Ricardo González Leandri, Curar, persuadir, gobernar: La construcción histórica de la profesión médica en Buenos Aires, 1852-1886. Madrid: Consejo Superior de Investigaciones Científicas, 1999, 259 pp.

Mainstream historical studies on Argentina focus on economic and political aspects, and often ignore the diverse processes related to more specific social fields. Thus, for instance, the slow process of transformation of universities, the analyses of the institutionalization of scientific activities or the professionalization of medicine are subject matters that have not been very deeply studied yet. They have been mostly viewed as an epiphenomenon of an underlying political and economic structure. However, during the last decade, there have been many attempts to reverse this tendency. González Leandri’s book is a significant proof of this.

González Leandri is an Argentine historian who lives in Spain, and this book is the result of his doctoral dissertation at the Complutense University of Madrid. It deals with the process that led to the emergence of a medical field, in Buenos Aires, between 1852 and 1886, through the consolidation of the legitimate monopoly of the art of cure. The author describes this process through quite diverse theoretical conceptions. He centres his analysis on the constitution of modern professions, an issue largely considered and conceptualised within the sociological functionalist trend. This includes the formation of ‘social closure’ mechanisms, as well as the definition of the specific cognitive and moral principles on which the autonomy of professions is usually based (medicine, in this case). But he has also resorted to Pierre Bourdieu’s theory of the dynamics of fields to make a narrative of the emergence of certain activities and relationships, shaped by struggles and negotiations, and aimed at widening the recognition of physicians, before society and the State, as the ones who posses the legitimate knowledge to cure. (At this point, it is important to take into account that there existed in Argentina –as in many other postcolonial countries–, by the second half of the Nineteenth-Century [and still nowadays], previous curative practices that stemmed from popular and pre-Columbian cultures).

During these years the initial institutional organization of the Argentine State took place. That is why, at the beginning of the process examined by the author, there were not enough regulations or laws related to curative practices or public health. Neither existed an official institution responsible for defining the legitimate knowledge to cure, and the legitimate education and qualification of the people in charge of cure (physicians). Therefore, while the State was getting organized, establishing its concerns and scope, the physician elite was struggling and negotiating to set its rights and to obtain hierarchical posts. In other words, given the fact that the State was small and the resources and positions limited, what was at stake not only was the way in which these new institutions should be constructed, and the shape they should have, but also –to put it in a more theoretical way– the appropriation of roles and authority.

The physician elite, which got together in the Academy of Medicine, plays the main role in the account of González Leandri. The analysis takes into consideration its diverse relationships, both with the subordinate physicians (foreigners, young physicians) and with the governmental authorities. ‘The Academy’ (‘la Academia’), as it was called at the time, constituted the authority of the School of Medicine at the University of Buenos Aires (then, the most important university of Argentina). Its first members were named by the national government. And only when one of them had died or given up his post (at that time the academicians were only men) was a new member elected by the very Academy. Besides, their posts were ad vitam. I deem all these features sufficient to show the stern social closure exerted by the physician elite. Thus, the fact of belonging to the Academy or teaching at the School of Medicine was closed to those physicians who did not have a strong or direct relationship with the elite or with the national government. (It should be stated that, in those days, Buenos Aires was a small town and the national ruling elite was small, too. [González Leandri quotes a census made in 1869 that shows that of the 177,787 inhabitants that were living in Buenos Aires half were Argentine and half immigrants]. This facilitated the concentration of different prestigious posts of authority amidst the same members of the national elite).

No sooner had the number of physicians in Buenos Aires increased with young physicians and foreigners that the medical elite was criticized because of the closed functioning of the Academy. These ‘outside’ physicians complained because many outstanding scholars could not teach in the School. They said that they were put aside unfairly, and they demanded a less arbitrary method to name professors. Furthermore, they strongly disagreed with the teaching the School offered. Then they began to organize themselves, creating their own associations (the Asociación Médica Bonaerense [1860] and the Círculo Médico Argentino [1875], among the most important) with their own journals, which allowed them to convey their ideas to a larger audience. Thus, new groups of power arose within an incipient medical field.

Apart from the changes of the rules to name professors, these physicians (especially those belonging to the Círculo Médico Argentino) claimed that a noteworthy institution of German ‘research’ universities of the Nineteenth-Century be imported: the privatdozent. The German privatdozenten represented the professors who taught the subject they wanted to, that is the subjects they knew most about, and whose fees were paid directly by the students that they could gather. This institution implied a kind of competition within the German university system and among professors that, in Joseph Ben-David’s already classical book, The Scientist’s Role in Society: A Comparative Study (1971), was regarded as one of the most important factors of the accomplishments of German medical sciences (especially physiology and anatomy) during the Nineteenth-Century. As regards the physicians’ claims of the Círculo Médico Argentino, they considered the privatdozent necessary for the School of Medicine, due to its lack of experimental and observational practices and laboratory tasks in the training of the medical students. However, these claims and demands would disappear as soon as the members of these associations were gathered under the physician elite, whether as professors in the School or as members of the Academy. In the following years, the claims for the establishment of the privatdozent did not cease, but it would not be until the academic reforms of 1918 that it would be institutionalized.

As a result, González Leandri’s book is a valuable contribution to the Argentine historiography and enlarges our knowledge on the (always partial) importation of culture and institutions that was carried out by the progressive professionalization of medicine.

IEC (Institute for Social Studies of Science & Technology) Mariano BargeroNational University of QuilmesRivadavia 2358 6° piso, dcha.C1034ACP, Buenos AiresArgentina