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Caring for pobres dementes:Madness, Colonization, and the Hospital de San Hipólito in Mexico City, 1567–1700

Published online by Cambridge University Press:  21 October 2020

Christina Ramos Open the ORCID record for Christina Ramos [Opens in a new window]
Christina Ramos*
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Washington University, St. Louis, Missourichristina.ramos@wustl.edu
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Abstract

This article examines the early history of the Hospital de San Hipólito in Mexico City, which delivered charitable care and basic medical services to a vulnerable category of colonial subjects known as “pobres dementes,” or mad paupers. In spite of the vast and robust literature on the history of madness and its institutions, surprisingly little is known about this institution, which, founded in 1567, holds a claim to being the first hospital of the Americas to specialize in the care and custody of the mentally disturbed. The article draws on archival sources and biographies of the hospital's founder to reconstruct San Hipólito's origins, activities, patient population, and interior life. It asks how the hospital registered the transfer and adaptation of institutions, ideas, and practices from the Old World to the New. It argues, ultimately, that San Hipólito served as an imperfect tool of colonial governance—and that it did so less through exerting control over a multiracial, recalcitrant, and marginal group of colonial society than through the reproduction of charitable practices and ideas that lent legitimacy to Catholicism and Hapsburg models of paternal authority.

Keywords

colonial hospitalsmadnesshistory of medicinemedical charitysocial welfare
Type
Article
Information
The Americas , Volume 77 , Issue 4 , October 2020 , pp. 539 - 571
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press on behalf of Academy of American Franciscan History

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Footnotes

The author wishes to thank her colleagues Corinna Treitel, Miguel Valerio, Diana J. Montaño, Daniel Bornstein, Christine Johnson, and Stephanie Kirk, and the participants of the Early Modern Reading Group at Washington University in St. Louis for their encouragement and thoughtful comments on drafts of this article. She thanks also Katharine Park, Pete Sigal, David S. Jones, and Charles Rosenberg for their feedback on earlier versions, and the two anonymous reviewers at The Americas for their especially incisive and substantive remarks. Writing and research was made possible by support from a Ford Foundation Postdoctoral Fellowship, the Frederick Sheldon Traveling Fellowship from Harvard, and multiple grants from the David Rockefeller Center for Latin American Studies.

References

1. The hospital is located at the intersection of Calle Hidalgo and Paseo de la Reforma. It is not the original sixteenth-century building, but is based on an eighteenth-century remodeling. Although the plaque identifies 1577 as the founding date, Bernardino Álvarez, the hospital's founder, obtained a license to build the hospital in 1566, originally intending to construct it on a small plot of land located Calle Celada. In 1567, he relocated the facility to its present location, operating in a modest adobe house while construction of the main building was underway. It is plausible that the 1577 date refers to the completion of the building. de Arce, Juan Díaz, Libro de la vida del próximo evangelico, el venerable Padre Bernardino Álvarez (Mexico: 1762), 40–44Google Scholar; García, Francisco, Vida de el venerable Bernardino Álvarez, fundador de la Orden de Caridad (Madrid: Julián de Paredes, 1678), 35–37Google Scholar; Muriel, Josefina, Hospitales de la Nueva España, vol. 1 (Mexico City: Universidad Nacional Autónoma de México [hereafter UNAM], 1957), 188–189Google Scholar.

2. While San Hipólito was not the only mental hospital to appear in New Spain, it was certainly the earliest and the largest. Following its establishment, three other mental hospitals appeared: San Pedro for demented priests (1577) in Mexico City; San Roque in Puebla de los Angeles (1594); and the Hospital del Divino Salvador for demented women (1687), also located in the viceregal capital. The first hospital to admit mad patients in Anglo North America was the Pennsylvania Hospital in Philadelphia, founded in 1752.

3. Sebastián Labastida, “Informe del director del Hospital de San Hipólito,” 1877, Archivo Histórico de la Secretaria de Salud [hereafter AHSS], Fondo Beneficencia Pública, Sección Hospital de San Hipólito, leg. 2, exp. 17, fols. 6-7v.

4. de Lizardi, José Joaquín Fernández, The Mangy Parrot: The Life and Times of Periquillo Sarniento, Written by Himself for His Children, Frye, David L., trans. (Indianapolis: Hackett Publishing Company, 2004), 413Google Scholar.

5. Rumbaut, Ruben D., “Bernardino Álvarez: New World Psychiatric Pioneer,” American Journal of Psychiatry 127:9 (1971): 1217-1221CrossRefGoogle Scholar; Moreno, Samuel Ramirez, “History of the First Psychopathic Institution on the American Continent,” American Journal of Psychiatry 99:2 (1942): 194–195CrossRefGoogle Scholar; Jiménez-Olivares, Ernestina, “Bernardino Álvarez, iniciador de la atención psiquiátrica en América,” Historia general de la medicina en México, tomo II, Beltrán, Gonzalo Aguirre and de los Arcos, Roberto Moreno, eds. (Mexico City: Academia Nacional de Medicina, UNAM, 1990), 242–243Google Scholar; Muriel, Hospitales, vol. 1, 187–196.

6. For a discussion of these practices, see Rivera-Garza, Cristina, “Dangerous Minds: Changing Psychiatric Views of the Mentally Ill in Porfirian Mexico, 1876–1911,” Journal of the History of Medicine 56 (2001): 36–67Google Scholar; and Stephanie Ballenger, “Modernizing Madness: Doctors, Patients and Asylums in Nineteenth-Century Mexico” (PhD diss.: University of California, Berkeley, 2009).

7. Vaughn, Megan, Curing Their Ills: Colonial Power and African Illness (Stanford: Stanford University Press, 1991)Google Scholar; Sadowsky, Jonathan, Imperial Bedlam: Institutions of Madness in Colonial Southwest Nigeria (Berkeley: University of California Press, 1999)CrossRefGoogle ScholarPubMed; Keller, Richard C., Colonial Madness: Psychiatry in French North Africa (Chicago: University of Chicago Press, 2007)CrossRefGoogle Scholar; Mahone, Sloan and Vaughn, Megan, eds., Psychiatry and Empire (New York: Palgrave Macmillan, 2007)CrossRefGoogle Scholar.

8. Important studies in this vast field include MacDonald, Michael, Mystical Bedlam: Madness, Anxiety and Healing in Seventeenth-Century England (Cambridge: Cambridge University Press, 1983)Google Scholar; Midelfort, Eric H. C., A History of Madness in Sixteenth-Century Germany (Stanford: Stanford University Press, 1999)Google Scholar; Porter, Roy, Mind-Forg'd Manacles: A History of Madness in England from the Restoration to the Regency (London: Athlone Press, 1987)Google Scholar; Scull, Andrew, The Most Solitary of Afflictions: Madness and Society in Britain, 1700–1900 (New Haven: Yale University Press, 1993)Google Scholar; Goldstein, Jan, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (Chicago: University of Chicago Press, 2001 [1987])Google Scholar; Goodheart, Lawrence B., Mad Yankees: The Hartfort Retreat for the Insane and Nineteenth-Century Psychiatry (Amherst: University of Massachusetts Press, 2003)Google Scholar; Goldberg, Ann, Sex, Religion, and the Making of Modern Madness: The Eberbach Asylum and German Society, 1815–1849 (New York: Oxford University Press, 1999)Google Scholar; and Mellyn, Elizabeth, Mad Tuscans and Their Families: A History of Mental Disorder in Early Modern Italy (Philadelphia: University of Pennsylvania Press, 2014)CrossRefGoogle Scholar. The seminal if controversial work is, of course, Michel Foucault, Histoire de la folie à l’âge classique: Folie et déraison (Paris: 1961), published in English as Madness and Civilization: A History of Insanity in the Age of Reason (New York: Vintage Books, 1988).

9. For a departure from this approach that looks instead at the “dynamics of institutional practice, as opposed to discourse,” see Claire Edington, “Going In and Getting Out of the Colonial Asylum: Families and Psychiatric Care in French Indochina,” Comparative Studies in Society and History 55:3 (2013): 725–755; and Beyond the Asylum: Mental Illness in French Colonial Vietnam (Ithaca: Cornell University Press, 2019).

10. Headrick, Daniel, Tools of Empire: Technology and European Imperialism in the Nineteenth Century (Oxford: Oxford University Press, 1991)Google Scholar. Recent works on colonial hospitals include Risse, Guenter, “Shelter and Care for Natives and Colonists: Hospitals in Sixteenth-Century New Spain,” in Searching for the Secrets of Nature: The Life and Works of Dr. Francisco Hernández, Varey, Simon et al. , eds. (Stanford: Stanford University Press, 2000)Google Scholar; Ramos, Gabriela, “Indian Hospitals and Government in the Colonial Andes,” Medical History 57:2 (2013): 186–205CrossRefGoogle ScholarPubMed; Van Deusen, Nancy, “The ‘Alienated’ Body: Slaves and Castas in the Hospital de San Bartolomé in Lima, 1680–1700,” The Americas 56:1 (1999): 1–30CrossRefGoogle Scholar; and Adam Warren, Medicine and Politics in Colonial Peru (Pittsburgh: University of Pittsburgh Press, 2010), chapt 1. The classic account of colonial hospital development in New Spain is Josefina Muriel, Hospitales de la Nueva España, 2 vols.

11. Ramos, “Indian Hospitals and Government.”

12. Borah, Woodrow, “Social Welfare and Social Obligation in New Spain: A Tentative Assessment,” Congreso Internacional de Americanistas, España 1964: Actas y Memorias 36:4 (1966): 45Google Scholar.

13. Díaz de Arce, Libro de la vida del próximo evangelico; García, Vida de el venerable Bernardino Álvarez. García's biography was written for the purposes of advancing Álvarez's beatification. Both biographies are essentially hagiographies.

14. Díaz de Arce, Libro de la vida del próximo evangelico, 43–44.

15. Díaz de Arce, Libro de la vida del próximo evangelico, 31. On the spiritual gardening metaphor in narratives of Spanish colonization, see Jorge Cañizares-Esguerra, Puritan Conquistadors: Iberianizing the Atlantic, 1550–1700 (Stanford: Stanford University Press, 2006), chapt. 5.

16. The property for the original hospital was donated by two vecinos (citizens) of Mexico City, Miguel de Dueñas and his wife, Isabel de Ojeda. Díaz de Arce Libro de la vida del próximo evangelico, 41–42; Muriel, Hospitales, vol. 1, 188.

17. Muriel, Hospitales, vol. 1, 187–188.

18. García, Vida de el venerable Bernardino Álvarez, 37–38.

19. Silvia Marina Arrom has identified and discussed this trope and its uses in connection to the foundational story of Mexico City's Poor House. Arrom, Silvia Marina, Containing the Poor: The Mexico City Poorhouse, 1774–1871 (Durham: Duke University Press, 2000), 32Google Scholar. European examples include the story of the establishment of the Hospital de los Inocentes in Valencia as discussed in Hélène Tropé, Locura y sociedad en la Valencia de los siglos XV al XVII (Valencia: Centre d'Estudis d'Historia Local, 1994), 28–30.

20. My discussion of San Hipólito's role in the broader evangelizing project is indebted to Guenter Risse's two seminal articles on hospital development in New Spain and Robert Ricard's classic study of the “spiritual conquest” of Mexico, both of which emphasize the hospital's deployment in the Americas for the purposes of religious conversion. Risse, “Shelter and Care”; “Medicine in New Spain,” in Medicine in the New World; New Spain, New France, and New England, Ronald L. Numbers, ed. (Knoxville: University of Tennessee Press, 1987), 12–63; Ricard, Robert, The Spiritual Conquest of Mexico: An Essay on the Apostolate and the Evangelizing Methods of the Mendicant Orders in New Spain, 1523–1572 (Berkeley: University of California Press, 1974), 155–161Google Scholar.

21. León-Portilla, Miguel, “Las comunidades mesoamericanas ante la institución de los hospitales para indios,” Boletín de la Sociedad Mexicana de Historia y Filosofía de la Medicina 44 (1983): 196–197Google Scholar; Venegas, Carmen, Regimen hospitalario para indios en la Nueva España (Mexico City: Instituto Nacional de Antropologia e Historia, 1973), 9Google Scholar.

22. Quoted in Oliveras, J. Guijarro, “Política sanitaria en las Leyes de Indias,” Archivo Iberoamericano de Historia de la Medicina y Antropología Médica 9 (1957): 256Google Scholar; also cited in Risse, “Shelter and Care,” 66–67.

23. Risse, “Medicine in New Spain,” 41–42. On Spanish Caribbean hospitals, see Gómez, Pablo, “Hospitals and Public Health in the Sixteenth-Century Spanish Caribbean,” The Spanish Caribbean and the Atlantic World in the Long Sixteenth Century, Altman, Ida and Wheat, David, eds. (Lincoln: University of Nebraska Press, 2019)Google Scholar.

24. On poor-relief in Spain, see the essays by Jon Arrizabalaga and María Luz López Terrada in Healthcare and Poor Relief in Counter-Reformation Europe, Ole Peter Grell, et al., eds. (London: Routlegde, 1999); Linda Martz, Poverty and Welfare in Hapsburg Spain: The Example of Toledo (Cambridge: Cambridge University Press, 1983); James William Brodman, Charity and Welfare: Hospitals and the Poor in Medieval Catalonia (Philadelphia: University of Pennsylvania Press, 1998); and Maureen Flynn, Sacred Charity: Confraternities and Social Welfare in Spain, 1400–1700 (Ithaca and New York: Cornell University Press, 1989).

25. Borah, “Social Welfare and Social Obligation in New Spain,” 45.

26. Arrom, Containing the Poor, 32. On the ideology of charity, see James William Brodman, Poverty and Religion in Medieval Europe (Washington, DC: Catholic University of America Press, 2009), esp. chapt. 1.

27. On hospitals for Indians in New Spain, see Ramirez, Regimen hospitalario; David A. Howard, The Royal Indian Hospital of Mexico City (Tempe: Arizona State University, 1980).

28. Risse, “Shelter and Care,” 67.

29. “Carta de Fray Pedro de Gante al emperador D. Carlos (1532),” Cartas de Indias 8 (Madrid, 1877): 52.

30. Risse, “Medicine in New Spain,” 20–21.

31. On the role of nurses as spiritual models, see Ricard, The Spiritual Conquest, 155–161.

32. Recopilación de leyes de los reynos de las Indias, Bk. 1, Tit. 4, Ley I, quoted in Borah, “Social Welfare and Social Obligation in New Spain,” 47.

33. Borah, “Social Welfare and Social Obligation in New Spain,” 47.

34. Gabriela Ramos has noted that the “position of the king as protector of the poor was always unstable,” and that the Church too vied for this role. Ramos, “Indian Hospitals and Government,” 189.

35. Milton, Cynthia, The Many Meanings of Poverty: Colonialism, Social Compacts, and Assistance in Eighteenth-Century Ecuador (Stanford: Stanford University Press, 2007), 6–11Google Scholar.

36. On the miserable status of the Indian, see Ramos, “Indian Hospitals and Government,” 189; and Delgado, Paulino Castañeda, “La condición miserable del indio y sus privilegios,” Anuario de Estudios Americanos 28 (1971): 245–335Google Scholar. On the Valladolid debate and the notion that natives were natural children, see Padgen, Anthony, The Fall of Natural Man: The American Indian and the Origins of Human Ethnology (Cambridge: Cambridge University Press, 1981), chapt. 4Google Scholar.

37. Risse, “Medicine in New Spain,” 37-40. On the activities of the Protomedicato in New Spain, see John Tate Lanning, The Royal Protomedicato: The Regulation of the Medical Profession in the Spanish Empire, John Jay Tepaske, ed. (Durham: Duke University Press, 1985).

38. Huguet-Termes, Teresa and Arrizabalaga, Jon, “Hospital Care for the Insane in Barcelona, 1400–1700,” Bulletin of Spanish Studies 87:8 (2010): 84CrossRefGoogle Scholar; Park, Katharine, “Healing the Poor: Hospitals and Medical Assistance in Renaissance Florence,” in Medicine and Charity before the Welfare State, Barry, Jonathan and Jones, Colin, eds. (London: Routledge, 1991): 26–45Google Scholar.

39. Huguet-Termes and Arrizabalaga, “Hospital Care for the Insane in Barcelona,” 86–88.

40. On this institution, see Tropé, Locura y sociedad. In the sixteenth century, the hospital was subsumed into the Hospital General as part of a broader hospital consolidation project initiated by state reformers.

41. Nalle, Sara Tilghman, Mad for God: Bartolomé Sánchez, the Secret Messiah of Cardenete (Charlottesville: University Press of Virginia, 2001), 158–159Google Scholar; Tropé, Locura y sociedad, 30–32.

42. Roy Porter, “Madness and Its Institutions,” in Medicine in Society: Historical Essays, Andrew Wear, ed. (Cambridge: Cambridge University Press, 1992), 179–180; Andrew Scull, “The Asylum, the Hospital, and the Clinic,” The Routledge History of Madness and Mental Health, Greg Eghigian, ed. (London: Routledge, 2017), 101–102. Ahmed Ragab offers a detailed description of the activities that took place in Islamic mad wards. See Ragab, The Medieval Islamic Hospital: Medicine, Religion, and Charity (New York: Cambridge University Press, 2015), 193–199. Michael W. Dois has observed that these wards developed in tandem with the introduction of Galenism into the Arab world. See Dois, Majnun: The Madman in Medieval Islamic Society (Clarendon Press: Oxford, 1992), 112–116.

43. Enrique González Duro, Historia de la locura en España, vol. 1 (Madrid: 1994), 43. See also Carmen López Alonso, Locura y sociedad en Sevilla: Historia del Hospital de los Inocentes (1436?–1840) (Seville: Diputación Provincial, 1988); Carmen B. Viquera, “Los hospitales para locos e ‘inocentes’ en Hispanoamerica y sus antecedentes españoles,” Revista Española de Antropología Americana 5 (1970): 341–384; and Tropé, Locura y sociedad en la Valencia.

44. Nalle, Mad for God, 158.

45. Nalle, Mad for God, 158-160.

46. Sebastián de Covarrubias, Tesoro de la lengua castellana (Madrid: 1611), 505, 419.

47. Cheryl English Martin has conducted the most extensive research on the Order of San Hipólito's formation, activities, and internal organization, and the various hospitals they administered. See Martin, “The San Hipólito Hospitals, 1566–1702,” (PhD diss.: Tulane University, 1976). Petitions to create a formal order began in the late sixteenth century, and Álvarez insisted that alongside the traditional monastic vows of poverty, chastity, and obedience, the order's members follow a fourth vow, to hospitalidad or hospitality. It was not until 1700, however, that Pope Innocent XII officially recognized the brothers, who were known throughout New Spain as the hipólitos, as an autonomous religious order. Prior to that point, they operated first as a brotherhood and then as a congregation. See also, Muriel, Hospitales, vol.1, 89.

48. José María Marroquí, La Ciudad de Mexico, 2nd. ed. (Mexico City: J. Medina, 1969), 551. A copy of the license from the archbishop Montúfar granting Álvarez permission to build the hospital is included in the Archivo General de la Nación [hereafter AGN], “Información seguida en la Audiencia Arzobispal de esta corte, en favor de la Congregación de la Caridad,” 1645, Hospitales, vol. 45, exp. 9, fols. 380-381.

49. “Informaciones y otros recaudos tocantes a la institución y fundación de la orden y hospitalidad de San Hipólito,” 1662, AGN, Hospitales, vol. 73, exp. 2, fol. 74.

50. Patricia Seed, Ceremonies of Possession in Europe's Conquest of the New World, 1492–1640 (Cambridge: Cambridge University Press, 1995). Seed argues that the Spanish, unlike the French or English, were far more willing to establish claim through warfare, thus making battle sites all the more significant. See Chapter 3.

51. This holiday has been analyzed and reconstructed by Barbara Mundy. See Mundy, The Death of Aztec Tenochtitlan: The Life of Mexico City (Austin: University of Texas Press, 2015), 95–96.

52. In both Spain and Mexico, the Day of the Holy Innocents developed into a quasi-April Fool's day, involving jokes and pranks. George M. Foster, Culture and Conquest: America's Spanish Heritage (New York: Wenner-Gren Foundation for Anthropological Research, 1960), 104–105.

53. “Copia simple del memorial de nuestro venerable padre patriarca Bernardino Álvarez, fundador de la religion de la Caridad,”1569, AGN, Clero Regular y Secular, vol. 65, exp. 1, fol. 27v.

54. The most detailed analysis of the Zaragoza hospital in the sixteenth century is Aurelio Baquero, Bosquejo histórico del Hospital Real y General de Nuestra Señora de Gracia de Zaragoza (Zaragoza: Sección de Estudios Médicos Aragoneses, Institución “Fernando el Católico,” 1952), chapt. 3.

55. The Order of San Hipòlito's 1616 statutes contain detailed specifications for how these relief convoys were to be conducted. “Testimonio de las constituciones de la orden del glorioso mártir San Hipólito,”1697, AGN, Tierras, vol. 3082, exp. 1, fols. 7v-8v.

56. “Copia simple del memorial de nuestro venerable padre patriarca Bernardino Álvarez, fundador de la religión de la Caridad,”1569, AGN, Clero Regular y Secular, vol. 65, exp. 1, fol. 27v; Díaz de Arce, Libro de la vida del próximo evangelico, 55–60; Muriel, Hospitales, vol. 1, 207–208; Martin, “The San Hipólito Hospitals,” 75–76.

57. García, Vida de el venerable Bernardino Álvarez, 37.

58. García, Vida de el venerable Bernardino Álvarez, 37, 110.

59. “Informaciones y otros recaudos tocantes a la institución y fundación de la orden y hospitalidad de San Hipólito,” 1647, AGN, Hospitales, vol. 73, exp. 3, fols. 228v, 234v.

60. “Información seguida en la Audiencia Arzobispal de esta corte, en favor de la Congregación de la Caridad,” 1645, AGN, Hospitales, vol. 45, exp. 9, fols. 382-382v.

61. Risse, “Medicine in New Spain,” 39. A similar practice occurred in colonial Peru: Ramos, “Indian Hospitals and Government,” 192–193.

62. “Testimonio del expediente formado y instancia del Reverendísimo Padre General de la religión de San Hipólito Mártir,” 1774-76, AGN, Obras Pías, vol. 3, fols. 132-132v; “Instrucción del rey de España para la construcción y aprovisdionamiento del Hospital de Dementes de San Hipolito Mártir, dirigida al Virrey de la Nueva España,” 1776, AGN, Indiferente Virreinal, caja 4122, exp. 6, fols. 1-2; La administración de Fray Antonio María de Bucareli y Ursúa (Mexico City: Talleres Gráficos de la Nación, 1936), 170.

63. “Información seguida en la Audiencia Arzobispal de esta corte, en favor de la Congregación de la Caridad,” 1645, AGN, Hospitales, vol. 45, exp. 9, fols. 366v-367.

64. Libro de cuenta, AGN, Indiferente Virreinal, caja 0930, exp. 2, fol. 12.

65. Van Deusen, “The Alienated Body,” 13.

66. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fol. 18.

67. Marroquí, La Ciudad de México, 583–584; Muriel, Hospitales, vol. 1, 196.

68. “Informaciones y otros recaudos tocantes a la institución y fundación de la orden y hospitalidad de San Hipólito,” 1662, AGN, Hospitales, vol. 73, exp. 2, fol. 70.

69. On the Order of San Hipolito's sugar plantations see Martin, “The San Hipolito Hospitals,” chapt. 5; also, Martin, “Crucible of Zapatismo: Hacienda Hospital in the Seventeenth Century,” The Americas 38:1 (1981): 31–43.

70. Marroquí, La Ciudad de México, 583–584; Muriel, Hospitales, vol. 1, 196.

71. I have not been able to locate the original decree. Instead, I cite a copy included in the hospital's records and dated to 1764, when the decree appears to have been reinforced with greater urgency. “Autos a instancia del Padre fray José de la Peña, Prior del Convento de la Caridad de San Hipólito Mártir,” 1773, AGN, Indiferente Virreinal, caja 0974, exp. 18, fol. 14.

72. “Denuncia que de sí mismo se hace Juan Fernández de León por haber dicho fuera de su juicio cosas inconvenientes y pide se le imponga penitencia,”1573, AGN, Inquisición, vol. 76, exp. 27, fol. 2. The case involving Fernández de León dates to 1573 when he appeared before the tribunal to denounce himself for uttering “inconvenient things” against the Catholic faith. A quick investigation revealed that he suffered from chronic melancholy. He had appeared before the Holy Office two years prior and was subsequently transferred to San Hipólito. For an excellent analysis of madness as viewed from the perspective of the Inquisition, see María Cristina Sacristán, Locura e Inquisición en la Nueva España; (Mexico City: Colegio de Michoacán, 1992).

73. AGN, Inquisición, vol. 218, exp. 3, fol. 80. See also Nora Jaffary, False Mystics: Deviant Orthodoxy in Colonial Mexico (Lincoln: University of Nebraska Press, 2004), 149-150. The number of prisoners of the Inquisition arriving at the hospital increased in the late eighteenth century, and prior to that was sporadic. See María Cristina Sacristán, Locura y disidencia en el México ilustrado, 1760–1810 (Mexico City: Colegio de Michoacán, 1994), esp. chapt. 2; Christina Ramos, “Bedlam in the New World: Madness, Colonialism, and a Mexican Madhouse, 1567–1821” (PhD diss.: Harvard University, 2015); and my book in progress, Bedlam in the New World: A Mexican Madhouse in the Age of Enlightenment.

74. Ramos, “Indian Hospitals and Government.”

75. Arrom, Containing the Poor, 89–92, 100–102; Bradley Lewis Chase, “Medical Care for the Poor in Mexico City, 1770–1810” (PhD diss.: University of Maryland, 1975), 159. See also Milton, The Many Meanings of Poverty.

76. Although Cheryl D. Martin observes that the brothers of San Hipólito became more worldly following Álvarez's death and slackened in spiritual zeal, she nonetheless concludes that the statutes give a rough approximation of the hospital's administration in the seventeenth century. Martin, “The San Hipólito Hospitals,” 81.

77. This plan can be found in “Compromiso que hizo la sagrada religión al monarca Don Felipe Quinto,” AGN, Tierras, vol. 3802, exp. 8. Its precise date is unclear. Although it is located alongside documents dating to 1701-2, the plan appears to have no relation to these documents. Moreover, it is also not clear if the ground plan belongs to the Hospital de San Hipólito or one of the other eight institutions administered by the brotherhood. The archival description identifies the illustration as the Convent of San Hipólito in Mexico City, but the document itself makes no clear reference to its status as such. If the layout indeed represents San Hipólito, then the illustration predates 1700, as the hospital seems to have stopped admitting women by the late seventeenth century, if not much earlier.

78. For a discussion of the cruciform plan and other architectural hospital arrangements, see Henderson, John, The Renaissance Hospital: Healing the Body and Saving the Soul (New Haven: Yale University Press, 2006), 81–88, 151–161Google Scholar.

79. The earliest set of surviving records of patient admissions dates from 1697–1706; it makes no reference to female patients. Thus, if San Hipólito did admit women, it ceased to do so some time before the 1690s.

80. Tropé, Locura y sociedad, 47–50.

81. For a sustained discussion of how early modern hospitals incorporated the dual project to heal the body and soul, see John Henderson, The Renaissance Hospital.

82. Specifically, the hospital's kitchen staff is referred to as being either Indian, black, or “some other” (qualquiera). “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fol. 19v.

83. Libro de Cuenta, AGN, Indiferente Virreinal, caja 0930, exp. 2.

84. “Real provision de la Audiencia Real de México ordenando a las justicias de su Majestad que saquen a Blas, esclavo mulato huido,” 1675, AHSS, Fondo Hospitales y Hospicios, Sección Hospital de San Hipólito, exp. 8. There is evidence that the other hospitals administered by the brotherhood owned slaves as well. See Martin, “The San Hipólito Hospitals,” 89–90.

85. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fols. 16v-17; Van Deusen, “The Alienated Body,” 10.

86. It is unclear whether San Hipólito enjoyed the regular services of a physician. Although the statutes make reference to the presence of a physician on the hospital grounds, the other hospital records do not. In Spain, physicians were morally and legally obligated to minister to the poor free of charge, but, as Lanning has discussed in his study of the Protomedicato, these rules were not easily enforced in the colonies, which faced a dearth of medical practitioners and pervasive corruption. Given these issues, it is likely that much of the medical work at the hospital was undertaken by the brothers themselves. See Lanning, The Royal Protomedicato, chapt. 8.

87. For the Hospital de los Inocentes in Seville, Carmen López Alonso observes that by the end of the sixteenth century, the physician had become a key presence, playing an important role in determining who was admitted to the hospital as well as in curative treatments. The same observation cannot be extended to San Hipólito. Even when, in the late eighteenth century, the hospital became more medical in orientation, physicians remained a peripheral presence, with the brothers of San Hipólito undertaking the majority of medical activities. On medical activities at the Hospital de los Inocentes in Seville, see López, Locura y sociedad en Sevilla, 264–296. Although John S. Leiby documents medical treatments performed by physicians at San Hipólito, I have examined his sources and cannot corroborate his evidence. Leiby, “San Hipolito's Treatment of the Mentally Ill in Mexico City, 1589–1650,” The Historian 54:3 (1992): 491–498.

88. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3087, exp. 1, fol. 15v.

89. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3087, exp. 1, fols. 17v, 18.

90. “Testimonio de la constituciones,” 1697, AGN, AGN, Tierras, vol. 3087, fol. 18.; Henderson, The Renaissance Hospital, 163.

91. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp, 1, fol. 8v.

92. “Información seguida en la Audiencia Arzobispal de esta corte, en favor de la Congregación de la Caridad,” 1645, AGN, Hospitales, vol. 45, exp. 9, fols. 569-569v.

93. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fols. 8v-9.

94. “Testimonio de la constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fols. 8v-9.

95. Carrera, Elena, “Understanding Mental Disturbance in Sixteenth- and Seventeenth-Century Spain: Medical Approaches,” Bulletin of Spanish Studies 87:8 (2010): 128–129Google Scholar.

96. The statutes indicated that the apothecary would be a member of the brotherhood; however, the earliest surviving book of medical receipts (dating to 1698) indicates that medicines were purchased from the apothecary shop of Urbano Martínez. The annotations are difficult to decipher. AGN, Indiferente Virreinal, caja 1627, exp. 7. On New World materia medica see essays by J. Worth Estes, and José M. López Piñero and José Pardo Tomás in Searching for the Secrets of Nature: The Life and Works of Dr. Francisco Hernández, Simon Varey et al., eds. (Stanford: Stanford University Press, 2000); and Huguet-Termes, Teresa, “New World Materia Medica in Spanish Renaissance Medicine: From Scholarly Reception to Practical Impact,” Medical History 45 (2001): 359–376CrossRefGoogle ScholarPubMed.

97. “Informaciones y otros recaudos tocantes a la institución y fundación de la orden y hospitalidad de San Hipólito,” 1647, AGN, Hospitales, vol. 73, exp. 3, fol. 234v; Carlos Viesca Treviño and Ignacio de la Peña, “Las enfermedades mentales en el Códice Badiano,” Estudios de Cultura Nahautl 12 (1976): 81.

98. For a discussion of the centrality of regimen to the careful management of the non-naturals in hospital care, see Horden, Peregrine, “A Non-Natural Environment: Medicine without Doctors and the Medieval European Hospital,” The Medieval Hospital and Medical Practice, Bowers, B. S., ed. (Aldershot, UK: Ashgate, 2007)Google Scholar.

99. I have consulted the following account books: Libro de cuenta, 1671-74, AGN, Indiferente Virreinal, caja 1030, exp. 3-5; Libro de cuenta, 1676-85, AGN, Indiferente Virreinal, caja 1004, exp. 3-6; and, Libro de cuenta, 1691-97, AGN, Indiferente Virreinal, caja 0930, exp. 2-6.

100. The statutes instructed the cook to take orders from the head nurse concerning dietary modifications for specific patients. “Testimonio de las constituciones,” 1697, AGN, Tierras, vol. 3082, exp. 1, fol. 19v.

101. Libro de cuenta, 1673-76, AGN, Indiferente Virreinal, caja 1004, exp. 4, fol. 44.

102. See for instance Midelfort, A History of Madness in Sixteenth-Century Germany; Roy Porter, Mind-Forg'd Manacles; and Elizabeth Mellyn, Mad Tuscans and their Families.

103. San Hipolito's eighteenth-century transformations, including its growing alignment with the Inquisition and secular criminal courts, are examined at length in my book-in-progress, Bedlam in the New World.