[The mirage of free practice. Regulation of medical care in nineteenth-century Spain].

This article examines the organization of extrahospitalary medical care in Spain during the nineteenth century. We have attempted to use contemporary sources (newspapers, medical monographs, parliamentary records) within the background of the establishment of liberal politics in Spain. Our central hypothesis was that medical practice has to be considered a helping profession, to which free private practice was associated in an opportunistic manner. Faced with the mirage of "market" deregulation, foreseen even by the professional élite, regulation by the state and corporative pressures framed the public system of health care, and favored consolidation of the profession. Successive reforms in the regulation of medical practice reflected the marked anatagonism between city and country. The resulting hybrid model made public practice compatible with private practice by physicians on the state's payroll.