The Healing Nation: Hygiene, Sanitation, and the Public Health Enterprise in Spain, 1845–1920

Abstract

This dissertation examines the intimate relationship between disease and state building from 1845 to 1920 uncovering the role of the Dirección General de Beneficencia y Sanidad in crafting a sanitation system in Spain. This work begins with the first cholera outbreak, in the 1830s, by examining medical dictionaries, inspector reports, census records, legislature, regional health correspondence, newspapers, pamphlets and advice literature. It shows the initial emergency response and the networks that emerged to contain and eliminate the threat of disease. As Spain continued to suffer from epidemic outbreaks throughout the nineteenth century, Spanish politicians and physicians crafted projects that extended into all aspects of ordinary life. During the nineteenth-century, the Spanish state was considered backward, corrupt, and saddled with a disengaged citizenry. Political corruption was mired in caciquismo, political bossism, which further alienated ordinary Spaniards from political participation. In addition, Spain underwent various political turns which challenged the very validity of the state. As a result, from a purely political focus, the traditional story of the nineteenth-century in Spain is one of failure. This dissertation challenges that narrative by showing the different legislative efforts and hygienic projects Spanish politicians and physicians attempted. The questions they asked regarding sanitation and hygiene shed new light on how epidemics and disease, public health more broadly, redefines state formation.