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ABSTRACT
In 1739, the viceroy and archbishop of New Spain accused an enfermero (male nurse) of strangling a patient on his deathbed at a hospital in Mexico City. The crime was not an isolated incident, but the culminating indictment in a seething report on the alleged abuses committed by members of the Order of San Hipólito, one of four nursing or hospital orders (órdenes hospitalarias) active in New Spain. This article uses the viceroy-archbishop’s report, and the reform movement it provoked, as a window into the history of religious nursing within New Spain’s hospitals during a moment of alarming decline and in the face of numerous obstacles, including chronic underfunding, shifting Church-state relations, and internal feuding. It introduces the hospital orders, religious brothers who took vows to hospitality (hospitalidad), as critical if overlooked actors in the history of medical care in the Spanish colony. It argues for viewing the crisis in hospital care as a crisis of religious values as the ideal of hospital nursing eroded as these orders found themselves embroiled in scandals and accused of widespread spiritual laxity.
Acknowledgements
The author wishes to thank Bianca Premo, Diana Montaño, and Patricia Palma for their feedback on an early and unpolished version of this essay. She also thanks Miguel Valerio for reading through multiple drafts and the members of the Eighteenth-Century Salon at Washington University in St. Louis, where a version of this essay was workshopped. Finally, the author thanks the two anonymous reviewers secured by CLAR for their thoughtful engagement with the essay and rich feedback.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes
1 Throughout this article, I use the terms hospital and nursing orders interchangeably.
2 AGI, Mexico, 2744, s/f.
3 The exception here is Warren (Citation2010), who discusses orders and confraternities (albeit in passing) as exemplars of the religious models of healing that dominated hospital care under the Hapsburgs and that came under attack under the Bourbons. See especially chapter 1.
4 For early modern Europe, much of the scholarship on religious nursing has concentrated on the Daughters of Charity. See, e.g., Jones Citation1989; Dinan Citation2006; Broomhill Citation2004, especially chapter 3. On nuns as hospital nurses, see Strocchia Citation2019, chapter 5. Significantly, sustained histories of nursing for this period have overwhelmingly focused on women despite the predominance of men. I hope, in future iterations of this project, to explore the gendered dynamics of nursing in the Spanish Americas.
5 Cabrera y Quintero Citation1746. On the role of popular devotion during the plague, see Ramírez Citation2018, chapter 1.
6 For a discussion of New Spain’s mendicant orders and their varied corporate identities, see Melvin Citation2012, chapter 2.
7 Antonio de Morales, ‘Sermon panegyrico que en la solemne octava de la canonización de S. Juan de la Cruz,’ quoted in Melvin Citation2012, 110–11.
8 On the hospital as a colonial institution that aligned with religious missions of the Catholic Church and the Spanish Crown, see Warren Citation2010, 18–27; Risse Citation2000, 66–67.
9 ‘Carta de Fray Pedro de Gante al emperador D. Carlos (1532),’ Cartas de Indias, No. 8 (Madrid, 1877), 52.
10 Cheryl English Martin has conducted the most extensive research on the Order of San Hipólito’s internal organization and the background of many of the early followers. She concludes that although it was created in New Spain, the Order of San Hipólito ‘was decidedly Iberian in membership and leadership for the first century of its existence.’ By the seventeenth century (1612–1660), a small minority of brothers were American-born Creoles, all of whom ‘presented proof of the purity of their lineage; hence it can be assumed that none had any obvious Indian ancestry’ (Citation1976, 48–49).
11 Here, I follow Karen Melvin’s (Citation2012) meticulous research, which documents a shift among the mendicant orders from missionary to urban work after 1570.
12 Scheper Hughes builds on Muriel’s terminology (Citation2021, 49–52).
13 AGN, Hospitales, vol. 45, exp. 9, f. 539.
14 AGN, Hospitales, vol. 45, exp. 9, f. 569r/v.
15 AGN, Hospitales, vol. 45, exp. 9, f. 361.
16 Missionaries, such as the Franciscans, followed a more intense schedule of daily prayer and meditation to ‘induce spiritual trance and state of self-denial and holiness.’ See Galindo Citation2017, 120.
17 AGN, Tierras, vol. 3082, f. 13r/v.
18 The earliest surviving book of medical receipts (dating to 1698) indicates that medicines were purchased from the apothecary shop of Urbano Martínez. See AGN, Indiferente Virreinal caja 1627, exp. 7. On evidence that slaves worked inside the hospitals, see Martin Citation1976, 89–90.
19 The constitution makes general references to the administration of medications, while López (Citation2017) offers more specifics on the type of medications and technique for application.
20 AGN, Tierras, vol. 3082, fs. 17v–18v.
21 Focused on the Hospital de San Hipólito, in particular, Ramos (Citation2022) notes the consistent absence of a physician in the hospital’s records.
22 AGN, Tierras, vol. 3082, f. 15v.
23 Pullan adds: ‘Work among the so-called incurables was particularly important as an ascetic exercise and technique for mortifying the senses, given the exceptionally repellent, Job-like nature of the patients’ afflictions’ (Citation1999, 23).
24 An earlier version of this paragraph appeared in Ramos Citation2022, 53.
25 AGI, Mexico, vol. 2744, s/f.
26 AGI, Mexico, vol. 2744, s/f; Martin Citation1976, 253–54; Canterla Citation1980, 136–37. Although the pope issued his decrees in 1700, the bulls were not promulgated until 1702.
27 AGN, Hospitales, vol. 43, fs. 189–96; Martin Citation1976, 253–54; Canterla and Tovar Citation1980, 136–37.
28 As Muriel observes, the decree made clear that the Crown granted the order of San Juan de Dios control of various hospitals solely for the purposes of caring for patients and not to ‘propagate the institute of San Juan de Dios’ (Citation1956, 2:10).
29 An earlier version of this paragraph appeared in Ramos Citation2022, 53.
30 All hospitals depended on mixed sources of income coming from the Church, state, and private donors, which were vulnerable to demographic crises and natural disasters. On these complexities, see Cahill Citation1995. In the case of the hospitals managed by the hipólitos, these experienced steady financial hardship after the brothers’ sugar plantations fell into debt in the late seventeenth century; see Martin Citation1976, 112–58. Regarding population increase in New Spain, in 1640, the colony’s population was estimated to have been 1.5 million. A century later, it was between 1.5 and 3 million. The increase in the number of people of mixed ancestry and the demographic ‘recovery’ of the Indigenous population were largely responsible for this population growth. See Martínez Citation2008, 229.
31 According to Lance Thurner, seventeenth-century records indicate that the previous nurses were Indigenous men and women (Citation2018, 115).
32 Quoted in Thurner Citation2018, 116–17; see also Howard Citation1980, 11.
33 AGN, Indiferente Virreinal, caja 4749, exp. 37, f. 1. Moreno’s visita is also cited Ramos Citation2022, 54.
34 AGN, Indiferente Virreinal, caja 4749, exp. 37, fs. 1–2.
35 AGN, Indiferente Virreinal, caja 4749, exp. 37, fs. 1–2.
36 AGN, Hospitales, vol. 56, exp. 9, fs. 145–59.
37 AGN, Hospitales, vol. 56, exp. 9, f. 146v.
38 AGN, Hospitales, vol. 56, exp. 9, fs. 147r/v, 151r/v.
39 AGN, Hospitales, vol. 56, exp. 9, f. 148r/v.
40 AGN, Hospitales, vol. 56, exp. 9, f. 149.
41 AGN, Hospitales, vol. 56, exp. 9, f. 150.
42 AGN, Hospitales, vol. 56, exp. 9, fs. 152v–53.
43 AGN, Hospitales, vol. 56, exp. 9, f. 156r/v.
44 AGN, Hospitales, vol. 56, exp. 9, fs. 155, 157v.
45 AGN, Hospitales, vol. 56, exp. 7, fs. 129–31.
46 AGI, Mexico, 2745, s/f.; Canterla and Tovar Citation1980, 140–42.
47 AGI, Mexico, 2745, s/f. On the connections between illegitimate birth and honor, see Twinam Citation1999. On discourses of blood purity, see Martínez Citation2008.
48 AGI, Mexico, 2745, s/f.
49 Adam Warren makes a similar observation for colonial Peru when, in 1732, the viceroy decided to install the Bethlehemites at the Hospital de Santa Anta, ousting a lay brotherhood of veintecuartos after reports of mismanagement (Citation2010, 36).
50 See Plummer Citation2022, 20. As Stephanie Kirk remarks, regarding convent reform, ‘Reformers usually used excessive and hyperbolic language, and while there seems to be a propensity for words such as “relajación” (laxity) and “decadencia” (decadence) […] specific examples of such outrages are scarce’ (Citation2016, 79).
51 In 1741, Balbuena pleaded with the Council of Indies to pursue a reform of the order instead of its dissolution. He submitted a detailed report to the Council describing the order’s fallen condition (reiterating most of Vizarrón’s complaints) as well as a plan for the reform. AGI, Mexico, 2745, s/f.
52 A much-abbreviated version of the next two paragraphs appeared in Ramos Citation2022, 56.
53 AGI, Mexico, 2744, s/f.
54 AGI, Mexico, 2744, s/f.
55 AGI, Mexico, 2744, s/f.
56 Melvin makes a similar observation for the reform of the mendicant orders after 1730 (Citation2012, 57).
57 AGI, Mexico, 2744, s/f.
58 AGI, Mexico, 2744, s/f.
59 AGN, Indiferente Virreinal, caja 2512, exp. 26, f. 20.
60 AGN, Indiferente Virreinal, caja 2512, exp. 26, f. 20r/v.
61 AGI, Mexico, 2744, s/f.
62 AGN, Indiferente Virreinal, caja 0246, exp.1, fs., 314–15v; AGN, Indiferente Virreinal, caja 2512, exp. 26, fs. 31–32.
63 AGI, Mexico, 2744, s/f.
64 AGI, Mexico, 2744, s/f.
65 A condensed version of the next four paragraphs appeared in Ramos Citation2022, 56–57.
66 AGN, Indiferente Virreinal, caja 2512, exp. 26, fs. 33v, 12.
67 AGN, Indiferente Virreinal, caja 2512, exp. 26, f. 12.
68 AGI, Mexico, 2744, s/f.
69 On the hardening of views towards the poor and the criminalization of begging, see Arrom Citation2000, especially chapters 1 and 2; Milton Citation2007, chapter 6.
70 AGN, Indiferente Virreinal, caja 2512, exp. 26, f. 12v.
71 AGN, Bienes Nacionales, vol. 185, exp. 9, s/f.
72 In the case of the Hospital de San Hipólito, for instance, a report dating to 1755 indicated that the hospital was deep in debt, with its two sugar plantations in the pueblo of Olintepec long ago seized by creditors, leaving the hospital to subsist off alms and rental income derived from various smaller estate holdings. This situation was only compounded by increases in the number of patients. See AGI, Mexico, 2745, s/f.
73 The report specified that 40 members had died while 13 or 14 had fled the convent. A fraction of the remaining 56 or 57 brothers were carrying out their sentences and could therefore only perform certain menial or internal tasks.
74 AGI, Mexico, 2745, s/f.
75 AGN, Indiferente Virreinal, caja 2187, exp. 2, fs. 1–52.
76 On the reform of the juaninos, see Velasco Ceballos Citation1945.
Additional information
Notes on contributors
Christina Ramos
Christina Ramos is assistant professor of History at Washington University in St. Louis. She is the author of Bedlam in the New World: a Mexican madhouse in the Age of Enlightenment (2022).