Tropical medicine and bacteriology in Boston and Peru: studies of Carrión's disease in the early twentieth century.

Recent historical studies on medicine as a tool of empire have underlined the importance of local perceptions and responses when analysing the strategies and impact of European and North-American powers in various regions of the globe.1 These studies have suggested that the development of tropical medicine has not been a one-way street, that the rich texture of local societies occupied a central place in this process, and that authority had to be negotiated and accommodated by recipients who were able to redefine imported ideas and institutions.2 This article adds to this literature by using comparative history and by suggesting that developments in the so-called "periphery" provide crucial insight into the work of the metropolitan scientific centres. This article analyses the achievements and difficulties confronted both by Peruvian researchers trying to reinforce a local medical culture in a poor country and by U.S. investigators endeavouring to persuade philanthropic sponsors of the need to establish tropical medicine as an independent academic subject. The story takes place in early twentieth-century Peru, a country that in the wake of its defeat in the War with Chile (1879-1883) initiated a process of national reconstruction and modernization based on an agreement with foreign bondholders. This included ceding control of its railroads for sixty-six years, the arrival of major U.S. investments which displaced the dominant