Salud pública en España: Ciencia, profesión y política, siglos XVIII-XX, and: Las políticas de la salud: La sanidad valenciana entre 1855 y 1936 (review)

These two volumes are a good example of the intensive historical research carried out on Spanish public health in recent times. They are, however, very different from each other regarding both their perspective and their conclusions.

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The work of Esteban Rodríguez Ocaña is, without doubt, a strong reference point within this scholarly trend due to the number and quality of his contributions, but also due to his ability to suggest a particular historiographic approach to health problems. The new book contains nine of his most significant publications (the first published in 1986, and the last in 2001) on relevant and complementary issues of public health in Spain. These papers have been republished with no amendments, exactly as they originally appeared. However, the selection itself, and the grouping of the papers in three sections, results in an end product that reaches well beyond the usefulness of making easily accessible in a single volume previously widely scattered material: it provides the whole with internal consistency, which allows the recognition of a global contribution summarizing a major portion of the history of public health in contemporary Spain.

The first part is devoted to the creation of the Spanish health-care administration. The initial paper—the only one to treat the eighteenth century—examines the establishment and development of the Junta Suprema de Sanidad (Supreme Health Care Board) and of local, provincial, and harbor-related Juntas de Sanidad, whose main goal was to defend or "protect" the health of the Crown's subjects against the threat of potentially catastrophic diseases, such as the plague, which might have reached Spain through the French Mediterranean. This represents a major contribution to the study of preliberal Bourbon health care. The remaining papers in this section deal with the nineteenth and twentieth centuries. The article on the Instituto de Higiene Urbana de Barcelona and the statistical work developed there by Luis Comenge discusses the implications and limits of health-care practices as linked to local institutions. The next two studies address, on the one hand, the state organization of health care and its legal, doctrinal framework in early twentieth-century Spain, and, on the other hand, the significance of international links. In the latter case, the discussion of the role of the Rockefeller Foundation represents, in my opinion, an outstanding contribution, for it provides a novel—and essential—perspective for understanding the constitutive process of public health in the Spain of the 1920s.

The second part, entitled "A Discipline for Capitalist Development," includes two papers on the way in which discourses and proposals developed from a public medicine and health perspective may legitimize state power, and may even become decisive factors in the financial and cultural functioning of contemporary societies. Industrial hygiene and urban hygiene are the topics sensibly selected by Rodríguez Ocaña to illustrate this role of health care in the rule-making processes within the framework of industrialization.

Finally, the third part includes three papers on the acquisition of the techniques and methods adopted by contemporary public health: statistics, surveys, and health-care campaigns. These are incomplete approaches, specific case studies through which, in my opinion—and such is the author's intention—we are enabled to address the constitutive process of a technical core for public health. This is defined as a scientific discipline that begins with the development of a sanitarian technology and, not surprisingly, leads to the emergence of experts in the study of health problems, considered collectively rather than individually, with a keen desire to improve the health of...