Entre médicos y curanderos is an extremely interesting and varied collection of articles that is representative of new work in the sociocultural studies of medicine in Latin America. Armus gives a comprehensive but succinct overview of recent scholarship in the field and highlights some important themes in the collection: health issues as represented in popular culture, hygiene as a civilizing project for the poor or marginalized ethnic groups, responses of popular sectors to public health initiatives, studies of "total institutions" such as mental hospitals, the ways people combine aspects of different healing systems, and the complexity of relations between patients and healers. Armus points out that, in general, current social studies of medicine tend to focus on illness and healing to illuminate broader historical concerns.
María Silvia Di Liscia's article deals with changing attitudes of the Argentine political elite toward smallpox and the Indian population and Indian attitudes toward vaccination. In the 1830 s, Juan Manuel de Rosas used vaccination to protect the health of his Indian allies, guarantee their loyalty, and integrate them into the population. Significantly, although there was some resistance, groups of natives did accept vaccination. In 1879 , however, with the so-called conquest of the desert, smallpox became an ally in the extermination of the native population, justified through social Darwinist arguments about the Indians' inherent unfitness and lack of resistance to the disease.
David Sowell's and Steven Palmer's very interesting articles examine the appeal of popular healers as alternatives to the secularism and political and economic liberalism associated with scientific medicine. Sowell's article on Miguel Perdomo Neira, an "empirical" doctor who combined Catholic spirituality with his curing, shows that his approach struck a responsive chord in the 1870 s, when liberalism and scientific medicine were struggling to gain ideological ascendancy. Palmer studied Costa Rican professor Carlos Carbell, who in the 1930 s combined some of the techniques of biomedicine with spiritualism and a rejection of the purely materialist basis of modern knowledge. He demonstrates that spiritualism in the period was not necessarily linked to a conservative Catholicism but could be joined to progressive, populist politics, as in the case of Augusto César Sandino and Costa Rican president Rafael Angel Calderón Guardia. The appropriation of an elite discourse on civilization by the working class is the subject of two fascinating articles on Peru and Chile in the early twentieth century. In "Higiene y vivienda en Lima," David Parker shows how organized white and mestizo workers and artisans used an ideology of self-improvement (hygiene, education, and culture) to affirm their rights as citizens. Although in the case of skilled workers the "civilizing" project could include radical social and economic demands, the workers also tended to accept the [End Page 511] racist assumptions of the elite. This prevented broader unity among workers; in fact, organized workers and artisans supported the razing of tenements occupied by Asian laborers who were considered to be the cause of disease. María Angélica Illanes writes about the revival of the categories of "civilization" and "barbarism" in early-twentieth-century Chile, especially the use of the term "barbarism" among different groups, including organized workers. Her use of labor newspapers and poetry of the working class shows that, unlike in Peru, where the skilled workers favored the destruction of conventillos believed to be foci of disease, in Chile organized workers condemned the government's fumigation and destruction of working people's homes. For them, science had put itself at the service of barbarism (the bourgeoisie), and the discovery of bubonic plague was only an excuse to attack the working class.
Christina Rivera-Garza's article on La Castañeda, a national mental hospital that opened outside Mexico City in 1910 , is a fascinating examination of an institution that began life as an example of Porfirian order and progress but ended up being far less therapeutic, modern, and "total" than its creators intended. Lack of funds, overcrowding, an untrained staff...