From Popular Medicine to Medical Populism

Doctors, Healers, and Public Power in Costa Rica, 1800–1940

From Popular Medicine to Medical Populism

Book Pages: 352 Illustrations: 8 illustrations Published: January 2003

Author: Steven Palmer

History > Latin American History, Latin American Studies > Central America, Medicine and Health > Medical Humanities

From Popular Medicine to Medical Populism presents the history of medical practice in Costa Rica from the late colonial era—when none of the fifty thousand inhabitants had access to a titled physician, pharmacist, or midwife—to the 1940s, when the figure of the qualified medical doctor was part of everyday life for many of Costa Rica’s nearly one million citizens. It is the first book to chronicle the history of all healers, both professional and popular, in a Latin American country during the national period.
Steven Palmer breaks with the view of popular and professional medicine as polar opposites—where popular medicine is seen as representative of the authentic local community and as synonymous with oral tradition and religious and magical beliefs and professional medicine as advancing neocolonial interests through the work of secular, trained academicians. Arguing that there was significant and formative overlap between these two forms of medicine, Palmer shows that the relationship between practitioners of each was marked by coexistence, complementarity, and dialogue as often as it was by rivalry. Palmer explains that while the professionalization of medical practice was intricately connected to the nation-building process, the Costa Rican state never consistently displayed an interest in suppressing the practice of popular medicine. In fact, it persistently found both tacit and explicit ways to allow untitled healers to practice. Using empirical and archival research to bring people (such as the famous healer or curandero Professor Carlos Carbell), events, and institutions (including the Rockefeller Foundation) to life, From Popular Medicine to Medical Populism demonstrates that it was through everyday acts of negotiation among agents of the state, medical professionals, and popular practitioners that the contours of Costa Rica’s modern, heterogeneous health care system were established.


"From Popular Medicine to Medical Populism is a well-written book that will assume a leading place in the scholarship on medicine in Latin America. Scholars interested in public policy, the growth of the state and populism will benefit from it as well." — David Sowell , Hispanic American Historical Review

"From Popular Medicine to Medical Populism is among the finest of these new histories of medical and health institutionalization in Latin America. Beautifully written and drawing from an impressive range of archival sources, journals and newspapers, legal proceedings, and personal reports, he traces the intersecting trajectories of herbalists, empirics, midwives, pharmacists, several grades of doctors, and other healers from colonial times to the launching of Costa Rica's modern exemplar of rapid public health advancement." — Anne-Emanuelle Birn , Latin American Research Review

"From Popular Medicine to Medical Populism is an important book about Latin American medical history. The author's emphasis on the co-existence between popular and professional medicine is a needed correction to the biases in favor of scientific medicine. Palmer is comparative and encyclopedic in his approach and regularly refers to medicine in other parts of Latin America. Finally, this is an important original study on the medical profession in Costa Rica." — Vera Blinn Reber , The Americas

"[W]ell-written and thoroughly researched. . . ." — Robin L. Anderson , American Historical Review

"In this clearly written and informative book, Palmer renders a compelling explanation of the rise of medical pluralism during the period of consolidation of the biomedical profession in Costa Rica. . . . The book contains a wealth of fascinating detail. . . . For the richness of its sources and the clarity of its analysis, this book constitutes a major contribution to the history of social medicine, medical anthropology, and Latin American studies." — Valentina Napolitano Quayson , Canadian Journal of Latin American and Caribbean Studies

"Palmer deserves credit for . . . a story that nicely discusses why, even now, despite their substantial cultural authority and influence over crucial governmental policies, Latin American physicians are not alone when it comes to the business of healing." — Raul Necochea , Social History of Medicine

"Palmer makes an important contribution to the history of Latin American medicine, although readers will share his lament that the evidence is not more copious. He does his best to quantify when he can, extrapolate about trends based on just a few cases, and buttress his arguments by referring to events happening elsewhere in Latin America." — Lynn M. Morgan, Social History

"Palmer's well-written and original book clearly describes the history of medicine and power, as well as the impact of medicine on politics and society in this important case. It should be read by historians, public health scholars and social scientists who want to understand Costa Rica's relative success."
— Kirk Bowman, The Latin Americanist

"Steven Palmer does show us that along with a distinctive 'biomedical vanguard' in Costa Rica, a broad landscape of healers existed until at least the mid-twentieth century that reflected a vibrant medical eclecticism there. He argues that this medical eclectism was also central to the role that physicians played in populist politics in this small nation that straddles the Central American isthmus." — James Goodyear, Bulletin of the History of Medicine

"Steven Palmer’s book is a path-breaking work that shows how popular and conventional medical knowledge were closely interrelated in the Costa Rican case throughout the nineteenth century and the first half of the twentieth. . . . [A] well-crafted work that brings new and interesting issues to the historiography of Latin American medicine and that, by its constant comparisons to other case studies in Argentina, Peru and Colombia, among others, turns out to be much more than a history of Costa Rican medicine." — Camilo Quintero , Bulletin of Latin American Research

"From Popular Medicine to Medical Populism presents new material of substantial interest to both Latin American specialists and medical historians. Steven Palmer has marshaled a convincing story in a challenging way that both informs and raises issues for debate.” — John K. Crellin, coauthor of Professionalism and Ethics in Complementary and Alternative Medicine

"As a comprehensive study of the medical profession in Costa Rica and a sound comparison with medical developments in Latin America, this work is remarkable, novel, and useful. Steven Palmer’s integrated analysis of class, gender, professional hierarchy, and hybrid medical combinations is superb. This work will be a splendid addition to an emerging literature on the social history of medicine in Latin America." — Marcos Cueto, author of The Return of Epidemics: Health and Society in Peru during the Twentieth Century


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Author/Editor Bios Back to Top

Steven Palmer is Assistant Professor of History at the University of Windsor, Ontario. He is the author of The History of Costa Rica.

Table of Contents Back to Top
Illustrations ix

Acknowledgments xi

Introduction 1

1. Healers before Doctors 17

2. First Doctors, Licensed Empirics, and the New Politics of Practice 37

3. The Formation of a Biomedical Vanguard 67

4. Conventional Practice: New Science, Old Art, and Persistent Heterogeneity 91

5. Other Healers: Survival, Revival, and Public Endorsement 119

6. Midwives of the Republic 139

7. Hookworm Disease and the Popularization of Biomedical Practice 155

8. The Magician versus the Monopolists: The Popular Medical Eclecticism of Professor Carbell 183

9. Medical Populism: Dr. Calderon Guardia and the Foundations of Social Security 207

Conclusion 231

Notes 239

Bibliography 299

Index 319
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Additional InformationBack to Top
Paper ISBN: 978-0-8223-3047-9 / Cloth ISBN: 978-0-8223-3012-7
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