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

This work is a pathmarking study of the historical interaction of medical ideologies in Latin America. Specifically, it explains how, during the last third of the nineteenth century, scientific medicine became institutionalized while Catholic empiric healing traditions were "sublimated into 'popular' medicine" (p. xvi). The study focuses on one such faith-based healer, Miguel Perdomo Neira, and the opposition his methods provoked among "professional doctors" in Bogotá and Quito around 1870. Sowell aims both to demonstrate the "integrity and presence" of alternative healing traditions and to study historically their subordination to rational science. More ambitiously, he seeks to link the controversy over Perdomo's medical practices to Colombia's (and Latin America's) conflicted and contested process of modernization during the (long) nineteenth century.

A first chapter on the colonial period traces the emergence of a pluralist "medical spectrum," within which Perdomo and most healers operated. While "Hispanic medicine"—linking humoral knowledge with Catholic spirituality—was most prominent, it overlapped with indigenous and African healing traditions (p. 31). Sowell's second chapter offers an absorbing examination of the introduction of "rationalist, scientific medicine," into Colombia after the 1790s, and its eventual "institutionalization." Sowell demonstrates how new medical knowledge became professionalized through education, periodicals, and "anatomoclinical" investigation. Between the 1860s and 1880s, scientific medicine also received official state sanction, marginalizing "the authority and social powers" of empiric and homeopathic healers (p. 59).

It was during this period that Perdomo made his "miraculous" healing sojourns through Ecuador and Colombia, performing painless surgery with "Indian drugs" at no cost to the afflicted. The book's third chapter recounts Perdomo's rise to fame, and his notorious run-ins with the medical establishments in Quito and Bogotá. It analyzes the partisan debates in the Colombian press and the testimonials of Perdomo's thankful patients (many of which are included as an appendix), revealing a society divided over validity of the healer's empiric method and the Catholic "Hispanic" cultural understandings that underpinned it. A concluding chapter positions Colombia's conflict over medical ideologies within a broader conservative confrontation with liberalism's "scientific rationalism without religion" (p. 98). Sowell also extrapolates from the Perdomo case to suggest compellingly that the continued "social power" of popular healers in contemporary Latin America is testimony to the persistence of a Catholic heritage that fuses healing and religion.

Sowell extends his analysis to Ecuador—Perdomo's healing-grounds for several years—to supplement his assessment of the Colombian experience. He reasonably concludes that Ecuador followed "a similar course" with variations in the church's role in colonial medical practices (greater); the ethnicity of popular healing (more Indian); and the institutionalization of scientific medicine (slower). However, the evidence is sparse, and unevenly integrated into the richly documented Colombian case—providing little context with which to understand the particular engagement of scientific—rationalist discourses within Ecuador. The history of medical discourses and practices in nineteenth-century highland Ecuador, a society marked by a feeble liberal tradition, an interventionist church and acute parochialism, awaits a more rigorous examination.

To its credit, the study coherently integrates a sophisticated secondary literature, including medical anthropology, cultural history, and an impressive array of Spanish American monographs. However, given the pioneering nature of this study, the book would have benefited from an engagement with the more developed historiography on competing "medical knowledges" in other regions during the nineteenth century, such as the marginalization of homeopathy and the institutionalization of "orthodox" medicine in the United States; the interaction of religious-magical and "western" medical practices in west Africa; or the embattled rise of the Brazilian tropicalista school of medicine. Such linkages could have helped to better locate Colombia's unique experience within a broader history of...