INVITED EDITORIAL
The origins of psychiatry in Brazil
Othon Bastos
Professor, Universidade Federal de Pernambuco (UFPE) and Universidade Estadual de Pernambuco, Recife, PE, Brazil. Former president, Brazilian Psychiatric Association (1992/1995).
I usually say, playfully, that the official history of psychiatry in Brazil has its origins when the royal Portuguese family arrived in Rio de Janeiro, in 1808, bringing on board the queen D. Maria I "in a cage." Her Highness had been considered insane and prevented from performing her duties by the court physician, José Correia Picanço, born in Pernambuco and first Baron of Goiana, founder of medical courses in our country.
At that time, mental patients used to wander in the streets of the main Brazilian towns and villages, serving as buffoons to inhabitants, or lived segregated in solitaries or safe rooms in the backyards of wealthy families. This fact aroused criticisms and complaints by more educated sectors of the population.
Santas Casas de Misericórdia in larger cities then started to shelter the mentally insane in their hospitals during the first reign and regencies. Upper floors were destined to clinical and surgical patients, whereas "madmen" were thrown into infected dungeons, usually located below patients with cholera. The most agitated patients were tied to a log and beaten by guards. There are registers of such incidents at Santa Casa de S. João Del Rei, in 1817, first historical reference; at Hospital de São Cristóvão, in Bahia; at Hospital de São Pedro de Alcântara, in Recife; and at Santa Casa de Misericórdia do Rio de Janeiro, over the first decades of the 19th century.
However, complaint against abuse of mental patients increased, reaching its climax after the creation of Sociedade de Medicina do Rio de Janeiro. In 1830, physicians J. M. da Cruz Jobim, J. F. Sigaud, L. V. De Simoni and Antônio Luiz da Silva Peixoto, author of the first Thesis on Psychiatry in Brazil (1837), started an intensive attack against that situation. The protests were heard by the Empire Minister and Purveyor of Santa Casa, José Clemente Pereira, who decided to use public resources and private donations to build Hospício de Pedro II, in Praia Vermelha, which was started in 1841 and luxuriously inaugurated in December 1852, celebrating the young king's anticipated majority. "The most beautiful building in a neoclassical style at that time in South America." Professor Leme Lopes, with regard to Hospício Nacional de Alienados, a name given after the Proclamation of the Brazilian Republic, and future headquarters of the University of Brazil, in the 1940's, remembered the prodigality of existing statues in its noble room and ironically said that only those concerning charity and justice remained outside the building.
Hospício Pedro II was essentially responsible for providing custody and shelter, aiming at isolating mental patients, alienating them from social experience. The institution would know better days of scientific progress after the nomination of Prof. Juliano Moreira, in 1902, by Minister J. J. Seabra, both from Bahia, during the government of President Rodrigues Alves. That inauguration would have consequences in large Imperial provinces, forcing their presidents to assume the mission of building asylums for the mentally ill.
In São Paulo, in 1852, Asilo Provisório do Largo dos Curros (current Praça da República) was created, and was then transferred to Ladeira da Tabatinguera, in Várzea do Carmo. Hospício do Juqueri would only be concluded in 1903. In Pernambuco, patients at Hospital de São Pedro de Alcântara, in Convento do Carmo, Recife, were transferred to Hospício da Visitação de Santa Isabel, Olinda, in 1860. From 1874 to 1883, Barão de Lucena built Hospício de Alienados in Tamarineira through popular subscriptions, fundraising parties and public resources. It was in Tamarineira that former Juliano Moreira's pupil, Ulysses Pernambucano de Mello, in the 1920's and 1930's, revolutionized Brazilian psychiatric care through pioneering innovations in the country and in Latin America. In 1873, the Asilo de Alienados do Pará started operating close to the leprosarium in Tucunduba; later, patients were sent to Hospício de Alienados, in Marco da Légua. In Bahia, patients were transferred, in 1874, from Hospital de São Cristóvão to Asilo de São João de Deus, located at a beautiful ranch, which would later be named Hospital Juliano Moreira. Hospício São Pedro, in Rio Grande do Sul, known at that time as "Great Jailhouse," was built in 1884 and then managed and maintained by the public power.
Other provinces followed the example: in Fortaleza, Asilo de Alienados de São Vicente de Paula, in Porangaba (1886); in Maceió, Asilo Santa Leopoldina (1891); in Paraíba, Asilo do Hospital Santa Ana, in Cruz do Peixe (1893); in Manaus, Hospício Eduardo Ribeiro (1894); in Barbacena (MG), Hospital Colônia (1903); and so forth.
At first, alienists practiced an evidently French-inspired neuropsychiatry, based on studies by Pinel, Esquirol, Magnan, Chaslin, Babinski, Pitres and Régis, etc. The asylum regulations followed Pinelian guidelines: search of reason and struggle against "unreason." After Juliano Moreira took over management of Hospício Nacional de Alienados, German influence was installed in our country. The works by Griesinger, Bonhoeffer, Birnbaum, Kraepelin, Lange and many others became known.
Nuno Rodrigues was the first alienist to do a foreign internship, and Teixeira Brandão, the first professor of Psychiatry to be admitted by public contest in 1883, in Rio de Janeiro. Official teaching of psychiatry in the country started almost simultaneously in Rio de Janeiro (Nuno de Andrade, 1881; and Teixeira Brandão, 1883) and in Bahia (in 1886), with Demétrio Tourinho and Augusto Maia.
We are already at the late 19th and early 20th century. These are the first steps, the origins of psychiatric care and teaching in Brazil.
Bibliography
1. Bastos O. História da psiquiatria em Pernambuco e outras histórias. São Paulo: Lemos; 2002.
2. Bastos O. The history of psychiatry and mental health in Brasil. In: Bastos O. História da psiquiatria em Pernambuco e outras histórias. São Paulo: Lemos; 2002.
3. Medeiros TA. Formação do modelo assistencial no Brasil [dissertação]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 1977.
Publication Dates
-
Publication in this collection
13 Dec 2007 -
Date of issue
Aug 2007
