Open Journal Systems

HISTORY AND PHILOSOPY OF MEDICINE

Received: March 23^rd 2015

Judged: April 28^th 2015

Doctor Levi B. Salmans, founder of The Good Samaritan sanitarium in Guanajuato

Carlos Olivier-Toledo,^a Carlos Viesca-Treviño^b

^aPosgrado en Ciencias Médicas, Odontológicas y de la Salud

^bFacultad de Medicina

Universidad Nacional Autónoma de México, Ciudad de México, México

Communication with: Carlos Olivier-Toledo

Telephone: (55) 4426 4098

Email: oliviertcarlos@gmail.com

In this research we focus on the medical evangelist Levi B. Salmans, and The Good Samaritan sanitarium. Doctor Salmans lived in Mexico for about 50 years (1885-1935). During the first part of his stay, he was devoted to found churches and Methodist schools. However, from 1891 he took a turn in his career by founding dispensaries in different towns of Guanajuato to create, in 1899, the private charity association for the sick and infirm The Good Samaritan. His intense, intellectual, and practical work led him to create health journals, to train nurses, and to promote physiotherapies in accordance with the science advances of that time. By itself, this research shows that the history of medicine in Mexico still has long way to go and that Protestant communities, in favor of modernity and scientific knowledge, took a big part in shaping the history of this discipline in Mexico.

Keywords: Altruism; Beneficence; Protestantism; History of medicine; Mexico

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From the last third of the nineteenth century to the beginning of the revolutionary movement in 1910, Mexico saw the building of various institutions, both public and private, dedicated to the care and restoration of health. We have for example the cases of the Hospital Civil of Aguascalientes, Guadalajara, and Chihuahua, the Hospital de Toluca, the Hospital Militar of San Luis Potosi, the Hospital Miguel Hidalgo in Aguascalientes, and of course the Hospital General de Mexico, opened in 1905. Some private hospitals were also founded like Hospital Concepción Béistegui or the Hospital Americano. In addition, this period brought together a variety of doctors who took responsibility for ensuring the health of the inhabitants of the country, creating media for dissemination, implementing health codes, publishing writings, promoting public health, teaching in institutions dedicated to medicine, and, of course, practicing it; we have the cases, just to name a few, of Nicolás León, Eduardo Liceaga, Matilde Montoya y Lafragua, Rafael Silva y Zayas, Luis E. Ruiz, Porfirio Parra y Gutiérrez, and Jesús Monjarás Miranda. Most likely, it was because of the magnitude and importance of many Mexican doctors and the creation of health establishments to consolidate medicine in Mexico that not only has the health project sponsored by the Methodist community in Mexico gone virtually unnoticed, so has its main representative, Doctor Levi Brimmer Salmans, and the first medical facility, namely the Asociación de Beneficencia Privada para Enfermos, (Private Association of Charity for the Sick), "El Buen Samaritano", founded by the Methodist church.    

Therefore the objective of this study is basically to present a general outline showing the figure of the doctor Levi Salmans and a general structure of the El Buen Samaritano hospital. For this, we mainly consulted newspaper sources founded by the Protestant and American community based in Mexico, namely: El Abogado Cristiano Ilustrado, Mexico; The Organ of the Methodist Church of Mexico; El Faro, and The Mexican Herald. Meeting minutes of the Methodist community in Mexico and bibliographical sources that frame the life of Levi Salmans, El Buen Samaritano hospital, and the political and economic situation that our country experienced at the arrival of this evangelical doctor were also reviewed.

We do not stop believing that the importance of this research lies not only in demonstrating the incompleteness of studies about the history of medicine in Mexico, but also that it incorporates both players and spaces dedicated to medicine in Mexico belonging to Protestant communities whose participation in the construction of "modern Mexico and the institutionalization of medicine" is undeniable.

Life and Work of Dr. Levi Brimmer Salmans  

Born March 19, 1855, in Hocking, Ohio, United States, to a Methodist family, Levi Brimmer Salmans was a fervent believer in the Christian life and simultaneously in the progress made in the field of science and medicine. Someone very close to him, Dr. McCombs, wrote in 1938 that from an early age he had received his visions on the need to do missionary service to promote the Gospel.¹

Dr. Levi Salmans, married to Sara Jones Smack and father of five children (Edith, Clara, Helen, Louis, and Flora), chose to study at DePaul University. He later entered Drew Theological Seminary for three years and finally began his medical studies in New York, which he discontinued to travel to our country to continue building the Methodist church.

Leaving behind his job as secretary to Dr. J. M. Buckley, editor of the New York Advocate, Levi Salmans arrived in Mexico in interesting political and economic times. A year before his arrival in 1885, Porfirio Diaz was reelected to the post of president. This allowed him to reform the constitution on October 21, 1887 and thus be reelected in the elections held in 1888. In addition, US expansion was in force since the decade of the seventies. Now with solid economic power, the United States fully joined the imperialist competition characteristic of European countries. John Hart mentions that US companies, led by financiers, industrialists, and politicians, rapidly strengthened in Mexico and the Caribbean. He says that Mexico was very attractive to its northern neighbors, and the first to arrive were the railway owners. This is very interesting, since a year before Levi’s arrival two things happened: the culmination of the Mexican Central Railroad, carried out with foreign capital, and approval by the Mexican Congress of the mining code, "specifically designed to attract foreign investment".² Therefore it is not difficult to understand that evangelical communities almost doubled in number from 1877 to 1882, because in this period an average of 239 Presbyterian, Baptist, Congregational, and Methodist congregations were developed throughout the country; however, from 1882 to 1890 the congregations reached 566.³ Almost immediately upon arrival, Levi Salmans was appointed pastor in the congregations of Pachuca, Santa Gertrudis, Real del Monte, and Omitlán. In 1887 he requested transfer to Puebla to lead the Methodist Seminary and High School; he was also named Honorary President of the Literary High School "Melchor Ocampo".  

So far it seemed that the master of arts and bachelor of theology, Levi Brimmer, would have his field of action in preaching and education, not strange if we remember that the major strategies and areas of conversion used by evangelical communities consisted of establishing churches and schools. However, in 1889 he applied for permission from the Methodist church to travel to the United States due to health problems and extreme fatigue. Once recovered and advised by his wife, Levi decided to finish his medical studies in Indianapolis and Louisville and as a graduate did his specialty in Germany (Figure 1).

In the period from 1891 to 1893, Salmans spent his time in Mexico giving lectures and recruiting subscribers to Abogado Cristiano Ilustrado (the official publication of the Methodist Church), relatively common practice for him. In 1893 he was appointed lead priest of the northern district, which included the cities of Celaya, Guanajuato, Queretaro, Salamanca, and Silao. That same year moved his residence to Silao where he had his first dispensary.  

Despite working in their dispensary since 1893, it was only after Levi Salmans’ allocation as superintendent of medical work in Mexico in 1896 that the Methodist community formally decided to undertake conversion work other than that done in temples and educational spaces. The dispensaries and hospitals were designated spaces to promote, not only the gospel, but also health. Under superintendent Salmans were Dr. Margaret Cartwright in Guanajuato; Dr. George B. Hyde in Silao; the Mexican Pablo del Rió Zumaya as a pharmacist in Guanajuato; Juan Hernández, dispensary assistant and Bible reader in Silao; Andrea Vega as Bible reader in Silao; Refugio Zavala as dispensary assistant Guanajuato, and Graciana Ramirez, Bible reader in Guanajuato. Ahead of his time and aware of the needs of women, he also opened “La Casa Nueva para la Obrera” ("The New House for Women Workers") with his wife Clara Salmans in April 1904, which was dedicated to the care of children of working mothers. 

On June 14, 1925 Sara died in Guanajuato and two years later, on July 5, 1927 and 50 years old, Levi contracted a second marriage with Ana María Blake (born in Burlinton, Iowa in 1877), daughter of a newspaper editor in Guanajuato. This marriage lasted until January 29, 1938, the day Levi Brimmer Salmans last saw the light. 

In 2004 the district superintendent of the Methodist Church in Guanajuato, Guadalupe Martínez Ortiz, referred to Dr. Salmans as the "Schweitzer of Mexico". Among his patients (it is said that there were more than 115,000)¹ Levi was also known as "the Holy Protestant".⁴ Vernon McCombs saw him as the first evangelical doctor in Latin America, who also founded the first nursing school in Latin America.⁴ McCombs says he wrote about 35 works, however, we only have "God's Plan for the support of his work", "Medical Evangelism in Guanajuato", "Evangelical Medical Work" and "History of the Salmans Family".^5-8 He was also director of the hygiene magazines Mexico Tidings (published in Silao, Guanajuato), El Buen Samaritano, and  La Salud  (published first in Guadalajara and later in Guanajuato). All were fundamental to the understanding of what we can consider his medical and evangelical work in the country and, with it, the foundation of the Asociación de Beneficencia Privada para Enfermos “El Buen Samaritano”.

Founding “El Buen Samaritano” Hospital

With the byline of establishing a network of spaces dedicated to medical work, Levi Salmans founded the first Methodist dispensary in Silao in 1891, whose main objective was to "do good to suffering humanity".⁹ At the same time, demand for service increased, so Salmans had to set up other clinics in Leon, Guanajuato, Romita, and Cuerámaro. Because Salmans had the discipline to record the number of patients he attended from 1892 to 1904, we know that these establishments were those that sustained Methodist medical work for a period of twelve years. 

Along with the work in clinics, in 1898 Levi Salmans began constructing the Sanatorio El Buen Samaritano, however it was not until 1899 that he could realize his dream of having a larger space to care for the sick.

In 1902 the Mexican Herald newspaper reported that in the 1880’s the Missionary Society of New York acquired a lot on Avenida Pardo that they ended up lending indefinitely for the creation of the Sanatorio El Buen Samaritano.¹⁰ The lot measured 200 meters wide by 50 deep and was bought at 10,000 pesos from a family that acquired the land in an embargo, but that ultimately decided to resell because of their appreciation for the care that the Methodists gave to the sick and the difficulties that they had in renting a lot because of being Protestants. Upon acquiring the site, the Missionary Society planned to divide it to build a residence for Dr. Salmans, a room for the clinic, a hospital, a church, and school that at the time was called "Juarez".

Much of the time the Methodists had to wait for the opening of the sanatorium was because "mortmain" had been banned since the establishment of the Reform Laws in 1856, or, in other words, ownership of real estate by ecclesiastical corporations or others that were not limited trading companies. This was just what stopped the establishment of the Methodist Hospital and prompted the temporary closure of the clinic in Guanajuato. However, on November 7, 1899 Porfirio Díaz enacted the Ley de Instituciones de Beneficencia Privada (Private Charitable Institutions Act) that promoted and enabled the acquisition of spaces with private funds with philanthropic or secular educational purposes. Private charity could result in hospitals, orphanages, asylums, and more. It was under this law that the Methodists were able to organize the Asociación de Beneficencia Privada para Enfermos, El Buen Samaritano.    

Salmans tells us that the Administrative Board of the Missionary Society of New York appointed John Butler as attorney to be their representation to sign a contract or Constitutive Act of the Association El Buen Samaritano, giving them the absolute power and freedom of action dictated by law, such as building schools or teaching courses. To consolidate the project, Levi bought the medical equipment that he tells us cost more than four thousand pesos, while the association made it theirs; for its part, the federal government gave the new Association all the rights of law including legal status and the right to receive bequests and donations of almost all kinds. In those times that hardly became relevant, however, thirteen years later, an amendment to the Ley de Beneficencia Privada led to the ban on ministers being not only employers but also managers or administrators of schools. Thus it was that the Guanajuato state government notified the representatives of El Buen Samaritano that if they wanted to continue enjoying this law, they would have to change the direction and administration of the place. In view of this, Dr. Salmans, to ensure the funds necessary to support his work and wanting to be able to receive, within the law, all hospital donations, found no other way but to conclude all his formal relations with the conference, and to stop being a minister to take the legal form appropriate to the hospital, thus being able to work freely for the hospital he directed.¹¹ So the Protestant saint asked the Missionary Society of New York for his retirement from the ministry to take his place as a layman. The Society responded that it had no objection or problem with Levi's resignation, and in August 1911 they forwarded his resignation accompanied by his ordination credentials to the district superintendent, who had to accept it.

With all that and what would happen thirteen years later, in 1899 Levi would achieve his mission to overcome the legal adversities that the area presented him. At that time the federal state required any association to be secular; it also demanded that the employer or head not be a minister of any religious sect. So the El Buen Samaritano association consisted of five Americans and Europeans, two of them missionaries and three merchants in the country, plus two Mexican employees at the institution, i.e., doctors Pablo del Río Zumaya and Petra Toral (Mexicans under the auspices of the Methodist church who had acquired their medical training in the US), and two liberal Catholic Mexican lawyers, making a total of nine partners. Mr. Dwight Furness, an American consular agent in Guanajuato, was the head and Dr. Levi B. Salmans was chosen as director. The formal objectives of the association were to:

1. Establish, maintain, and promote private hospitals and nursing schools in Mexico.
2. Practice pure philanthropy. Consequently, in their hospitals all patients will be served with the same attention and given the same care, regardless of the race or nationality they belong to, religion or opinions they profess, and monetary resources at their disposal.
3. Assistance to the homeless will be entirely free. Those with the potential to contribute to sustaining the hospital will be assigned an equitable fee proportional to their resources, on the understanding that paying or failing to pay their dues, patients always receive equal services from the association.
4. The association will be purely secular and therefore will not recognize the domain of any religious corporation.¹²

It bears remembering that the hospital’s proposal regarding care without discrimination of class, gender, or race took place in the context of the persecution of Evangelicals; therefore we find even more worthy the nondenominational position promoted by Levi Salmans. This speaks of a person loyal to the principles of respect and the right to difference, for which he did not stop saying "The hospital will serve the needs of all patients in their care regardless of race, nationality, or religious opinion; nor will it matter the remuneration that they can give [...] All patients in the hospital can enjoy absolute freedom and equality in their right to the comfort of their own religion; so they can call priests or ministers for spiritual service".¹⁰

Nor should we ignore that the formal objectives of the association made sense in the institutional context, but behind curtains the hospital had also intended to...

Provide more continuous treatment for patients requiring more than one visit. Many patients reported by Dr. Levi arrived needing several days of treatment, but could not finish because of the long distances traveled from home to the clinic; "Several clients died on the way back to their homes before taking the first dose of medicine, who would not have died if we could have received and treated them in a nursing home";¹³

Have a place to receive and treat patients from other communities to enjoy scientific nursing care in the treatment of their ailments. Treatments were proposed such as hydrotherapy, surgery, and even creating a modern nursing school, "teaching so far not seen in any establishment of the Republic";¹³

Gain the respect of the community and raise funds to allow the medical work to sustain itself.

Through medical movement, let the establishment gain influence for the gospel.

In terms of structure, the hospital had a facade 65 meters long and a sign in front that read: "The Guanajuato Sanitarium". It began with only 16 rooms and 11 beds, although they said it could accommodate 32. However, over time the sanatorium grew so that it could incorporate a dining room for doctors, nurses, and private patients. By 1904 they already had first aid, an operating room, an electrical treatment room, a general ward for women, a general ward for men, three halls of distinction, a kitchen, a medical office, rooms for nurses, and a residence for the director and founder of the place.¹⁴

Just one year later, the hospital already had 44 rooms and 12 more under construction. It had 36 beds in use. The installation of all equipment for physiological therapy was already complete, which together accounted for a department perhaps of equal importance to internal medicine or surgery, consisting of the use of light, heat and cold, electricity, water, vibration, and manual massage. It was believed that many diseases that could not be healed with medicine internally or through surgery gave way to physical or physiological therapies, while many others were best cured by these modern means.¹⁵ In 1915, through various donations, they managed to build a spa, a print shop with hood for a line department, two pantries, a chapel for the use of the dispensary with a capacity of up to 80 people, and some apartments.¹⁶

Many doctors, nurses, and other personnel passed through El Buen Samaritano. In 1902 the hospital had four doctors in charge: Levi Salmans, Pablo del Río,¹⁷ Petra B. Toral,^12.18 and Charles W. Foster. In 1904 the medical team consisted of Dr. Levi Salmans, Dr. Pablo del Río, Mr. Foster, eight nurses, four received formally, and four students. Mr. Foster was the head of the electricity department, Isabel Esquivel, senior nurse of the house, and Natividad Gonzalez and Esther Campos were nurses. In 1906 Salmans would affirm: "The Hospital is built by itself, is furnished and is maintained. It has 14 nurses, several doctors, and other top-ranking employees, in addition to 10 employees for the domestic tasks of the establishment."¹⁹

No doubt the period 1899-1910 was of great achievement for the El Buen Samaritano establishment, however, with the beginning of the revolutionary movement in 1910, both Dr. Levi Salmans and the sanatorium lived through a number of avatars that were hard to overcome, such as the temporary appropriation of the sanatorium by the constitutionalist movement, repeated exits from Mexico by the Americans, including Salmans, due to insecurity in the country, flooding in Guanajuato that forced the suspension of medical activities to convert the sanatorium into a free public dining room, lack of donations, and, of course, the arrival of old age for Levi Salmans. It was most likely these reasons that led Levi to leave El Buen Samaritano shortly before the start of the thirties, to devote himself to promoting vegetarianism, giving lectures, and publishing pamphlets and books in the print shop that he had founded. Since Dr. Salmans’ retirement, we do not know anything more from what was a place of training and commitment to care and health promotion; undoubtedly a space for the realization of dreams and promotion of the gospel, but also, no doubt, the exercise of modern practices for the prevention and restoration of health: Sanatorio de El Buen Samaritano.

References

1. McCombs VM. Doctor Levi B. Salmans is cromned. México. The Organ of the Methodist Church of Mexico, april-june 1938, pp. 1-4.
2. Hart JM. Imperio y revolución. Estadounidenses en México desde la guerra civil hasta finales del siglo XX. Primera edición. Distrito Federal, México: Oceáno; 2006, p. 134.
3. Bastian JP. Los disidentes. Sociedades protestantes y revolución en México, 1872-1911. Distrito Federal, México: Fondo de Cultura Económica; 1993.
4. El Buen Samaritano en Guanajuato. El Abogado Cristiano Ilustrado. 18 01 1906.
5. Salmans LB. El Plan de Dios para el sostén de su Obra. Primera edición. Guanajuato, México: La salud; 1918.
6. Salmans LB. Medic-Evangelism in Guanajuato. Primera edición. Guanajuato, México: La salud; 1919.
7. Salmans LB. La Obra Médica Evangelista. Primera edición. Guanajuato, México: La salud; 1919.
8. Salmans LB. History of the Salmans Family. Primera edici{on. Guanajuato, México: s/e; 1936.
9. Un Evangélico Sr. Director de El Abogado Cristiano Ilustrado. El Abogado Cristiano Ilustrado. 15 07 1893. p. 125.
10. Borton FS. The Methodist Conference. The Mexican Herald. 21 01 1902. p. 5.
11. Retiro del Doctor Salmans. El Abogado Cristiano Ilustrado. 07 03 1912. p. 146.
12. Salmans LB. Informe de la Casa de Salud El Buen Samaritano. Acta de la conferencia anual de la iglesia Metodista Episcopal en México. January 18-22 1900, p. 87.
13. La obra médica en México. El Faro. 15 03 1904. p. 45.
14. Las fachadas de la Casa de Salud El Buen Samaritano. El Abogado Cristiano Ilustrado. 09 11 1905. p. 364.
15. Osorio C. Construcción. El Abogado Cristiano Ilustrado. 23 09 1915. p. 305.
16. Gómez-Vargas E, Martínez-Guzmán M. Dr. Pablo del Río Zumaya. Pionero de la medicina en la ciudad de León, Guanajuato (1873-1965). Boletín Mexicano de Historia y Filosofía de la medicina, [Internet] 2009;(1). Available from: http://new.medigraphic.com/cgi-bin/resumen.cgi?IDARTICULO=20251
17. La Srita. Petra Bonilla Toral. El Abogado Cristiano Ilustrado. 29 05 1902. p. 176.
18. Salmans LB. La Obra Médica Misionera. El Faro. 15 07 1906. p. 118.

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