The Tale of Healer Miguel Perdomo Neira: Medicine, Ideologies, and Power in the Nineteenth-Century Andes (review)

Miguel Perdomo's career illustrates the late nineteenth-century conflict between modern science and traditional faith. Perdomo, an empiric with strong religious faith, traveled throughout Colombia and Ecuador and allegedly treated as many as 200,000 people between 1867 and 1874. He was successful and popular, and he charged little or nothing for his services. In both countries, the scientific establishment of professional doctors attacked him and tried to have him imprisoned, launching investigations on two occasions when his patients died. Perdomo and his loyal followers defended his healing skills and asked why no investigations ensued when the patients of scientific doctors died. Perdomo escaped the clutches of the law and continued to practice until he succumbed to smallpox or yellow fever in Guayaquil in 1874 at the age of 41.

Sowell argues that the ferocity of opposition to Perdomo, whose cures were more numerous than his failures, illustrated a clash of medical ideologies in the Northern Andes. Traditional medicine rested on herbal remedies, practical experience, the Hippocratic-Galenic system, and was strongly buttressed by Catholic faith. In contrast, biomedicine drew its inspiration from eighteenth-century science and envisioned the body as a machine that could be repaired without the intervention of religious faith. Contemporary political ideologies overlapped the contending medical perspectives. Conservatives tended to defend Perdomo while Liberals scorned him as dangerous and old fashioned. With the ascendancy of positivism, scientific medicine became the official paradigm, and doctors and Liberals urged the state to regulate and license physicians. In effect, Sowell describes the Northern Andean version of the rise of the professional classes who would so influence the activist states of the twentieth century.

By the 1930s, scientific medicine had become firmly established in the Northern Andes, but empirics and faith healers did not disappear. Traditional healers continue to be active up to the present, at least in part because the state had inadequate resources to provide modern medical care for all. Moreover, many people preferred an integral approach to healing that also drew upon their faith. In contemporary Latin America, the continuing vitality of both medical ideologies has resulted in a system that might be described as medical pluralism. Many people consult healers, but also go to modern hospitals. Healing cults have developed around saintly figures who had also been physicians, such as Venezuela's José Gregorio Hernández and Costa Rica's Ricardo Moreno Cañas. Sowell's necessarily brief overview of the contemporary scene does not permit him to tackle the intriguing question of why Hernández and Moreno inspired cults while Perdomo did not. Perhaps Hernández and Moreno, as men of science and of faith, figuratively represented both ideologies while Perdomo's history located him solely on the side of the empirics.

This clearly-written work is well suited for classroom use; it illustrates themes of faith and modernization in the nineteenth century as well as the continuity and dynamism of popular culture. The Appendix contains testimonials on Perdomo's healing drawn from newspapers and court documents. One weakness of the work is that, although Perdomo is the fulcrum around which the ideological conflict plays out, we do not really know much about him. How did he acquire his experience? How did he become relatively affluent if he did not charge for his services? What relationship did he have with his family? Unfortunately, the newspapers and archival sources in Quito and Popayán failed to provide Sowell with the answers to questions about Miguel Perdomo the person.

In The Structure of Scientific Revolutions, Thomas Kuhn suggested that modern scientific paradigms with more explanatory power eventually replaced less sophisticated ones. Sowell's book reminds us again that cultural revolutions may produce more ambiguous results. The contending traditions may fight to a draw...