Introduction for Enlightened Immunity

Introduction

Minerva’s Children

Looking back on his time in the plantation society of the Caribbean, things must have seemed simpler. A graduate of the prestigious University of Montpellier, Esteban Morel (1744–1795) served a tour of duty in the French Caribbean as court physician for the French and Spanish Bourbons. On the island of Guadeloupe, he certified surgeons and apothecaries in military hospitals, visited pharmacies to inspect medications and prescriptions, and oversaw some eight thousand inoculations among the island’s enslaved workers and slave owners, observing outcomes and instructing others to inject smallpox fluid from one body to the next. Departing on a peregrinaje (pilgrimage), as he called it, he sought out additional healing experience in the climates of Venezuela, Cuba, and New Orleans (and looked after interests in the mining centers of Guanajuato and Real de Catorce) before he settled in Mexico City in 1778.¹

In the cosmopolitan capital of the viceroyalty of New Spain, Morel found a welcoming cultural scene and a population besieged by smallpox. It was a time when vapors from desiccated lakes, sudden drops in temperature, and suspicious odors prompted persons of means to visit a physician or barber-surgeon for preemptive bleeding and sparked bonfires and pungent fumigations with sulfur. Documents from the period are stained where drops of vinegar landed for disinfection, the acrid material of the paper the remnants of a time when disease was sensed in the nose. Morel noticed the ways that residents came together to pray for divine intercession, filing out into the streets to plead with saints to intercede.

He agitated for a different approach. The inoculation technique that he had practiced on the island Guadeloupe was still largely unknown in colonial Mexico. Hopeful to prevent a full-blown epidemic, city officials and the viceroy supported Morel’s proposal to initiate trials. A public advertisement announced the availability of inoculation for residents aged three and up under the supervision of Dr. Morel, “trained and expert in the matter.” Meanwhile, in a clinic set up in a partitioned room in his own home, Morel—eager to demonstrate inoculation’s effectiveness on Indian bodies—conducted experimental trials on six indios and indias between the ages of three and ten. The children were injected with live smallpox following a preparatory period of several days and segregated to contain the infection.² Along with eight Spanish children who were inoculated in their homes, these were the first recorded trials in Mexico City.

Morel documented the outcomes in a treatise on inoculation that he submitted to the city council for publication. In a prefatory letter he thanked the municipal authorities for their support but reminded them that the beds designated for inoculation in the convent hospital of San Hipólito lay empty. The few inoculations carried out in private homes or in Morel’s makeshift clinic had been successful, but in one week ten patients who were being prepared for the procedure perished from smallpox. Now rumors swirled about amputations and deaths. As the tide of public opinion turned, the city council declined to publish Morel’s treatise and sidelined inoculation measures in favor of a renewed focus on atmospheric conditions and sanitation. The treatise languished as an unrealized vision in the city council’s files.

In possession of considerable training and practical experience, Morel had navigated an interconnected Atlantic world. Yet the medical learning he brought, developed on the estates of the Caribbean and further refined on children in Mexico City, ran aground in the streets and homes of New Spain’s upper classes. Why, in light of such vigorous efforts? Morel suggested one possibility in the treatise, a litany of responses to the most common moral, medical, and theological objections. On its first page Morel conjured a tableaux for the frontispiece, in which a figure of Minerva, goddess of wisdom and medicine’s muse, would appear with shield in the portico of the capital’s municipal building, with smallpox victims arrayed in the dark shadows below to represent the misery, death, and deformity caused by smallpox. To the right, in the same light bathing the goddess, a group of joyful children playing with toys or in the hands of the inoculator, indicated the procedure’s complete safety.³ An icon of the Enlightenment, Minerva became patron and protector, who would guide the population out of the darkness of pestilence and misery and into the light of reason, health, and immunity.

Although he failed to introduce inoculation, Morel correctly anticipated opposition and predicted that the rhythms of emergencies would dictate the pace of reform. More than orders, instructions, and missives arriving from the Spanish metropolis, he thought that acceptance of a medical novelty depended especially on the degree to which the population perceived the severity of the disease it was to remedy. Recent studies of enlightened absolutism and reform in Spanish America and Europe have confirmed Morel’s prediction, destabilizing the absolutist nature of the Bourbon state. In the aftermath of these revisions, projects look more precarious than seamless, translated and initiated by colonial actors, according to factors, connections, and patterns that have their own cadences and logic.⁴ We are left looking to other phenomena—the tastes of merchants, the flow of information in urban centers, the salient effects of microbes on the body—for convincing explanations for change.

In 1794, in an atmosphere of paranoia about the French Revolution, Morel was swept up in the reaction. He died in a cell of the Mexican Inquisition while awaiting trial on the charge of deism, months before inoculations commenced en masse in villages and towns in New Spain. He had been prescient in another respect: when the time came to promote and adopt new techniques, the path would be paved by a host of celestial and terrestrial mediators and agents. In an age when ships and newspapers throughout the Atlantic bore the name of the goddess of medicine, many more emblematic Minervas—patrons across the viceroyalty—would mediate cultures, knowledge, and public health programs. The people, rituals, and routines responsible for this transition in Mexico have remained in the shadows. Enlightened Immunity attempts to bring them to light.

DISEASED POPULATIONS

When Morel arrived in Mexico City, judges, city officials, physicians, architects, and the police were in the midst of a program of urban reform that had begun to transform the city center. Cities teemed with human waste, piles of refuse, and filthy drinking water, and other obstacles to good health. Among those who indicted Mexico City’s dismal sanitary record was the talented lawyer and oidor (royal judge) Baltasar Ladrón de Guevara (1725–1804), whose 1788 discurso (essay) evoked a city redolent of putrid odors. Guevara believed that the pathological effects of poor atmospheric conditions might be countered by the methods of enlightened administration, informed by principles of rational order, or policía. Guevara had in mind efficient municipal planning: clean air, clear sight lines, regularity in public spaces (down to the size and shape of lettering on homes and businesses), and especially the suppression of transgressions by individuals and groups. Public health suffered owing to desórdenes (disorders) that consisted not only of violations of the municipal code but also exemptions and special privileges that undermined its spirit. Frequently, regulations were simply not enforced.

The result was repeated abuse, including the resale of articles of clothing previously worn by infected residents, ineffective cleaning of the city’s aqueducts, decomposing meat passing through poorly controlled entrances, and lice and the stench of urine brought into public spaces by swine, which contaminated the air and facilitated the spread of epidemics. The ad hoc conglomeration of barrios further deprived the city of rational beauty and salubrious air, of symmetrical and rectilinear street grids that, in Guevara’s view, had been the hallmark of the “enlightened” sixteenth-century monarchs, Charles V and Philip II. The proximate remedy was ventilation, more trees for shade and clean air for residents strolling through the Alameda, and aromatic plants such as chamomile, jasmine, peppermint, rosemary, rue, thyme, watercress, “and others that embalm the atmosphere and facilitate healthy and pleasant respiration with their emanations.”⁵ As in such European cities as Madrid, Paris, and Venice—which served as ideals of rational planning—cleanliness and regularity in Mexico City’s appearance would bespeak the calm, health, and good order within.

Penned at the height of the Bourbon monarchy’s interest in enlightened administration and healthy human populations, Guevara’s essay articulated itself around the defining axis of happiness and liberty, which derived from the ability to live within the constraints established by a clean, ordered urbs. The contemporary interest in policía—indicated by regulations on burial practices, the use of public spaces, and ceremonial life—has been construed as a manifestation of anxiety among the upper classes: poorly masked and frequently contested measures to control plebeians, who were viewed as inherently disorderly in their living habits and associations.⁶ Vagrants, beggars, pilgrims arriving for feast-day celebrations, and the lower classes in general were most often and easily targeted by reformers, and modern historians have readily seen them as victims of a regime of discipline under the rhetoric of the Enlightenment.

It is a selective reading that edits out systematic criticisms aimed at the social elite, who behaved in ways prejudicial to the common good and were not above reproach. If the physical environment was so potentially deleterious to human health when not managed with a rational hand, private actors were accessories in this tale of negligence, carelessness, and self-interest. They were the manos poderosas (powerful or favored persons; literally “hands”) cited in streams of petitions received by the General Indian Court (Juzgado General de Indios) from indigenous villages (repúblicas de indios) beginning in the seventeenth century. In seeking out viceregal protection, communities accused justices and administrators, Spanish ranchers, parish priests, and Indian governors of usurping land, rigging elections, extracting excessive tribute, and submitting villagers to a variety of onerous labor exactions. These abuses inflicted harm on the petitioners, the king’s most humble and deserving subjects (as they stressed), and offended the authority of the royal person.⁷

Enlightened diagnosticians in pursuit of social reform referred to these and other discursive and legal traditions. Guevara looked nostalgically to the rectilinear grids of the sixteenth-century “golden age” of Spanish American urban planning. The long-serving archbishop of Mexico, Alonso Núñez de Haro y Peralta (tenure from 1772 to 1800), a major figure in urban and public health reforms, found historical justification in the patristic era of the early Catholic Church. In the 1779 smallpox outbreak, when he ordered victims buried in new camposantos (cemeteries) rather than overcrowded churches, he announced that “the ancient discipline of the [Church] Fathers” must be restored “as current circumstances permit” to maintain the decorum of the church building, to achieve indispensable public health (salud pública), and to compel uniform cooperation.⁸ The reformist narrative presented an image of old, sound habits of thought, behavior, and speech that had been undermined by inertia and neglect. New restraints and regulations were a restoration rather than an innovation.

In fact, steps by residents and officials to introduce rational planning and protect the populace from disease were already entangled in conversations about health, population, and industry taking place across the Atlantic and deep in the agricultural countryside. The Swiss physician Samuel-Auguste Tissot announced a troubling demographic trend in the first lines of his widely read 1761 advice manual on health and medicine: “It is an unyielding fact known to all and shown by census registers that the number of inhabitants of Europe has declined. This depopulation has many causes, and I would be pleased if I could remedy one of the principal ones, which is the poor method employed in the curing of diseases.”⁹ Tissot’s work was published in six Spanish editions over the century, and the supposed demographic fact of Europe’s population decline worried ministers of absolutist states at a time when a healthy workforce was indispensable to agriculture and industry.

The Spanish statesman Pedro Rodríguez, Count of Campomanes, was so concerned by reports that he fully endorsed inoculation, still controversial in the Spanish world, in his influential 1774 essay. “The Indies suffer even greater devastation from smallpox” than Europe, he observed, and “we are indolent in view of such repeated devastation, which we could easily stem.”¹⁰ If there were doubts about the means to achieve it, monarchs agreed that healthy populations were the responsibility of enlightened states. New Spain’s reformist viceroy, the Conde de Revillagigedo (tenure from 1789 to 1794), advised his successor that few matters were as worthy of a ruler’s attention as prevention of epidemic illness. “If in governing New Spain the necessary precautions for public health had always been taken,” he reasoned, “we would not have seen frequent epidemics, to which is and should be attributed in great part the depopulated state of the provinces of these kingdoms.”¹¹ In Lima, the city’s creole (of Spanish descent born in the Americas) physicians positioned themselves at the center of this debate, as the antidote to decline through applications of “useful knowledge.”¹²

Although inoculation remained mostly unknown, the Bourbon notion of the state as guarantor of healthy populations moved ahead in New Spain, the source of nearly half of Spain’s mineral wealth and the most populous and wealthiest of its colonies.¹³ Indian tributaries, some 90 percent of the population and a vital source of revenue, participated in economies centered on regional and provincial capitals, where they were separated from the royal treasury by layers of intermediaries who controlled trade and tribute. In an arrangement known as the repartimiento de comercio (a system of monopoly trade), district governors, sometimes in partnership with merchants and parish priests, distributed merchandise and animals or advanced cash on woven goods or future crops to villagers. To regalist ministers, the practice invited abuse, consolidated the power of these individuals in the countryside at the expense of royal officials, and undermined competition and economic progress.¹⁴

A vast reorganization of administration was proposed to integrate populations into the economic realm of Spain and eliminate these inefficiencies. Beginning in the middle of the century, the mendicant orders were removed from doctrinas, or “protoparishes” of Indian subjects (many were still administered by the Augustinian, Dominican, and Franciscan orders), which were placed under the authority of diocesan priests. With the appointment of regalist or reform-minded bishops to posts at the top of the ecclesiastical hierarchy in the Americas, vast territories were implicitly attached more firmly to royal control.¹⁵ The secularization of parishes accelerated in the wake of Spain’s defeat at the hands of the English in the Seven Years’ War, when reformers under Charles III (1759–1788) sought to diminish the privileges and social influence of corporate communities, especially those of the Catholic Church.¹⁶

The intent was to transition from the traditional partnership between monarchy and the church, in which priests and district governors were powerful mediators between Indian communities and colonial authority, to one in which governance was centralized and rule-bound.¹⁷ José de Gálvez (1720–1787) epitomized this modernizing spirit. As minister of state, he instituted new French-style intendancies designed to temper the influence of semi-independent creole administrators, whose payment for posts and vast social networks motivated them to turn a profit rather than serve the Crown. Promulgated in 1786, the new royal ordinance (Real Ordenanza de Intendentes) transformed provincial capitals into administrative centers under the rule of salaried intendants who were assisted in the countryside by subdelegates.¹⁸ The decades-long movement to secularize parishes, standardize fees and feast days, and introduce Spanish-language instruction to indigenous pueblos encountered opposition from both priests and parishioners.¹⁹ But in commerce, administration, and education, the ideology of enlightened governance made a mark on the countryside.

Less often considered within this movement is the emphasis on administering healthy populations. On April 15, 1785, José de Gálvez wrote to the viceroy of New Spain—at the time, his brother—to inform him of the king’s wishes to protect his American subjects from infectious disease. Administrators in New Spain were to enact a program for disease management that had recently been followed to good effect in Louisiana. Sick persons, conceived as sources of contagion, were to be isolated in a chapel or rural building, distant and downwind from populations to avoid contamination of healthy persons. Gálvez assured his brother that these measures posed minimal risk to Spain’s American vassals (“el ningún riesgo que de su ejecución puede resultarles [sus vasallos de América]”). When Bernardo de Gálvez (1746–1786), former governor of Louisiana and Cuba, succeeded his father as viceroy of New Spain months later, he declined to issue the bando that his uncle had ordered; instead he left the mandate to prelates and secular administrators to enact. He apparently thought this route more effective and was overwhelmed in any case by the devastating famine that he faced in his brief term as viceroy. Bernardo de Gálvez died after just a year in office, at the age of forty, perhaps himself a victim of rampant disease.²⁰

The program enacted the idea that disease spread by communication with infected persons, which meant infirmaries at a distance from nucleated settlements, rapid separation of infected victims, and limited contact with patients. Adapted from a 1784 medical treatise by the Spanish surgeon Francisco Gil (whose anticontagion measures had reportedly been tested in the royal monastery of San Lorenzo, on the island of Mallorca, and in Spanish-governed Louisiana), it temporarily resolved the debate over inoculation by rejecting it as too dangerous, in favor of quarantines and cordons sanitaires around infected communities. An extract of Gil’s treatise circulated to parish priests and royal governors in 1788, with orders to follow its instructions in the event of an outbreak.²¹ Resembling in its specifics measures enacted in medieval England and Italy to contain plague and other contagious diseases, the program was novel in its universal implementation, in the incorporation of medical opinion about infection by proximity (as opposed to miasma), and in its vision of governance in which public utility necessitated restrictions on movement, even when potentially harmful to commercial interests.²² Thus it bore the features of the moment: uniformity through fixed rules, to be enforced without preference (“sin distinción”) of caste, class, or gender.

Disease management had become one of the means to a productive state and a measure of Spain’s modernity. Inspired in part by European models of statecraft and sanitation, public health initiatives evolved in tandem with bureaucratic restructuring of the countryside and signaled the most comprehensive plan of defense against disease yet. The program was characterized as a restraint on arbitrary private interest (and corporate exemptions) to restore the “liberties” of Spanish subjects to be productive contributors to the Spanish state. Defending American pueblos from the ravages of infectious disease—whose consequences went beyond mortality to include the debilitation of producers and consumers, social unrest, and flight from devastated villages to cities that filled with destitute and starving masses—would, it was thought, allow Spain to participate on more equal footing with France and Britain for territory, trade, and oceanic supremacy.²³ Administrators on the ground were motivated to eliminate desórdenes well beyond the cities in which antiepidemic and sanitary measures had usually been applied before.

As a result, by the time a ship armed with Edward Jenner’s smallpox vaccine reached the port of Veracruz in 1804, communities across colonial Mexico had years of experience with modernizing health initiatives. Officially known as the Real Expedición Filantrópica de la Vacuna (Royal Philanthropic Vaccination Expedition), the undertaking has long been recognized as the start of mass vaccinations in Mexico. Twenty-two children along with nurses, caretakers, and physicians set sail from La Coruña, Spain, in November 1803 to transport vaccine to subjects across the four continents of Spain’s empire. Following stops in the Canary Islands, Puerto Rico, Caracas, and Cuba, teams moved across Mexico by horse carriage and by foot to transfer vaccine to children, to train practitioners and administrators, and to establish vaccination juntas in district seats and capital cities to coordinate future efforts. It was an unprecedented achievement, but its story, in which communities struggled to make immunized populations a reality, is inseparable from a deeper history of reforms in managing disease.

Enlightened Immunity locates the vulnerabilities of late colonial public health projects, as evident in expressions of confusion, contradiction, and contestation. One paradox had to do with the role assigned to the Catholic Church, traditionally a pillar of viceregal power whose members were at once sympathetic to the reforming spirit and part of an institution under threat. José de Gálvez, viceroys, magistrates, and local authorities in New Spain all turned instinctively to parish priests when they sought to implement reforms. Guevara signaled their authority when he contrasted the esteem in which the lower classes held the viceroy and Mexico’s archbishop; while the former was shown little consideration in public, the prelate received extraordinary demonstrations of respect. In Guevara’s words: “Once the plebeians (who make up without doubt four-fifths of the crowds in this city) see him at a distance, even if in his carriage, they make ready, halt, and even kneel, devoutly removing their hats to receive his blessing, and remain several minutes directing their gaze at him and by their demeanor show the most humble and blind deference.”²⁴ Such displays elicited grudging respect from Guevara, who reasoned that the clergy must be involved in instituting reforms, by persuading parents from the pulpit and in the confessional, for instance, to teach modesty and public cleanliness to their children. Plenty of prelates were ardent reformers; it remained to ensure that such a potential force for progress not become an obstacle to change. The role of priests in public life would be constrained, as some hoped, or else more rational public health practices would penetrate within colonial society. According to Guevara, both would not prevail.

DISTANT ENCOUNTERS: THE WIDOWS OF GUICHICOBI

In January 1796 communities of salt workers, fishermen, and farmers on the Isthmus of Tehuantepec, the narrow landmass that connects the heartland of Mexico to Chiapas and Guatemala, were tasked with enforcing the new anticontagion regime as smallpox spread into New Spain. Not only were parents there asked to relinquish their infected children to isolation, villagers were recruited to assist by providing care and patrolling roads. In San Juan Guichicobi, two widows who had volunteered to minister to the sick children in the infirmary on the outskirts of the village approached Joseph Mariano, the friar overseeing preparations, about an apparent oversight. In halting Spanish they asked, “Father, if a child cries during day or night and wants to feed, who will call its mother to give it milk? We no longer have it.” Lifting their huipiles (cotton blouses) to illustrate their point, they bared their breasts, which looked to the friar like the slack pouches used to transport pulque (agave liquor) or the sagging buttocks of a corpse. Mariano reassured the women that he knew how to make a milk substitute from wine, beetles (cochinita de humedad), and atole (a corn drink) with butter, to which they allegedly replied, in their native Mixe, “Who knows if that is true?”²⁵

Contemporary medical understandings of infectious disease, distilled in a program of prevention and treatment by Bourbon reformers, affected some of the poorest producers and tributaries at the end of the colonial period. Viceregal orders prohibiting villagers from interacting with contagious members of the community targeted susceptible children especially but somehow failed to address nursing infants or the provision of milk (to say nothing of milk substitutes). The question posed by the widows, expressing commonsense anxieties about sustenance and the dangers of the new infirmary, along with the friar’s response, alluded to material conditions in which the livestock that might provide an alternate source of milk were scarce, as were other resources to sustain villagers under quarantine. In effect, the exchange between the bilingual widows and their pastor was part of a combined effort to improvise a solution, to make viable a modernizing scheme developed for places that were more hypothetical than real.

The significance of the encounter in San Juan Guichicobi depends as well on what the historical literature on medical reform in Spanish America has trained us to see. Even if economic activity brought producers, merchants, and carriers on the Isthmus into regular contact with other ethnicities, classes, towns, and regions, it was a place viewed by administrators (and by Mexicans and travelers since) as remote in linguistic, cultural, and geographic senses. Because of an accident of geography, with Tehuantepec in the immediate path of contagion, many villagers nevertheless had early and immediate experience with experiments in disease prevention, and they responded to measures that depended for success on communal cooperation. Villagers there and elsewhere would soon express an opinion about the sanitary and quarantine measures in which they were involved. These laypeople appear awkwardly in a literature that has tended to emphasize critical publics for Enlightenment learning as masculine, urban, creole, and literate. Enlightened Immunity, the first full-length study of the inception and reception of public health programs in Mexico during this eventful period in the history of medicine, seeks to revisit and reconsider the ways they fit in the picture.

Seeing through the haze of the intervening centuries is a tricky proposition. In the last decades of the nineteenth century, germ theory and modern immunology, backed by modernizing states and informal empires, helped justify unsavory medical campaigns throughout Latin America. Under the influence of critical theory (from Foucault’s history of “biopower” to the feminist questioning of patriarchal structures), the modern developments once hailed by historians of medicine look rather regressive in retrospect, compelling us to understand the ways in which ordinary people experienced the state and medical power as untrustworthy, disciplining, or intrusive. Examples for Latin America abound. In the name of public health and progress, social workers, psychiatrists, medical doctors, and the police regulated and reformed some of the poorest citizens of Mexico.²⁶ Favelas and tenements in port cities were razed, emptied, and fumigated, and their sick isolated in sanatoriums. In 1901, when yellow fever threatened the economy of the United States, sanitarians and engineers from the occupying government teamed up with Cuban health officers to implement invasive sanitation measures on the island, including a mosquito eradication campaign that ruined supplies of drinking water.²⁷

The spread of immunization, so emblematic of advances in scientific health care, took place in campaigns that were no less heavy handed. In 1904 a forced immunization drive in Rio de Janeiro coincided with an assault on tenements, under the auspices of an urban renewal and beautification project, and precipitated a major riot that forced the government to rescind a compulsory vaccination article in the health code.²⁸ Though many submitted willingly, more than a few of those immigrants and working poor who dared resist elsewhere were vaccinated at gunpoint or under threat of corporal punishment. Multiplied, examples would seem to illustrate the rise of what the anthropologist James Scott has called the “high modernism” of twentieth-century totalitarian states. He traces the impulse to impose rationalism and order on populations through control of environments, bodies, and health to the eighteenth century, when governments across Europe acquired the desire and capacity to engineer ambitious human-improvement programs in a “broadening and deepening” of old objectives of statecraft related to productivity and human health.²⁹

With their utopian ends and tendency to regard local knowledge and experience in reductive or dismissive ways, the reforms in health pursued by Bourbon ministers, prelates, intendants, priests, district governors, and physicians in Spanish America seem to invite similar assessments. The Bourbon monarchy generally sought to restrict the flexibility characteristic of their Hapsburg predecessors, after all, and to that end promulgated reformist programs that were less tolerant of regional variations and customs. Occasionally these schemes were put into practice violently. A study of the neighboring kingdom of Guatemala turns up examples of intimidating shows of force and “militarized spaces” in inoculation campaigns during the mid-1790s, including the erection of pillars to whip intransigent subjects, which gave way to a medicalized society with the arrival of Jennerian vaccine.³⁰ Research on subsequent vaccination campaigns highlights both symbolic and physical violence, as when a smallpox outbreak in Guatemala’s western highlands moved the creole physician (and future president) Cirilio Flores to impose quarantine on Quetzaltenango in April 1815. Following attacks by Indian residents on the quarantine house to liberate its patients, the priest in Tejutla, fearing a general riot, demanded an end to invasive house inspections and coercive vaccinations. Sixty armed men were nevertheless stationed around the plaza during Easter week to ensure compliance. In historian Greg Grandin’s interpretation of these incidents, they are symptomatic of a trend toward state meddling in “nearly every aspect of community life” in the pre-Independence years, and prefigured the liberal state’s interventions in a 1837 cholera outbreak, when it sought to incorporate Indians as modern, hygienic, educated, ladino (non-Indian) citizens.³¹ Honed in medical campaigns, elite paternalism in regard to Indians apparently found ever-greater expression in an era of heightened nationalism and liberalism.

The Mexican case offers striking if not surprising similarities having to do especially with the way acculturating discourses and projects acquired focus through medical practice. In a 1780 smallpox outbreak, one priest in rural Oaxaca pronounced that “all of the Indians, generally speaking [generaliter locuendo], have such horror and fear of the hospitals that it is not possible to persuade them to go there to be healed, because they respond that they die.”³² Such commentaries on Indian nature were among the more innocuous tropes propagated during epidemics. Often these gave way to blanket condemnations of superstition, stubbornness, or timidity; violent campaigns against temascales (sweat baths) and other rural healing practices involving alcohol or herbal treatments; and occasionally even whippings or incarceration of villagers who contravened orders for quarantine to seek out markets or tend their fields. At the same time, the Mexican context suggests a meaningful contrast. Administrators invoked and cautiously monitored public opinion, aware of the considerable dangers of popular discontent. Assaults on local healing practices by medical officials or priests might turn villages into states of siege, but communal flight and protest remained viable options long after teams of vaccinators first arrived in the countryside. Documented violence is exceptional, in other words, perhaps because violence was an expensive and ultimately ineffective way to manage public health if prevention was to “work” in any sense.

And there were undoubtedly successes in disease management, no less significant for being modest. Hundreds of registers in archives in Mexico and Spain document the names, ages, and caste status of children vaccinated by priests, district governors, physicians, and local healers, a feat sustained, with starts and stops, through years of insurgency. These sources present a puzzle that has not been sufficiently explored in the literature on medicine and health care in Latin America. Why, with little prior experience and so many reasons for suspicion, did parents allow their children to be immunized in the first place? Medicine was still firmly in the ancien régime: therapeutics remained ineffective, controlled tests were few, and the population was overwhelmingly rural and illiterate. Even today, with the benefit of historical perspective, studies in peer-reviewed journals, and far higher literacy rates, immunization can be controversial. Why did peasants voluntarily participate two hundred years ago, when so much conspired against it? How did certain schemes to improve the human condition succeed?

The introduction of preventive techniques forms a pivotal chapter in the history of medicine and public health, yet the historical literature on Mexico offers few sustained descriptions of how campaigns operated on the ground, much less explanations for why parents assented to epidemic measures or immunization technologies when they did. More nuanced understandings of the mechanisms of rule, the mediating role of local knowledge, the nature of medical and scientific technologies, and the scope of debate in colonial cities, towns, and villages would help to crossfertilize histories of medicine. The ways in which natural philosophers, physicians, and administrators addressed different publics across regions or invoked their learning is an especially obscure topic, perhaps because Mexico’s geographically fragmented public sphere has discouraged the pursuit of these connections.³³ Broadening the chronological and methodological approach might help to situate disease and public health within a fuller political and socioreligious context.

Instead, the imperial crisis brought about by the Napoleonic invasion of Spain and the king’s abdication of the throne in 1808, so transformative of Spanish America, has marked a rupture for historians interested in the origins of modern modes of sociability, a moment when questions of representation and critique moved to the fore. The political crisis ushered in not only a decade of economic catastrophe, disease, famine, and warfare, but also critical experiments in Atlantic republicanism and self-rule. Studies of political representation and culture in Spanish America emphasize new reading and publishing practices, maintaining an imperiously urban and literary focus on a “geography of modernity” that is almost perfectly coextensive with places of print and literacy, above all Mexico City—at the time second only to Madrid in publishing.³⁴ In histories of medicine and public health, this emphasis is reinforced by the fact that publication and correspondence about scientific matters took place in urban centers, where the handful of institutions that promoted, produced, or divulged “modern” medical practice and scientific methods were based.³⁵

Some of the most compelling research on late colonial Spanish America has challenged the assumption that people acquired information about their world or engaged in politics primarily through print and political literature. Studies have taken issue with the “public sphere” model as developed by the German social theorist Jürgen Habermas, which emphasized what appear retrospectively as the most modern modes of communication, to the exclusion of other ways of sharing and shaping information, such as pasquinades and rumors.³⁶ The historian of science Jorge Cañizares-Esguerra stands out for questioning both the primacy of textual analysis and the embrace of Europe (and specifically France) as the core of the Enlightenment universe: creole intellectuals in Mexico City spilled much ink refuting European works that disparaged the populations of the New World as physically, culturally, or intellectually inferior and elaborated an “aggressively modern” historical project that, in certain respects, was not literary at all. By examining ancient Mesoamerican monuments and ruins, glyphs, and Mexican antiquities, these creole writers illustrated the superiority and antiquity of the New World while showcasing the critical capacities of Americans. Though the protagonists are similar—clergy, students, and intellectuals in a cosmopolitan center oriented toward the Atlantic world—the political pamphlets in studies of high politics are secondary, drastically altering the picture of Enlightenment knowledge.

With the shift to this side of the Atlantic and a more eclectic documentary base, barriers of class, gender, and geography have yet to be crossed. Histories of science that move to deemphasize national boundaries and narratives of progress tend to highlight the accomplishments and identities of those creole classes that most actively fueled Iberian expansion in the early modern world and eventually formed the political backbone of the new Latin American nations. It remains difficult to shake the notion that a critical “willingness to question authority,” taken as a fundamental characteristic of the “radical modernity” of Spanish America, was for the most part limited to elite, literate, Spanish circles.³⁷ The construal of the modern critical mind’s genesis at the upper echelons is largely a result of the objects of study—history writing, scientific investigation, political philosophy, and national identity.

If the major problems in need of consideration are a matter of perspective and definition, how are the dominant “practices and ideas” defined, and by whom? By restricting these to questions of nationalism, the decline of empire, class identity, and the significance of Mesoamerican artifacts and civilization for modern polities, the opinions and concerns of many ordinary people—peasants, artisans, weavers, and others who were not trained scientists, technicians, inventors, natural historians, collectors, or functionaries—have been inadvertently marginalized. Most laypeople in New Spain did not, strictly speaking, consume technical scientific studies in Mexico City’s literary journals as part of a reading public, or contribute in writing to its production by way of debate, experimentation, or collection, although whether they contributed otherwise is another matter. They were peripheral insofar as most lived beyond centers of publication and were infrequently involved in industry and major problems of statecraft. In sum, the historiography has made clear, on one hand, that Mexico in the eighteenth century was enlightened in unique ways; on the other hand, it has generally not considered how various parts of society fit into the whole. That the lower classes were excluded or forsaken is often assumed, rather than demonstrated.

Disease presented society with another sort of crisis of equal or greater concern to people than the political, historiographical, or absolutist ones.³⁸ From the beginning of Spanish rule in the Americas, contagious disease was a constant wherever European friars and settlers traveled to gather converts to Christianity.³⁹ These “virgin soil” epidemics, caused by pathogens and vectors against which indigenous populations lacked immunological defenses, were particularly destructive in their physiological, social, and cultural effects. In acute infections of measles or smallpox, chronic diseases such as typhoid or dysentery, and tropical and semitropical ones such as malaria, microbes wreaked havoc on human bodies and communities. Preceded or accompanied by drought, famine, or warfare, disease outbreaks might weaken or depopulate communities to the point of total collapse and exacerbate subsistence crises, which had grave implications for the Europeans who depended on these ailing communities for food.⁴⁰

For the “mature” colony of Mexico, spanning the eighteenth and early nineteenth centuries, studies of demographic impact, timing, and regional variation show that the effects of disease on human migration, land tenure systems, and sanitary reforms remained considerable.⁴¹ Cycles of settlement along the northern frontiers of New Spain even recapitulated some of the early demographic, epidemiological, and immunological patterns. In the mid-eighteenth century a Jesuit priest in the Pimería Alta, in Sonora, observed that a great scourge of measles had decimated fully half the Indian population of the cabecera (head town) of Tubutama—but also, miraculously, brought into the mission residents of outlying settlements, apparently for subsistence and baptism.⁴² Although not all contemporaries invoked the hand of God to explain such episodes, it is rare to read sources from the period without finding some trace of famines, acute infections, anxieties about health, and physical disease.

When epidemics struck, intellectuals, bureaucrats, physicians, merchants, priests, and village leaders converged to cope with heightened mortality, pursue explanations, and restore stability. Bureaucrats and physicians arrived as urban emissaries in barrios and outlying Indian pueblos to heal, diagnose, and report, sometimes leaving behind rich documentary trails.⁴³ Not only officials and medical practitioners, but also pamphlets, microbes, plant remedies, and instruments moved across the Atlantic and between cities and their hinterlands; eventually Jenner’s cowpox vaccine followed these itineraries into provincial capitals and beyond. One such traveling object, the pastoral letter (carta pastoral), like the sermon, aimed to inculcate proper Catholic practice, orient the faithful toward God and the Catholic monarch, and define what it meant to be a good Catholic. One such carta issued by the bishop of Oaxaca to priests and parishioners in his diocese conveyed news of the arrival of the vaccinating expedition from Spain. Exhorting parents and grandparents to adopt vaccination for the young, Jenner’s vaccine was presented as divinely ordained and a gift from King Charles IV (1789–1804), who had previously provided schools for Castilian language instruction and improvements in industry, agriculture, and the arts. Now the king sought to secure the health of his vassals at great cost, “to protect you from the contagious illness of smallpox.” As copies traveled to parishes throughout the countryside, the carta linked the Spanish capital of Antequera to auditors in the parishes of Oaxaca, where portions were read or paraphrased; mediated between literate and oral cultures; made present the monarch in virtual interaction with his American subjects; conveyed Jenner’s experiments in England to vaccinators and parents in rural Mexico; and finally, as the bishop surely intended, aligned the celestial realm with the terrestrial, where the vaccine was to be used.

This ecclesiastical genre makes rare appearances in histories of disease and preventive medicine. Rather than assume that the announcement fell on deaf ears, following such an intermediating object across geographic divisions discloses another dimension of the way preventive techniques and programs were communicated, interpreted, and occasionally adopted. Applying this same hermeneutic to more traditional sources, such as instructional pamphlets and periodicals, we can discern some of the features of and reasons for practice. While some were dismissive of the lower classes, others believed that medical science might accord with popular views and earnestly tried to close a perceived educational and cultural gap. The authors of a simple instruction (método sencillo), published to treat fevers and pulmonary illnesses afflicting residents of Mexico City in the early Republic, employed “a simple language,” they wrote, avoiding “the technical terms of the art [of healing]” in order to “place science within the reach of those who do not understand it.”⁴⁴ Such vernacular productions and scientific transpositions had their beginnings in the colonial past, when attempts to teach people best practices in healing or the latest fashions in medical science required translations in the dual sense: knowledge physically relocated, and converted into other media, forms, and systems. Though Bourbon reformers complained of the number of intermediaries that stood between Spain and its tributaries, in colonial Mexico, where even saints performed indispensable mediating roles for towns and villages, preventive medicine would have remained a utopian dream without these intermediary links.⁴⁵

The story told in this book is as much about false starts and minor victories as the “conquest” of a particular disease. At the nexus of pueblos de indios, the Catholic Church, and urban institutions and media, it takes its cue from studies of the Enlightenment that insist that other ways of apprehending the world made possible the production of knowledge.⁴⁶ Not only were these epistemologies, or modes of knowing, compatible with textual learning; literacy is imperfectly understood without these dimensions. Scholarship on the French case proves illustrative. In the years preceding the French Revolution, the monarchy and Parisian police devoted considerable resources to gauging rumors uttered by popular classes, because speech conveyed newsworthy—and potentially dangerous—information and criticism. If not public opinion in the Habermasian sense, this style of speaking warrants serious consideration because it shaped perceptions and attitudes (and was taken seriously by authorities as an expression of popular mood).⁴⁷ In the following century, residents of rural France are said to have lived in an “auditory landscape,” in which, following a revolutionary campaign to desacralize bell ringing, the practice once again communicated messages and news from a national sphere beyond the village. Bells became “a prerequisite of modernity,” according to historian Alain Corbin, “in a society increasingly subject to haste but as yet without any other means of transmitting information simultaneously.”⁴⁸ The same scholar has documented a “perceptual revolution” in the olfactory register, beginning perhaps with the vinegar used in France’s battle with miasmic putrefaction. Vinegar reflected a relationship between chemical science and broader cultural practice; while communities of experts weighed, measured, and classified harmful exhalations in the atmosphere to quantify disease, society became more attuned to foul odors in everyday life. “We have lost sight of that connection,” Corbin observes, “because we operate with a history of science that favors the discovery of scientific truth and neglects the history of scientific error.”⁴⁹ Focusing on reading publics alone obscures the multiple forms of social criticism, perception, and practice that were not strictly literary but that made a difference in the adaptation, elaboration, and experience of enlightened knowledge.

Whether they intended a playful meaning, by baring their breasts the widows of Guichicobi communicated what they knew and feared about complications resulting from the separation of unweaned children from their mothers. To understand this exchange and the binaries (clergy / laity, male / female, urban / rural, European / Indian, scientific literacy / folk orality) that structure it, we need a sense of the endogenous knowledge and rituals that conditioned external forces and policies. Whatever his thoughts about their rusticity, the friar reported their words and actions, suggesting one way that embodied, multilingual exchanges produced effects beyond local settings. Other villagers critical of government policies did not hesitate to raise matters that urban bureaucrats and physicians had not sufficiently considered when formulating public health policies and occasionally ventured “to express their interests in loud, coarse, and, yes, abrasive ways.”⁵⁰ In this manner authorities were compelled to come to terms with what laypeople knew about disease and health, and what they reckoned the important questions to be.

Disease prevention, like any scheme to conquer or convert, was a matter of what anthropologist Marshall Sahlins called “distant encounters”: unpredictable meetings of communities with agents of state-sanctioned policies and practices. Tracking these encounters, we will see more clearly the restraints on critique in a compound public sphere fractured by class, gender, generation, geography, and caste, as well as restraints on the authority of scientific reason.⁵¹ The world contracts in curious ways when infection travels, according to the living logic of microbes instead of the paper logic of colonial Mexico’s cordoned administrative units. The resulting encounters put into relief the conflictual and unpredictable structure in which global policies and technologies and notions of public happiness acquired relevance (as menaces or benefits) for “consumers” and “producers” beyond those who ordinarily read scientific journals or followed intellectual debates in societies or periodicals. These laypeople—agriculturalists, artisans, day laborers, the urban underclass—were not mere spectators of the encroachment of state policy on intimate and communal spheres of life but participants in it. They felt these developments in powerful ways, and it is fairly inconceivable that they would not have had something to say.

ORGANIZATION OF THE BOOK

Enlightened Immunity situates the eighteenth- and early nineteenth-century transition in medical techniques, theories, and policies within a backstory of epidemic management in colonial Mexico. The organization is a methodological nod to the epistemologies and habits through which people viewed their world, their environment, and their health. Individual chapters in Part I (“Contagion”) examine the complex of rituals and practices—religious, political, and medical—to which communities turned to resolve disease emergencies and address public health reforms. Part II (“Immunization”) is a case study of the rituals, debates, and complications surrounding the introduction of preventive techniques in Mexico.

Most scholars agree that the peste that struck the Valley of Mexico from 1736 to 1739 was an outbreak of typhus. The epidemic decimated cities and wiped entire villages off the map.⁵² Preceding the outbreak, the louse-borne bacillus that causes it would have been invading human settlements and larger cities from the countryside, where months of failed harvests (occasioned by droughts and hailstorms) had destroyed the grains on which their hosts fed. Contemporaries did not perceive the microbial culprit, or the virus that spread smallpox across the viceroyalty in 1779 or 1796, which required sufficient numbers of immunologically vulnerable human hosts to survive. Nor were they likely to identify the coughs and sneezes that spread pneumonia or pleurisy, what contemporaries called “dolores de costado,” following another viceregal-wide famine around 1784.

Instead, residents of colonial Mexico turned to saints, herbal remedies, and cordons sanitaires to combat these disease outbreaks. The epidemic of 1737 in Mexico City, documented by an eyewitness and promoter of the cult of the Virgin of Guadalupe, provides a point of departure for a deeper history of public pageantry in cities and towns, when appeals to saints transformed urban centers into thoroughfares of statues and devotees. Chapter 1 examines how these dramas were regularly sponsored by corporate bodies and actively solicited by laypeople well into the eighteenth century, when administrators aggressively pursued sanitation and hygiene campaigns alongside divine succor.

Publishing practices in the Atlantic world inspired physicians, natural philosophers, clerics, and others conversant in learning about climatic conditions, sanitation, and the sciences of anatomy, botany, chemistry, and statistics to forge connections with one another and with communities in need to improve medical care in New Spain. Chapter 2 examines this process beginning in 1768, when the rise of a scientific periodical press offered a novel means to collect and disseminate learning about health care, natural remedies, and scientific developments. Reproducing a conceit of colonial healing manuals, the print culture of the Enlightenment went further to shape a repository of vernacular knowledge from correspondents in cities, towns, and villages. Some even hoped that this venue might induct a broader swathe of women, Indians, and mixed-race castas into scientific and medical practice.

The government’s anticontagion measures occasioned novel experiments in disease management with the arrival of another epidemic of smallpox at the end of the eighteenth century. Chapter 3 draws on judicial inquiries, administrative correspondence, and legal briefs and petitions filed by guilds, villages, religious orders, and administrators to reconstruct the complaints of agriculturalists, artisans, merchants, priests, and local governors as communities wrestled with disease and royal policies. Following months of social unrest in the intendancy of Oaxaca, the viceregal government confirmed the technological shift already under way in rural villages by endorsing inoculation. Colonial Mexico’s mediated social structure, oriented toward commerce, production, and revenue, gave a platform to the voices of many more rural actors aggrieved by the official measures. Their concerns form the core of the chapter.

These experiences tilled the landscape for Jenner’s smallpox vaccine. Part II examines the ways in which the new technology traveled, through multiple media, communities, and personnel, and years of insurgency. Today, vaccinations against deadly diseases are often genetically engineered in labs, to simulate one portion of a virus to stand in for the real thing. The early modern approach was at once simpler and more complex. It involved introducing into otherwise healthy, nonimmune persons a live version of the virus against which it was meant to protect. In the earliest practice, human smallpox was often simply injected into the skin, which produced a mild case of smallpox. Known as inoculation, or variolation, the procedure triggered the formation of antibodies that conferred protection against a deadlier case. The term “vaccine” derives from inoculation’s replacement: the Spanish word vacuna referred to the bovine variety of smallpox virus, or cowpox, injected from an infected cow (vaca) into a person. The infection similarly produced antibodies to protect against the human virus, but with lower risk of death, and without the possibility that it might spark an outbreak of smallpox. Whether drawing on a reservoir of smallpox or cowpox, the organic material was often transmitted from person to person, by transferring the fluid from the mature pustule on the arm of an immunized person (the “arm to arm” method).

Today the public health principle behind this method of prevention is called herd immunity, which refers to the way that the protection of enough individuals against disease works to defend an entire community. Early modern views on the mechanism were more diffuse, with considerable disagreement about how the procedure worked, who was capable of practice, and its value and safety.⁵³ Drawing on the insights of historians of science, who note that novel technologies must be “domesticated” before they work, as well as previously unavailable archival records of immunization campaigns in Mexico, this section of the book situates the twice-told tale of the Royal Vaccination Expedition against immunization’s promotion and practice over decades.⁵⁴ Moving thematically and chronologically, the chapters show how ceremonial routines, colonial healers, and political rituals brought laypeople into contact with foreign medical matter and techniques and fulfilled, however imperfectly, vaccination’s radical potential.⁵⁵

Chapter 4 traces the domestication of the technique in medical treatises, sermons, pastoral letters, legal briefs, and public ceremonies, as physicians, bishops, and ministers aimed to convince governments, parents, and other caretakers of its value. These colonial genres and rituals, along with gifts of coins and cookies to parents and children, rendered preventive medicine viable and sacred for diverse publics in New Spain. These ceremonies did not last, however, and in the chaotic decade of insurgency (1810–1820)—a time of acute warfare, infection, and famine—the ability of a shattered government to sustain programs of disease prevention was overwhelmed by a perennial shortage of funds. Chapter 5 considers the types of skill and expertise involved in the propagation of vaccine in these years. Priests, female healers, Spanish administrators and Indian governors, as well as barbers and surgeonsm helped coordinate vaccinations in campaigns that adhered to the dictates of disease outbreaks and warfare as often as those of medical professionals. The final chapter returns to the experience of medical reform in pueblos de indios, where rumors and political action mediated the arrival of urban practitioners, Atlantic technologies, and Enlightenment convictions. This process allowed parents and Indian officials to assess and interpret these medical interventions, discern efficacy, and occasionally shape more acceptable campaigns.

The Royal Vaccination Expedition has from its inception been a source of considerable national pride and contention, which requires an additional note. Upon the triumphant return of its director, the Spanish surgeon Francisco Xavier de Balmis (1753–1819), to Spain after circumambulating the globe, readers of a special edition of the Gazeta de Madrid learned not only of the feats of the team throughout Spanish America, “and even including the gentiles and neophytes of the Pimería Alta” (on New Spain’s northwestern frontier), but of the fact that Balmis had introduced vaccine in Macao and Canton, China, which not even the English had managed in multiple attempts. In case the irony was lost on readers, the article stressed that though the English nation had discovered and publicized vaccine, it was the Spanish who were consummating its use.⁵⁶ This national myth making was no less evident in the counternarrative being written in Mexico City, where a special issue of the viceroyalty’s newspaper, the Gazeta de México, announced the successful vaccination of several orphans in the capital’s foundling home—months in advance of the expedition’s arrival. This feat had been made possible with vaccine fluid acquired from Havana via the ayuntamiento (city council) of Veracruz, thanks to the viceroy’s patronage and the patriotic efforts of creole physicians.⁵⁷ When the Spanish surgeon José Salvany arrived in the capital of Lima, Peru, as head of the South American branch of the expedition, creole councilmen and physicians there were even less inclined to credit him with success or follow his lead.⁵⁸ (For their part, both Balmis and Salvany later cast aspersions on the quality and viability of these early American vaccinations.)

Full-throated claims in print to the glory bestowed on nations and people by a modern public health program attune us to the considerable stakes of this history, which frequently exacerbated elite rivalries by pitting the paternalism of peninsular physicians, natural philosophers, and authorities against the “patriotic science” (in Cañizares-Esguerra’s phrase) of creoles. Discussion of these conflicts has been mostly relegated to chapter notes in this book because they have been well studied elsewhere and because they were often less salient to the actors whose views are highlighted.⁵⁹ Instead, these chapters pursue realities of disease, quarantine, and vaccination that have been less fully documented, including matters of ritual, technology, genre, accessibility, and emotion, which no less shaped this late movement to improve the health of New Spain’s populations.

In Mexico smallpox was declared eradicated by President Miguel Alemán Valdés in 1952, following more than 150 years of work by physicians, nurses, priests, administrators, and medical brigades to introduce vaccine in the countryside. By then, medical practice and ideas about disease and immunity had changed dramatically, but preventive medicine still depended on familiar political routines and stoked the fear and anxiety of parents and children. Today, conversations about the possible hazards of immunization—from autism to multiple sclerosis to infant death syndrome—proliferate in even the most “developed” nations. In the United States, where the polemics have been especially virulent and vaccination rates comparatively low, citizens reluctant to vaccinate their schoolaged children can make use of personal belief exemptions (PBEs) to opt out.⁶⁰

With a far more complex immunization schedule—vaccines for measles, mumps, rubella, diphtheria, tetanus, chickenpox, and pertussis—and more literate and informed citizenries, we have scarcely stopped debating imperatives of public good, divine will, and human liberty, and what peasants in colonial Mexico might have called manos poderosas in the form of politically influential chemical and pharmaceutical industries, seemingly poised to compromise public health and the natural health of our bodies.⁶¹ The logic of this skepticism merits serious consideration. In considering the patrons, benefactors, healers, and translators who worked as mediators across different communities and cultures in colonial Mexico, there may be lessons for us in the history recounted in this book.

Notes

1. Biographical details are from Esteban Enrique Morel, “Disertación sobre la utilidad de la inoculación, escrita de encargo de la nob^ma Ciudad de Mexico,” AHDF 3678 exp. 2; and Schifter Aceves, Medicina, minería e inquisición, 37. Unless otherwise noted, all translations into English are the author’s.

2. Morel, “Disertación,” 59v.

3. Ibid., 1r. On Morel’s struggles with Mexico City’s ayuntamiento, see Schifter Aceves, Medicina, minería e inquisición, 18–19.

4. For a recent volume in this direction, see Paquette, Enlightened Reform in Southern Europe and Its Atlantic Colonies.

5. Baltasar Ladrón de Guevara, “Discurso sobre la policia de Mexico: Reflexiones, y Apuntes sobre varios objetos que interesan la salud pública y la Policia particular de esta Ciudad de Mexico, si se adaptasen las providencias o remedios correspondientes,” AHDF 3627 exp. 43, items I, II, VII, VIII, X, XVIII, XIX, quotation from para. 154. The archival copy is a borrador, with corrections. For a transcription with introduction, see González-Polo, Reflexiones y apuntes sobre la Ciudad de México. Guevara cited his role in the establishment of comisarios de barrio, which he had proposed in September 1778 and executed in the following years. A decade later, however, he considered them a failure owing to the lowly status of the people who had been commissioned to oversee policía in the new cuarteles.

6. Beezley, Martin, and French, Rituals of Rule, Rituals of Resistance; Viqueira Albán, Propriety and Permissiveness; and Bailey Glasco, Constructing Mexico City.

7. Owensby, Empire of Law and Indian Justice in Colonial Mexico, 58–77. The lawyer Hipólito Villaroel’s treatise on the “political illnesses” of Mexico City (1785) is sometimes cited as evidence of elite disciplining efforts, but his disapproving gaze was also turned on the vices and excessive liberty of the upper classes, who were no less threatening to good order. Villaroel would have known: he was accused before the Juzgado General de Indios of abuses committed during his time as district governor (alcalde mayor), including distributions of merchandise to villagers in the practice known as repartimiento de comercio. See Borah, “Alguna luz sobre el autor de las Enfermedades políticas,” 62–66.

8. Núñez de Haro y Peralta, Nos el Dr. D. Alonso Nuñez de Haro y Peralta, por la gracia de Dios, 1779.

9. Tissot, Aviso al pueblo acerca de su salud, 10–11 (the Spanish edition of Avis au peuple sur sa santé). Though fears of depopulation were overdrawn, the size and health of the population “was considered an essential component of the wealth of nations” (Rusnock, Vital Accounts, 39).

10. Campomanes y Sorriba, Discurso sobre el fomento de la industria popular, 52.

11. Torre Villar, Instrucciones y memorias de los virreyes novohispanos, 1070 (item 237).

12. Warren, Medicine and Politics in Colonial Peru, especially the introduction.

13. On free trade reglamentos and the strategic importance of New Spain, see Stein and Stein, Apogee of Empire, 69–80 and 143–175.

14. Brading, Miners and Merchants, 47–51.

15. Scholars debate the degree to which this effort was imposed by the secular state or endorsed by the ecclesiastical hierarchy. For the view that stresses the role of a heterogeneous ecclesiastical hierarchy, see Connaughton, “Transiciones en la cultura político-religiosa mexicana,” 447–466. In support of this regional perspective is the varied timing of secularization: in Puebla, for instance, the process began as early as the seventeenth century due largely to the efforts of Bishop Palafox y Mendoza.

16. The principal blueprint for “defensive modernization” undertaken under Charles III appeared as early as 1743 in José del Campillo y Cosío’s Nuevo sistema de gobierno económico para la América, which was incorporated wholesale into Bernardo Ward’s influential Proyecto económico in 1762, discussed in Brading, Miners and Merchants, 25–54, 63–65, and 74–92. See also Phelan, People and the King, chapters 1 and 2.

17. Taylor, Magistrates of the Sacred, 13–14.

18. Gálvez, Informe sobre las rebeliones populares de 1767, 63–64. Kuethe and Blaisdell, “French Influence and the Origins of Bourbon Colonial Reorganization,” 595–596, downplay the Francophile Gálvez’s role in favor of other ministers and prior efforts internal to Spain. For a recent view that stresses emulation and international influence (especially English and French), see Paquette, Enlightenment, Governance, and Reform in Spain and Its Empire. On obstacles to the abolition of repartimiento in Oaxaca, see Guardino, Time of Liberty, 91–101 and 116–121.

19. On regional variation, see Mazín Gómez, “Reorganización del clero secular novohispano.”

20. Joseph de Gálvez to Señor Virrey de Nueva España, Aranjuez, April 15, 1785, AGN Epidemias 7 exp. 1, 4–5. Reasons for suspending publication of the bando in New Spain were given by the man who served as his secretary: the Conde de Gálvez apparently preferred to pass royal orders to justices and parish priests, for immediate communication of the measures to their subordinates and parishioners. Fernandez de Cordova to Viceroy, Mexico City, September 17, 1797, ibid., 29.

21. Extracto de la obra publicada en Madrid el año pasado de 1784 con el título de Disertación Físico-Médica, AGN Epidemias 7 exp. 1, 9–14. After an original printing of four thousand copies, a revised edition printed in New Spain in 1786 included anecdotal evidence of success by the prescribed method to convince readers of the benefits of its adoption.

22. In the port of Veracruz, fear of contagion propagated by goods and persons arriving on ships from Havana in the spring and summer of 1790 moved municipal officials, in consultation with Viceroy Revillagigedo and the Protomedicato in Mexico City, to subject ships to quarantine in harbor and individual pieces of mail to fumigation when they could not be so detained. When the frigate Nuestra Señora de la Piedad arrived from Campeche with three enslaved women purchased in Havana, who were apparently recovering from smallpox, the governor prevented the women from disembarking in port, and the captain was fined 1,000 pesos for contravening orders not to carry sick passengers. Whether or not he paid, officials were deadly serious about the propagation of infection. Correspondence on the reputed outbreak of smallpox in Havana (more common than exceptional there) and emergency measures in Veracruz is in AGN Epidemias 7 exp. 2. (The final documents on the enslaved women are by the captain, Diego de Mérida, requesting permission to sell them and claiming that they did not show signs of viruelas in two and a half months in his home after traveling from Havana; and the viceroy’s legal assessor, who advises that the esclavas be examined to see whether they are free of contagion and can be sold; see Mérida to Viceroy, Veracruz, June 23, 1790, ibid., 95–96 and following.)

23. The new philosophy of governance correlated the health and productivity of populations to increased tax revenue, trade, and military strength; problems of disease became urgent globally, as evidenced by the way absolutist states employed quantitative studies of populations, achieved by counting births and deaths and tracking life expectancy, health, and average age, as measures for more efficient and enlightened statecraft. Porter, Health, Civilization, and the State; Rosen, History of Public Health; Rusnock, “Biopolitics,” 49–68; and Foucault, “Politics of Health in the Eighteenth Century,” 166–182.

24. Guevara, “Discurso sobre la policia de Mexico,” item XX (titled “Concurrencia eficaz y necesaria de la jurisdicción arzobispal o eclesiástica para la policía de México”).

25. Fray Joseph Mariano to Pedro Fessar, San Juan, January 22, 1796, AGN Historia 531 exp. 3, 39–41.

26. On the higienista “foot soldiers” and their regulation of sexual practices, see Bliss, “Science of Redemption.” On the “scientific” groundwork for many urban renewal and public health campaigns, see Stepan, “Hour of Eugenics.” McCrea, Diseased Relations, 83–94, notes that in Yucatán physicians prescribed expensive beverages like brandy and opiates for outbreaks of cholera in the 1850s, which were inaccessible or impractical for the region’s poor residents.

27. See Espinosa, Epidemic Invasions, chapter 3 and 63–66. Mariola Espinosa notes a cruel irony in the fact that the disease targeted with such zeal was not one that had much prevalence in the local population. Chalhoub, “Politics of Disease Control,” makes a similar observation for Brazil.

28. The revolta contra vacina brought poor and working-class residents from crowded tenements and favelas of the capital’s most marginal districts into the streets for days in November 1904, where longstanding grievances and resentment over the government’s invasive hygienic policies found violent expression. On the centrality of the medical issue, see Chalhoub, Cidade febril, 101–102 and 121–162, which places the moment within a longer history of vaccination. Others have deemphasized the importance of vaccination, including Needell, “Revolta Contra Vacina of 1904”; Nachman, “Positivism and Revolution in Brazil’s First Republic”; and Meade, “Civilizing” Rio, 90 and 75–120.

29. Scott, Seeing Like a State, 51–52.

30. Few, For All of Humanity, 150–152 and 248n39. In Guatemala, inoculation campaigns were entangled in a growing interest in caesarean operations to save and baptize the unborn fetus in the event of its mother’s death. Few portrays this process both in terms of biomedicalization (the colonization of bodies through medical discourse and practice) and as a more compassionate expression of “medical humanitarianism” that gives way to coercion and surveillance owing to the scale on which Jennerian vaccine was enacted (163–164). That the Guatemalan case shows a characteristically modern state apparatus—one capable of making bodies legible through public health measures, accurate censuses, and the experience or threat of violence (199–200)—is not entirely borne out by evidence in the chapter on the expedition. The Mexican case seems to indicate greater variability across space and time.

31. Grandin, Blood of Guatemala, 74–76. For Peru, coercion in Lima and along the South American path of the vaccination expedition appears minimal. Historian Adam Warren has found orders for priests to persuade their parishioners and the occasional posting of a soldier outside a vaccination site, but few instances of opposition, induced by uncertainties and inconsistencies in the official program, lack of funds, and the reasonable fears and apathy of parents. Warren, “Piety and Danger,” 145–160, 174, and for San Miguel de Piura, where villagers “actively took part in the destruction of the vaccine project,” 165–166.

32. Joseph Antonio Rincón, San Martin Tileagete, February 20, 1780, AGN IV 5724 exp. 12, 42r-v. This newly classified section was paginated in somewhat haphazard fashion; other identifiers, such as dates, authors, and places, should be followed in the likely event that the pages are rearranged.

33. On rumor as a substitute for public discourse in this setting, see Lomnitz, Deep Mexico, Silent Mexico, chapter 7.

34. The phrase is from the late French historian François-Xavier Guerra, who institutionalized the study of Spanish American independence movements at the Sorbonne. On Guerra’s influence on studies of revolutionary liberalism, see Ávila, “De las independencias a la modernidad,” 76–112. For the position sketched here, see Guerra, Modernidad e independencias, 11–15, 46–47, 85–113, and 275–318; and Guerra, “Spanish-American Tradition of Representation and Its European Roots.”

35. The Royal College of Surgery in the Indian Hospital (established in 1770), the Royal Botanical Garden (established in 1788), and to a lesser extent the Royal College of Mining (established in 1792) contributed to reforms in epidemic management in Mexico. All were located in Mexico City, although each institution had important rural connections and dimensions. Continuing in this vein, there is a growing literature on the Enlightenment that connects the history of early modern Mexico to Spain and the rest of Europe by examining the writings of elite creoles within an Atlantic world framework, highlighting processes of identity formation and patriotism in and through the great debates of the period. See, for example, Paquette, Enlightenment, Governance, and Reform in Spain and Its Empire; Paquette, Enlightened Reform in Southern Europe and Its Atlantic Colonies; and Cañizares-Esguerra, How To Write the History of the New World.

36. Guerra and his colleagues contributed to this revision, as in the edited volume by Guerra and Annick Lempérière, Los espacios públicos en Iberoamerica, especially the introduction, 9–10. The concept of a bourgeois sphere, these critics pointed out, was a European paradigm that did not apply to Latin American reality at the time of Independence. The individual case studies nevertheless affirm the centrality of political revolution as the key crisis transforming thought and action in what became the Republic of Mexico: of thirteen chapters, ten focus on the Independence wars in Latin America and their aftermath; of four that devote significant portions to the colonial period, two (one by Guerra) emphasize old forms of sociability in corporatist ancien régime society, in contrast to modern forms of political practice. The exceptions on “public spaces” prior to Independence are provocative analyses of critical publics in late colonial Spanish America, by Annick Lempérière and Renán Silva.

37. On the more radical modernity of the Spanish American Baroque, see Cañizares-Esguerra, How To Write the History of the New World, 344. He observes that the history of science in the colonial Spanish world, “by and large, does not belong in the ‘non-Western world.’ The scientific practices and ideas that became dominant were those brought by Europeans as they strove to create stable, viable colonial societies.” See Cañizares-Esguerra, Nature, Empire, and Nation, 46–47. The absence of indigenous science is explained by the flattening of social hierarchy experienced by formerly complex Aztec, Inca, and Maya civilizations, with an accompanying decline of the priests, scribes, and intellectuals who produced scientific knowledge and asked the important theological and cosmological questions prior to the arrival of the Spanish. What remained was a hybrid “folk Catholicism,” Cañizares-Esguerra argues, largely popular knowledge relegated to the margins of colonial society.

38. In Greek and European medical practice, “crisis” designated a turning point in an illness, the moment in which it culminated, after which the patient’s condition either improved (often by expelling some corrupted humor from the body) or declined. The words “crisis” and “critique,” as in “critical days” of an illness, are etymologically related, the one implying the other.

39. Epidemics also compelled these friars to become healers, and to the extent that they were received as effective in their art, they made inroads among communities of neophytes. On the Jesuits in New Spain, see Reff, Disease, Depopulation, and Culture Change; for the Guaraní of South America, see Chaves de Resende, “Entre a cura e a cruz,” and Prieto, Missionary Scientists.

40. See Florescano and Malvino, Ensayos sobre la historia de las epidemias en México; Austin Alchon, Native Society and Disease in Colonial Ecuador; Newson, Life and Death in Early Colonial Ecuador; Cook, Born To Die; Cook and Lovell, “Secret Judgments of God”; and Hernández Palomo, Enfermedad y muerte en América y Andalucía.

41. See Márquez Morfín, La desigualdad ante la muerte en la Ciudad de México, on the typhus and cholera epidemics of 1813 and 1833; Cuenya Mateos, Puebla de los Ángeles, on the city of Puebla during the epidemic of 1737; and Molina del Villar, La Nueva España y el matlazahuatl, on the 1737 epidemic in Mexico City and the Valley of Mexico, the relation of epidemics to famine crises, and their effects on migration and land tenure.

42. Father Jácobo Sedelmayr to Juan Antonio Balthasar, 1749, quoted in Radding, Wandering Peoples, 123.

43. In other words, “the official obsession with the pathological generates an almost surreal record of the normal.” Starn, foreword to Calvi, Histories of a Plague Year, xiv.

44. “Breve exposicion de la Epidemia que está reinando en Mexico y sus alrededores,” signed Juan de Balenchana, Francisco Montes de Oca, and Joaquin Piña, Mexico City, April 30, 1824, AHDF 3674 exp. 21.

45. Intermediaries in the mature colony were readily available in the resources of the Catholic Church. Devotional images came to acquire such roles in much the same way as magistrates, priests, and village elders, all crucial figures linking rural populations to urban centers and global processes. See Taylor, “Between Global Process and Local Knowledge.”

46. In part this has been achieved by widening the geographic focus of the Enlightenment (ilustración in Spanish) to consider the production and reception of new knowledge, values, or theories among a wider range of people and across national borders. See Darnton, “High Enlightenment and the Low-Life of Literature”; Golinski, Science as Public Culture; Stewart, Rise of Public Science; Bolufer Peruga, “De la historia de las ideas a la de las prácticas culturales,” 21–52; and the essays in Manning and Cogliano, Atlantic Enlightenment. Art historian Daniela Bleichmar approaches the natural history expeditions that traversed Spanish America in the final decades of the eighteenth century in search of plants, minerals, and other useful goods through a visual sensibility, or “visual epistemology,” evident in the importance scientists placed on the thousands of illustrations they produced. See Bleichmar, “Visible and Useful Empire,” 290–310, and Visible Empire, especially 38–39. On religion as an analytical category in Enlightenment studies, see Sheehan, “Enlightenment, Religion, and the Enigma of Secularization,” noting that religion can be usefully understood in its anthropological, social, ideological, and institutional aspects, along with the emphasis on “belief” of eighteenth-century societies.

47. Farge, Subversive Words. Studies of the press in Latin America’s insurgency period stress that the true political import of the written word can only be understood in relation to the spoken word, even after Independence, when nation-builders were far more likely to associate writing with civilization. See the contributions to Jaksic, Political Power of the Word, especially Earle, “Role of Print,” and Serrano and Jaksic, “Church and Liberal State Strategies on the Dissemination of Print.” We would do better to speak of hearing and speaking publics as well as reading publics.

48. Corbin, Village Bells, x.

49. Corbin, Foul and the Fragrant, 15, 44–45, and 49.

50. Historian Mary Ryan has described women’s grievances in the 1863 draft riots of New York as “both just and reasoned, if tragically misdirected.” She warns that boundaries “must be permeable to even distorted voices” of such excluded people. See Ryan, “Gender and Public Access,” 286. Critical theorist Nancy Fraser proposes avoiding a priori definitions of the common good by focusing on “subaltern counterpublics”: groups with distinct issues and styles of reasoning and conversing whose concerns (e.g. women’s rights) have import for the broader society and cannot be set apart. See Fraser, “Rethinking the Public Sphere,” 129, 116–118, and 122–132. These contributions emphasize multiple publics in conflictive interaction, resurrecting Gramsci’s notion of hegemony and hegemonic processes whereby groups struggle over contested meanings; see Eley, “Nations, Publics, and Political Cultures,” 319–325.

51. Sahlins, Islands of History, 7–8.

52. Carreón Nieto, Epidemias y desastres en el Obispado de Michoacán, 50–55.

53. Historians and demographers disagree about the epidemiological impact of inoculation and vaccination in Mexico. Some aver that death rates declined even with inoculation, others that the nature of the available data makes it difficult to disentangle those factors that might have contributed to improve human health, including nutrition and care. For the former position, see publications by Cramaussel, especially “Epidemias y endemias”; for the latter, see McCaa, “Inoculation.” These debates and methodological challenges aside, it is equally certain, whatever the biomedical efficacy, that residents were far more familiar with the practice after 1804, long before legislation making immunization against smallpox obligatory proliferated at the federal, state, and municipal levels in the 1880s and 1890s. For an overview of this legislation and struggles to enact it, see Carrillo, “Por voluntad o por fuerza.”

54. New interpretations are facilitated by access to more of the record, including the recent classification in Mexico’s national archive of a cache of unbound documents spanning roughly 1805 to 1821. Such virgin source material considerably enriches the picture by filling out some of the gaps for the years of the Mexican insurgency.

55. While this thematic approach to the early decades of immunization in Mexico offers analytical and interpretive advantages, it leaves out much of the narrative of the Royal Philanthropic Vaccination Expedition. For detailed accounts, see the studies cited in the Bibliography by Francisco Fernández del Castillo (Los viajes de don Francisco Xavier de Balmis), Michael Smith (“Balmis en la Nueva España” and “Real Expedición Marítima de la Vacuna” in New Spain and Guatemala), and Susana María Ramírez Martín (“Fuentes bibliográficas para el estudio,” La mayor hazaña médica de la colonia, and La salud del Imperio).

56. Gazeta de Madrid, no. 84 (October 14, 1806), “Suplemento”: “managing in both places to introduce the fluid, fresh and fully active . . . a task that the English have not been able to achieve on the various occasions that they tried, by transporting on ships of their East India Company samples of pus, which arrived inert.”

57. Gazeta de México 12, no. 12 (May 26, 1804), “Suplemento,” 93–96.

58. The politics of this rivalry in Peru is fully examined in Warren, Medicine and Politics in Colonial Peru, chapter 3, especially 104–112.

59. The political charge of literature on the expedition is briefly revisited in the Conclusion. For a full account of efforts to vaccinate in advance of the expedition, see Smith, “Real Expedición Marítima de la Vacuna” in New Spain and Guatemala.

60. Available in nineteen states, as of 2012, according to Marcuse, “Prudent Personal Belief Exemption Policies.”

61. For observations about the affinities between rising vaccination skepticism in the United States and certain strands of environmentalism, see Conis, Vaccine Nation, chapter 6.