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Physicians, the State and Public Health in Chile, 1881–1891

Published online by Cambridge University Press:  05 February 2009

Carl J. Murdock
Carl J. Murdock
Affiliation:
research student at theUniversity of Connecticut.
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Abstract

This study of public health policy in Chile uncovers some of the social tensions in that country during the 1880s, and illustrates the fragmentation of the Chilean elite prior to the Revolution of 1891. The Chilean government's controversial and contested public health policies implied the increasing bureaucratic organisation and regulation of society. The justifications offered for these policies by central government officials reveal both the deep roots in Chilean politics of a powerful Executive, and the early linkage between the ‘scientific discourses’ of medical professionals and the bureaucratic centralisation of state power.

Type
Articles
Information
Journal of Latin American Studies , Volume 27 , Issue 3 , October 1995 , pp. 551 - 567
Copyright
Copyright © Cambridge University Press 1995

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References

1 El Mercurio, 5 Oct. 1883.

2 The state is defined here as the Executive branch, the various ministries under its nominal control, and the emergent bureaucracy supporting these ministries. A fuller description of state personnel, their social backgrounds and behaviour in office lies beyond the scope of the present study. Two particularly stimulating analyses of the state in nineteenth-century Chile are Zeitlin, Maurice, The Civil Wars in Chile (or The Bourgeois Revolutions That Never Were) (Princeton, 1984), pp. 31–5Google Scholar, 211–12; and Góngora, Mario, Ensayo histórico sobre la noción de estado en Chile en los siglos XIX y XX (Santiago, 1986)Google Scholar. My understanding of the Chilean state is shaped by Weber's, Max discussion of the emergence of modern bureaucratic officialdom in ‘Bureaucracy’, in Gerth, H. H. and Mills, C. Wright (eds.), From Max Weber: Essays in Sociology (New York, 1958), pp. 196–240Google Scholar.

3 El Independiente, 31 Dec. 1889.

4 Loveman, Brian, Chile: The Legacy of Hispanic Capitalism, 2nd. ed. (New York, 1988), p. 188Google Scholar.

5 El Mercurio, 5 Oct. and 3 Nov. 1883.

6 Mamalakis, Markos J., Historical Statistics of Chile, vol. 2, Demography and Labor Force (Westport, Ct., 1980), pp. 40Google Scholar, 47.

7 Ibid., p. 413.

8 El Mercurio, 22 Aug. 1884.

9 El Ferrocarril, 2 Feb. and 20 Nov. 1890.

10 Zañartu, J. Joaquín Larraín, Reflaciones entre la autoridad i el ciudadano en época de epidemia (Valparaíso, 1887), pp. 13Google Scholar, 15.

11 Ibid., pp. 27–8, 17, 9.

12 Ibid., pp. 19–22.

13 The Chilian Times, 6 Oct. 1883.

14 El Mercurio, 22 May 1884.

15 Collier, Simon, ‘From Independence to the War of the Pacific’, in Bethell, Leslie (ed.), Chile Since Independence (Cambridge, 1993), p. 4Google Scholar.

16 La Epoca, 26 Dec. 1886.

17 The periodical materials used in this study do not offer a great deal of information concerning the reactions of the working class to compulsory vaccination and other forms of medicalisation in Chile. However, considering the widespread evidence of working-class activism in the face of medicalisation in Europe, North and South America in the late-nineteenth century, further research will probably reveal similar patterns of resistance in Chile. For examples of lower-class resistance to medicalisation at the turn of the century, see Frieden, Nancy M., ‘The Russian Cholera Epidemic, 1892–1893, and Medical Professionalization’, Journal of Social History, vol. 10, no. 4 (1977), PP. 538–59CrossRefGoogle Scholar; Leavitt, Judith Walzer, The Healthiest City: Milwaukee and the Politics of Health Reform (Princeton, 1982)Google Scholar; Meade, Teresa, ‘“Civilizing Rio de Janeiro”: The Public Health Campaign and the Riot of 1904’, Journal of Social History, vol. 20, no. 2 (1987), pp. 301–22CrossRefGoogle Scholar; Meade, Teresa, ‘“Living Worse and Costing More”: Resistance and Riot in Rio de Janeiro’, Journal of Latin American Studies, vol. 21 (1989), pp. 241–66CrossRefGoogle Scholar; Chalhoub, Sidney, ‘The Politics of Disease Control: Yellow Fever and Race in Nineteenth Century Rio de Janeiro, Journal of Latin American Studies, vol. 25 (1993). PP441–63CrossRefGoogle Scholar.

18 Diario Oficial, 28 Nov. 1889.

19 Ibid., 5 Dec. 1889.

20 El Mercurio, 3 Jan. 1884.

21 Ibid., 18 April and 26 Sept. 1884.

22 Ibid., 22 May and 12 July 1884.

23 Ibid., 3 and 7 April 1884.

24 DeShazo, Peter, Urban Workers and Labor Unions in Chile, 1902–1927 (Madison, 1983), p. 71Google Scholar.

25 El Mercurio, 20 Aug. 1884.

26 This figure (550 of 677) was calculated from a sampling of weekly vaccination totals published over a three month period in ibid., 10 Oct., 10 Nov., and 18 Dec. 1883.

27 Ibid., 1 June 1884, suplemento.

28 Ibid., 18 Aug. 1884.

29 Ibid., 22 Aug. 1884.

30 Ibid., 10 Sept. 1884.

31 Diario Oficial, 2 Dec. 1889.

32 Ibid., 9 Dec. 1889.

33 Loveman, Chile, p. 152.

34 Discussed below, Dr Wenceslao Díaz was the oldest son of a central valley landowner, and Dr José Joaquín Aguirre was a member of one of the oldest elite families in the nation. Biographical information on the doctors is drawn from Figueroa, Pedro Pablo, Diccionario Biográfico de Chile, 4th edn., 3 vols. (Santiago, 1897)Google Scholar; Jordi Fuentes y Lía Cortés, Diccionario histórico de Chile, 4th edn. (Santiago, 1966)Google Scholar; and Chile a color biografías (Santiago, 1983).

35 Each of the doctors discussed below was educated in the Instituto Nacional and the Universidad.

36 An important professor of medicine at the Universidad, and instructor of several of the doctors discussed here, Carlos Sazie supported Balmaceda in 1891. From the standpoint of the state, he was apparently insignificant as a socialising force.

37 Orrego Luco, the most activist of these doctors, and Aguirre, Protomédico de Estado under Balmaceda, opposed the President in 1891.

38 In Frías, E. Fernández, Hygiene popular: la salud de los niños, o sea caticismo higiénico de la infancia (Santiago, 1885), p. viGoogle Scholar. Dr Aguirre was also professor of anatomy at the Escuela de Medicina.

39 In Ibid., p. v. Emphasis in original.

40 Ibid., p. 78.

41 Mamalakis, Historical Statistics of Chile, vol. 2, p. 142.

42 In Frías, Fernández, Hygiene popular. El cólera: cartilla sanitaria (Santiago, 1886), pp. 4–5Google Scholar.

43 Ibid., pp. 7–8. Emphasis in original.

44 Díaz, Wenceslao, Instrucciones prácticas y populares sobre el cólera (Santiago, 1887), pp. 5Google Scholar, 10. Díaz also served as deputy to Congress.

45 Ibid., p. 9.

46 González, Tomás Rios, La hygiene i la escuela (Santiago, 1888), p. 6Google Scholar. Emphasis in original.

47 Ibid., pp. 8–9.

48 Ibid., p. 32.

49 Ibid., pp. 8–9.

50 Manuel Montt was president of Chile from 1851 to 1861. During his administration the central government suppressed two rebellions by regional interests allied with opponents of the authoritarian structures of government developed by Diego Portales and Joaquín Prieto in the 1830s. For an overview of the Montt period see Loveman, Chile, pp. 161–5.

51 Bourgeois, Eleodoro, Estudio sobre profilaxis del cólera (Santiago, 1888), p. 58Google Scholar.

52 Ibid., p. 46.

53 Ibid., p. 35.

54 Larraín Zañartu, Relaciones entre la autoridad i el ciudadano, p. 26.

55 Boza, R. Dávila, ‘Los cadáveres considerados desde los puntos de vista higiénico i social’, La Lectura, tomo 1, núm. 29 (1884), p. 226Google Scholar.

56 Ibid., tomo 1, núm. 31 (1884), p. 242.

57 Ibid., tomo 1, núm. 32 (1884), p. 251. Dávila single out Balmaceda's role in arguing for this legislation before the Congress in ibid., tomo 1, núm. 31 (1884), p. 243.

58 Ibid., tomo 1, núm. 32 (1884), p. 250.

59 Lois, Juan S., ‘Los cadáveres bajo el punto de vista higiénico y social’, La Lectura, tomo 1, núm. 37 (1884), p. 294Google Scholar.

60 On the actions of these presidents, see Góngora, Ensayo histórico, pp. 45–6.

61 Boza, Dávila, ‘Los cadáveres considerados,’ La Lectura, tomo 1, num. 43 (1884), p. 340Google Scholar; and ibid., tomo 2, núm. 72 (1885), p. 178.

62 Lois, ‘Los cadaveres bajo’, ibid., tomo 2, núm. 84 (1885), p. 273; and ibid., tomo 2, núm. 55 (1885), p. 35.

63 See Clement, Jean-Pierre, ‘El nacimiento de la higiene urbana en la América Española del siglo XVIII’, Revista de Indias, num. 171 (1983), p. 92Google Scholar.

64 El Independiente, 27 Dec. 1889.

65 Augusto Orrego Luco, ‘La cuestión social en Chile’, originally published in La Patria, reprinted in Hernan Godoy Urzua (ed.), Estructura social de Chile (Santiago de Chile, 1971), p. 224.

66 Ibid., pp. 228, 230.

67 Ibid., pp. 229, 230.

68 On Balmaceda and taxes, see Loveman, Chile, p. 189.

69 Orrego launched a series of attacks on Balmaceda in La Epoca in 1890–1891. The physician later championed Chile's claims to the Puña de Atacama in a dispute with Argentina.

70 DeShazo, Urban Workers and Labor Unions in Chile, p. 69.