Race, Place, and Medicine: The Idea of the Tropics in Nineteenth-Century Brazilian Medicine (review)

Hookworm, beriberi, leprosy, and a host of other diseases and disorders associated with the tropics constitute the unconventional subject matter of Race, Place, and Medicine. Peard takes aim at "the long-standing image of nineteenth-century Latin American physicians faithfully (and passively) reproducing European science in their mainly tropical countries" (166). The doctor-scientists who, according to the author, refute this claim formed a cohort of about thirty Tropicalistas, practitioners in the emerging field of tropical medicine in Salvador, Bahia, between the 1860s and 1880s. Marginalized by Brazil's medical establishment based in the capital of Rio de Janeiro, these native-born Bahians, together with a few key foreigners, gained international recognition for their contributions to parasitology; they founded a prestigious journal (Peard's most important primary source) to disseminate their ideas and discoveries; and they influenced the direction of sweeping educational reforms during the waning years of the Second Empire.

The group's heyday was short-lived. Its members failed to institutionalize their informal network and recruit disciples to pursue their research and social agendas. Nevertheless, Peard argues that in opposition to European scientists, who perpetuated racial and cultural "stereotypes of passive and unhealthy natives of the tropics, [the Tropicalistas] forged their own definition of tropical medicine" (5). Their home-grown model emphasized the link between wretched social conditions and illness in the tropics. Ironically, they were not always successful among some of their own patients, notably in persuading women to abandon a midwifery tradition-deemed backward-in favor of scientifically trained male doctors-deemed modern.

A skillfully written, avidly researched monograph, more than one-third of which is devoted to endnotes and bibliography, Race, Place, and Medicine will fascinate a full spectrum of readers. Its narrow focus is deceptive, since Peard, like the physicians whom she studies, conceptualizes her subject broadly. The Tropicalista conviction that a torried climate and racially mixed population need not hamper Brazil's progress reflected a preoccupation with national identity and modernization that obsessed the Brazilian elite in general. The Tropicalistas "provided conceptual tools with which the national intelligentsia could resist derogatory labels of difference and inferiority produced by European scientific and medical discourse" (9).

That readers searching for interdisciplinary innovation will not find much hard science in this book is a disappointment, given that the Tropicalistas identified themselves above all as men of science. Peard is more interested in the politics of their stance than in the daily practice of their evolving craft. One would like to explore in greater depth the Tropicalistas' science, which included experimentation on animals to test the notion that a lack of oxygen in the blood caused various tropical ailments, and a decision to continue the practice of bleeding, despite a shift away from this therapy in European medical literature. This book is an exercise in the history of science; it is not history and science. Even so, Race, Place, and Medicine contributes more than enough that is new-about doctors, public health, and the larger nineteenth-century intellectual and political context of which they formed a part-to secure a lasting place in the historiography of nineteenth-century Brazil.