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Bulletin of the History of Medicine 78.1 (2004) 252-253

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Diego Armus, ed. Entre médicos y curanderos: Cultura, historia y enfermedad en la América Latina moderna. Colección Vitral. Buenos Aires: Grupo Editorial Norma, 2002. 455 pp. $18.22 (paperbound, 987-545-062-6).

Entre médicos y curanderos is a knowledgeable collection exploring the role that disease and the institutionalization of biomedicine have played in the modernization of Latin America since the late nineteenth century. Based on detailed country-specific analyses, the essays vividly trace the parallel development of public health and urbanization. Drawing upon the long tradition of social history, the authors incorporate new and relevant sources crucial to understanding the development of public health in Latin America.

One set of articles focuses on how individual experiences and social representations of disease (smallpox, tuberculosis, HIV/AIDS, bubonic plague) were used as instruments of social regulation and racial stigmatization (David Parker), while at the same time they were reinterpreted as confronting and/or legitimizing ideological and cultural systems (Maria Di Liscia). Parker's, Diego Armus's, and Maria Angelica Illanes's analyses of urban working classes and urbanization in Peru, Argentina, and Chile, respectively, discuss not only public health discourses as an attempt to define social and political membership in "civilized" society but also the incipient development of property rights and ownership as symbols of hygiene/healthy behavior, public/urban sanitation, and therefore civilized behavior. Paul Farmer's article on the construction of a collective representation of AIDS in rural Haiti from 1983 to 1990 explains in great detail how rural communities' perception of the disease changed with their proximity to it. Through the analysis of in-depth interviews over different periods of time, Farmer identifies the coexistence and transformation of biomedicine and witchcraft paradigms used to understand, explain, and deal with the new disease.

A second set of articles focuses on understanding how the institutionalization of biomedicine and the increasing role of the state in the provision of health care helped shape new forms of social, cultural, and political inclusion/exclusion. The articles by David Sowell, Steven Palmer, Maria Eugenia Módena, and Emilio de Ipola highlight the multiple conflicts between the curanderos, traditional healers, and "popular doctors" in Colombia, Costa Rica, Mexico, and Buenos Aires, and the increasing presence of the biomedical systems promoted by the [End Page 252] state. For historians, these informative essays offer a vivid insight into the Latin American process of medical institutionalization. Cristina Rivera-Garza's study of the dynamics between patients in a mental health facility skillfully probes conflicts within the official medical system. Zandra Pedraza's analysis of media representations of healthy behavior, fitness, and aesthetics among the Colombian bourgeoisie from 1940 to 1980 demonstrates the significant role played by social and cultural private institutions in fixing the boundaries of healthy and civilized behavioral patterns.

In conclusion, the relationship between urbanization and disease and health is discussed in great depth, revealing to both the historian and the nonhistorian reader the intertwined roles of race, gender, and class in the history of modern Latin America. Moreover, the variety of issues, locations, and time periods covered in this book offers historians a rich and broad picture of public health history, and a solid basis for understanding the complex development of medical institutionalization in Latin America.

Ruth Iguiniz
New School University
New York



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pp. 252-253
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