Ricardo Gonzlez Leandri, Curar, persuadir, gobernar: La construccin histrica de la profesin

mdica en Buenos Aires, 1852-1886. Madrid: Consejo Superior de Investigaciones Cientficas,

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. Gonzlez Leandris book is a significant proof of this.
Gonzlez 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 Bourdieus 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 Gonzlez 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. [Gonzlez
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 Asociacin
Mdica Bonaerense [1860] and the Crculo Mdico 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 Crculo Mdico 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-Davids already classical book, The Scientists 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 Crculo Mdico 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, Gonzlez Leandris 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)
National University of Quilmes
Rivadavia 2358 6 piso, dcha.
C1034ACP, Buenos Aires
Argentina

Mariano Bargero