Medicine and Politics in Colonial Peru: Population Growth and the Bourbon Reforms

Conclusion

218 conclusion  Despite the ambition Peru’s creole medical elite displayed under Bourbon rule, in the first two decades after independence their campaigns to create healthy colonial subjects failed to translate into projects aimed at reforming citizens. One reason for this failure was that in the early 1820s the government began to treat creole doctors and members of the Church as competing agents of healing. As a result, several government decisions diminished the position of creole doctors as medical modernizers and reformers. Officials saw the Church as more stable than doctors’ institutions because the Church had reliable networks and resources for carrying out medical reforms. The government thus experimented with placing reform measures in the hands of the clergy. Nowhere is this policy more evident than in the efforts to eliminate smallpox through vaccination. The country’s liberator and first president, José de San Martín, undermined and dismissed the bold claims of Lima’s creole physicians when, in 1822, he placed priests in charge of large portions of the smallpox vaccine project. Shifting away from a failed junta model of medical intervention, San Martín ordered through his minister, Bernardo Monteagudo, that all parish priests appear before the protomédico, Miguel Tafur, “from whom they will receive the vaccine fluid, showing warren text i-290.4.indd 218 7/23/10 10:42 AM conclusion 219 the president of their Department the corresponding certificates in order to obtain their papers [to travel].”1 San Martín also required priests to transport and distribute instructions for administering the vaccine to members of their parishes, and he stipulated that every month they were to report to departmental authorities the number of children they vaccinated. The authorities would then forward these numbers to the government in Lima. Furthermore, he ordered priests to designate a particular day each month for assembling children and vaccinating them en masse, forcefully “compelling mothers to bring them there.”2 In this way, San Martín’s government made the Church’s existing network of rural parish priests central to implementing medical reforms in the countryside. The Church would thus compensate for creole physicians’ failure to train provincial doctors in sufficient numbers or extend new scientific knowledge beyond Lima. In addition to issuing these orders for parish priests in rural areas, San Martín’s decree on smallpox vaccinations placed new urban vaccination efforts in the hands of local religious figures and government authorities. San Martín believed this measure would address the problems and failures of creole doctors’ central vaccine junta, which had ceased operations in 1820 after its stock of the vaccine lost potency. Through Monteagudo, San Mart ín asked the country’s religious orders to name “those monks considered most apt and zealous, so that one day each week they will be employed to vaccinate children.”3 He required the superiors of each monastery to report regularly to secular authorities the number of children vaccinated in their houses of worship. Finally, San Martín ordered local neighborhood authorities (comisarios de barrio) in cities to report children not vaccinated to the local parish priest or the president of the local vaccine junta so that they could receive the vaccine. This tendency to entrust the smallpox vaccine to individuals other than Lima’s local physicians continued in 1826, when the government placed responsibility for the preservation and distribution of Lima’s vaccine sources in the hands of a French birthing specialist, Benita Paulina Cadeau de Fessel , at the newly established Hospital de la Maternidad.4 This decision, however, was likely a response to the waning interest of physicians themselves , who largely failed to develop new, innovative proposals for vaccination in the 1820s. Instead, as has already been mentioned with regard to medical education, many of Peru’s most prominent creole physicians abandoned the medical profession to assume positions in government in the years after 1821. Hipólito Unanue, for example, served as both president of the Constituent Congress and head of the treasury in the 1820s, having prewarren text i-290.4.indd 219 7/23/10 10:42 AM 220 conclusion viously served in the 1810s in Spain’s wartime parliament at Cádiz. Uriel García Cáceres, John Woodham, and others have argued that Unanue had lost interest in medicine by the time he returned from Spain.5 This lack of interest is reflected in his writings, very few of which addressed...