This article analyzes the vicissitudes and difficulties in the construction of discourse and practices of hygiene in Lima in the first half of the twentieth century. This analysis of illnesses deals with a repertoire of practices and imagery that reflect the history of Medicine. In this sense, this work analyzes the discourse of the government and the doctors concerned with the epidemics. We discuss the limits of hygiene illustrated by popular or rural hygiene and the factors that blocked this slow process for several decades. The role played by doctors in the decades of 1840 to 1860 is underlined, as shown by the first publication of La Gaceta Medica de Lima.

Much praise has been given to Cayetano Heredia's role as first dean of the Medical College of Lima. Less common are mentions on interruptions this work suffered as a result of the Peru's first decades’ economic turmoil and Heredia's own ailing health. This text draws on primary sources to share a new look on Heredia's remarkable achievements, the reasons behind his departure from his role -despite ample recognition of his work in Peruvian medical society- and the chronic illness that would lead to his ultimate death.

This article analyzes the vicissitudes and difficulties in the construction of discourse and practices of hygiene in Lima in the first half of the twentieth century. This analysis of illnesses deals with a repertoire of practices and imagery that reflect the history of Medicine. In this sense, this work analyzes the discourse of the government and the doctors concerned with the epidemics. We discuss the limits of hygiene illustrated by popular or rural hygiene and the factors that blocked this slow process for several decades. The role played by doctors in the decades of 1840 to 1860 is underlined, as shown by the first publication of La Gaceta Medica de Lima.

En general, el principal problema del sector salud es la escasa capacidad de prestar servicios oportunamente en los establecimientos públicos a sus usuarios. Esto obliga a que el consumidor genere gastos de su propio bolsillo (gastos en consultas privadas, en automedicación, en buscar otro sistema de salud, entre otros). Estos gastos, llamados gastos de bolsillo, representan el 32% del total del presupuesto destinado al sector salud, cifra superior a la que aporta el Estado, 31%. Es decir, los hogares aún son los principales financiadores de la atención de su salud.

En general, el principal problema del sector salud es la escasa capacidad de prestar servicios oportunamente en los establecimientos públicos a sus usuarios. Esto obliga a que el consumidor genere gastos de su propio bolsillo (gastos en consultas privadas, en automedicación, en buscar otro sistema de salud, entre otros). Estos gastos, llamados gastos de bolsillo, representan el 32% del total del presupuesto destinado al sector salud, cifra superior a la que aporta el Estado, 31%. Es decir, los hogares aún son los principales financiadores de la atención de su salud.

Introduction: The health status of Peru requires more health professionals provide care in health facilities of primary care, mainly located in remote, rural or poorer areas of the country. Objective: To identify professional and personal expectations of future health professionals who are trained in a medical school in Lima, particularly work on the first level of health care. Design: observational, descriptive and exploratory study. Location: Faculty of Medicine, National University of San Marcos, Lima, Peru. Participants: Students pre boarding of Professional Academic Schools. Interventions: The convenience sample and included 278 students from five schools that make medical school. An ad hoc questionnaire with aspects relating to labor, economic and vision of students as future professionals wondered expectations was applied. Means, standard deviation, frequency distribution, confide...