Entre medicos y curanderos: Cultura, historia y enfermedad en la America Latina moderna (review)

Diego Armus has assembled an impressive collection of methodologically innovative studies of the history of health and society in Latin America. The volume includes twelve essays covering themes ranging from the political uses of vaccination in early nineteenth-century Argentina to contemporary conceptualizations of HIV/AIDS in rural Haiti. Following the title's emphasis on the tension between popular and Western conceptualizations of disease treatment, the essays provide a critical analysis of the ways in which "hegemonic" and "subaltern" perspectives on health meet in institutional, clinical and domestic settings.

Entre médicos y curanderos is organized chronologically. Armus first provides an overview of the field and the philosophical and methodological influences that have shaped it. Emphasizing that histories of medicine and health must go beyond institutional analyses to demonstrate the significance health and well-being have in popular context, he outlines the historiography to which the volume is meant to contribute: the social and cultural arenas in which debates over body, health and nation take place. Because each author has made an effort to place his or her study in political and social context, the works give the reader a sense of similarities and differences which characterized processes of modernization, urban development, the professionalization of medicine, and the rise of higienismo across the region. But while the writers are consistent in their effort to situate health socially and politically, their approaches differ. For example, in his case study of curandero "Professor Carlos Carbell" in 1930s Costa Rica, Stephen Palmer uses press reports, court documents, and patient testimony to demonstrate how authorities used discourses of femininity and homosexuality to discredit a popular healer. In her study of everyday life in the early twentieth-century Mexico City psychiatric asylum, La Castañeda, by contrast, Cristina Rivera-Garza uses inmate letters to offer insight into the ways in which interned men and women experienced their confinement. María Angélica Ilanes relies on journalistic accounts to show how a campaign against bubonic plague in several Chilean cities linked images of rats and the working poor to generate a broader indictment of class conflict in the early twentieth century.

The essays in the last half of the book survey more recent events, treating such issues as diet in mid-twentieth century Colombia, relations among midwives, healers and self-identified Western doctors in Mexico, and the controversy surrounding a decision to withdraw a chemotherapy drug from clinical trials in Argentina. These pieces draw on sociological and anthropological methods to elicit information about such issues as the co-existence of popular and hegemonic ideas with respect to maternity and childhood illness, the relationship of ideas about body and diet to ideas about nation, and the ways in which popular conceptualizations of disease origins and treatment may be linked to broader societal critiques of political authority.

Readers may recognize some of the essays in Entre médicos y curanderos from previous publications. Armus's own study of gender, hygiene and popular culture in turn-of-the-century Argentina appeared in the Boletín del Instituto de Historia Argentina y Americana Dr. Emilio Ravignani. David Parker's examination of hygiene campaigns in twentieth-century Lima appeared in the collection by Ronn Pineo and James Baer, Cities of Hope: People, Protests, and Progress in Urbanizing Latin America, 1870-1930 (1998), and an earlier edition of Paul Farmer's essay on HIV/AIDS awareness in Do Kay, Haiti appeared in Medical Anthropology Quarterly. Nevertheless, their union with new work makes this an exciting collection that offers an array of perspectives and topics.

Entre medicos y curanderos joins a growing number of essays and monographs regarding the history of culture, health, and society in Latin America. A collection of thoughtful analyses that pay special attention to the social, cultural and political contexts in which disease and health policies develop, the volume raises a series of methodological questions...