The Ecuadorian Public Health Service was founded in 1908 in response to the arrival of bubonic plague to the country. A. Kim Clark uses this as a point of departure to explore questions of social history and public health by tracing how the service extended the reach of its broader programs across the national landscape and into domestic spaces. Delving into health conditions in the country—especially in the highlands—and efforts to combat disease, she shows how citizens’ encounters with public health officials helped make abstract ideas of state government tangible. By using public health as a window to understand social relations in a country deeply divided by region, class, and ethnicity, Conjuring the State examines the cultural, social, and political effects of the everyday practices of public health officials.