Archibald Smith

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 qu 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,