For All of Humanity: Mesoamerican and Colonial Medicine in Enlightenment Guatemala by Martha Few (review)

In this well-researched study, Martha Few presents a detailed account of the responses to smallpox, typhus, and other epidemic illnesses in colonial Guatemala. Her analysis follows three main lines of argument. First, Few questions the assumption that knowledge, technologies, and experiences emanated from the center to the periphery and convincingly demonstrates the centrality of the recirculation of knowledge to the development of colonial medicine. Second, Few disputes the strict separation of indigenous and European medical practices in the Guatemalan context and sets out to demonstrate the presence of different Mesoamerican medical cultures, which coexisted in constant, although not necessarily harmonious, interaction. Finally, she argues that, despite the tendency toward greater rationalization and experimentation characteristic of the Enlightenment, the practice of colonial medicine in the eighteenth century cannot be understood without considering Christian and indigenous religious practices.

The book begins by tracing the earliest accounts of epidemic diseases in the region and their effect on colonial society and indigenous communities. It vividly describes the impact of these illnesses on the everyday lives of individuals, families, and communities. The historical narrative quickly moves from sixteenth- to eighteenth-century Guatemala, discussing the efforts made by colonial authorities to combat smallpox and typhus through a variety of medical, administrative, and ritual practices. These practices were shaped by what Few considers a humanitarian ideology that was nevertheless not free from a significant authoritarian and coercive component. Their efforts led to the introduction of smallpox inoculation in Guatemala in 1780, a task whose success can be attributed in large part to the work of the medical physician José Flores.

In chapters 2, 4, and 5, Few carefully reconstructs the rural and urban contexts in which colonial medicine was practiced, underlining the importance of the Spanish Royal Maritime Vaccination Expedition to the region. This expedition took advantage of the smallpox vaccine developed in 1796 by English physician Edward Jenner and became the first mass-scale vaccination project in history. The aforementioned Guatemalan physician José Flores, a striking example of the importance of the recirculation of knowledge in the Spanish Empire, was among those asked to assist in designing the campaign. Few analyzes the different strategies of inoculation that had taken place before the arrival of the expedition and the reactions of Maya communities to these inoculation and vaccination campaigns. She then turns her attention to the efforts to obtain cowpox fluid for vaccination, the vaccination campaigns of the early nineteenth century, and the “unprecedented wave of experiments with human smallpox, cowpox, and other pustular diseases conducted on humans and animals alike” (p. 166).

Few diverts the reader’s attention from the book’s main focus on epidemiology in chapter 3, which is devoted to the practice of performing postmortem cesareans on pregnant women for the purpose of fetal baptism. Few argues that such a practice, common in Guatemala and in other parts of colonial Spanish America at the time, illustrates the importance of the intersection of medicine and religion in eighteenth-century Guatemala. While the information it contains is undoubtedly relevant to understanding the broader context of colonial epidemiological practices and how they were shaped by religious considerations, the transition between this chapter and those that precede and follow could perhaps have been better articulated.

In sum, Few’s book is an excellent study that makes a substantial contribution to our understanding of the practice of medicine in the Spanish Empire that will be especially valuable to those who are interested in the uneasy relationship between the various medical cultures present in colonial Guatemala in the eighteenth century and the circulation—and recirculation—of knowledge in the broader Atlantic world.