Curar, persuadir, gobernar: La construccion historica de la profesion medica en Buenos Aires, 1852-1886 (review)

Traditional histories of medicine used to be, and in large part still are, a territory cultivated by doctors interested in the past, who write biographies of famous physicians and effective treatments. Beyond their specific contributions, these histories appear to have attempted to reconstruct the "inevitable progress" generated by university-certified medicine, to unify the past of an increasingly specialized profession, and to emphasize a certain ethos and moral philosophy that is presented as distinctive, unaltered and emblematic of medical practice throughout time. In recent decades, however, a strong revisionist approach has been unveiling, and Latin American historiography is part of this trend. The emphasis now is on delving into the development of medicine as a more ambiguous and faltering process, looking at power, the politics of health, the impact of public health interventions, and representations of disease.

One of the topics of this renovated historiography is the making of the medical profession. Sometimes these narratives offer a celebrant effort of the first generation of public health professionals, responsible for offering solutions to the disease problems of the modern world. In other cases, the tone is set by Foucauldian interpretations. In these, medicalization (often overlooking mediations and particularities) is discussed as a rationalizing enterprise in which doctors, having developed particular disciplinary languages and practices, ended up controlling and regulating bodies, individuals, and society, labeling difference, and legitimizing ideological and cultural systems.

González Leandri's book avoids these two approaches. It discusses the long path that culminated in the consolidation of medical doctors as the only professional group legitimately entitled to practice what was then called el arte de curar. In so doing, Curar, persuadir, gobernar explores doctors' efforts to be heard by the state, their attempts to corner the market and criminalize any competitors—from popular healers to pharmacists ready to advise the sick—and the reactions of well-established physicians when confronting the demands of upstarts trying to carve their own space and voice within the profession.

The book is an absorbing but sometimes excessively detailed inquiry into the strategies of persuasion and institutional control developed by Buenos Aires physicians during the third quarter of the nineteenth century, a contested period when doctors laid down the basis from which later professionals will emerge with a "real monopoly." In fact, according to González Leandri, it was only during the last decade of the nineteenth century—with its new state agencies, a renovated school of medicine, and new attitudes of the popular sectors regarding their own health and medical expertise—that an incipient market scenario will emerge, one in which medical doctors will be recognized as a professional group legally entitled to monopolize elarte de curar. But before this happened, the group was basically a learned, rather than a consulting, profession: that is, it was a group serving the state, rather than a solid clientele interested in getting some kind of assistance. As a consulting profession, the group persuaded and was persuaded by the political class to confront the recurrent epidemic challenge, to disseminate by any means the new hygienic code, and to moralize the urban masses. Its achievements were uneven, not only at the level of public health infrastructure but also in their efforts to become the only professional group entitled to control el arte de curar.

The book successfully contextualizes the historical construction of the medical profession while underlining its relative autonomy. It also convincingly explores the influences on peripheral Buenos Aires of both the Anglo-American model of the liberal professional, and the French one of the state professional. Curar, persuadir, gobernar should be read not only as a contribution to the new history of disease, health, and medicine (a subfield in...