The prevention of communicable diseases, the containment of epidemic disorders, and the design of programs and the implementation of public health policies went through important transformations in Mexico, as in other Latin American nations, between the final decades of the 19th century and first half of the 20th century. During that period not only did the advances in medical science make possible the identification and containment of numerous contagious diseases; it was also a time when the consolidation of formal medical institutions and their interaction with both national and international actors contributed to shape the definitions and solutions of public health problems. Disease prevention strategies were influenced by medical, scientific, and technical innovations and by the political values and commitments of the period, and Mexico experienced profound and far-reaching political, economic, and social transformations: the apogee, crisis, and downfall of the long Porfirio Díaz regime (1876–1910), the armed phase of the Mexican Revolution (1910–1920), and the period of national reconstruction (1920–1940). Thus, during the period under consideration, and alongside the consolidation of an official medical apparatus as an integral part of public power, the promotion of public health became a crucial element to reinforce the political unification and the social and economic strength of the country.
Andrés Ríos Molina
In Mexico, there were hospitals for the “demented” from the early years of the Spanish colony. It was not until the second half of the 19th century, however, that the first physicians interested in alterations of the brain published articles on the etiology, symptomatology, and treatment of mental illnesses. Within a larger context of health reforms launched during the presidency of Porfirio Díaz (1876–1911), known as the Porfiriato, healthcare officials decided to close the hospitals for the insane and construct a modern institution where psychiatry could grow as a discipline and where patients could be treated using scientific methods. Furthermore, along with the economic and cultural development that took place during the Porfiriato, there was an increase in the number of patients admitted to hospitals for the insane, while at the same time the number of doctors interested in the clinical treatment of mental illnesses increased, as well. The officials’ decision became a reality on September 1, 1910—just two months before the Revolution broke out—when La Castañeda General Asylum was opened. It was a complex of twenty-four buildings in the town of Mixcoac. In addition to being an institution for patient care, it was also where the first generations of Mexican psychiatrists and neurologists were trained. As early as the 1930s, the asylum began to have problems with overcrowding, unhealthy conditions, and deterioration of the facilities. The doctors there repeatedly called for the patient care system to be restructured. In 1944, a psychiatric reform called the “Castañeda Operation” began, seeking to decentralize psychiatric care and to use agricultural work as a therapeutic tool. The result was the creation of seven new hospitals and the permanent closure of the asylum in 1968. Recent historiography on psychiatry from its beginnings in the Porfiriato to the time of that reform have shown that it was a period marked by the rise and fall of a utopian dream, that of the therapeutic effectiveness of psychiatric internment. It was a transition from the single, large asylum in the capital city to a network of hospitals that relied on outpatient care, early detection, and medication as a way to dismantle the asylum model. As a result, La Castañeda General Asylum has held a privileged place in historical study as the stage for the beginning, the development, and the consolidation of Mexican psychiatry.
Scholarship on Latin America’s medical history has traditionally relied on collections located in specific countries that are housed in national and regional archives, universities, medical schools, and government institutions. Digitized source repositories and reference websites will make these materials more accessible for researchers and students, and it is likely that digitized content will become increasingly available in the coming years. In the 21st century, various institutions in Latin America and the United States have made a concerted effort to digitize materials related to the study of health and medicine in Latin America. This effort is the product of advancements in technology that make digital preservation of material possible, as well as a growing awareness that not all archival collections, especially in Latin America, are stored in optimal conditions. The push for digitization, therefore, is centered on two primary goals: first, to make resources more available to researchers and remove obstacles to the use of archival collections, including accessibility and physical distance or travel restrictions, and second, to preserve materials in danger of decay or neglect from storage in subpar conditions. The digitization of a broad array of materials, including historical documents, newspapers, popular culture, photographs, music, and audio recordings, fosters greater use of these collections by researchers, teachers, and students inside and outside of Latin America and enhanced interaction with the institutions that maintain the digital and original collections. While not exhaustive, these sites demonstrate the extensive range of digitized sources available for the study of Latin America’s medical history. Materials span from the pre-Columbian through modern periods; the priority is collections with significant 20th-century content, but those focused on the colonial period and the 19th century are noted. The collections tap into several historiographical themes and discussions prominent in Latin American medical history, including questions about individual agency and the role of the state in administering health and medical initiatives; race, gender, and discriminatory health practices; social issues, such as prostitution and alcoholism, as public health concerns; debates about who can produce medical knowledge; the creation of medical professionalism and medical authority; and Pan-Americanism and the role of United States influence on Latin American health programs. The pace of digitization has been uneven across Latin America. A country’s wealth and access to resources determines the extent to which materials can be digitized, as do political considerations and legislation regarding transparency. Mexico, Brazil, Chile, and Argentina are well represented in the entries, and the collections are either supported by national institutions, such as universities, libraries, or government archives, or sponsored by grants that facilitate the digitization of materials. For example, the collection from Peru relies on a UK-based charitable foundation for its existence. Digital collections based in the United States are located in archival institutions and research centers and focus on the activities of Inter-American, Pan-American, and philanthropic organizations, although not exclusively. Digitized collections greatly improve accessibility to sources related to Latin American medical history, but also depend on the user’s ability to navigate different interfaces and knowledge in how to limit and target searches. Many of the sites allow for keyword searches and the opportunity to browse collections; therefore, a user’s familiarity with the topic, scope, and keywords of a collection will determine the usefulness of search results. Where downloadable material is available, it is provided free of charge, and most of these repositories state a commitment to open access and to growing their digital collections.
Elena Jackson Albarrán
The shape, function, and social meaning of the Mexican family changed alongside its relationship to the state, the Catholic Church, and popularly held beliefs and customs over the course of the 20th century. Liberal reforms of the 19th century, and in particular the Penal Code of 1871 and the Civil Code of 1884, accelerated the intentionally political function of the family, as policymakers sought to bring the domestic sphere into the service of the state. Although domestic policies aimed to wrest influence over the private sphere from the Catholic Church, both the secularizing effects and economic impact of these efforts resulted in markedly unequal gender standards. The Mexican Revolution of 1910 wrought some dramatic demographic changes that had a long-term impact on family structure, gender roles within the family, and, perhaps most significantly, the resulting revolutionary government’s conception of the role that the family unit ought to play in nationalist development projects. The post-revolutionary decades saw the reinterpretation of late-19th-century liberalizing tendencies to align the family more consciously with a vision of a modern, collectively identified economic nationalist vision of the future. Men, women, and children saw their social roles reimagined in the rhetorical ideal, even as agrarian and educational reforms revised individuals’ relationships to the labor and socializing institutions that had come to define their identities. By the 1940s, economic growth, political stability, and technological advances in medicine and healthcare all contributed to the beginning of a surge in population growth that continued until the early 1970s. Coupled with a radical shift in population density to the urban areas, these changes contributed to transformations in family residence patterns, the division of labor, and the role of children and young people. But events in the 1970s conspired to bring a radical end to the high birth rate. These included the conscious domestic-policy reform of the Luís Echeverría administration (1970–1976); the availability of contraception and its tacit approval by the Mexican Catholic Church; the transnational feminist movement, culminating in the 1975 meeting in Mexico City of the United Nations’ Conference on Women to commemorate International Women’s Year; and, not least of these, preventive measures taken by citizens themselves to reduce the strain on the family unit. By the end of the 20th century and the beginning of the 21st, transnational migrations and remittances came to define an increasing percentage of families and kinship structures.