Murder, Médicos Titulares, and Modernization in Restoration Spain: The Campaigns in Support of Dr. Alfredo Alegre, 1915–26

This paper analyzes the trial of and pardon campaigns on behalf of Dr. Alfredo Alegre, a médico titular, or state-mandated doctor for the poor, who was convicted in 1916 for the murder of the mayor of El Pobo. This altercation developed out of the mayor’s refusal to pay Alegre’s salary. While the mayor’s denial of salary was illegal, local elites could often act with impunity because of the system of caciquismo, clientelist and patronage ties that linked local elites to the state and to national politics. Often local administrative abuses were forgiven or ignored in exchange for votes. Articles about the Alegre case in the daily press and medical journals provided a space for reformers to critique caciquismo and propose alternative visions of the state. In viewing Alegre as a hero and victim rather than a criminal, his supporters defended scientific authority and proposed that the state should be guided by general principles rather than particular interests. In addition to illuminating Spanish debates on scientific authority and the state, the case also sheds light on the role of the rural in the development of public health systems in Europe and on the interwar crisis of liberalism. The Alegre case suggests that liberalism was in crisis in a dual sense. First, the state’s administration was not functioning as intended and second, the system in place no longer aligned with the conceptions of political power and scientific authority held by medical professionals and their allies.