ABSTRACT
Throughout the nineteenth century the Spanish population was mostly rural. The birth of a health administration was linked to the fight against infectious diseases and poor living conditions. The 1855 Health Act established the control of borders and an internal national administration composed of provincial and local health boards. At the end of the nineteenth century, municipal laboratories controlled drinking water, food quality and adulterations, providing vaccines and serums. Regional initiatives in cities were regulated under a Central Institute of Bacteriology and Hygiene (1894) in Madrid, which evolved into the Instituto de Seroterapia, Vacunación y Bacteriología Alfonso XIII. It coordinated policies on vaccination, immunization, and bacteriological tests. A Commission for Social Reform (1880) focused on public policies regarding poverty. Its first survey (1884) provided a grim picture of malnutrition, poor clothing, housing, morbidity, and mortality rates among workers and peasants. In 1904 a General Health Instruction established a health administration. The General Health Board was the executive branch; the Royal Health Council was the central consultative body. Health officials were the technical body. In the 1920s, provincial health institutes had three technical sections: epidemiology and disinfection; clinical, hygienic, and chemical analysis; and vaccinations. Creating a health administration involved a transition from charity to secular institutions endowed with technical knowledge in laboratory medicine.
