Professor Faustino Esposel: Neurology, football and spiritualism

ABSTRACT Faustino Monteiro Esposel was a renowned neurologist from Rio de Janeiro, born on October 24, 1888. Together with his mentor, Professor Antônio Austregésilo Rodrigues Lima - the founder of modern Brazilian Neurology -, Professor Esposel described one of the rival signs of the Babinski sign, known as the Austregésilo-Esposel sign, in a study published in the renowned journal L'Encéphale in 1912. This article aims to summarize the life story of this illustrious neurologist as well as to highlight his achievements “beyond medicine”.


INTRODUCTION
Neurology in Brazil was deeply influenced by the French school of neurology and its outstanding Neurology Service at the Hospital de la Salpêtrière, in Paris, which was considered the birthplace of Neurology worldwide at the end of the 19th century, with its most prominent figure, Professor Jean-Martin Charcot 1,2,3,4 . In Brazil, the first neurology school was founded in 1912, having Professor Antonio Austregésilo as the first professor of the Chair of Neurology at the Faculty of Medicine of Rio de Janeiro, current Federal University of Rio de Janeiro 1,2,3,5,6 . Professor Austregésilo has made several study trips to Europe, mainly to France, for internship programs in neurology services under the supervision of Pierre Marie, Babinski and Dejérine, among others 1,2,3,5,6 .
The School of Neurology directed by Professor Austregésilo, who is considered the founder of modern Brazilian Neurology, has become a reference throughout Brazil. Professor Austregésilo had several disciples, including Professor Deolindo Couto, his successor, and also Professor Esposel 1,2,3,5,6 . Professor Esposel has worked very close to his master and friend, Professor Austregésilo, with whom he shared the publication of several scientific articles. In addition, he had also replaced his master as chairman of Neurology, when Professor Austregésilo was elected Congressman 1,2,3,5,6,7 . This article aims to point out Professor Esposel´s major contributions to the field of Neurology in Brazil, as well as to highlight his non-medical related activities.

MEDICINE AND NEUROLOGY
Faustino Monteiro Esposel (1888-1931) was born in the city of Rio de Janeiro, and graduated from the Faculty of Medicine of Rio de Janeiro in 1910, when he submitted his thesis entitled "Cerebral Arteriosclerosis" 7,8 . He was awarded with a trip to Europe, where he had the opportunity to study with renowned neuroscientists, such as Pierre Marie, Joseph Babinski and Jules Dejérine 7,8 . Shortly after, he applied for an assistant physician position at the Hospital Nacional de Alienados, which would later become the first Neurology Institute in Brazil, founded by Professor Deolindo Couto in 1946 1,3,5,6 . During his medical career, he was also head of service at Policlínica de Botafogo and adjunct physician at Santa Casa de Misericórdia in Rio de Janeiro. He has also been an outstanding professor while teaching as full professor and assistant at the Nervous Disease Clinic of the School of Medicine of Rio de Janeiro, as substitute professor in the Neurology and Psychiatry Section of the School of Medicine of Rio de Janeiro, as professor of Neurology at the Fluminense School of Medicine, and as substitute professor of Public Medicine at the Teixeira de Freitas School of Law 7,8 . One of Professor Esposel's major contributions to the field of Neurology, jointly made with his mentor, Autregésilo, is the identification of a semiotic sign, described in their article entitled "Le phénomène de Babinski, provoqué par l'excitation de la cuisse" (The Babinski phenomenon provoked by pressure on the thigh), which was published in the famous journal L'Encéphale in 1912 5,9 . The semiotic sign was considered a substitute for Babinski sign, in which the extension of the hallux and fan-shaped opening of the toes could be evoked by stimulus, superficial or deep, on the external surface of the thigh of the limb affected by pyramidal syndrome. (Figure 1) 9,10 Van Gijn, in his work entitled "The Babinski sign: a centenary" recognizes the Austregésilo-Esposel sign as a rival sign 11 . In 1927, Esposel was elected as Full Member of the National Academy of Medicine, holding chair number 58, when he presented a memoir entitled: "Around the Babinski sign" 7,8 . In 1931, Esposel died as a result of uremia. However, bibliographic data suggest cancer as an underlying disease 7,8 .

FOOTBALL CAREER
In addition to medicine, Esposel was a sports enthusiast, holding various technical and administrative positions in different areas, specially soccer 7,8 . The most relevant position he held was the presidency of Clube de Regatas do Flamengo for three terms: 1920-1922, 1924-1927, 1928-1928, respectively ( Figure 2

ESPOSEL'S HISTORY WITH SPIRITUALISM
A very controversial subject was Esposel's involvement with spiritualism 7,8,12 . Some biographical data suggest that his Arq Neuropsiquiatr:1-3 interest in spiritualism arose only after he had been diagnosed with cancer and the final stage of uremia. However, there is information published in the local media suggesting an interest prior to the onset of his disease 7,8,12 . Luciano dos Anjos, a journalist who studies spiritualism, suggests in his work "The True André Luiz" that the identity of the spirit André Luiz would be that of doctor Esposel in life 12 . The relationship of doctors, researchers and intellectuals in general with spiritualism always raises many discussions, in general fierce and without definite conclusions, such as the famous case of doctor and writer Arthur Conan Doyle, among others 13,14 .

CONCLUSION
Faustino Esposel is considered one of the pioneers of Brazilian Neurology, along with his mentor Antônio Austre-gésilo. Together they described an important semiotic sign, which has been considered a sign rivaling Babinski sign. At the same time, Esposel has also stood out in matters "beyond medicine", mainly in the sports world when he acted as president of Clube de Regatas do Flamengo, and in a controversial situation involving spiritualism, according to some references.