Protomedicato, a board of physicians in the Spanish Indies responsible for regulating medical practitioners and inspecting apothecary shops. Established in Spain in the fourteenth century, the protomedicato evolved very slowly in the Indies. Initially, regulation and licensing of physicians fell to city councils (Cabildos), which tried to verify the legitimacy of medical practitioners, inspect apothecary shops, and provide medical care for the local jails and the indigent. Then in 1570 Philip II took steps to bring the protomedicato to the Indies by appointing the physician-botanist Francisco Hernández as protomédico general of the Indies with instructions not only to regulate medical practice but also to investigate New World medicinal herbs, seeds, trees, and curatives. Since Hernández proved far more interested in the latter task, the Cabildo continued to be responsible for examining and licensing physicians.
In 1646, however, Philip IV finally ordered establishment of protomedicatos in the major cities of the Indies. Made up of three physicians (protomédicos), the protomedicato consisted of the most distinguished chair in medicine (prima) at the local university, the senior professor of the medical faculty, and a third physician appointed by the viceroy. Salaries for this board came from fees collected for examination and licensing of physicians, surgeons, phlebotomists (blood-letters), midwives, and other practitioners and from inspections of apothecary shops. Jurisdiction of the protomedicato was never resolved. Anxious to collect more fees, the protomé-dicos hoped to extend their jurisdiction beyond the city where they exercised their authority, but practitioners and pharmacists outside the major cities strongly resisted their attempts in order to avoid the onerous fees and to remain independent of the meddlesome protomedicato.
Establishment of the protomedicato manifested the belief of Spanish authorities that the state must assume some responsibility for regulating medical practice, and in many respects, the institution was successful, particularly in the larger cities. Through both a rigorous oral questioning in the halls of the protomedicato and a practical examination in a hospital, protomédicos made certain that those entering medical practice in the Indies were adequately trained. The board also exposed those who practiced without a medical degree—or with a forged one—and helped to ensure that apothecary shops maintained a proper stock of drugs that conformed to the standard pharmacopoeia.
On the other hand, the protomedicato was less successful in regulating medical practitioners in the provinces, where unlicensed doctors, surgeons, midwives, and local healers (Curanderos) went about their business unchecked. In fact, in Mexico the medical board licensed only two midwives in all the colonial period, and this at the very end. Moreover, certain surgeons (not trained in Latin), barbers, and phlebotomists consistently avoided examination—and payment of fees—even in the large cities. Strangely, too, the protomedicato proved less interested than the viceroy, local authorities, and professors at the universities in promoting public health policies, new medical techniques, and measures to stop the spread of epidemics, particularly the use of inoculation and vaccination against smallpox in the last half of the eighteenth century. The view of most protomédicos was that well-being and health of the community could be best maintained if trained, licensed doctors practiced medicine in the Indies.
John Tate Lanning, The Royal Protomedicato: The Regulation of Medical Practitioners in the Spanish Empire, edited by John Jay TePaske (1986).
Astrain Gallart, Mikel. Barberos, cirujanos y gente de mar: La sanidad naval y la profesión quirú rgica en la España ilustrada. Madrid: Ministerio de Defensa, 1996.
Fajardo Ortiz, Guillermo. Los caminos de la medicina colonial en Iberoamérica y las Filipinas. México: Universidad Nacional Autónoma de México, Coordinación de Humanidades, Facultad de Medicina, 1996.
Hernández Sáenz, Luz María. Learning to Heal: The Medical Profession in Colonial Mexico, 1767–1831. New York: Peter Lang, 1997.
Sánchez, Raúl Francisco. Del protomedicato al Colegio de Médicos y Cirujanos: 145 años de historia. San José: Editorial Porvenir, 2002.
John Jay TePaske