From document to monument: the school of Tropical Medicine of the University of Puerto Rico.
Abstract: The history of the health sciences has the elements of a gripping narrative: heroic moments and crushing disappointments, major breakthroughs and unresolved puzzles, value conflicts and occasional consensus. The Puerto Rico Health Sciences Journal seeks to capture some of these historical vignettes in "Historical Notes," a new section which begins with the current issue. The PRHSJ welcomes submissions of brief historical essays which describe and analyze events related to the following topics: the prevention, diagnosis, and treatment of disease; the development of health policies and health services; and the evolution of the health professions. Essays should follow the guidelines for all articles to the PRHSJ, and will be subjected to appropriate peer review.
Subject: Escuelas de medicina (Historia)
Escuelas de medicina (Evaluacion)
Author: De Arellano, Annette B. Ramirez
Pub Date: 06/01/2009
Publication: Name: Puerto Rico Health Sciences Journal Publisher: Universidad de Puerto Rico, Recinto de Ciencias Medicas Language: Spanish Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Universidad de Puerto Rico, Recinto de Ciencias Medicas ISSN: 0738-0658
Issue: Date: June, 2009 Source Volume: 28 Source Issue: 2
Geographic: Geographic Name: Puerto Rico
Accession Number: 201212347
Full Text: It is not often that one can identify the conception and birth of an institution. The original creative spark is usually forgotten, eclipsed by subsequent events that were never documented, or maintained only in the memories of those who took part in the events, to be lost to history. That, however, is not the case with the School of Tropical Medicine of the University of Puerto Rico. The creation and development of this important center of research and learning were captured in somber documents that are of interest to historians as well as to all those who are connected to the University.

The vision of Dr. Bailey K. Ashford and his tireless efforts to establish a school of tropical medicine in Puerto Rico, preferably as part of a Pan American University, have been amply documented in the memoirs of this distinguished physician (l) and in the works of other scholars (2). Less well-known are the distinctive milestones in the process of the School's creation, of which we include two here. One represents the political and fiscal commitment to the school; the other, its building.

Because the projected school was to be both part of the University of Puerto Rico and under the auspices of Columbia University in the City of New York, all the documents related to the school's founding were shared with the latter institution. As a result, what would have otherwise been an internal document or a private act was imbued with a public presence transcending the boundaries of the island. In addition, Ashford was heir to several professional traditions, each of which valued evidence. As a clinician, researcher, and soldier, he was intent on documenting every process of which he was a part. Thus it is possible to track his multiple activities, be these scholarly or political (3).


The document authorizing the budgeting of funds for establishing the school is formalized by a gold seal and a red ribbon. This assigned a total of $100,000 for the construction of the new school, a sum that would amount to $1.01 million in current dollars. In 1924, this allowed the creation of an elaborate building worthy of the prestige of the sponsoring institutions and the aspirations of Ashford and his colleagues. Writing to his brother, Ashford boasted that his proposal for the school promised a "New Jerusalem," thereby alluding to the biblical image of a magnificent and spotless city, resplendent with glass and gold (4).

Although Governor Horace Towner had intended the School to be part of the University of Puerto Rico, in close proximity to the rest of the buildings on the Rio Piedras campus, Ashford envisioned a more prominent location for the academic institution (5). The selection of a plot of land within the island of San Juan, with the Atlantic on one side and Ponce de Leon Avenue on the other, assured the School a well-traveled site, with an ocean view and close proximity to the Capitol, which was then under construction. The photo accompanying this essay shows the recently-completed School, already landscaped, while the Capitol is still in process, with scaffolding around its dome. The School's relative warmth contrasts with the cold marble sheathing of the Capitol, as if to underline the primacy of research and learning over the machinations of political life.

The School's design embodies a nostalgic look toward Spain. At a time when European architecture was starting to shed the ornate facades of the Ecole des Beaux Arts and other similar traditions, and high-rise buildings were beginning to alter the cityscapes of many urban centers in the US (6), Puerto Rico was in the midst of a movement described as hispanophilia (7). The authorized $100,000, supplemented by an additional $25,000, were sufficient to permit an array of architectural details based on the Monterrey Palace in Salamanca. But while the latter is surrounded by buildings of similar height that conceal its distinctive design, its Caribbean version, adapted to the tropics and the uneven topography of San Juan, was more visible and noteworthy: like a precious stone set with minimal support, the new School's unique site exposed its presence to all who passed.


The name of the School etched on the facade of the building was in English, but its design, the work of Rafael Carmoega and Eduardo Martin (8), was distinctly Spanish. The structure incorporated Moorish motifs, bearing witness to the complex legacy of peninsular architecture. Tiles, turrets, and terracotta ornamented the galleries, which had carved balustrades and Moorish arches. An imposing cornice was decorated with arabesques in subtle colors. The building also had courtyards which organized the interior spaces and bathed the classrooms with light. These patios also allowed space for relaxation and recreation.

When the School opened in 1926, a mere two years after the budgetary authorization had been signed, San Juan acquired a new landmark and Ashford, a new title: "I am now a prof with bata and trimmings," he would write to his brother, not without pride (9). Years later, while taking stock of his achievements, Ashford would describe the School of Tropical Medicine as his utmost triumph, "everything in my life that dreams have clustered around" (10).

Over time, the School's building has suffered numerous changes. The elements --wind, water, and sea air--have all taken a toll on its detailing, damaging the ornamentation and reducing some of the motifs to muffled colors. More drastic have been the changes inflicted by human design. The need to build a hospital next to the laboratories and classrooms greatly reduced the area originally devoted to vegetation and landscaping. And the few remaining green areas were later paved over to accommodate the intrusive automobile and the need for parking. Similarly, the interior spaces were repartitioned multiple times, the once-open galleries being enclosed and converted into office spaces. The transfer of the School of Medicine to the Puerto Rico Medical Center in 1972, followed by the conversion of the building into the Department of Natural Resources, completed the final metamorphosis of the original structure.

Yet the building retains its name, and Ashford's dream lives in the memories of the many cohorts who passed through its halls and classrooms. For the hundreds who studied medicine, dentistry, public health, and the allied health professions, as well as for many researchers and faculty members, the building will always be referred to as the "School of Tropical Medicine." And its continuing aura will be as memorable as the classrooms that resembled dovecotes, and the site which "combined the beautiful and the practical" (11) in a unique medical citadel.


(1.) Bailey K. Ashford, A Soldier in Science. New York: William Morrow, 1934.

(2.) Emilio Morayta, Apuntes para la Biografia de un Edificio, San Juan: Escuela de Medicina, Recinto de Ciencias Medicas, 1969 (mimeo); Annette B. Ramirez de Arellano, "La Escuela de Medicina Tropical: Raices ideologicas e imperativos politicos," Revista de Historia 2 (4), julio-diciembre 1986: pp. 102-120.

(3.) Some of Ashford's papers are archived in the Conrado Asenjo Library of the Medical Sciences Campus of the University of Puerto Rico; part of his correspondence is in the archives of the Medical School of Georgetown University in Washington DC and in the Archives and Special Collections of the New York Academy of Medicine, New York.

(4.) Letter from Bailey K. Ashford to Mahlon Ashford, August 8, 1923, Collection of the New York Academy of Medicine, New York.

(5.) Bailey K. Ashford, A Soldier in Science. New York: William Morrow, p. 361.

(6.) It is interesting to note that some of the structures that are emblematic of modern architecture in France (e.g. Le Corbusier's Villa Stein) and of the Bauhaus in Germany (e.g., the industrial buildings of Peter Behrens) are contemporaneous with the School of Medicine. Rockefeller Center in New York and the skyscrapers of Daniel Burnham and Louis Sullivan in Chicago also date to the same years.

(7.) Enrique Vivoni and Silvia Alvarez Curbelo, Hispanofilia: Arquitectura y Vida en Puerto Rico, 1900-1950. San Juan: Editorial de la Universidad de Puerto Rico, 1998.

(8.) While Ashford's memoirs state that the building was designed by Gonzalo Fernos, the archives of the UPR School of Architecture indicate that Carmoega and Martin were responsible for the design, having signed the plans.

(9.) Bailey K. Ashford to Mahlon Ashford, August 1926, Ashford Papers, Collection of the New York Academy of Medicine, New York.

(10.) Bailey K. Ashford, A Soldier in Science. New York: William Morrow, p. 365.

(11.) Francis W. O'Connor, Diary of a Porto Rican Trip, 1927, in Raul Mayo Santana, Annette B. Ramirez de Arellano, and Jose G. Rigau Perez, editors. A Sojourn in Tropical Medicine: Francis W. O'Connor's Diary of a Puerto Rican Trip, 1927. San Juan: La Editorial de la Universidad de Puerto Rico, 2008: p. 19.

Annette B. Ramirez de Arellano, DrPH, Health Researcher and advisor to the Institute of the History of the Health Sciences (IHICIS), University of Puerto Rico Medical Sciences Campus. Email:
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.