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Since the 1980s different scholars from diverse disciplines have increasingly studied the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions during the course of the twentieth century. Anthropologists, sociologists, and historians in particular have contributed to the enrichment, reassessment, and discussion of the important official and traditional approaches that prevailed in the study of the institutions and professionals of health care. Among the topics that have been progressively examined, the following stand out: the greater state intervention in health care, not as an inevitable result of the armed phase of the Mexican Revolution (1910–1920) and of the 1917 Constitution, but as the outcome of a prolonged process that began during the course of the final decades of the nineteenth century and that acquired particular strength during the Porfirio Díaz regime (1877–1910). Likewise, more attention has been given to the study of the political, economic, social, and epidemiological contexts that encouraged the health-care institutions (Consejo Superior de Salubridad [1841–1917], Departamento de Salubridad Pública [1917–1943], Secretaría de Salubridad y Asistencia [1943–1984], Secretaría de Salud [1984 to date]) to contain, control, or eradicate specific endemic, epidemic, and chronic diseases in both urban and rural settings. Furthermore, the construction of hospitals, the dynamics of medical and nursing specialization, the conformation of a fragmented and highly unequal welfare system, and the convergence and debates among nonofficial medical and official health-care practices and practitioners have become important areas of historical research. However, the contributions published in recent decades also illustrate significant gaps in the literature, which have occurred due to the preponderance of Mexico City and other major cities in specialized literature, and the fact that health care was not, until recent decades, a field of considerable interest among professional historians. This article includes studies that begin during the late nineteenth century, in particular during the Porfiro Díaz regime, when public health became an integral part of public power. It also includes studies that examine how the health-care system was oriented by biomedicine and professionalization, in particular after the armed phase of the Mexican Revolution (1910–1920), as well as the relevance of hospitals, clinics, and different public health services and campaigns implemented between the 1930s and 1960s. Finally, this text concludes by making reference to some key studies that examine the 1980s neoliberal health and welfare reforms that began to privilege treatment over prevention in addition to cost-effective health-care interventions.

Las reformas y las innovaciones por las que atravesaron las instituciones hospitalarias durante el transcurso de la primera mitad del siglo pasado fueron empresas ampliamente compartidas en el ámbito internacional. El artículo busca destacar la interacción y la circulación de ideas y proyectos en torno al polifacético concepto de “modernidad hospitalaria”, un término en constante movimiento y de enorme plasticidad que fue central para la reforma hospitalaria emprendida en la ciudad de México durante el transcurso de la primera mitad del siglo pasado. De igual forma, el artículo presta atención a las pautas, modelos y redes de expertos internacionales en renovación hospitalaria —de los que México formó parte— con la finalidad de enriquecer la historia del proyecto o plan nacional de hospitales durante los años iniciales de la década de 1940.

Having as a framework the tragic presence of covid-19, historians from Mexico, Argentina and Brazil reflect in this text on the context of the pandemic as well as its relationship with institutional sanitary precariousness, persistent stigmas and past social inequalities. Their interventions are a preliminary record of the impact of the pandemic on their countries. They are based on interventions presented at the session "História em tempos pandêmicos: reflexões sobre um ano de crises", held in June 2021, moderated by Marcos Cueto and organized by the Departamento de Pesquisa em História das Ciências e da Saúde of the Casa de Oswaldo Cruz, Fiocruz.Teniendo como marco la trágica presencia de covid-19, historiadores de México, Argentina y Brasil realizan reflexiones en este texto sobre el contexto de la pandemia, así como su relación con precariedades sanitarias institucionales, estigmas persistentes y desigualdades sociales pasadas. Sus intervenciones son un registro preliminar del impacto de la pandemia en sus países. Están basadas en intervenciones presentadas en la mesa “História em tempos pandêmicos: reflexões sobre um ano de crises”, realizada en junio de 2021, moderada por Marcos Cueto y organizada por el Departamento de Pesquisa em História das Ciências e da Saúde de la Casa de Oswaldo Cruz, Fiocruz.

orcid.org/0000-0001-9186-3028. Instituto de Investigaciones Históricas. UNAM. agostoni@unam.mx, El artículo reflexiona en torno a la importancia que revistió formar a especialistas en medicina del trabajo en la ciudad de México a partir de la década de 1930, destacándose la manera en la que esa naciente especialidad se asoció con algunas de las ideas en ese momento trazadas por la medicina social. De igual forma, se presta atención a la gradual transformación por la que atravesó esa asociación al iniciar la década siguiente, cuando se consideró que era vital consolidar y ampliar una moderna red hospitalaria al instituirse el régimen de seguridad social e iniciar la prestación de servicios médicos para los trabajadores asalariados urbanos por parte del Instituto Mexicano del Seguro Social en enero de 1944. En suma, lo que se argumenta es que, los paralelismos y las correspondencias entre la medicina del trabajo y la medicina social, reiterados por distintos médicos, entre éstos Alfonso Pruneda, adoptaron otras acepciones al ocupar un lugar preponderante el ámbito hospitalario estatal. En el mismo, la pericia técnica, la especialización médica y los datos clínicos ocuparon un lugar primordial para enfrentar y atender los problemas de salud de los trabajadores.

The covid-19 pandemic revealed the innumerable shortages that have characterized the nation's inequitable and fragmentary health care system for decades. The main goal of the following reflections is to outline the precarity of working conditions for health care personnel in Mexico, as well as the contradictory statements issued as the epidemic developed in the country, a combination of factors that magnified uncertainty about the new disease and how to deal with it.La pandemia de covid-19 puso al descubierto las innumerables carencias que durante décadas han formado parte del inequitativo y fragmentado sistema nacional de salud. Las siguientes reflexiones tienen como propósito central enunciar la fragilidad en la que labora el personal de salud en México, al igual que las contradictorias declaraciones que han acompañado el desarrollo de la pandemia en el país, una conjunción de elementos que han acentuado la incertidumbre frente a la nueva enfermedad y su manejo.

De la escuela al hogar; la formación de la enfermera visitadora.

Las enfermeras visitadoras y la salud pública al concluir la fase armada de la Revolución Mexicana.

"Este artículo tiene como propósito analizar la coexistencia de prácticas, ofertas médicas y curativas populares y ofciales en México durante la primera década del periodo posrevolucionario (1920-1930) a través del estudio del curandero ecléctico José Fidencio Síntora Constantino, mejor conocido como el Niño Fidencio (1898-1938). Se argumenta que la fluidez entre prácticas, ofertas y concepciones sobre los procesos de salud, enfermedad y atención, contrastó y se enfrentó con los anhelos de las instituciones sanitarias, así como de distintos médicos diplomados, cuando el suministro de los servicios de salud a través de las ofertas y propuestas de atención oficiales se erigió como un sustento clave para el proceso de reconstrucción nacional. De igual forma, el notable caso del Niño Fidencio arroja luz sobre las tensiones y la pluralidad de ofertas médicas que acompañaron los procesos de fortalecimiento de la medicina institucional en América Latina durante las primeras décadas del siglo pasado, e ilustra cómo sus eclécticas ofertas de atención y de curación ocuparon una notoria presencia pública en los medios masivos de comunicación, precisamente en un momento marcado por las incertidumbres del saber biomédico." "The purpose of this article is to analyze the coexistence of folk and official practices and medical and healing offerings in Mexico during the first decade of the post-revolutionary period (1920-1930), through the study of the eclectic healer José Fidencio Síntora Constantino, better known as el Niño Fidencio (1898- 1938). The paper argues that the fluid coexistence of diverse practices, offerings, and conceptions of health, illness, and care processes contrasted with the goals of health institutions and authorized physicians at a time when the provision of health services through official offerings and care proposals was a key element for the process of national reconstruction. Likewise, the notable case of El Niño Fidencio sheds light on the tensions and multiplicity of medical offerings that characterized the processes of strengthening institutional medicine in Latin America during the first decades of the 20th century. It also illustrates how his eclectic healing and care offerings achieved notorious public presence through the mass media at a moment marked by the uncertainties of biomedical knowledge." "Este artigo tem como objetivo analisar a coexistência de práticas, ofertas médicas e curativas populares e oficiais no México durante a primeira década do período pósrevolucionário (1920-1930) por meio do estudo do curandeiro eclético José Fidencio Síntora Constantino, conhecido como o Niño Fidencio (1898-1938). Argumenta-se que a fluência entre práticas, ofertas e concepções sobre processos de saúde, doença e atendimento contrastou com o desejo das instituições sanitárias bem como o de diferentes médicos licenciados, e os enfrentou, quando o fornecimento dos serviços de saúde por meio das ofertas e das propostas de atendimento oficiais foi instituído como uma forma de sustentação-chave para o processo de reconstrução nacional. Além disso, o notável caso do Niño Fidencio esclarece as tensões e a pluralidade de ofertas médicas que acompanharam os processos de fortalecimento da medicina institucional na América Latina durante as primeiras décadas do século passado, e ilustra como suas ecléticas ofertas de atendimento e de cura ocuparam uma notável presença pública nos meios massivos de comunicação, justamente num momento marcado pelas incertezas do saber biomédico."

This article discusses the various proposals and strategies to prevent the transmission of pulmonary tuberculosis in the City of Mexico from the 1920s decade onwards, when it was launched the first long-term campaign against the disease, and analyses the limitations and challenges faced until 1940. It looks upon the motives that led the need to contain the transmission of the disease to occupy a dominant role after ten years of civil war; it focuses on the models and strategies implemented, and examines the challenges faced by the construction and operation of the Huipulco Tuberculosis Sanatorium, a key component of the fight against tuberculosis at the international level since long ago.Este artículo estudia las diferentes propuestas y estrategias para prevenir los contagios de la tuberculosis pulmonar implementadas en la Ciudad de México a partir de la década de 1920, al comenzar la primera campaña de largo aliento contra esa enfermedad, y analiza las limitaciones y problemas a los que ésta se enfrentó hasta 1940. Se destaca por qué la contención de los contagios de esa enfermedad ocupó un lugar prioritario después de diez años de guerra civil; se presta atención a los modelos y estrategias implementados y se examinan los problemas por lo que atravesó la construcción y el funcionamiento del Sanatorio para Tuberculosos de Huipulco, sustento clave de la lucha antituberculosa desde tiempo atrás a nivel internacional.

The control and eradication of smallpox have been among the most studied and chronicled topics in histories of health and medicine, which is not coincidental considering the dramatic nature of the disease, the official measures developed to deal with it, and the declaration in 1980 by the World Health Organization of its global eradication. Smallpox first erupted in Mexico-Tenochtitlán in 1520 during the Spanish conquest, and in 1952 the health authorities and the federal government declared that that long-feared disease had finally been eradicated there. Numerous historical studies have perpetuated the image of a single smallpox campaign in Mexico, free from conflicts, problems, and inertia. Recent scholarship, however, has increasingly emphasized that smallpox vaccination efforts were not homogenous or consistent, that they were not pursued equally in all geographic and cultural regions, and that vaccination strategies and campaigns gradually became less coercive and more selective and persuasive.

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.

El artículo estudia algunas de las estrategias a las que recurrieron las autoridades de salud durante la puesta en marcha de programas vacunación antivariolosa durante los años de 1880 a 1940, periodo que corresponde al gobierno encabezado por Porfirio Díaz (1877-1911), a la fase armada de la Revolución Mexicana (1910-1920), y a las dos primeras décadas del estado posrevolucionario (1920-1940). Por una parte se prestará atención a la preeminencia que tuvo la vacunación en los centros urbanos, notablemente en la ciudad de México; y por la otra, se destacará la gradual, pero decisiva, organización y reglamentación de la vacunación antivariolosa en los programas destinados para el heterogéneo y desigual ámbito rural. Asimismo, se analizará la importancia que adquirió la educación higiénica, y se prestará atención a las divergentes respuestas que la aplicación masiva y cotidiana de la vacuna suscitó en las ciudades principales y en pequeños pueblos y municipios rurales, respuestas que incluyeron la resistencia, el temor, la incredulidad y la franca aceptación.The article examines some of the strategies employed by the Mexican health authorities that led to the organization of massive and obligatory smallpox vaccination campaigns from the late 1880s to the 1940s, a period of Mexican history that corresponds to the Porfirio Díaz regime (1877-1911), to the armed phase of the Mexican Revolution (1910-1920), and to the first two decades of the Post-revolutionary governments (1920-1940). Attention will be placed of the vaccination programs in the main urban settings, notably in Mexico City, as well as the gradual but decisive organization and regulation of vaccination campaigns in the heterogeneous rural milieu. Furthermore, the importance that hygienic education acquired will be explored, as well as the divergent and contested responses that emerged due to the obligatory vaccination campaigns, responses that included resistance, fear, uncertainty and widespread acceptance.

ResumenEste trabajo examina la importancia de la salud publica como elemento clave en la formacion del Estado en Mexico despues de la Revolucion de 1910–1920. Lo hace por medio de un analisis de las campanas para vacunar contra la variola organizadas en el Mexico rural de la decada de 1920 hasta el decenio de 1940. Propone que la contencion de la variola y la promocion de una cultura de higiene fueron aspectos basicos de la expansion y la consolidacion del Estado posrevolucionario. Ademas, el trabajo analiza los distintos tipos de trabajadores de salud, estudiantes de medicina y tecnicos que se incorporaron a los esfuerzos de vacunacion liderados por el Estado, y la reorientacion de los agendas revolucionarios en salud, asi como la manera en que los agentes de salud y las brigadas de vacunacion administraron el metodo preventivo en una escala masiva en todo el pais.

(2010). Introduction: Landscapes of Latin American Health, 1870–1970. Canadian Journal of Latin American and Caribbean Studies / Revue canadienne des etudes latino-americaines et caraibes: Vol. 35, Special Issue: Landscapes of Latin American Health, 1870-1970, pp. 5-18.

La incertidumbre y desconfianza que en ocasiones suscitó la presencia y actuación de los médicos diplomados en la ciudad de México durante el gobierno de Porfirio Díaz (1877-1911), condujo a que éstos profesionistas consideraran como esencial fortalecer, vigorizar y crear, hasta donde fuese posible, una imagen respetable, competente y homogénea de su labor profesional. Para ello, recurrieron, recrearon y adaptaron las máximas de ética médica de la cultura médica occidental a su labor profesional, y se abocaron a rescatar del olvido histórico a destacados médicos del convulso siglo diecinueve mexicano. Con ello, como se expondrá en este ensayo, anhelaban responder, reaccionar y neutralizar la incredulidad y la crítica que el público manifestaba en torno a su quehacer y desempeño profesional. The uncertainty and mistrust towards the presence and activities of academic medical practitioners in Mexico City during the Porfirio Díaz government (1877-1911) convinced these professionals that is was essential to create, strengthen and transmit a respectable, competent and homogeneous image of the profession. To this purpose they recovered, recreated and adapted the ethical maxims of the occidental medical culture to their professional work, and rescued eminent medical figures of Mexico's convulse nineteenth century from being lost in the oblivion of history. Their goal - as it will be expounded in the following pages - was to respond, oppose and neutralize the criticism and disbelief expressed by the public against their professional performance.

La incertidumbre y desconfianza que en ocasiones suscitó la presencia y actuación de los médicos diplomados en la ciudad de México durante el gobierno de Porfirio Díaz (1877-1911), condujo a que éstos profesionistas consideraran como esencial fortalecer, vigorizar y crear, hasta donde fuese posible, una imagen respetable, competente y homogénea de su labor profesional. Para ello, recurrieron, recrearon y adaptaron las máximas de ética médica de la cultura médica occidental a su labor profesional, y se abocaron a rescatar del olvido histórico a destacados médicos del convulso siglo diecinueve mexicano. Con ello, como se expondrá en este ensayo, anhelaban responder, reaccionar y neutralizar la incredulidad y la crítica que el público manifestaba en torno a su quehacer y desempeño profesional.The uncertainty and mistrust towards the presence and activities of academic medical practitioners in Mexico City during the Porfirio Díaz government (1877-1911) convinced these professionals that is was essential to create, strengthen and transmit a respectable, competent and homogeneous image of the profession. To this purpose they recovered, recreated and adapted the ethical maxims of the occidental medical culture to their professional work, and rescued eminent medical figures of Mexico's convulse nineteenth century from being lost in the oblivion of history. Their goal - as it will be expounded in the following pages - was to respond, oppose and neutralize the criticism and disbelief expressed by the public against their professional performance.

This article explores why alongside sanitary legislation and public health works, Mexican physicians of the late nineteenth century attempted to transform the habits, customs and day to day activities of the population. It stresses the importance that the teaching of the principles of private and public hygiene had for the future of the country, how this education was to be carried out, and why some members of the medical profession believed that the hygienic education of mothers/women was an unavoidable requirement for the progress of the nation. Este artiiculo analiza por quee durante las deecadas finales del siglo diecinueve, el gremio meedico mexicano consideraba que era absolutamente indispensable que los habitantes del paiis, y en particular las mujeres de la capital, contaran con una cultura de la higiene. No soolo era fundamental sanear y ordenar a la ciudad de Meexico mediante obras de infraestructura sanitaria, y emitir leyes que regularan la salubridad de la nacioon, sino que era igualmente importante, y quizaas maas urgente, que los habitantes transformaran sus haabitos y costumbres de acuerdo con lo establecido por la higiene puublica y privada. Asimismo, el artiiculo examina los meetodos mediante los cuales se procuroo crear una cultura de la higiene, y por quee la madre de familia fue considerada como una aliada imprescindible para la empresa de los higienistas.

This article examines some of the changes that the Mexican vaccination programs underwent starting in 1943, the year when the National Smallpox Campaign (Campaña Nacional contra la Viruela) was established. It analyzes why a uniform and coordinated vaccination method was adopted to counter the outbreaks of this endemic disease, especially in central Mexico; the actions of its numerous and heterogeneous staff; and the reasons why smallpox vaccination was considered critical to establish a culture of prevention. In summary, the article examines why selective vaccination was chosen and the expansion of the health-education programs, topics that have been seldom addressed in historical research.

"El artículo estudia algunas de las estrategias a las que recurrieron las autoridades de salud durante la puesta en marcha de programas vacunación antivariolosa durante los años de 1880 a 1940, periodo que corresponde al gobierno encabezado por Porfirio Díaz (1877-1911), a la fase armada de la Revolución Mexicana (1910-1920), y a las dos primeras décadas del estado posrevolucionario (1920-1940). Por una parte se prestará atención a la preeminencia que tuvo la vacunación en los centros urbanos, notablemente en la ciudad de México; y por la otra, se destacará la gradual, pero decisiva, organización y reglamentación de la vacunación antivariolosa en los programas destinados para el heterogéneo y desigual ámbito rural. Asimismo, se analizará la importancia que adquirió la educación higiénica, y se prestará atención a las divergentes respuestas que la aplicación masiva y cotidiana de la vacuna suscitó en las ciudades principales y en pequeños pueblos y municipios rurales, respuestas que incluyeron la resistencia, el temor, la incredulidad y la franca aceptación." "The article examines some of the strategies employed by the Mexican health authorities that led to the organization of massive and obligatory smallpox vaccination campaigns from the late 1880s to the 1940s, a period of Mexican history that corresponds to the Porfirio Díaz regime (1877-1911), to the armed phase of the Mexican Revolution (1910-1920), and to the first two decades of the Post-revolutionary governments (1920-1940). Attention will be placed of the vaccination programs in the main urban settings, notably in Mexico City, as well as the gradual but decisive organization and regulation of vaccination campaigns in the heterogeneous rural milieu. Furthermore, the importance that hygienic education acquired will be explored, as well as the divergent and contested responses that emerged due to the obligatory vaccination campaigns, responses that included resistance, fear, uncertainty and widespread acceptance."

The article examines some of the strategies employed by the Mexican health authorities that led to the organization of massive and obligatory smallpox vaccination campaigns from the late 1880s to the 1940s, a period of Mexican history that corresponds to the Porfirio Díaz regime (1877-1911), to the armed phase of the Mexican Revolution (1910-1920), and to the first two decades of the Post-revolutionary governments (1920-1940). Attention will be placed of the vaccination programs in the main urban settings, notably in Mexico City, as well as the gradual but decisive organization and regulation of vaccination campaigns in the heterogeneous rural milieu. Furthermore, the importance that hygienic education acquired will be explored, as well as the divergent and contested responses that emerged due to the obligatory vaccination campaigns, responses that included resistance, fear, uncertainty and widespread acceptance.

EL ARTÍCULO ANALIZA CÓMO CONCIBIERON Y DEFINIERON LAS AUTORIDADES DE SALUD EL TRABAJO DE LA ENFERMERA VISITA­DORA DURANTE LA DÉCADA DE 1920 EN LA CIUDAD DE MÉXI­CO, CENTRO DE LA VIDA POLÍTICA, SOCIAL Y CULTURAL DEL PAÍS DESPUÉS DE UNA DÉCADA DE VIOLENCIA, ENFERMEDAD E INSALUBRIDAD. PARA EL DEPARTAMENTO DE SALUBRIDAD PÚ­BLICA ERA ESENCIAL ELEVAR LA ESPERANZA DE VIDA DE LOS MEXICANOS Y PREVENIR LA MUERTE DE LOS NIÑOS MENORES DE DOS AÑOS. PARA ELLO, LAS AUTORIDADES DE SALUD CON­SIDERARON ESENCIAL TRANSFORMAR LOS HÁBITOS Y LAS COSTUMBRES DE LA POBLACIÓN CALIFICADOS COMO IRRESPONSABLES, INSALUBRES Y CONTRARIOS A LAS CIENCIAS MÉDICAS, Y LA ENFERMERA VISITADORA SE ERIGIÓ EN EL ESLABÓN FUNDA­MENTAL ENTRE LAS AUTORIDADES DE SALUD Y EL PÚBLICO EN GENERAL EN MATERIA DE MEDICINA PREVENTIVA.

The uncertainty and mistrust towards the presence and activities of academic medical practitioners in Mexico City during the Porfirio Díaz government (1877-1911) convinced these professionals that is was essential to create, strengthen and transmit a respectable, competent and homogeneous image of the profession. To this purpose they recovered, recreated and adapted the ethical maxims of the occidental medical culture to their professional work, and rescued eminent medical figures of Mexico's convulse nineteenth century from being lost in the oblivion of history. Their goal - as it will be expounded in the following pages - was to respond, oppose and neutralize the criticism and disbelief expressed by the public against their professional performance.