Clergy and lawyers more honoured than physicians
or surgeons.—University of St. Mark.—Anatomical
amphitheatre.—College of San Fernando.—State of the medical
schools and profession on the coast and in the Sierra.—General
remarks on Limenian education.
During the continuance of the royal authority in Peru, when military
titles were only conferred on men of Spanish blood, the honour of the
church and civil courts of judicature was pre-eminently fostered by the
government, and the duties of those high vocations devolved on select
individuals of white or Spanish race. If there were exceptions to so
partial a distribution of favour, these appear to have been made in
behalf of a few of the aborigines, or Indian people, whose blood to this
day runs in the veins of some of the first families of that country.
The Peruvian clergy have ever been jealous of the dignity of their
office, and consulted purity of blood in their august order with the
same earnestness that they watched over the orthodoxy of their faith.
They appear to have considered all mixture of African blood as a sort
of test of spiritual contamination, and never suffered those tarnished
with it to approach the altar, except as hearers or penitents,—never as
ministers of the sanctuary. We may reasonably suppose that much of this
partiality on the one hand, and rigorous exclusion on the other, was
originally founded on considerations of political jealousy and distrust;
but, be that as it may, the effects of this line of policy are still
observable notwithstanding the liberalism that is afloat, for we do not
meet with a single curate of negro or zambo progenitors, while in the
law the majority of professors are of Spanish origin. The practice of
medicine was looked upon as the proper occupation of those who, though
possessed of some classical attainments, were deemed unworthy a place
in the more distinguished departments of law and theology. But this
order of things admitted of a few exceptions; for, as in the dregs of
the legal profession there were certain tawny interlopers, so also in
the higher walks of the medical department there was a proto-medico, and
a few more physicians of European birth or descent. The great body of
the profession, however, were raised from among the genuine black, or
other more or less crossed Ethiopian castes, to whom, as is affirmed by
Ayanque at page 43 of his celebrated satire, titled “Lima por dentro y
fuera,” the healing art in all its branches, and especially surgery, was
almost entirely intrusted. This arrangement, which involved consequences
of vital interest to society, probably arose from inadequate ideas
entertained by the Spaniards respecting the medical profession; viewing
it less as a noble science than as a superior sort of handicraft.
Certainly it did not arise from indifference about their own lives or
personal safety; for no men are more careful of themselves when sick,
or more ready to call in professional assistance, than the Spaniards of
South America. An idea still prevalent is, that individuals selected from
“la gente prieta,” or the sable people, are, on account of their more
vigorous character and constitution, the best suited for the exercise
of a laborious and active profession in the debilitating climate of
Lima, where, in former days, young men of European parentage not in
some government employment, or members of legal and ecclesiastical
establishments, had an insuperable aversion, which they have not yet
overcome, to work for their bread.
But, leaving these matters as we find them, we shall here give an
extract from the well-known work, titled “Mercurio Peruano,” by which it
will be seen what was the ancient state of medicine in Peru.
“In the sixteenth century, the taste of our nation leaned in favour of
scholastic theology, the philosophy of Aristotle, and the civil law of
the Romans; so that at the period of founding the university of Saint
Mark, as well as for some time after, there were established for teaching
each of the above branches of learning a competent number of well-endowed
professorships; and, moreover, colleges were erected not only in Lima,
but in all the principal cities within the viceroyalty of Peru, for
teaching the same.
“For medicine two chairs were appointed or intended,—one (de prima) on
the theory of medicine, and the other (de visperas) on pathology; but,
no salaries being fixed, these fell to the ground. It is not therefore
to be wondered at, that when, in the year 1637, they deliberated upon
restoring the medical professorships, it was stated by Dr. Huerta, that
in arts, laws, and theology, there had flourished a large number of
doctors, enumerating about one hundred in Lima that very year, (seventy
years from the foundation of the university,) but that in this lapse of
time only three or four physicians were known among them, who, having
studied in other parts, had incorporated themselves with the university.”
It was at the same time urged by Dr. Huerta (who was professor of the
Quichua language) that the appointment of medical professors was quite
useless, “as it was notorious that the Indians performed better cures
than the physicians, recovering those whom the doctors had given up for
lost; and, moreover, that many who were for some time in hospitals had
from their own experience found out how to cure very successfully,
without being professed doctors, like Martin Sanches and Juan Ximenes.”
Let no one suppose, from the date of the fact here stated, that the age
of empiricism is passed away; for now, in the nineteenth century, we have
hospital-dressers who take upon themselves the character of instructed
practitioners, and are employed as such; while the famous curandera,
or doctress, La Señora Dorotea, wants not among the opulent and
best-informed persons of Lima warm defenders of her skill and superiority
over the doctors of the university.
Before an anatomical amphitheatre was opened in Lima in the year 1792,
the study of the healing art continued to be much neglected, as we are
informed by the founder of this school, who, after some statements on
this important subject,[14] observes, that the public instruction of
medicine being wanting in the royal seminary, and having no colleges
that might supply this deficiency, it followed as a consequence that in
the medical profession those improvements had not been made that the
importance of the art demanded,—a great detriment to the public health.
Some years after the anatomical amphitheatre, or practical school of
anatomy, was formed, its founder was raised to the head of the medical
profession in Peru; and, desirous to advance medical science among his
countrymen, he had further prevailed with the viceregal government to
establish a college of medicine and surgery in Lima as an independent
medical seminary, dedicated to San Fernando, in honour of their august
sovereign Ferdinand VII. of Spain.[15] This college, as we are informed
by one of its earliest inmates, was established in the year 1809, and
in it different professorships were properly assigned. Here there was
a professor of chemistry, but, for want of suitable apparatus, he had
not yet opened an experimental course; a professor of botany, who really
gave some practical lessons when walking out with his pupils in the
neighbouring “_potreros_” or grazing parks. There were also professors of
the practice of medicine and surgery, &c. all on a goodly plan, after the
manner of European colleges. But, while these improvements were going on,
the revolution came, to do evil that good might come; and then all the
fair hopes from the college of San Fernando were nipped in the bud.
This seminary, which, at present, metaphorically represents the tree
of knowledge, stripped of its green leaves and fair promise, under the
shade of the wide-spreading tree of liberty, on which it is to be hoped
that science ere long may be grafted, is, in its now blighted condition,
under the nominal rectorship of Doctor Don Caietano Heredia, one of the
earliest and most illustrious of the disciples educated in this school,—a
gentleman who, to his infinite praise, caught no small portion of that
love of knowledge, and desire to disseminate it, which so eminently
distinguished the eloquent founder, Don Hipolito Unanue.
We may briefly remark that, at the period when the revolution broke out
in Lima, there were in the medical profession some men of excellent
classical knowledge, well versed in medical literature; and the valuable
libraries which some of them have left behind them would, if only spared
by the most destructive moth of that country, long stand as monuments
of their professional scholarship. Among the junior physicians of the
capital there is less ancient learning, but a better acquaintance
with modern authors, especially French works, which are imported very
freely; and the revolution, which so lately subverted the ancient form
of government, may likewise be said to have opened up new sources of
professional knowledge and improvement in medical practice.
At present, however, young men hardly acquire the rudiments of medical
knowledge when they are hurried away to the army; and having never
enjoyed the advantages of an early systematic education, and being thus
hurried into practice, it is to be feared that many of them will be
satisfied with the perusal of a few manuals or formularies, and never
attain enlarged views of their profession. But the military surgeon has
ample opportunities of using the knife; and surgery is now very much
improved in Peru, where, till lately, the first principles of this branch
of the profession were ill understood. The pharmacy of Lima consisted
chiefly of herbs and simples, till English and French apothecaries’
stores were opened, and furnished the public with the best remedies,
which were soon approved, and recommended by those native physicians
who adopted a more active practice than their predecessors. In the
present day nearly all the native physicians of any note order their
prescriptions from the French apothecaries.
This leads us to remark, that in the well-known Memoirs of General Miller
there is a lively account of the wandering practisers of physic of the
aboriginal tribe of Callavayas or Yungeños, who, laden with barks,
balsams, and herbs, are said to migrate periodically from the vicinity
of La Paz, and “traverse the mountains of Peru, Quito, and Chile, and
the Pampas of Buenos Ayres, exercising their vocation wherever their
assistance is required, to the distance of five or six hundred leagues.”
Some medicinal herbs collected on the mountains and in the valleys are
always in requisition, and constitute the chief ingredients of the
domestic medicine of those who inhabit the villages of the interior of
Peru; but as French and English assortments of medicine have become so
common of late, the Callavayas have ceased to visit such parts of that
country as we are acquainted with. But there are still a set of quacks,
generally men of swarthy and mixed race, in every town and village of
general traffic or importance, who subsist on the credulity of mankind,
and are appropriately distinguished by the name of Mata-sanos, or killers
of the healthy.
No active measures have yet been adopted to suppress the flagrant
abuses of the Mata-sanos, who infest the interior villages of Peru;
where, we regret to say, even the regular practitioner is a kind of
public extortioner, who, persuaded that the price of his services is
never to be paid after pain and the sense of danger are removed from
the sick, is accustomed to make his bargain, and withhold his remedy
till he secures beforehand his fee: and the bargain is usually screwed
up to the utmost when the patient is known to be rich, and believes
his own life in danger. In consideration of the medical destitution of
the interior of the republic, and the crying evil thus entailed on the
community, it was suggested to the legitimate government in the year
1835, that, from every prefectorate of the republic, a certain number of
disciples should be sent to be educated at the common expense, in the
medical college at Lima; and that after these young men had completed
their studies, and were found duly qualified to exercise the medical
profession, they should be made to return as practitioners to their
respective provinces. This proposal would probably have been carried
into effect, had the country been left to enjoy public tranquillity;
and it is obvious how easily, under such an arrangement, villages and
districts of several thousand inhabitants could, by contributing an
average annual sum of only a few reals from each individual, procure
for themselves a salaried medical adviser, from the midst of their own
Indian or mixed population, in every way the most fitted to pass his time
usefully and agreeably among his native hills. But, as things are at
present, it is almost impossible, even at great expense to individuals,
to procure proper medical attendance in the time of need; for the
variable climate and temperature of the interior changing from hill to
dingle, and frequently from league to league, is peculiarly unfavourable
and disagreeable to the constitution and habits of the medical gentlemen
of the coast, (among whom there are some highly respectable and able
men,) who are commonly of various gradations of caste, from the black
through all the tints between this colour and white or European; so
that we need not be surprised at the reluctance of these individuals to
undertake the practice, or expose themselves to the privations of the
frigid regions of the interior. But the people of the Sierra, or upland
of Peru, being unprovided with medical teachers of their own, can only
rely on the capital and coast (where there is no scarcity of doctors,
both native and foreign,) for the supply of such regularly educated
physicians or surgeons as are here and there found in the interior; and
even these are not always stationary in one town or province, but often
ambulate backwards and forwards as their interest or inclination happen
to dictate. But, whether settled permanently in one locality or not,
it usually happens that when the Sierra doctor is called upon to visit
a patient, he rises from the card or diceing table; and the sort of
prescription given for the cure of the sick will naturally depend on the
state of mind in which the gambler happens to be at the time.
Having said so much on the state of the medical schools and practice of
medicine, it may be expected that we should advert to the interesting
subject of schools and education in general.
Small schools for reading, on the Lancasterian plan, are very common in
the capital, and not unknown in the provincial and inland towns; and
all—we think all—the white children are taught to read and write. The
Bible too, as translated by Scio, is openly sold by book-dealers, and it
is read by individuals in the Spanish language; but no _Mr. Wood_[16] is
found among them, to carry forward the instruction of the pupils on the
basis of the sacred writings.
Close to the public library at St. Pedro’s church, which contains a large
and valuable collection of books, there is a Latin academy, which was
intended to be a great national school after the declaration of Peruvian
independence; but it is not, we believe, now in a flourishing state:
and the colleges of San Carlos and San Toribio have dwindled away under
the baneful influence of a succession of revolutions, and governments
misnamed patriotic, which are as hostile to science, though on a
different principle, as was the dark reign of the inquisition under the
sway of old Spain.
Early in the nineteenth, as we have already shown to have been the case
in the sixteenth century, the taste of the natives leaned to scholastic
theology, the philosophy of Aristotle, and the civil law of the Romans.
Heineccius still preserves his authority within the cloisters of the
Lima colleges, which are too often deserted for want of funds for
their support,—one of the many evils consequent on frequent political
commotions!
It has been long a subject of remark and regret, that, in these principal
seminaries of learning, scarcely any of the scholars attended to their
studies, except those who were sent from remote provinces, and who were
not yet wedded to the idle and luxurious habits of the Limenian youth.
Indeed, the expression “buen colegial” is proverbial in all Peru as
peculiarly characteristic of young gentlemen devoted to gallantry, or who
are observed to care more for their loves than their lessons.
A new school for law and philosophy was commenced in Lima, a few years
ago, by Don Jose Joaquin de Mora, who for some time delivered lectures,
and also published a text-book on the Scotch philosophy, which he taught
with credit.
Mr. Mora, himself a native of Spain, has thus opened, in Peru and
Bolivia, new sources of investigation in the departments of metaphysical
and ethical science. As a civilian more especially, this indefatigable
individual has acquired transcendent celebrity in those countries. Still,
however, the blessing of well-directed instruction is confined to a very
few; and the lower classes of dark race, as well as the Indian orders
of the Peruvian people, have seldom any education except that which is
necessarily acquired in the ordinary intercourse between man and man,
without the medium of letters, and in the usual discharge of the common
duties of life; for the exercise of which it should be the main object of
education to prepare the individual, so as to fit him to act his part in
society with dignity and usefulness, becoming a being of immortal nature.
But we need hardly remark, that in Lima the ornamental takes precedence
of the useful; because there the chief aim of education is to train the
young to please in company, by such accomplishments as music, dancing,
and play, with only a very superficial acquaintance with more solid
attainments. From what has been already stated in the course of the
preceding pages, it may be inferred that female education, especially, is
very much of the kind now alluded to; though among the fair sex there is
a great abundance of excellent talent, which, if properly directed, could
not fail to be productive of the best social results.
But it is not our purpose to speculate on plans of public instruction,
or to point out what may be called the philosophy of education; into
the secret of which, we think, an English friend, the father of four
well-brought-up boys, has pretty well penetrated, when he enjoins, as a
_sine quâ non_ of good tuition, absolute obedience, under good example,
in early life. How very little philosophy has to do with the present
style of training youth in Peru, and Lima in particular, we think the
general moral details of this book are well calculated to show; for early
indulgence takes the place of obedience, and the influence of example is
not always the best: yet upon the whole, when free from civil discord,
they are pleased with themselves,
And eat, and sing, and dance away their time,
Fresh as their groves, and happy as their clime.[17]