The Brazilian Neurology centenary (1912-2012) and the common origin of the fields of Neurology and Psychiatry

O centenário da Neurologia brasileira (1912-2012) e a origem comum das áreas de Neurologia e Psiquiatria

HISTORICAL NOTES

The Brazilian Neurology centenary (1912-2012) and the common origin of the fields of Neurology and Psychiatry

O centenário da Neurologia brasileira (1912-2012) e a origem comum das áreas de Neurologia e Psiquiatria

Marleide da Mota Gomes^I; Jose Luiz de Sá Cavalcanti^II

^INeurologist, Associate Professor, Institute of Neurology, Faculty of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil

^IINeurologist, Adjunct Professor (retired), Director of Institute of Neurology, UFRJ, Rio de Janeiro RJ, Brazil

^{Correspondence}

ABSTRACT

It is reported the Brazilian Neurology birth (1912), that has as the hallmark its first Neurology Cathedra of Rio de Janeiro, and the links between Neurology and Psychiatry, besides the main medical protagonists at that time in Rio de Janeiro: João Carlos Teixeira Brandão (1854-1921), first professor of the cathedra of Clinical Psychiatry and Nervous Diseases (1883-1921); Juliano Moreira (1873-1933), the founder of the Brazilian scientific Psychiatry and director of the Hospício Nacional de Alienados (National Hospice for the Insane) (1903-1930); Antônio Austregésilo Rodrigues de Lima (1876-1960), first professor of the cathedra of Neurology, considered the father of the Brazilian Neurology. Aloysio de Castro (1881-1959) was a great Brazilian neurosemiologist at that time. Austregésilo practiced both disciplines, Neurology and Psychiatry, and like Jean-Martin-Charcot, he was very interested in a typically psychiatric disorder, the hysteria. It is also considered in this paper the first Brazilian authors of Neurology and/or Psychiatric texts and the places where Neurology was initially developed by the main founders: Hospício Nacional de Alienados, Santa Casa de Misericórdia do Rio de Janeiro and Policlínica Geral do Rio de Janeiro.

Key words: brazilian neurology, psychiatry, neuropsychiatry, history of neurosciences.

RESUMO

É relatado o nascimento da Neurologia brasileira (1912), que tem como marco principal a primeira Cátedra de Neurologia do Rio de Janeiro, bem como as ligações entre Neurologia e Psiquiatria, além dos principais protagonistas médicos da época naquela cidade: João Carlos Teixeira Brandão (1854-1921), primeiro professor da cátedra da Clínica psiquiátrica e de moléstias nervosas (1883-1921); Juliano Moreira (1873-1933), fundador da Psiquiatria científica brasileira e diretor do Hospício Nacional dos Alienados (1903-1930); Antônio Austregésilo Rodrigues de Lima (1876-1960), primeiro catedrático de Neurologia, considerado o pai da Neurologia brasileira. Aloysio de Castro (1881-1959) foi um grande neurosemiologista brasileiro da época. Austregésilo praticava tanto a Neurologia quanto a Psiquiatria e, como Jean Martin-Charcot, estava muito interessado em um típico transtorno psiquiátrico, a histeria. Consideram-se também os primeiros autores brasileiros de textos de Neurologia e/ou Psiquiatria e os locais onde a Neurologia foi inicialmente desenvolvida pelos fundadores principais: Hospício Nacional dos Alienados, Santa Casa de Misericórdia do Rio de Janeiro e Policlínica Geral do Rio de Janeiro.

Palavras-Chave: neurologia brasileira, psiquiatria, neuropsiquiatria, história das neurociências.

In this year of 2012, we celebrate the centenary of the Brazilian Neurology, and, looking backward, we can see the schism that occurred between Psychiatry and Neurology. For a long time, during the 19^th century and the beginning of the 20^th, there was hardly any distinction between them, because of the common scientific and practical interest in the brain and mind. The two disciplines developed together and they were both a branch of Internal Medicine. Even in Europe, at that time, many physicians practiced simultaneously both specialties¹. The same occurred in Brazil, mainly at the Medical School of Rio de Janeiro (FMRJ). In this paper, we presented how the autonomy of Neurology as a discipline happened: the academic structures/institutions and protagonists.

NATIONAL HOSPICE FOR THE INSANE: BRAZILIAN NEUROPSYCHIATRIC FORMER CENTER

The National Hospice for the Insane (NHI) was the first public institution focused specifically on mental illness in Brazil (Fig 1). Three of the primary precursors and leading figures of the Brazilian Neurology worked over there: João Carlos Teixeira Brandão, Juliano Moreira and Antonio Austregésilo Rodrigues de Lima (Fig 2)^2-6. In April 1883, after a competition, Teixeira Brandão was appointed as FMRJ Professor of Clinical Psychiatry and Nervous Diseases. He was also director of the NHI (1887-1897). In Salvador, Augusto Freire de Maia Bittencourt (1847-1891) was the professor of this chair (1886-1891), that was created by the Decree nº 3.141 of 1882⁷. Teixeira Brandão was also the diffuser of the French psychiatric thinking in Brazil. He became medical doctor in 1877 with a thesis entitled "Operations claimed by narrowing of the urethra...". After practicing medicine in the province of Rio de Janeiro (1878-1880) and under the suggestion of João Vicente Torres Homem (Fig 3), he traveled to France, Germany and Italy to study Psychiatry. He was a founder of Policlínica Geral do Rio de Janeiro in 1881, working at the Service of Diseases of the Nervous System.

In Brazil, Moreira was the founder of the Brazilian scientific Psychiatry, director of the NHI (1903-1930) and very influent in the Neuropsychiatric area. More qualifications of this great Brazilian, who influenced the Neurology development, are given in other papers^3-6.

Austregésilo moved to Rio de Janeiro from Pernambuco at age of 16 to attend the FMRJ, where he graduated in 1899 with his thesis "Clinical study of delirium". He worked at the NHI (1904-1910), where he was also involved in the journal and the society linked to Psychiatry and Neurology, both originated at this Hospital^3-6.

SANTA CASA DE MISERICÓRDIA AND POLICLÍNICA GERAL DO RIO DE JANEIRO

Austregésilo worked at Santa Casa de Misericórdia (1902-). In 1909, he was indicated by the congregation of the FMRJ as substitute professor of Clinical medicine, pathology and propaedeutic clinic⁸. Austregésilo had as opponents in two competitions for the position of substitute professor Miguel Pereira, Aloysio de Castro, Rubião Meira and Agenor Porto: in the first, Miguel Pereira won, in the second, Aloysio de Castro (Fig 2), and at a third moment (1909), the FMRJ congregation indicated him considering the two previous competitions⁸. Three years later, in 1912, he was appointed professor of the newly created cathedra of Neurology⁸. However, both Teixeira Brandão and his substitute, Henrique Britto de Belford Roxo (1877-1969), were against the creation of it⁸. At the beginning, neurological classes were taught by Austregésilo in the dependencies of the Santa Casa de Misericórdia at the 20^th Infirmary where he was the head⁸. At this year, the Decree nº 11.530 of 1915 officially unfolded the chair of Clinical Psychiatry and Nervous Diseases⁷, and Faustino Monteiro Esposel (1888-1931) was the new substitute professor⁸. Later, in 1926, new dependencies for the neurological courses and patients care were constructed besides those of the former Observation Pavilion transformed in Institute for Psychopathology and Psychopaths Assistance, at the backyard of the NHI^4,6.

Austregésilo was president of the National Academy of Medicine, member of the Brazilian Academy of Letters (1914) and federal deputy of the state of Pernambuco (1922-1930). He had several links with national, international medical and cultural societies. He wrote numerous essays and papers on Medicine and Psychology: "Clinical study of delirium", thesis (1899); "Neurological clinic", three volumes (1917, 1923 and 1945); "Medical clinic" (1917); "The psychoneuroses" (1933); "New acquisitions in the field of Neurology" (1934); "L'analyse mentale dans les psychoneuroses" (1936); "Mental pathology" (1948); "Psychology and Psychotherapy" (1951). Almost all of the works of Austregésilo were translated into Spanish. The complete works were published in ten volumes, edited by Editora Guanabara (1945-1947). His mental bias work is evident in his medical production, for instance, in "Hysteria and hysteroide syndrome" (1909). This was a theme of great interest in the transition from 19^th to the 20^th century, because of the difficulties to fit it in the classification systems and the intense discussion of its etiology, which had as a backdrop a gender influence. Situated at the crossroads of Psychiatry and Neurology, hysteria was for Austregésilo a subject of great interest, which inspired the Brazilian psychiatric production of the first decades of the 20^th century⁹. Unlike much of the Brazilian psychiatric thought at the time⁹, Austregésilo had positive image of women.

Aloysio de Castro was graduated (1903) with a thesis entitled "From the gait disorders and their clinical value". In 1906, he received an award for being the best student in his class, which allowed him to go to Europe to study nervous semiology. Over there, he attended the ward and laboratory of the Hôpital Bicêtre, directed by Pierre Marie (1853-1940), among others. He had attended at the Santa Casa da Misericórdia of Rio de Janeiro hospital since the time he was a third year undergraduate medical student. He helped to introduce Neurology from Paris to the 4^th Infirmary of the Santa Casa and to the Service of Clinical Medicine in Policlínica Geral do Rio de Janeiro, as quoted by Nava¹⁰. He was professor of Medical Pathology (1910) and Internal Medicine (1915), having held the latter chair until 1940, when he retired. He was director of the FMRJ (1915-1925) and worked at the Policlínica Geral do Rio de Janeiro (1907-1946), where he collected material for his monumental work, registering with film strips abnormal gaits in various nervous diseases.

Brazilian Neurology was created within the hegemonic psychiatric school, mainly at the NHI, but also at the Santa Casa de Misericórdia and Policlínica Geral do Rio de Janeiro. Antonio Austregésilo Rodrigues de Lima is its most important primordial leader.

Conflict of interest:

There is no conflict of interest to declare.

Received 26 June 2012

Received in final form 25 July 2012

Accepted 01 August 2012

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Publication Dates

• Publication in this collection
  16 Jan 2013
• Date of issue
  Jan 2013

History

• Received
  26 June 2012
• Accepted
  01 Aug 2012
• Reviewed
  25 July 2012