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Print version ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.70 no.8 São Paulo Aug. 2012
Cartas de Dom Pedro II para o professor Brown-Séquard: correspondência imperial e neurofisiologia
Hélio A. G. TeiveI; Francisco M. B. GerminianiI; Renato P. MunhozI; Andrew J. LeesII
INeurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba PR, Brazil
IIReta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom
The authors have analyzed the content of a selection of letters written by Dom Pedro II, the Emperor of Brazil, and sent to Doctor Charles Brown-Séquard, the famous neurologist, between 1876 and 1885. The content of those letters focuses mainly on his wife's, Princess Thereza Cristina, health issues and Dom Pedro's personal desire to foster the research into the physiological study of the nervous system.
Key words: Brown-Séquard, Dom Pedro II, emperor of Brazil.
Os autores analisaram o conteúdo de cartas selecionadas escritas por Dom Pedro II, o Imperador do Brasil, entre 1876 e 1885, e dirigidas ao Doutor Brown-Séquard, um famoso neurofisiologista. O conteúdo das cartas versa principalmente sobre os problemas de saúde da esposa do Imperador, a Princesa Thereza Cristina, bem como sobre seu interesse em fomentar a pesquisa no estudo fisiológico do sistema nervoso.
Palavras-Chave: Brown-Séquard, Dom Pedro II, imperador do Brasil.
The distancing of Neurology from both Internal Medicine and Psychiatry had its roots back to the second half of the 19th century. Professor Jean-Martin Charcot's systematic study of diseases of the nervous system at La Salpêtriére, in Paris, formed the first Neurology school1. Charles-Édouard Brown-Séquard, a Mauritian born in 1817, therefore a British citizen, had already conducted some important neurophysiological experiments in Paris and, in 1860, was appointed as the first physician at the National Hospital for Paralytic and Epileptic at Queen Square, in London. Both pioneer neurologists were respected physicians with large private practices. Amongst their many celebrated patients were some of Europe's aristocracy, including the Emperor of Brazil, Dom Pedro II2-4.
Dom Pedro II and Brown-Séquard shared both a friendship and a doctor-patient relationship. In this article, we have briefly presented some extracts from the correspondence shared between Dom Pedro II and Professor Brown-Séquard, highlighting some of the main topics and making a quick historical account of their shared events5.
Charles-Édouard Brown-Séquard, or simply Brown-Séquard (Fig 1) as he is better known, was born in Port Louis, Mauritius, in April, the 08th, in 1817, and died a few days before his 77th birthday, on April 02nd 1894, in Paris. His father was an American sailor and his mother a local Creole. He studied Medicine in Paris, and graduated in 18462,6.
He came to be recognized worldwide as a brilliant neuroscientist, whose area of expertise was the nervous system physiology, and he was eventually rewarded for his endeavors by his nomination to be the Professor of Experimental Medicine in 1878 in Paris, replacing Claude Bernard. Brown-Séquard was cyclothymic, with bouts of exuberance, grandiosity, excessive nervous energy alternating with periods of profound depression and apathy. This may in part explain his erratic career path in which he oscillated between laboratory research and private practice, in Paris, London, Boston, and Richmond, in Virginia2,6,7.
Among his major works is the description of the physical signs linked with spinal hemisection, better known as Brown-Séquard's syndrome, as well as other articles on the physiology of nerves, vasomotor reflexes, an experimental model of epilepsy and his most popular work - although highly controversial - the hormone replacement therapy. This international fame led to reach patients who traveled from all over Europe to visit him in his consulting suite. The list of his famous patients included Louis Agassiz, Professor of Zoology and Geology at Harvard College, American Senator Charles Summer and the Emperor of Brazil, Dom Pedro II2,6.
DOM PEDRO II - EMPEROR OF BRAZIL
Brazilian Monarchy began with the arrival of the Portuguese Royal Family in Brazil, after they had fled Portugal, with the aid of the British Royal Navy, in order to avoid the advancing troops of Napoleon Bonaparte. The Regent Prince of Portugal, Dom João, and his wife, Infanta Carlota Joaquina, settled in Brazil, and their son Pedro de Alcântara (Dom Pedro I) became the first Emperor of Brazil, who was married to Maria Leopoldina, archduchess of Austria. Their son, Pedro d'Alcântara, also known as Dom Pedro II, was born on December 02nd, in 1825, in Rio de Janeiro. In 1848, at the age of 23, he became Emperor of Brazil (Fig 1). His reign continued uninterrupted until 1889, when the royal family was banished following the proclamation of the Brazilian Republic. Dom Pedro II married Princess Teresa Cristina de Bourbon, with whom he had two daughters, the most famous being Princess Isabel, and two sons, both of whom died at two years of age8,9.
During his reign, Dom Pedro II made three grand voyages: to Europe, to North America, and to the Orient. A consummate reader and polyglot, he devoted himself to the arts and fostering of science. He had little interest in politics, which may have contributed to some of the offensive nicknames he was forced to bear ("Pedro Banana" - "Banana Peter"; "Pedro da Mala" - "Suitcase Peter")8,9.
Dom Pedro experienced profound fatigue, asthenia and malaise, and sought the opinion of a number of European doctors, however he was always traveling in the company of his private physician, doctor Motta Maia. He consulted Charcot, in Paris in 1887, who diagnosed him as suffering from sur menage psycho-physique (neurasthenia), diabetes mellitus and probably a related peripheral neuropathy. His death certificate was signed by Professors Bouchard, Motta-Maia, and Charcot, on December 5th, in 1891, at the Bedford Hotel, in Paris, with the cause of death recorded as pneumonia8-10.
THE CORRESPONDENCE BETWEEN DOM PEDRO II AND BROWN-SÉQUARD
Between 1876 and 1885, Dom Pedro II corresponded with Brown-Séquard, and ten of their letters were analyzed for the present article (Fig 2). The main topics covered in the correspondence are summarized in Table. Some were related to the health of the Emperor's wife, Princess Teresa Cristina, who suffered from recurring pain in her lower limbs, possibly neuropathic in origin, as well as spondylotic pain in the dorsal and lumbar segments. When the princess was first introduced to the emperor, she had already a painful leg and walked with a limp that may have predisposed her later to have a degeneration of the thoracic and lumbar spine5.
The letter written by Dom Pedro II, from February 24th, 1876, stated: "Ma femme souffre depuis longtemps avec des in terruptions plus ou mois longues d'horribles douleurs nevral giques à la jambe, et tous dernièrement, pour la première fois, du corps et à la tête, dans le cuir chevelu. Deux points sur l'épine dorsale se ressentent plus ou moins à la pression. Son état général est bon."5
Later, in the letter of June 29th, 1876, while the Emperor was in Philadelphia, he wrote to Brown-Séquard about his visit to Professor Charcot: "Je veux y consulter aussi le Dr. Charcot et c'est bon que vous deux puissent s'entendre aux même temps avec mon médicin qui a soigné ma femme, et vous donnera tous les renseigments nécessaires."5
In other letters, Dom Pedro II mentions lectures given by Brown-Séquard that he had attended in person, as well as his own interest in neurophysiology and science. He also enquires whether Brazilian physicians could come as visiting physicians to Paris. Finally, in a sympathetic gesture of friendship he wrote a letter in 1883 about the two vacancies left at the Academy of Medicine of Paris, one following the death of Professor Claude Bernard: "Il y a à present deux places va cantes à l'Académie. Quand vous fera-t-on justice?"5.
Dom Pedro II, the Emperor of Brazil, was an intellectual attracted to arts and sciences. These interests may help to explain the genuine friendships he forged with some of his physicians, including Charcot and Brown-Séquard, and his sincere desire to encourage the best Brazilian physicians to travel to France to enhance their education.
The authors thank Professor and Doctor Clotilde de L. B. Germiniani for proofreading. We would also like to comment that although the given name of Dom Pedro II's wife was Princess Teresa Cristina, her name is sometimes spelled as Theresa Christina and Thereza Christina in some documents in English or in Portuguese from Portugal (such as the Collecção D. Thereza Christina Maria from the Biblioteca Nacional - http://bndigital.bn.br/200anis/therezChristina.html. We chose to keep the more traditional Brazilian spelling of her name.
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Hélio A. G. Teive
Rua General Carneiro 1.103/102
80060-150 Curitiba PR - Brasil
Received 18 March 2012
Received in final form 28 March 2012
Accepted 04 April 2012
Conflict of interest: There is no conflict of interest to declare.