Ilustración y liberalismola legislación española sobre cuidados de salud (1749-1855)

Abstract

Presenting the cultural study of the health service between the former regime and the beginning of the Liberal State is one of the initial approaches of this case of study. The vision with which the XVIII and first half of the XIX century society affronted the health was far from what we understand about it currently. The approaches concerning the health and the health professions, which were responsible for starting a key change in investigation, diagnosis, care, training and management of the activities focused in increasing the level of the population health needs, were diametrically opposed to what we understand about health and hospitalization today. The charity and the different institutions that took part in this big social group, among them the hospitalization and its management which we cannot understand today without the implication of health professions, were something that did not have an immediate correlation with politicians or society. In this cultural and social framework in which the health is organized and managed, a lot of factors, circumstances and elements are involved, taking part in the variables to be examined in order to understand the behavior of the healthcare in the period of investigation. Its study in the transition period between the previous stratified society and the Liberal State requires a multifactorial and evolutionary analysis. The study of aspects as hospitality, population indexes, health professions, its training or the institutions that enable the clinical practice, constitute essential aspects to observe and understand modern ages. The treatment, definition and typology of poorness as fundamental objectives of health care should necessarily become relevant in the leap towards Liberalism. In this framework, the beneficence has to be analyzed and defined, as well as the worry of the local authorities about the aspects regarding health and disease prevention. The new liberal vision which tried to settle in politics, supported by a new hygienist concept and the changes that subsequently it was going to produce, were reflected in the parliamentary discussions, germ of the new health, charity and educational laws. The Triennial Liberal Essay will be the origin, and these same laws in the Elizabethan period, as a period in which the new parliamentary monarchy was practically accepted and implanted, justify from our point of view the time interval of more than a century for this investigation. The present study starts addressing, in a descriptive approximation, the health situation in the XVIII century. For this purpose, relevant information has been extracted from different questions from the so-called “general answers” of the Ensenada cadaster in relation to population, health professions, charity institutions, hospitals, monasteries and ecclesiastical numbers. Another aspect covered by this study is the education level of the stratified society in general and, particularly, the education level regarding health in the Castilian Crown. As an example on how the society was motivated by the new hygienist theories developed in Germany and England, the creation of new places for dead, built in the new city of the XVIII century, can be mentioned. The sanitaiy view on burials in the change into the liberal society, studied through the analysis of the legislation and the work of Pedro Felipe Monlau, put in frame the context in which they were accomplished, their facilitator elements and the reticences shown up on the way. The laws about charity and health, discussed in the “Cortes del Trienio”, together with the Law of Public Instruction in this period constitute a driving force for analysis in this study, making emphasis in the first regulations regarding the training of the sanitaiy professions. The Elizabethan period begins with the revision of the new educational laws in the course of study of Gil de Zarate, with a special insistence in the sanitaiy professions training. The analysis of the parliamentary discussions on the Charity Law of 1849 and the Sanitaiy Law of 1855 is another of the considered aspects. This investigation also approaches the appearance of the members of the Parliament who participate in the different discussions on the charity and educational laws listed in the previous paragraphs, as well as the Charity laws of 1822 and 1849, and the Sanitaiy laws of 1822 and 1855. The elaboration of collective profiles of those who took part in the debate of the different laws related to healthcare contributes to improve the understanding on the evolution of health care in the studied period.