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The Gray Zones of Medicine
The Gray Zones of
MEDI c INE
Healers & History in Latin America
———————————————————————
Edited by Diego Armus & pablo F. Gómez

University of pittsburgh press

Published by the University of Pittsburgh Press, Pittsburgh, Pa., 15260
Copyright © 2021, University of Pittsburgh Press
All rights reserved
Manufactured in the United States of America
Printed on acid-free paper
10 9 8 7 6 5 4 3 2 1

Cataloging-in-Publication data is available from the Library of Congress

ISBN 13: 978-0-8229-4685-4

ISBN 10: 0-8229-4685-8

cover art: José Guadalupe Posada, El doctor improvisado (México: Antonio Vanegas
Arroyo, ca. 1889–1918), 5. M1238, Posada Collection, box 1, folder 5, Cuento. Courtesy of the
Department of Special Collections, Stanford University Libraries.

cover design: Alex Wolfe

 CONTENTS

Acknowledgments
vii
Introduction
Diego Armus and Pablo F. Gómez
3
1. Domingo de la Ascensión and the Criollo Healing Culture
of the Seventeenth-Century Caribbean
Pablo F. Gómez
11
2. The Curing World of María García, an Indigenous Healer
in Eighteenth-Century Guatemala
Martha Few
26
3. Calundu: A Collective Biography of Spirit Possession
in Bahia, 1618–Present
James H. Sweet
40
4. Dorotea Salguero and the Gendered Persecution of Unlicensed Healers
in Early Republican Peru
Adam Warren
55
5. Pai Domingos: Healing Slavery in Nineteenth-Century Bahia, Brazil
João José Reis
74
6. Mystic of Medicine, Modern Curandero, and “Médico Improvisado”:
Francisco I. Madero and the Practice of Homeopathy in Rural Mexico
at the Turn of the Twentieth Century
Jethro Hernández Berrones
89
 7. Herbs, Roots, Amulets, and Prayers in the Practices of “Saint” Vicente
and other Healers in São Paulo in the 1910s
Liane Maria Bertucci
108
8. Recognition without a Diploma: The Wanderings of the Healer
Indio Rondín in Early Twentieth-Century Colombia
Victoria Estrada and Jorge Márquez Valderrama
123
9. The Miraculous Doctor Pun, Chinese Healers, and Their Patients
in Lima, 1868–1930
Patricia Palma and José Ragas
138
10. Stepping through a Looking Glass: The Haitian Healer Mauricio Gastón
on the Romana Sugar Mill in the Dominican Republic in 1938
Alberto Ortiz Díaz
155
11. Jesús Pueyo: The “Modern Argentine Pasteur” of the 1930s and 1940s
Diego Armus
170
12. Doña Hermila Diego: Zapotec Healer, Entrepreneur, Social Activist,
Media Star in Modern Mexico
Gabriela Soto Laveaga
189
Notes
211
Selected Bibliography
249
List of Contributors
253
Index
255
 ACKNOWLEDGMENTS

We came up with the idea for this book after a talk Diego Armus gave in Madison,
Wisconsin, where he was invited to speak by Pablo Gómez. What followed is par
for the course. The support of many people and institutions allowed us to orga-
nize an intensely productive workshop where participants were able to discuss
drafts of their articles in great detail. The Department of Medical History and
Bioethics, the Latin American Caribbean and Iberian Studies Center, and the
Anonymous Fund of the College of Letters and Sciences at the University of Wis-
consin, Madison, provided financial and administrative support for the event. In
addition to the book’s contributors, Sheila Cominsky, Joshua Doyle-Raso, and
Natalia Botero Tovar also participated in the workshop and provided valuable
feedback on all chapters. The enthusiasm and support of Abby Collier, our editor
at the University of Pittsburgh Press, was essential in completing this project.
The Department of Medical History and Bioethics at the University of Wis-
consin and the Department of History at Swarthmore College have efficiently
assisted with editorial work. Two anonymous reviewers bestowed valuable sug-
gestions for improving the final version of this book. We would like to thank all
the book contributors for both crafting engaged and engaging narratives about
the rich histories of the individuals and groups discussed in their essays as well
as for their efforts in completing them amid a global pandemic that has upended
all of our lives. Finally, our recognition goes to two medical doctors who are not
in the “gray zones of medicine” but who do understand what we are aiming for
with this volume: Pablo Gómez would like to express his gratitude to Carolina
Sandoval for all of her love and support. Diego Armus thanks Laura Laski, as
always, for her warmth and companionship.
The Gray Zones of Medicine
 Introduction

Diego Armus and Pablo F. Gómez

Speaking to inquisition officials about his successful practice in Caracas, Ven-

ezuela, African health specialist Domingo Congo declared in 1658 that he had
been treating patients from all walks of life for years and that the accusations that
had brought him to the attention of the Holy Office stemmed from professional
jealousy. Congo told the officials that “the doctors of Caracas are my enemies
because I heal the sick people they leave as incurable.”1 From the sixteenth cen-
tury onward, practitioners like Congo, laboring outside or in the margins of the
world of licensed medicine, have continued to be key providers of health care for
people of all social extractions in Latin America and the Caribbean.
In spite, or as a consequence, of these healers’ success, professional, govern-
mental, and ecclesiastical authorities tried to suppress or ignore their practices.
The majority of these health practitioners made use of a variety of therapeutic
tools, including methods firmly situated outside of normative/legal therapeutics,
as well as others that were in a more or less intense dialogue with licensed med-
icine. We know about them because of the documentary trail they left in legal,
ecclesiastical, medical, and journalistic records as a result of their prosecutions
or popularity—or through advertisements of their cures in the printed media.
These historical actors thrived in a gray space between legality and criminali-
ty. This book is about the trajectories of these practitioners, mostly neglected

3
4 DIEGO AR MUS & PA BLO F. GÓMEZ

in historical scholarship, and the fundamental role they had while working in
interstitial spaces between official and unofficial medicines in shaping Latin
America’s many worlds from colonial times to the present.
A 1999 article suggested that scholarship on the history of science and medi-
cine in Latin America appeared ready to “take off.”2 The prediction was just par-
tially right. Although social studies on Latin American science, in general, have
been growing in relevance, they are still in quite a preliminary stage two decades
later. The situation, however, is different for the studies of health, disease, and
medicine, already a vibrant and well-consolidated subfield of historical inquiry.3
Today, monographs, articles, bibliographies, state-of-the-art reviews, edited vol-
umes, and textbooks, as well as panels in conferences and thematic workshops,
are recurrent features, frequently in conversation across the Anglo-American,
European, and Latin American academic worlds.4
Latin Americanists from many disciplinary backgrounds—historians, med-
ical anthropologists, public health scholars, sociologists, and cultural critics—
have been unveiling a domain where health, medicine, healing practices, and
disease meanings are contestable, debatable, and subject to controversy. They
have recreated, revised, or adjusted questions and problems discussed in other
academic milieus. They have also occupied a terrain previously monopolized by
traditional historians of medicine, physicians, and antiquarians. Now, diseases
and health issues are time and again discussed as slippery, ambiguous, complex
entities constructed and framed historically, taking into consideration the indi-
vidual and the collective as well as the sociocultural and the biological.
For the past two decades, scholars working on the history of disease, health,
and medicine in Latin America have focused on themes that highlighted epide-
miological trends and metaphors associated with specific diseases; the influences
of foreign players in the shaping of state health policies; the subtle or undisguised
efforts to institute a presumably proper, civilized, and ordered hygienic code
that society at large should engage in; and the state and civil society initiatives
aimed at disciplining and/or assisting the population, particularly its popular
sectors. They also have paid some attention to issues that this book explores,
we believe, in great detail: discourses about the exchange of medical knowledge
and therapies in the Atlantic world as well as its adjustments in the many Latin
American peripheries; the racialization of certain diseases and more in general
the relation between maladies and race; the social and political role of creole
and mixed-race healers within their communities; the medical practice and the
more or less overt state efforts during colonial and republican times aimed at
 INTRODUCTION 5

making diplomate medicine as the only legitimized healing practice; and the ill-
ness narratives offered by sick people and health care practitioners. This vibrant
historiography can be broadly organized in three approaches that have plenty
of overlaps: the new history of medicine, the history of public health, and the
sociocultural history of disease and healing.5
Histories of heroic biomedical treatments and biographies of famous doctors
are no longer the dominant analytical perspective. Beyond their specific con-
tributions, these somewhat traditional narratives were aimed at reconstructing
the “inevitable progress” generated by university certified medicine, to unify
the past of an increasingly specialized medical profession, and to emphasize a
certain ethos and moral philosophy that is presented as distinctive, unaltered,
and emblematic of medical practice throughout time. The renovation of these
histories, by contrast, tends to see the history of medicine as a more irregular and
faltering process. In dialogue with the history of science and historical demog-
raphy, it discusses the epidemiological, social, cultural, and political contexts
in which certain initiatives, doctors, institutions, and treatments “triumphed,”
making a place for themselves in history as well as for those who failed and have
been forgotten.6
The history of public health emphasizes political dimensions: looking at pow-
er, the state, the medical profession, the politics of health, and the impact of public
health interventions on mortality and morbidity trends. To a large extent, this is
a history focused on the relations between health institutions and economic, so-
cial, and political structures. Practitioners of the history of public health, at least
some, research the past in order to reduce the inevitable uncertainties that mark
every decision-making process, thereby facilitating (in general rather than in
specific ways) potential interventions in the contemporary public health arena.7
The sociocultural history of disease and healing emphasizes the complexity
of both illnesses and health as concepts, and not only as problems in themselves
but also as tools for discussing other topics. This scholarship’s focus has been ap-
plied to a wide array of subject matters, including the sociopolitical dimensions
of particular diseases; the increasing medicalization of modern societies; the
cultural uses and representations of diseases and illnesses; the class, race, gender
and age dimensions of diseases; the place certain diseases had in the making
of nationhood ideals as well as in the many Latin American modernities; the
responses of ordinary people vis-à-vis taking care of their own health; and finally,
the ways different historical times, social groups, or even individuals have defined
for themselves the etiology, transmission, appropriate therapy, and meaning of
6 DIEGO AR MUS & PA BLO F. GÓMEZ

a given disease, definitions that reflect not only changing medical technologies
and knowledge but also broader influences, including religious beliefs, gender
obligations, nationality, ethnicity, class, politics, and state responsibilities.8
These three lines of inquiry undoubtedly reflect an effort to move away from
the limitations of yesteryear histories of medicine. All of them take medicine to
be an uncertain and contested terrain, where the biomedical is shaped as much
by human subjectivity as by objective facts. They also discuss disease and illness
as problems that have not only a biological dimension but also social, cultural,
political, and economic connotations. The rapid expansion and increased sophis-
tication of this historiography keeps unveiling new issues that motivate novel
interpretative perspectives. This volume is intentionally designed to address at
least two of these emerging issues.
First, it aims to provide a reading of medicalization as a historical process,
giving relevance to the many uncertainties and limitations not present when
such a process was becoming consolidated. This recognition allows for the un-
derstanding of official medicine and later biomedicine as historically located
processes whose seeming social and cultural dominance was never preordained,
or inevitable, nor was it ever complete. Second, The Gray Zones of Medicine em-
phasizes the unrelenting resilience of health care providers offering services on
the fringes of official medicine, often as hybrid practitioners using very diverse
medical traditions, such as healers, herbalists, bonesetters, midwives, and many
others—from colonial times to the present. It highlights their existence not only
in the centuries when medicalization was just emerging and marginal, as in the
case of seventeenth-century Cuban healer Domingo de la Ascención (chapter
one), but also in modern societies when biomedicine and medicalization be-
came hegemonic, for instance, in the Argentina of Jesús Pueyo during the 1940s
(chapter eleven).
The examples of María García in eighteenth-century Guatemala, Dorotea
Salguero in nineteenth-century Peru, and Hermilia Diego in twenty-first-cen-
tury Mexico (discussed in chapters two, four, and twelve, respectively) reveal
the persistent presence of health practitioners laboring outside or in the mar-
gins of the world of licensed medicine, providing health care for people of all
social extractions in Latin America and the Caribbean. In spite of having being
separated by three centuries and working in very different social and cultural
settings, readers will also recognize similarities between the strategies used by
practitioners in early modern times—like de la Ascención and those like Mauri-
cio Gastón, a Haitian health practitioner very active in the Dominican Republic
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