Betances: Doctor for poor and black populations in the cholera epidemic


Last month (April 9, 2020) Liliana Cotto Morales wrote a beautiful historical piece in honor of Ramón Emeterio Betances, who was born on April 8, 1827, in my beloved Cabo Rojo, Puerto Rico. Although Betances is better known for his political thought and advocacy as an abolitionist, here, Cotto Morales underlines his work as doctor and medical researcher, and his ethical example in the context of today’s pandemic. [See PRTQ for the original article in Spanish.]

On April 8 we commemorate the birth, in Cabo Rojo (1827) of the Father of the Puerto Rican Homeland [Padre de la Patria puertorriqueña] and one of the “founders of academic medicine.” [i] On the occasion of his birthday, and in keeping with the pandemic we are suffering, I want to highlight a little-known aspect of the hero: his contribution as a practical doctor and as a medical researcher. [ii] The laboratory that prepared him for that dual task, which characterized Dr. Betances’s work, was the cholera outbreak that struck the island [Puerto Rico] in 1855-56.

Betances obtained his Doctor of Medicine and Surgery degree from the University of Paris School of Medicine in April 1856. He presented his credentials to the Mayagüez City Hall on May 19, 1856. He brought with him the most advanced of the great currents of European medicine and science. Councilor José Antonio Ruiz Gandía… elaborated the necessary precautions for the outbreak with José Francisco Basora as lead doctor and Ramón Emeterio Betances as interim surgeon.

The plague manifested itself in Naguabo, Mayagüez, Ponce and other “villages.” About 25,820 people died. Most were poor: day laborers and slaves. The administration divided the “village” into sections, assigning Basora to the north and Betances to the south. There, he created a camp to care for the impoverished. In addition, there were sanitary divisions created to protect the villages and brigades were organized to care for the sick and the dead. Many of the cemeteries for cholera victims [cementerios “colerientos”] later became municipal cemeteries.

Betances’ commitment to the poor generated criticism. He did not give priority to Spanish nationals or soldiers. The epidemic dramatized, before the young doctor’s eyes, colonialism and the poverty suffered by the population. This image of Betances—who would later become the Father of the Homeland [Padre de la Patria], like the doctor who tired out five horses to tend to the poor and the black slave population—spread. He became well known as the doctor of the poor and black. In the municipal acts of Mayagüez one may see the recognition that the City Hall made to Betances: “He did not stop being useful for a single moment to the neighborhood, especially to the destitute classes.”

He earned the love of the Puerto Rican people. He began his activity with abolitionist secret societies. He also began his support of the struggles for the restoration of the Dominican Republic. When he was persecuted by the Spanish government, the people protected him. In 1858, the Spanish authorities forced him to leave Puerto Rico due to his abolitionist activism. He returned to Paris with Dr. Basora and settled in the Latin Quarter. He eagerly coordinated with his half-sister the arrival in Paris of his fiancée María del Carmen (Lita) Henri Betances. Thus, began a romantic-tragedy of love and loss that merits another full essay. [iii]

Later on, when he was already exiled in Paris, between 1872 and 1887, he published important works of medical research. However, his fundamental activity was practical medicine. He took care of patients with various conditions and wrote about them: obstetrics, ophthalmology, and surgical techniques, treatment for therapeutic medical conditions, surgical technique for urology, cholera, public health, and gynecology. In 1889-90 he founded the Etablissement Médical des Eaux Azotées to offer “azotherapy,” the use of nitrogenous water to cure diseases of the throat, chest, stomach and other parts of the body. In 1887 his former fellow-student, Professor León Labbé presented, to the Académie de Médecine de France, Betances’ writing on the treatment of elephantiasis.

His experiences in the treatment of cholera, along with other research, were the basis for his 1884 El cólera: Historia y medidas profilácticas. Síntomas y tratamiento [Cholera: History and prophylactic measures. Symptoms and treatment]. It explains the causes of the disease and establishes guidelines to avoid it. He published it again in 1890 to help eliminate an outbreak of the epidemic in several other Latin American countries. In the introduction to that publication, Betances wrote: “I will be rewarded for my work if it serves any use in America; because this publication was made for America, in particular.” [Translator’s note: America is used in the broad sense—the Americas—and not the United States.]

Celebremos hoy la ruta de Betances, sus prioridades y compromisos como patriota, periodista, literato y otras, pero también como médico e investigador que trató y estudió para Puerto Rico y las Américas la epidemia del cólera. Encontraremos guías pertinentes para la pandemia hoy.

Today we celebrate Betances’ trajectory, his priorities and commitments as a patriot, journalist, writer, and more, but also as a doctor and researcher who treated and studied the cholera epidemic for Puerto Rico and the Americas. In his example, we may find relevant guidelines for today’s pandemic.


[i] Cancel Sepúlveda, Mario. 1988. “Betances y la epidemia del cólera.” Revista/Review Interamericana. Otoño-Invierno, vol. VIII,no. 3-4. pags.133-134

[ii] Rodríguez Vázquez, Eduardo. 2008. Ojeda Reyes, Félix y Paul Estrade eds. Obras Completas Vol. I Escritos Médicos y científicos.

[iii] Cotto Morales, Liliana. 2015. “Mapa Biográfico Ruta Betances.”

[Translated by Ivette Romero. For original article (in Spanish), see

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