By the end of the eighteenth century, Peru had witnessed the
decline of its once-thriving silver industry, and it had barely
begun to recover from massive population losses due to smallpox and
other diseases. At the time, it was widely believed that economic
salvation was contingent upon increasing the labor force and
maintaining as many healthy workers as possible. In "Medicine and
Politics in Colonial Peru, "Adam Warrenpresents a groundbreaking
study of the primacy placed on medical care to generate population
growth during this era.
The Bourbon reforms of the eighteenth century shaped many of the
political, economic, and social interests of Spain and its
colonies. In Peru, local elites saw the reforms as an opportunity
to positively transform society and its conceptions of medicine and
medical institutions in the name of the Crown. Creole physicians in
particular, took advantage of Bourbon reforms to wrest control of
medical treatment away from the Catholic Church, establish their
own medical expertise, and create a new, secular medical culture.
They asserted their new influence by treating smallpox and leprosy,
by reforming medical education, and by introducing hygienic
routines into local funeral rites, among other practices.
Later, during the early years of independence, government
officials began to usurp the power of physicians and shifted
control of medical care back to the church. Creole doctors, without
the support of the empire, lost much of their influence, and
medical reforms ground to a halt. As Warren's study reveals,
despite falling in and out of political favor, Bourbon reforms and
creole physicians were instrumental to the founding of modern
medicine in Peru, and their influence can still be felt today.
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