Abstract
How do colonial scribal practices and archival practices shape our understanding of the past? Logbooks from the San Juan de Dios Hospital in colonial Guatemala showcase both the potential and the constraints of scribal interventions. A Hidden Plague examines the logbooks alongside contemporary criminal cases to demonstrate how individual scribes chose to conceal or reveal information in their official writings. This method challenges the contention by past scholarship that epidemic disease was the greatest health threat to women in the city of Guatemala. While epidemics did indeed affect women, reading the logbooks in new ways reveals the presence of a hidden epidemic: domestic violence.
“All of this is a labyrinth, a terror, and [a] confusion, and it seems that an exterminating angel of death is fleeing the curate.” 1 In this way the priest Juan José Juárez described the typhus epidemic that struck on the border of Guatemala and Mexico near the turn of the 19th century. Typhus, known in Guatemala as tabardillo, had struck the region many times already by 1804, when Juárez made his comments. With horrifying symptoms and a mortality rate between 5 and 25 percent, its recurrence did nothing to lessen the shock tabardillo; instead, it seemed only to appall anew every time. The English priest Thomas Gage observed, The filthy smell and stench which came from those who lay sick of this disease was enough to infect the rest of the house, and all that came to see them. It rotted their very mouths and tongues, and made them as black as coal before they died. 2
Although it was not known then, as it is known now, that typhus is transmitted by body lice that lay eggs in human clothing, the symptomology was clearly identifiable to priests, doctors and any untrained eye. The stench that Gage described was distinctive, like the breath of a cadaver, one physician said, and in some cases, it was enough to come near the door of a house that had been struck by typhus to know exactly what the people inside had suffered. 3 If typhus was so terribly familiar in its retreat and return, so gruesomely identifiable in its symptomology, surely it was simple to diagnose? One would think so, and yet, it seems that colonial observers somehow managed to mistake very different conditions for the ‘black tongue’ and ‘cadaverous stench’ of ‘tabardillo’. Did observers mistake other symptoms for indications of typhus? Or did they allow typus to conceal the occurrence of other conditions?
In the following pages, I consider how and why pandemics conceal other grave health concerns by looking closely at women’s health in late eighteenth-century Guatemala.
The common wisdom is that epidemics like typhus had the greatest public health impact in colonial Spanish America. It seems evident in the descriptions by contemporary observers, and it seems further supported by the work of historians of medicine. Lynda de Forest Craig, the only researcher to make a comprehensive study of hospital records in colonial Guatemala, supported this conclusion in her findings. De Forest Craig analysed the hospital logbooks of Guatemala City’s principal hospital, the San Juan de Dios, during the years 1788 to 1808. 4 Her analysis of several thousand entries from the logbooks yields valuable insights into the length of time patients spent in hospital, the race and gender and marital status of patients, mortality rates, regional distribution, and reasons for admission. In addition to these broad strokes, she offered statistical descriptions of how disease categories changed over time and which reasons for admission were linked to fatalities.
Reasons for Admission of Patients in Sample, 1788–808 5 .
De Forest Craig’s analysis updates and in some cases combines diagnoses used by contemporaries. By her reckoning, shown in the Table 1, the most common reason for admission was infectious disease (25.1%), in the form of fever, syphilis, dysentery and more. De Forest Craig notes that in 1792, 1793, 1797 and 1802, years associated with smallpox and typhus outbreaks, admissions of this kind increased; however, smallpox patients were treated in other facilities and thereby do not appear in the San Juan de Dios registers. 6 Tellingly, De Forest Craig finds that the second most common cause for admission affected men much more than women. Defining ‘traumatic conditions’ as ‘injuries, wounds, or accidents’, she finds that women with injuries constitute only 4.6% of the patient population while 75% of the patients with injuries were men. Most of them were single. 7
The documents that De Forest Craig used for her analysis, the logbooks of the San Juan de Dios, are invaluable sources for the study of public health. I approached them to learn more about women’s health, a subject that can be elusive in the colonial archive. At the end of the eighteenth century in Guatemala City, the Hospital San Juan de Dios admitted upwards of 600 female patients each year. As the largest hospital in the region, and counting on the expertise of several high-profile physicians, it attracted patients from near and far. Some died in the hospital; the majority were released after a few days, or a few months. The logbooks were created by the staff to record patient details upon admission. Bound in leather and written in (mostly) well-executed cursive, they are appealing documents for the quantitatively minded. They suggest a certainty and precision born of knowledge: the admitted patient has a name, an age, a race, a marital status, a place of residence and named parents. There is a date of entry and a date of either death (marked with a cross) or a date of release. She is placed in a bed that has a number. Most telling of all, there is only ever one diagnosis, and it is never a question mark.
These rich sources present themselves as a treasure trove of demographic data, capable of illuminating a detailed picture of colonial illness. Analysing the logbooks to discover trends, as we often do with demographic data, relies on two important assumptions: first, it assumes that we can interpret categories of disease meaningfully across time, using the diagnoses in the logbook to identify conditions corresponding to present day conceptions. Second, it assumes that the practitioners who created the logbooks could objectively observe qualities such as age, race, and marital status. But close scrutiny of the logbooks reveals that we cannot make either of these assumptions. Then, as now, diagnosis was interpretive. Sometimes consciously and sometimes not, practitioners construed symptoms in ways particular to their time. Race, age and marital status were also interpretive, each undeniably influenced by colonial mindsets and subject to the perception of the hospital scribe; conceptions about these categories also, in turn, influenced diagnosis. As a result, the logbooks are less a collection of data and more a subjective portrait, composed by writers who reflected, and in some cases contested, the worldviews around them. 8
It may be possible to learn more from the logbooks if they are taken as arguments made by scribes, the keepers of the hospital archive: they are complex statements about race, gender and the nature of bodily harm. My analysis focuses on the logbooks of female patients from 1793, 1797 and 1800. 9 Building on De Forest Craig’s impressive findings, I use statistical interpretation, close reading, and handwriting analysis to extrapolate the varied and sometimes contradictory arguments put forward by the logbooks. I also use criminal cases from the same period to investigate a few individual entries more closely.
Taken together, these methods suggest a surprising conclusion: one of the greatest perils to a woman’s health in colonial Guatemala was not infectious disease but social violence. In some parts of the logbooks, this violence is recognised and mentioned, but in others it is overlooked or concealed. Domestic abuse was a health epidemic in colonial Guatemala, but not everyone acknowledged it as such. The most obvious consequence of this hiddenness is that we have underestimated social violence as a health risk. The less obvious and more challenging consequence of this hiddenness is how it has shaped historical inquiry, minimising the presence of violence and abuse in histories of medicine and public health. How can historians overcome the blind spots of their sources to foreground violence against women? 10
The San Juan de Dios and Its Staff
The Hospital San Juan de Dios in Guatemala City was created in the new capital soon after the migration prompted by the 1773 earthquake. It was one of many San Juan de Dios Hospitals in Spanish America, renowned for their charity and dedication to the poor. 11 And yet by the late eighteenth century, the hospital was neither entirely dedicated to the poor nor entirely in the hands of the San Juan de Dios order. Indeed, the hospital was secularised in 1800. 12 Over the course of the 1780s and 1790s, it attracted physicians who considered themselves the vanguard of enlightenment medicine—most notably José Flores (1751–824) and Narciso Esparragosa y Gallardo (1759–819)—who in turn attracted patients from every part of the region and across the socioeconomic spectrum. Flores distinguished himself, among other things, for the creation of a comprehensive plan to combat typhus outbreaks; he conducted one of the early smallpox inoculation campaigns in the 1780s; and he developed intricate wax models, patterned after the creations of Felice Fontana, for the teaching of anatomy. 13 Esparragosa, a talented surgeon, developed methods for the removal of cataracts, invented baleen forceps to replace the iron forceps used in difficult births, experimented with the removal of kidney stones and participated in the creation of a vaccination board in 1814. 14 Both men greatly influenced the workings of the hospital, including the approach to diagnosis.
Less can be known with certainty about the rest of the hospital personnel in the 1790s. Financial records from this period give a clear picture of names and occupations, at least. In 1798, monthly wages were dispersed to eight friars, one comptroller, two interns, one pharmacist, a ‘chocolatero’ (whose work making chocolate would have complemented the pharmacist’s), three male nurses, a head female nurse, three female nurses, three female cooks, two laundresses, a bed maker, a person to stock the linens, a meat supplier and a barber, whose tasks would have included bleeding the patients. 15 Those who could sign for receipt of their salaries did so—around eight in a typical month—and these were usually a handful of friars and the two interns. We also know from other sources that volunteers occasionally spent months at the hospital to engage in service work, and some Guatemalans (both male and female) served criminal sentences by assisting at the hospital. 16 These various roles give us some sense of how the hospital functioned, though regrettably they tell us precious little about the individuals who spent their days cooking food, making beds, washing linens, attending services in the hospital chapel, and tending to the sick.
The interns and friars—all men—are of particular interest because the hospital logbooks of patient admissions were undoubtedly composed by them. Although the cover page for each logbook acknowledges the names of hospital administrators, the entry pages themselves are not signed, and no author(s) is indicated at the beginning or end. Most are written in at least three different hands that recur at irregular intervals, suggesting that the work of admitting patients and keeping the logbook was not a proprietary task for a single employee. The primary purpose of the logbooks was clearly to know who was in each bed; the logbook for 1796 lists only the patient’s name and her bed number. 17 (Presumably, this made it much easier to coordinate instructions behind the scenes.) It was a fairly straightforward undertaking, in theory: to record the name and date, the particulars of each patient, and the number of the bed to which she had been assigned. And yet, as the logbooks make evident, even the simple task of describing a patient according to her bare demographic details was an interpretive task. The men who created the patient logbooks made choices about what to include and what to omit, what could be guessed and what could be known. Their choices depict their perspectives, opinions and worldviews just as much as they depict colonial women and colonial illness.
The Statistical Portrait
One perspective offered by the writers of the logbooks is that infectious disease drove women to the hospital in large numbers. We can see this perspective manifested in their repeated diagnosis of syphilis, fever and chills (see Figures 1–3 below).
In 1794, ‘galico’ (syphilis) is the principal reason given for admission, followed by ‘fiebre’ (fever). Combined with ‘fríos’ and ‘calenturas’, identified as distinct but also suggestive of fever (101 patients), this category outranks even syphilis (90 patients). Further, ‘dolor pleuritico’ and ‘dolor de costado’, both of which may have described pneumonia, also occurred with some frequency. 18 An outbreak of typhus in 1797 accounts for the very high diagnosis (176) of ‘tabardillo’ in that year. In 1800, there were fewer cases diagnosed as syphilis than there were in 1794, but the various forms of fever are easily the leading reason for admission. 19
The logbooks also argue that infectious disease was a leading cause of death for women at the San Juan de Dios. In 1797, the mortality rate for cases of reported ‘tabardillo’ was 20%, in keeping with estimates for typhus outbreaks occurring in the colonial period. 20 Women who arrived at the hospital with fevers also suffered high mortality rates. In 1800, women patients with ‘calenturas’ or ‘fiebre’ had a 23% mortality rate, and women with diarrhoea had a 63% mortality rate. The rates were similar in 1797 (27% and 60% respectively) during the typhus year, but in 1794 the mortality rate for fever was higher (48%), and it reflects a heavier burden of disease for women described as ‘India’, the colonial-era term describing women of indigenous descent. Of all the women who died of reported fever that year, 68% of them were Indias. If we consider the Indias diagnosed with ‘fiebre’ as a group, it is striking that almost all of them came from outside of Guatemala City, in some cases travelling significant distances to reach the hospital. Overall, half the female patients in 1794 were naturales of Guatemala City—born in the city and residing there—but among the Indias who died of fever not a single one was. They came from remote, rural locations: Jocotenango, Zumpango, Sonsonate, Pinula, Comalapa, San Lucas and elsewhere. 21 The long travel affected the trajectories of their illnesses; many died within one or two days of arriving at the hospital.
The high number of deaths among Indias with reported fever is reflected in the mortality rate for Indias overall in 1794. Women identified as Indias were more likely to die than women of other races. 22 And Mulatas, women of mixed African descent, were significantly less likely to die at the San Juan de Dios in this year. Indias accounted for more than half of the deaths that year while Mulatas accounted for only a quarter, even though each group made up 37% of the patients in 1794. In part, varying patterns of diagnosis help explain this divergence. Syphilis was the leading diagnosis among Mulatas; half of the syphilis cases in that year (44 of 90) were ascribed to them. And the mortality rate for syphilis in 1794 was only 1%. Although the significantly high mortality rate among Indias is not apparent in the other two years, the high incidence of ‘fiebre’ among Indias and ‘galico’ among Mulatas is repeated in 1800. In that year, 51% of the women diagnosed with ‘fiebre’ were Indias and 65% of the patients diagnosed with ‘galico’ were Mulatas.
Taken together, these extrapolations suggest a few key arguments: Indias came from far away and died at high rates of infectious disease; Mulatas, mostly from the city, suffered disproportionately from syphilis and did not die as often as Indias. These arguments are not findings so much as perceptions by the hospital staff. To begin with, it must be emphasised that they rely on tenuous terms. As the term ‘fiebre’ with its close kin ‘calenturas’ and ‘fríos’ makes evident, the authors of the logbooks did not offer clear-cut diagnoses. Rather, they offered a mix of diagnosis (syphilis, tumour), symptomology (pain, fever) and loose description (old age, chest) that only somewhat correspond to present-day medical terminology. Discerning an equivalent diagnosis in our own time seems simple when we are rendering ‘galico’ as ‘syphilis’, but even such direct translations risk creating a false sense of certainty in the emerging categories of disease. Do we trust the practitioners at the San Juan de Dios to diagnose cancer? What about madness? What did these terms even mean to Guatemalans at the time?
Perceiving Illness
The subjectivity of diagnosis and description is made starkly evident in the treatment of repeat patients. Consider the case of Manuela Castro, a woman described as ‘India’ and ‘doncella’ who arrived at the San Juan de Dios on 29 May 1794. While ‘doncella’ and ‘soltera’ both describe unmarried women, the terms differ in how they confer honour: ‘doncella’ designated a woman who was chaste, while ‘soltera’ designated a woman who was not. Castro’s age was 70 and her reason for admission was ‘hip pain’. She was released on 2 June 1794, only to return later on 23 June 1794. This time, she suffered from ‘stomach pain’, and her age was recorded as 60. She was released on 13 July 1794 but returned yet again on 28 July 1794. This time, her diagnosis was ‘insane’. And after a brief absence from 16 August 1794 to 22 August 1794, she returned to the hospital for good. This time, she was described as ‘mulata’ and was once again diagnosed as ‘insane’. She died on 6 October of that year, suggesting that perhaps Manuela Castro had some serious illness other than madness requiring medical care at the hospital.
A similar pattern is evident in the treatment of other elderly women, notably Andrea Alfaro, a 60-year-old Mulata diagnosed first with ‘old age’ and then with ‘dementia’, and Maria de los Ángeles, a Mulata also diagnosed as ‘insane’ on her two visits. Notably, both of these women had no release date logged in 1794, even though they arrived in July and August; this suggests that the two women remained semi-permanently in the hospital for long-term care. María de los Ángeles was 50 years of age on her first visit and, mysteriously, eighty years old on her next visit a couple weeks later. The striking disparity reveals that in some cases—if not all—the determination of age was not data provided by the patient but a subjective assessment by the medical practitioner.
Indeed, it seems likely that race, too, was a subjective assessment, as Manuela Castro’s shifting racial designation suggests. We know that patients did provide their personal information because in some cases where women arrived with insulto or privada (unconscious) the logbook is short on details. For example, a woman who arrived near the end of the year 1797 had this note to describe her admission: ‘On the 12th an unconscious woman arrived who did not give her name because she arrived on the verge of death’. In other cases, women who arrived very ill were accompanied by people who either offered some information about them or ‘they gave no further account’. This suggests that the practitioner relied on the patient and her companions to supply information about marital status, parentage, and so on. But the entries for race from 1797 demonstrate unequivocally that in some years, at least, race was construed by the writer. In 1794 and 1800, ‘Indias’ made up 37% and 36% of the patients, respectively. In 1797, they were only 4% (see Figures 4-6). There are certain dynamics that could conceivably explain this—notably how the typhus outbreak drove Indians beyond the city to shun the kind of treatments provided by the San Juan de Dios, as Martha Few has documented. 23 But the very high number of women who are not identified racially at all makes it more likely that the practitioner recording race chose not to ask and instead made his own assessment.
This becomes even clearer when we look at the composition of the 1797 logbook. It is written in three different hands; I’ve labelled them ‘M’, ‘E’ and ‘G’, based on their most distinctive letters. M mostly does not record race, but in the several dozen entries he records a handful of ‘Indias’ and one ‘Negra’. E records race in a manner more similar to how it appears in 1794 and 1800: recording Indias, Mulatas, Españolas (Spanish women), Mestizas (women of mixed Spanish and indigenous descent) and the occasional Pardas (lighter-skinned women of African descent) and Negras (Black women). And G, who wrote the vast majority of the logbook, recognises only two races: Mulata and Criolla (Creole). The use of the term ‘criolla’ by G is especially notable, because it is rarely used in other documentation from this period. It usually means a woman born in the Americas but of Spanish descent, and its closest approximation in the other logbooks would be ‘Española’.
The unusual depiction of race in the 1797 data naturally reminds the reader of the constructedness of race, but considered apart from the other documents, it also has the curious effect of suggesting that women described as ‘India’ barely frequented the hospital, a portrayal quite at odds from the impression conveyed by other years.
It is suggestive that women identified as ‘Mulata’ in 1797 have a 16% mortality rate, while women who have no racial designation at all have a 29% mortality rate. (The very few ‘Indias’ recorded have a 43% mortality rate.) From what we know about the high mortality rate among Indias in other years, it is possible that this ‘blank’ category conceals primarily women who would in other years have been identified this way.
And yet the most significant concealment in these logbooks, I believe, emerges not around race but among marital status. For it is here that the predominance of infectious disease reveals itself to be an illusion. It is true that when we look at all of the women patients, infectious disease is the primary reason for admission. But among married women, it is ‘heridas’—injuries (see Figure 7). During the typhus outbreak, typhus outpaces injuries, but as we will see below, even this may be illusory. In 1794, married women were 32% of the admitted patients but bore 59% of the injuries. In 1797, they were 27% of the admitted patient and bore 54% of the injuries. And in 1800, married women were 32% of the admitted patients and bore 71% of the injuries.
Married women are disproportionately diagnosed with ‘heridas’, sometimes described as ‘golpes’. It seems possible, at first glance, that something about the occupations or ages of married women could potentially explain this trend. Did married women engage in riskier work? Were married women older and more prone to accidents? Both of these explanations seem unlikely. The average age is remarkably constant (about 35), and there were few occupations entirely closed or exclusively open to married women. It seems instead that the greater risk of injury for married women came from simply having a spouse. The visible plagues were infectious diseases, but the invisible plague was domestic abuse.
Revealing and Concealing Injuries
The legal privileges accorded to married men rendered physical abuse common, if not ubiquitous. As Victor Uribe-Uran has argued for the larger Spanish Atlantic, domestic abuse did not draw attention unless it caused ‘“serious injuries,” “severe bleeding,” or “public outrage”’. 24 Criminal cases from Guatemala demonstrate that in some cases women were able to effectively tie a husband’s abuse to behaviour perceived by the courts as criminal and malignant: drunkenness, unwillingness to work, and the propensity for public scandal. But for the most part abuse did not prompt censure. Criminal cases rarely resulted in convictions, and the depositions in these cases often describe long years of abuse endured without redress. 25
In some cases—we cannot know how often, proportionally—a woman’s injuries were severe enough that she required medical attention. And in a small subset of these cases, the magistrates initiated a criminal case against the abuser. Such cases recount more complex stories that can barely be inferred from the laconic lines of text in the hospital logbooks. In 1797, three such cases correspond to entries in the San Juan de Dios register.
On 26 February 1797, Indian authorities from the town of Petapa arrived in the city with a grievously injured woman, María Gallina. 26 She had travelled two days from Santa Catarina Aguascalientes after suffering a stab wound to her chest. Once she had been conducted to the hospital and received medical attention, she gave her testimony to the court scribe who attended her there. She reported that she was 28 or 30 years old and that she had been married only three weeks. On the evening of the 24 February 1797, her husband, Cristobal Piche, had come home and asked when dinner would be ready. She said that she was still cooking. He replied to ‘hurry up, by the devil’, and left the room; then he came back with a knife and stabbed her in the chest, piercing her lung.
Dr Narciso Esparragosa gave testimony to the court after examining her injury. He described the stab wound and opined that it was serious; he was most concerned about complications that might develop. However, some three months later, Esparragosa wrote to the court to say that Gallina had recovered: a fortunate turn of events for Gallina, and an immediate signal to the court that it could halt its proceedings. Esparragosa’s words conclude the case. Gallina was free to leave the hospital and, we presume, free to return to Cristobal Piche in Santa Catarina Aguascalientes.
In the hospital logbook (see Figure 8), María Gallina appears (incorrectly) on the 16 February 1797. She is described as 40 years old, from Santa Catarina, and married to Cristobal Piche. Her cause for admission is not mentioned.
The errors here may seem to not amount to much—a mistaken date, an exaggerated age, a missing racial designation and absent diagnosis. And yet, such a cluster of distortions in a single entry suggest more elsewhere: if this entry is mistaken in so many particulars, how many others are similarly marked with errors?
A second case from February 1797 concerns Feliciana Morales, a resident of Guatemala City who travelled with her husband, Pedro Atanacio Perez, to the shrine of Esquipulas. On their return from the shrine, they camped out in a field to spend the night. Perez woke her at two in the morning and demanded to know if she was having an affair with a family friend, Don Francisco Juarez. Morales denied this repeatedly, but her husband was not satisfied with her response. Tying her by the hands and feet, he whipped her repeatedly across the back of her body. When she protested that she could no longer take the pain, he hung her from a tree to continue the lashings. At one point, Morales agreed to confess if only he would stop. As dawn broke, three men who identified themselves as officers of the law appeared at the scene and arrested Perez. Morales was taken back to the city to recover. 27
The training physician who examined Morales’s injuries, José Santos Alesio, described in vivid detail the extensive lacerations, some of which were still raw and open and others of which had begun to scab over. He judged the injuries to pose no immediate threat to her life. Meanwhile Perez, in prison, sent letters to his wife in his own hand: tangled knots of jealousy, recrimination and longing that do not for a moment deny his guilt. In testimony to the court, he described the incident in almost the same way, explaining the passion that motivated his actions. Curiously, the court exhorted him to think about his conduct, describing his ‘punishment’ of Morales as excessive. Even this mild reprimand is unusual, and it may have had something to do with the couple’s social standing. Although Morales is not identified racially, Perez was a 31-year-old mestizo and literate; their association with Don Juarez and the presence of three Indian carriers who camped with them on the journey suggest some modest social means.
In the hospital logbooks (see Figure 9), Morales is described as ‘soltera’ and from Tabasco. But her injuries do not register. She is diagnosed as suffering from ‘tabardillo’.
While Tabasco may have been her birthplace, and ‘soltera’ may have accurately reflected her state of mind soon after the injuries (for a brief moment, she never wanted to see her husband again), there is little to explain the diagnoses of ‘tabardillo’. The term so commonly used for typhus can also describe ‘peste’ or putrefaction. 28 But Morales does not seem to have suffered from any such complication. In the criminal case, the doctor observing Morales’s injuries was satisfied with her progress, and by 4 March she came to the court to plead for her husband’s release.
Another case from March 1797 echoes this troubling misdiagnosis. Tomasa Vásquez, a 17-year-old Mulata from Guatemala City, arrived in the hospital with a stab wound to the lung. 29 In her deposition at the hospital, Vásquez declared that she was ‘soltera’ and that the injury had come about when she was raped and assaulted by Juan Chanquín, a man who had already raped her on six previous occasions. In this case, the stab wound to the chest had necessitated both medical and legal action. 30 In May, Esparragosa declared that she was fully healed, but the case against Juan Chanquín continued for some time; he was found to have been involved in various crimes, including robbery and the carrying of outlawed weapons. He was sentenced to three years presidio in 1799.
Tomasa Vásquez appears in the hospital logbook as a “mulata soltera”, 17 years of age (see Figure 10).
She is identified as ‘Tomasa García’, but her mother is recorded as Lucia Vasquez and the exact match of dates, status, and age make it clear that this is the same Tomasa who appears in the legal proceedings. Once again, instead of ‘heridas’ she is diagnosed with ‘tabardillo’.
It is possible that both Vásquez and Morales suffered fever during their recovery periods. And it is doubtful that hospital staff undertook to actively conceal the women’s injuries. But regardless of why the injuries were not mentioned, there can be no question about the effect: the ‘heridas’ these women endured have become invisible in the logbook. It cannot be denied as we consider these three cases together that injuries to women caused by men are not fully reflected in the hospital data. How many other women diagnosed with ‘tabardillo’ were in fact suffering primarily from injuries inflected by others?
Criminal cases in Guatemala gesture towards a big picture (see Figure 11). Violent crime in Guatemala was prosecuted most aggressively towards the end of the eighteenth century, after a series of policing reforms increased the presence of urban police by a factor of 10. In the last decade of the eighteenth century, the number of court cases skyrocketed.
However, Bourbon policing was oriented almost entirely towards what we might think of as crimes of ‘public’ disorder—brawling on the street, homicides in taverns, insults towards officials, and similar offences.
Cases of domestic abuse account for a small portion of the violent crimes documented during the colonial periods. (In this chart, ‘homicides’ and ‘injuries’ do count crimes against women, but the vast majority of these crimes were against men.) It is, of course, impossible to believe that serious domestic abuse cases occurred less than once a year. The hospital logbooks themselves make this evident. And so, we must acknowledge that both the hospital logbooks and the criminal cases are ineffective at describing the reality of this plague—the plague of violence in the home. There are many reasons for this, including the predictable indifference of the court and the risks of reporting, but I think it’s also important to recognise that this was a crime that many people simply did not see.
The inability to see, paired with the possibility of deliberate concealment, is made even more evident when we consider the choice made by the hospital scribe in 1794. In this year, no injuries are recorded month to month in the logbook. During a period untroubled by typhus, syphilis and fever appear to be the most common diagnoses—until the reader reaches the end of the logbook, where the hospital scribes created a separate section dedicated exclusively to ‘heridas’, or injuries: ‘Account of the women who have arrived with injuries in the present year 94 beginning with the first who has been in hospital since the prior year, 93 ….’ This in itself is a remarkable choice: isolated, the injuries are made salient. They become a long, disturbing litany of ‘golpes’, or blows. But as the pages progress, the decision to separate injuries is revealed as an even more pointed gesture. Some patients are simply described as ‘herida’ (injured) or ‘golpeada’ (beaten). But in other cases, the hospital staff made the unprecedented decision to name the person who caused the injuries: ‘Herida por Don Vicente Aycinena’; ‘Golpeada por Sr. Gomara’; ‘Herida por Don Vicente Aycinena’ (see Figure 13). 31
In total, six women are listed as injured by Don Vicente Aycinena, the second Marquis de Aycinena (1766–814), a member of the Guatemalan aristocracy. Eight women are listed as injured by Sr Gomara, likely the prior of the Guatemala city council, Ambrosio de Gómara. Four other ‘señores’ are mentioned, each with a similar handful of injuries attributed to them. The women are of all races. They range in age from 15 to 60. Most are married, but there are ‘doncellas’ (maidens) and ‘viudas’ (widows) and ‘solteras’ (single women) among them, too. Some of them return more than once with injuries caused by the same person. It seems almost certain that these injuries were inflicted in the course of household service. Any of the high-ranking señores listed in the logbook would have had sizeable properties with a large staff. Most remarkable to me is that the injuries attributed to these men of high rank started in April 1794 and ended in September 1794. Alas, it seems unlikely that they actually took place during such a short window. Rather, the explanation seems to lie in authorship: it is a single hand that fills these pages. One of the hospital scribes, and only one of them, thought it was important to document the recurring abuse taking place in Guatemala City’s most elite households.
Conclusion
The criminal cases seem to expose significant flaws in how the logbooks recorded names, ages, dates, and diagnoses. In the span of a single month, from February to March 1797, the entries appear to make critical mistakes in all three entries. One might reasonably wonder whether any record in the hospital logbook is entirely correct. Setting aside the interpretive nature of race and diagnosis, how much can even be relied upon from this data if a simple arrival date can be recorded wrong? Taken to its logical conclusion, this line of questioning could potentially undermine any observations about the state of women’s health in Guatemala: the intake data is flawed, and it thereby cannot tell the truth.
This is a fair conclusion. Indeed, using the data to determine how much infectious disease occurred, or how many ‘Indians’ or ‘Creoles’ arrived at the hospital seems risky: it requires too much trust in unreliable data. That is perhaps not the truth we should look for. What these logbooks do offer is a detailed, if complicated, picture of what hospital staff perceived. Crucially, they did not all perceive the same thing. As a result, the logbooks advance varied, even contradictory arguments. What are these arguments? The authors of the 1797 logbook argue that typhus was the only illness of consequence in that year; everything else was insignificant. One writer from this year argues that ‘Indias’ do not exist: according to him, there are only Mulatas and ‘criollas’ in Guatemala City. But other authors, from 1794 and 1800, do see Indias; they argue that Indias from outside of the city suffer greatly from infectious disease. They live too far away, and by the time they get to the hospital it is too late to help them. Yet another argues that elderly women who insist on medical care are not persistent, they are mentally ill.
For the most part, these writers do not perceive injuries distinctly; they are folded into the other diagnoses, sometimes concealed or disappeared altogether. But one writer argues boldly that injuries cannot be lumped in with other ailments, because they are a serious problem with causes that need to be highlighted: this author sees abuse, not injuries. It occurs at the highest levels of society, in ways that are more than occasional. This is a medical problem, he seems to argue, but also a social problem—both part and not part of the hospital’s routine.
Yet his perspective is anomalous, and for the most part we have taken our cue from the other writers, the ones who either did not see injuries or failed to perceive their importance. The history of medicine generally does not encompass domestic abuse or sexual assault, both of which receive attention from historians of criminality instead. Are we perhaps letting the sources, and their perceptions, dictate the terms too closely? It has become a commonplace among historians to read ‘against the grain’, but the Guatemalan logbooks remind us that this is about more than the close reading of sources: it is also about reading against the historiographical grain, allowing for the possibility of omissions and blind spots.
Footnotes
Acknowledgements
I am grateful to the Editorial Collective of the Medieval History Journal for the invitation. Thank you in particular to Ranjeeta Dutta and Harbans Mukhia for their tireless long-distance hospitality and to Prasannan Parthasarathi for his response. I am indebted to Stephen G. Sellers for both assistance in the archive and for the invaluable statistical skills. Thank you to Paul Ramírez, Ana Díaz Burgos, Jeffrey Erbig, Jessica Delgado, David Carey, Jordana Dym, Tom McHale, and Brianna Leavitt-Alcántara for reading portions of this work and offering their very helpful comments.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The author received no financial support for the research, authorship and/or publication of this article.