In lieu of an abstract, here is a brief excerpt of the content:

Hispanic American Historical Review 81.3-4 (2001) 811-812



[Access article in PDF]

Book Review

Race, Place, and Medicine


Race, Place, and Medicine: The Idea of the Tropics in Nineteenth-Century Brazilian Medicine. By Julyan G. Peard. Durham: Duke University Press, 2000. Appendixes. Notes. Bibliography. Index. x, 315 pp. Cloth, $54.95. Paper, $17.95.

Although only a European pedigree conferred legitimacy on ideas and practices in nineteenth-century Latin American professions, those very European ideas demeaned Latin American people on the grounds of alleged racial degeneracy and climatic determinism. Race, Place, and Medicine revisits this elite conundrum through a group of medical doctors in the northeastern Brazilian city of Salvador in the nineteenth century. Known collectively as the Escola Tropicalista Bahiana, these doctors resisted the emerging European conventional wisdom concerning the etiology of tropical diseases. Instead of attributing diseases like beriberi and tuberculosis to a single pathogen, this group of doctors favored "multicausal" explanations of disease in tropical regions. Tropicalistas combined notions then considered outdated, such as miasma theory, with a precocious awareness of the socioeconomic context of disease and a considerable level of scientific professionalism. With their eclectic approach, these doctors purposefully designed a medical science suited to their Brazilian reality. For this international and racially mixed group of doctors, tropical medicine provided a means of countering European discourses that presaged a dismal future for the tropical, miscegenated Brazilian nation.

This study follows the trajectory of the Tropicalista school and its cycle of innovation (1865-80), acceptance (1880s), and eventual dissolution (ca. 1900). Far from Brazil's center of power in Rio de Janeiro, the Tropicalistas' marginal location provided them with an effective staging ground from which to challenge the medical establishment both in Brazil and Europe. The Tropicalistas identified themselves as purveyors of pure, apolitical science. However, their quest to understand local health concerns without the fatalistic climatic and racial determinism of their European counterparts led them toward a social activism that came to define their approach to medicine.

The Tropicalistas expressed their ideological leanings in professional and scientific terms. The doctors took a stand on both race and place, Peard argues, by denying the importance of either to Brazilian public health. "The Tropicalistas' [End Page 811] whole practice pointed to their belief that there was no such thing as a tropical miasma; rather, there were certain miasmatic sources, linked to the unhealthiness of refuse, of dug-up soil, of stagnant water, of unsanitary housing and street conditions, of the conditions of slavery, that led to disease in the same way all of these conditions did in the more temperate climates of Europe (p. 107)."

In contrast with their vociferous opinions about climate, the Tropicalistas remained "largely silent" regarding race (p. 100). Perhaps because of this silence, historians have largely ignored the Tropicalistas in tracing the genealogy of racially inflected ideas leading up to the reign of scientific racism. An abundant historiography already describes Brazilian elites' appropriation and nationalist rearticulation of European scientific racism at the end of the nineteenth century. Yet Peard breaks new ground in using medical debates about the socioeconomic causes of disease and the abolition of slavery to describe the Tropicalistas' contributions to theories of race in the mid-nineteenth century. During the brief episode of Brazilian history before the Tropicalistas were absorbed into the mainstream of scientific thought in the 1890s, these doctors offered a paradigm that allowed social reformers and public health workers to look away from biological determinism and toward material conditions to provide a more sanguine--and less racist--view of the Brazilian people. This book points suggestively to how the transatlantic flow of medical ideas touched individual doctors and patients in Bahia in a way that rehearsed and perhaps created the social divisions that came to characterize Brazil as it entered its post-slavery epoch. The full implications of how these ideas operated domestically in Brazilian society await concrete analysis in subsequent historical research.

Despite today's conventional wisdom that medical knowledge is socially constructed, it is curious that so few historians of...

pdf

Share