were the physicians, whose racial “purity” and university degrees conferred prestige. At the bottom were the often mixed-race bleeders and midwives. In the middle were the pharmacists and surgeons, the latter gaining respectability in the late eighteenth century because of their importance to the Bourbon armies. Even within each group there was a large range of status, as from the lowly itinerant surgeon who peddled his services in small towns to the well-connected faculty member of the new College of Surgery.
Hernández Sáenz is at her best when she sticks close to the archival data. Her broad generalizations are sometimes overstated. For example, her assertion that mixed-race individuals were increasingly represented in the medical professions is entirely based on late colonial evidence and contradicts earlier examples in Lanning’s book. Her data are likewise too thin to conclude that “medical care in Mexico was comparable to that in Europe” (p. 40). It is difficult to know whether the Mexican practitioners who kept abreast of European innovations were typical on the basis of information largely covering Mexico City between 1790 and 1812 and mostly applying to the legal practitioners, who were outnumbered by those practicing without a license. At times the work reads like a barely revised doctoral dissertation, as in the prologue, which can easily be skipped. Many of the tables lack dates and source references. The bibliography contains several errors and omissions, such as Francisco Flores’s multivolume history of Mexican medicine.
Nevertheless, Learning to Heal is an important contribution to understanding late colonial Mexico. It illuminates the impact of the scientific revolution and Bourbon reforms. It fills a gap in our understanding of the lives of those who were neither rich nor poor. It contains valuable tidbits on such disparate subjects as how penniless youths financed their medical education, how professional rivalries led to attempts to exclude peninsulares from the medical professions, and how midwives served as expert witnesses in cases of incest and rape. Social historians will welcome the fascinating thumbnail sketches of unlicensed practitioners brought to trial, such as the widowed “La Beata,” who ran a venereal disease clinic in her home, or the eccentric curandera “María la Gachupina,” who shaved a cross on her head and delivered health care that combined Western medicine with Catholic ritual. The careful explanations of medical treatments also help us comprehend why life expectancies were so low throughout this period.