For All Humanity: Mesoamerican and colonial medicine in Enlightenment Guatemala by Martha Few (review)

Martha Few's fascinating book establishes the colonial precedents of Enlightenment-era humanitarianism and medical science, and describes public health campaigns initiated and executed far from imperial centers of power. She details the contributions of remarkable individuals like Chiapas-born Creole physician José Flores, Maya diviner-healer Miguel Chonay, Franciscan friar and ethnobotanist Mariano José Herrarte, and other Central American men and women of European, Mesoamerican and African descent who drew on and contributed to medical knowledge that circulated the globe. Successful inoculation campaigns against smallpox in Central America in the 1780s and 1790s influenced future medical humanitarian efforts across the Spanish empire. At the same time, Few emphasizes the expanded state power that such campaigns implied and the distrust they aroused even after significant success in the reduction of disease.

The book is organized thematically and by types of medical intervention. Chapter 1 provides a general history of epidemic disease in Central America since the sixteenth century. Chapters 2 and 3 consider Guatemalan campaigns against typhus and promoting cesarean operations, respectively, in the late eighteenth and early nineteenth centuries. Relying on an impressive variety of sources, Few presents some of the most evocative accounts of the devastating experience of epidemic disease in Central America that I have seen, calling to mind Gabriela Ramos's sensitive portrayal of end-of-life practices amongst urban Andeans in the sixteenth century and Miguel León Portilla's poetic rendering of Nahuatl lamentations from central Mexico.¹ Although she does not engage the history of emotions directly, Few helps us consider the early modern devastation of the Native population in new, not merely statistical or biological ways.

By the late eighteenth century, Mesoamerican and European practitioners had been working sometimes in tandem, sometimes in opposition, for centuries to treat and comfort the sick. According to Few, the resulting patterns of collaboration, syncretism, resistance, and enforcement prefigured regional smallpox inoculation campaigns in 1780 and 1794, covered in Chapters 4 and 5. Traditionally Christian views of the poor, the enslaved and "Indians" as deserving of aid were integrated into a modernizing Enlightenment vision of science and the state. Nowhere is this integration more apparent than in the late eighteenth-century Catholic concern for the soul of a living fetus "imprisoned" within the womb of a dead mother. Guatemalan authorities trained practitioners in new surgical techniques and mandated post-mortem cesareans in the 1790s regardless of the desires of the family of the woman or the father of the child, instituting a "policy of surveillance" (113) in which women self-reported their pregnancies to priests and fetuses acquired the status of colonial subjects. Similarly, churchmen and women of all ethnicities helped implement state inoculation policies by reassuring parishioners, acting as interpreters, mobilizing local resources and learning inoculation methods themselves. Community funds gathered by the Catholic church helped to pay for massive distributions of food and blankets and to set up clinics to care for the sick. Longstanding colonial institutions and policies thereby helped the state assume unprecedented responsibility for the wellbeing of its subjects' bodies as well as their souls, according to the latest advances in medical science.

Throughout, Few emphasizes the "tensions between compassion and coercion" (163) that underlay these humanitarian efforts. On the one hand, Protomedicato Florés and other Guatemalan officials were surprisingly solicitous of the colonial subjects they were trying to help and surprisingly open to Mesoamerican healing practices. They used powders made from local insects to raise blisters for inoculation in order to frighten children less, considered Mesoamerican preferences when establishing invalids' diets, and preferred obsidian blades for bloodletting. Public displays of mutual respect between medical and local officials helped ensure cooperation. The Jenner cowpox vaccine, independently acquired in Central America during an energetic campaign to harvest the virus regionally in advance of samples being sent from Europe, was tested first on the children of urban Creole elites who had contributed the funds to obtain it.

On the other hand, the heavy hand of the...