Medical knowledge in Latin America and the Caribbean was made through survival, extraction, experiment, and political struggle.

“Latin America and the Caribbean” is useful here as a route through connected histories, not as the name of an ancient or uniform tradition. The guide includes societies shaped by Spanish and Portuguese rule as well as Caribbean territories formed through British, French, Dutch, Danish, and United States empires. It also begins before those empires: Nahua, Maya, Andean, Amazonian, Caribbean, and many other peoples maintained distinct forms of healing, childbirth care, bodily knowledge, and relations with plants and landscapes. African-descended practices were likewise remade across slavery, freedom, and migration rather than simply carried intact from one continent to another (Cueto and Palmer, 2015; Gómez, 2017).

Terms such as curandero (a broad Spanish term for a healer), materia medica (knowledge of medicinal substances), and “tropical medicine” describe historically changing categories. Officials often used labels such as “superstition,” “quackery,” or “folk medicine” to deny credentials to Indigenous, African-descended, Chinese migrant, rural, and female practitioners. Patients nevertheless moved among household care, midwives, herbalists, religious specialists, pharmacists, and university-trained doctors. Medical pluralism was not a temporary stage awaiting replacement by biomedicine (Carey, 2019).

This page discusses remedies and disease theories as historical evidence, not as present-day treatment advice. A plant's appearance in a manuscript or a remedy's long use does not by itself demonstrate modern safety, identity, dose, or efficacy. Conversely, the absence of a practice from official archives does not show that patients rejected it.

Before 1492–seventeenth century: epidemic loss and colonial medical pluralism

European invasion brought warfare and repeated outbreaks of smallpox, measles, influenza, and other infections into populations without the same histories of exposure. Catastrophic mortality is well documented, but surviving counts are incomplete and retrospective diagnoses remain uncertain. “Virgin-soil epidemic” shorthand is insufficient: forced labour, enslavement, tribute demands, hunger, displacement, crowding, and environmental change influenced exposure and survival. A local history of Xochimilco, for example, treats recurrent epidemics as part of a disease ecology shaped by colonial violence and climatic disruption, not as an automatic biological event (Conway, 2021).

Cocoliztli, a Nahuatl word for pestilence, illustrates the limits of retrospective certainty. Ancient DNA research identified Salmonella enterica Paratyphi C in ten people buried at the sixteenth-century epidemic cemetery at Teposcolula-Yucundaa in Oaxaca. The authors call it a strong candidate for disease at that site during the 1545–50 outbreak; the evidence does not prove that one pathogen explains every illness called cocoliztli across New Spain (Vågene et al., 2018).

Colonial records simultaneously preserve and transform medical knowledge. The 1552 manuscript now called the De la Cruz–Badiano Codex was composed by the Nahua healer Martín de la Cruz at the Colegio de Santa Cruz de Tlatelolco and translated from Nahuatl into Latin by Juan Badiano. Francisco de Mendoza commissioned it and sent it to the Spanish king as a gift. Its images and recipes document Nahua expertise, but its European paper, Latin text, college setting, patron, and courtly destination make it a translated colonial presentation—not a transparent inventory of pre-conquest medicine or proof that every remedy worked (INAH).

In the long seventeenth-century Caribbean, free and enslaved people of African descent made influential knowledge about bodies, substances, and healing. Pablo Gómez reconstructs more than one hundred Black ritual practitioners from Inquisition and other colonial records and shows that patients and officials treated their experiential claims as powerful and competitive. Those records were created to investigate and discipline people, however; accusations and interrogations cannot be read as neutral transcripts of practice. The archive reveals Black intellectual work while filtering it through institutions of slavery and religious prosecution (Gómez, 2017).

1801–1850s: vaccination moved through local and imperial routes

Cowpox vaccination against smallpox reached several Spanish American ports before the Royal Philanthropic Vaccine Expedition. Surgeons in Puerto Rico, Cuba, Venezuela, New Granada, Guatemala, New Spain, Peru, the Río de la Plata, and Chile circulated material and organised vaccinations through maritime and local networks. The expedition led by Francisco Xavier de Balmis and José Salvany left Spain in 1803 and established additional routes and vaccine boards across the Americas and into Asia. It kept vaccine viable through serial arm-to-arm transfer in children, including foundlings—an effective logistical technique that also raises questions about consent, guardianship, and the use of dependent children (Pérez Pérez and Vallejo, 2023; Mark and Rigau-Pérez, 2009).

Independence did not create a clean break with colonial medicine. New republics and independent Brazil inherited hospitals, charitable institutions, military services, and licensing practices while physicians sought authority in universities, academies, legislatures, and sanitary offices. Rural and urban patients continued to combine household, religious, Indigenous, African-descended, migrant, and professional care. In Central America, state campaigns sometimes persecuted healers and midwives as obstacles to progress, yet governments never achieved a complete medical monopoly (Carey, 2019; Cueto and Palmer, 2015).

1881–1920s: laboratories and sanitary states joined science to commerce

In Havana in 1881, Carlos Finlay argued that a particular mosquito transmitted yellow fever. The United States Army Yellow Fever Commission confirmed mosquito transmission in occupied Cuba in 1900, drawing on Finlay's hypothesis and insects as well as work by Henry Rose Carter and commission members. The later story was often compressed into a contest between Finlay and Walter Reed. A fuller history connects collective research to human experimentation, Cuban independence, United States military occupation, quarantine, and the commercial desire to protect southern ports and shipping (Espinosa, 2009).

Regional public health expanded through similar combinations of prevention and power. Eleven countries sent delegates to the 1902 International Sanitary Convention in Washington, which created the International Sanitary Bureau, later the Pan American Sanitary Bureau. Its first duties centred on exchanging epidemic information, regulating quarantine, and improving ports—evidence that health cooperation grew alongside trade and diplomacy (PAHO). In Rio de Janeiro, Congress approved compulsory smallpox vaccination in 1904 amid an epidemic and sweeping urban reform. The ensuing Vaccine Revolt cannot be explained as simple popular ignorance: opposition joined fear of vaccination to anger over intrusive household inspection, bodily authority, demolition, and police power. The government suppressed the revolt, arrested 945 people, and suspended compulsion (Casa de Oswaldo Cruz).

Laboratories in the region produced knowledge rather than merely receiving it. In 1909, working for the Oswaldo Cruz Institute during a malaria-control assignment along a railway in Lassance, Minas Gerais, Carlos Chagas connected a trypanosome, triatomine insects, and human illness. Later commemoration made this appear an unusually complete individual discovery. Historical analysis instead recovers railway workers and residents, the child Berenice whose blood supplied the first recognised human case, institute technicians and colleagues, clinical disputes, and the material support of Manguinhos. The achievement was substantial, but science was collective and the definition of chronic Chagas disease remained contested after 1909 (Kropf and Lima, 2022).

1930s–1990: social medicine, research abuse, and health as a right

Latin American social medicine made work, income, housing, food, land, and political violence part of causal explanations for illness. In Chile, physician and health minister Salvador Allende's 1939 La realidad médico-social chilena joined mortality and morbidity data to proposals for income redistribution, housing, nutrition, and occupational reform. Later movements in Argentina, Brazil, Chile, Colombia, Cuba, Ecuador, Mexico, and elsewhere developed different versions of medicina social and salud colectiva. These were contested intellectual and political projects, not a single doctrine imported unchanged from Europe (Waitzkin et al., 2001).

International research could also exploit political and economic inequality. From 1946 to 1948, United States Public Health Service researchers, working with the Pan American Sanitary Bureau and Guatemalan agencies, intentionally exposed prisoners, soldiers, psychiatric patients, and others to bacteria causing sexually transmitted infections without valid consent. The work was not published at the time. The 2011 United States presidential commission judged it wrong even by the researchers' own understanding of contemporary ethical requirements. Its report is a later official reconstruction based on dispersed records; the digitised John Cutler papers preserve the investigators' documentation much more fully than participants' voices (Presidential Commission, 2011; U.S. National Archives).

Health-system change followed no common path. Some governments expanded social insurance or national services while authoritarian regimes, civil wars, debt crises, rural exclusion, and private markets limited access. In Brazil, a health-reform movement linked democratisation to universal entitlement. The 1988 Constitution defined health as a right and state responsibility and created the basis for the decentralised Unified Health System (Sistema Único de Saúde, SUS); 1990 laws specified its organisation. SUS widened access, yet underfunding, regional inequality, and a subsidised private sector constrained universality. The history is therefore one of organised political struggle and unfinished implementation, not the gift of a single administration (Cueto and Palmer, 2015; Machado and Silva, 2019).

Printed treatises, laboratory papers, institutional anniversaries, sanitary reports, and legislation privilege authors, directors, officials, and measurable campaigns. Care also depended on patients, children used to maintain vaccine, household caregivers, midwives, nurses, pharmacists, laboratory assistants, sanitation workers, interpreters, port workers, and people whose homes were inspected or demolished. Race, legal status, gender, class, language, disability, and distance from a clinic shaped who could receive care, refuse an intervention, earn a credential, or leave a record.

Primary sources on this page perform limited tasks. The De la Cruz–Badiano catalogue establishes the surviving manuscript's commission, makers, material form, and custody; it cannot verify remedies. The Cutler papers document what investigators recorded about the Guatemala experiments; they do not restore participants' consent or perspective. PAHO and Fiocruz institutional histories establish dates and preserve objects, but they also commemorate organisations and leaders. Academic histories are used to test those narratives against social and political context.

This selective chronology remains much thinner for childbirth, disability, psychiatry, occupational disease, Chinese and South Asian migration, the Guianas, smaller Caribbean islands, Amazonian and rural communities, and patient organising than for infectious disease and state institutions. Those absences should not be mistaken for historical insignificance.