Hippocrates' Latin American Legacy: Humoral Medicine in the New World (review)

Abstract

Reviewed by: Hippocrates’ Latin American Legacy: Humoral Medicine in the New World Marcos Cueto George M. Foster. Hippocrates’ Latin American Legacy: Humoral Medicine in the New World. Theory and Practice in Medical Anthropology and International Health, vol. 1. Langhorne, Penn.: Gordon and Breach, 1994. xvii + 242 pp. Tables. $40.00, £26.00, ECU 33.00 (cloth); $18.00, £12.00, ECU 15.00 (paperbound). This volume is part of a fascinating debate that deals with the origin, content, and meaning of humoral ideas in the New World. On one side of the debate are scholars such as Robert Redfield, Alfredo Lopez Austin, and Joseph Bastien, who argue in favor of the existence of a pre-Columbian humoral system based on an opposition of Hot and Cold that reflected a general vision of dichotomy in humankind, nature, and the cosmos. According to these authors, the Hippocratic ideas that were introduced during the colonial period reinforced or were combined with the native humoral tradition. In the past few years, this holistic perspective has been defended by social historians who consider the survival of an indigenous medical system as a case of the cultural resistance of a dominated people. [End Page 138] To refute these arguments, the anthropologist George Foster begins by describing the three main world variants of humoral medicine (the Hippocratic-Galenic, the Ayurvedic from India, and the Chinese). He makes a crucial distinction between the two domains of temperature present in the humoral practices of Latin American (a thermal domain that is accessible to the senses, and a metaphoric domain inherent in food, medicinal herbs, and medicine); and he illustrates in detail the perceived sources of disease in Tzintzuntzan, a Mexican town where he has done extensive field work. According to Foster, contemporary humoral ideas of Spanish American countries are a simplified form of the Hippocratic-Galenic humoral tradition. His argument proceeds with the following suggestions: first, that indigenous humoral medicine in Latin America is not a coherent medical system because there is no direct relationship between therapy, which comes from the pragmatic knowledge of herbal and other remedies, and diagnosis, which is used to validate treatment; second, that the Hot-Cold opposition is a basic binary characteristic of many cultures, and is not specific to Latin American indigenous populations; and third, that European humoral medicine was filtered down in Spanish America beginning in the sixteenth century through university medical chairs, religious orders, hospitals, pharmacies, and home care manuals. A criticism directed to the third point is that Foster’s evidence is feeble and that the historical process of diffusion of European medical ideas is not described in detail. For example, with regard to medical education, he just mentions the early creation of the medical chairs in Mexico and Peru. Yet medical chairs in colonial Latin America frequently fulfilled merely an ornamental function, suffering from a chronic lack of funds; hospitals attended only a small fraction of the population, and many Spaniards—including high colonial and religious authorities—protected and resorted to the effectiveness of Indian healers, and used and commercialized Indian remedies such as quinine. By concentrating on the contrast between the ideas of Latin American popular medicine and an ideal Hippocratic model (which I doubt ever existed in one single place), Foster’s approach partially reflects that of other studies in the Third World, which treat science and medicine as products and not as processes; which view as derivative any result that does not directly reflect the intellectual achievements of original theories; and which consider that native cultures are inconsistent, not prescriptive, and easily infiltrated by coherent foreign ideas. Nevertheless, Foster’s study is remarkable because it states clearly the terms of a debate, provides sharp arguments to defend a position, and identifies new, attractive controversies. It should become a crucial point of reference in an ongoing debate. Marcos Cueto Instituto de Estudios Peruanos, Lima, Peru Copyright © 1996 The Johns Hopkins University Press