História, Ciências, Saúde-Manguinhos, Volume: 9 Supplement, Published: 2002
  • Editor's note

    Hochman, Gilberto; Cueto, Marcos; Carrillo, Ana Maria; Romo, Ana Cecília de
  • The trail of Aids in Peru

    Cueto, Marcos

    Abstract in Spanish:

    El presente trabajo es un estudio histórico sobre la epidemia del Sida en el Perú entre los años de 1983 y 2000. La investigación se centra en las respuestas legales, los estudios y las intervenciones médicas y en el contexto peruano de comienzos de la década de 1980 que estuvo marcado por una grave crisis económica y por la violencia terrorista. Como en otras partes del mundo el Sida, intensificó la interacción entre los científicos, los salubristas, los periodistas, los políticos, y los pacientes. Esta interacción tuvo una gran influencia en la cultura y en la misma respuesta sanitaria a la enfermedad. Además de contar una historia que creo que es importante e interesante quiero demostrar que una perspectiva histórica es válida, interesante y útil para comprender acontecimientos recientes de la salud y la sociedad.

    Abstract in English:

    This historical study of the Aids epidemic in Peru between 1983 and 2000 focuses on legal responses and on medical studies and intervention, especially during the early 1980s, a decade characterized by serious economic crisis and terrorist violence. As elsewhere around the world, the appearance of Aids intensified interactions between scientists, public health specialists, journalists, politicians, and patients, with major influence on culture as well as on public health responses to the disease. In addition to retelling an important story, the study demonstrates the validity and usefulness of the historical perspective, which affords a better understanding of recent events in health and in society overall.
  • Health and power: the political emergence of AIDS/HIV in Brazil Análise

    Marques, Maria Cristina da Costa

    Abstract in Portuguese:

    O artigo analisa a construção das respostas políticas à Aids no Brasil. A pesquisa pautou-se pelo estudo da epidemia desde seu surgimento articulado com a história das políticas de saúde nas últimas décadas no país, dos movimentos sociais emergentes nesse período, e dos dados sobre a evolução da Aids/HIV. As fontes orais constituíram parte fundamental da pesquisa, somadas a documentos produzidos no período. O resultado revelou que a evolução das respostas oficiais à Aids, desde sua emergência política no Brasil, configurou-se em diferentes estágios e estabeleceu, com dificuldades e limites, uma forma de responder a políticas cuja característica principal está na participação da sociedade.

    Abstract in English:

    This analysis of the construction of political responses to AIDS in Brazil is grounded on a study of the epidemic since its first appearance, against a backdrop formed by the recent history of Brazilian health policy, the period's emerging social movements, and data on AIDS/HIV evolution. Together with period documents, oral sources constitute a fundamental part of the research. The article sees official responses to AIDS from the time of the disease's political emergence in Brazil as evolving through different stages and eventually - after some problems and not without certain limitations - becoming characterized first and foremost by society's participation.
  • Economics, politics, and public health in Porfirian Mexico (1876-1910)

    Carrillo, Ana María

    Abstract in Spanish:

    Este trabajo aborda el nacimiento de la salud pública moderna en México durante el gobierno de Porfirio Díaz (1876-1910) y examina los elementos científicos, políticos y económicos que lo hicieron posible: en primer término, la recepción por parte de los médicos mexicanos de los descubrimientos de la microbiología, la inmunología y la epidemiología; en segundo lugar, la concentración creciente del poder del Estado en asuntos sanitarios que fue paralela a su concentración de poder político disciplinador y permitió poner los nuevos conocimientos al servicio de la prevención de los problemas colectivos de salud; finalmente, la necesidad del imperialismo y la elite porfiriana de proteger sus intereses comerciales. El artículo hace un balance de los alcances y limitaciones de la salud pública del porfiriato, la cual se vio interrumpida de manera abrupta por la revolución iniciada en 1910.

    Abstract in English:

    The article examines the scientific, political, and economic elements that permitted the birth of modern public health in Mexico under the Porfirio Díaz administration (1876-1910). Firstly, a portion of Mexican physicians were open to the discoveries of microbiology, immunology, and epidemiology. Secondly, the State's growing concentration of power in public health matters ran parallel to its concentration of disciplinary political power and enabled this new knowledge to be placed at the service of collective health problem prevention. Lastly, both imperialism and the Porfirian elite needed to protect their business interests. The article evaluates public health achievements and limitations during the Porfirian period, abruptly interrupted by the revolution begun in 1910.
  • Modernization, medicine, disease, and public health in Caracas (1870-1877)

    Yépez Colmenares, Germán

    Abstract in Spanish:

    Entre los años de 1870 y 1877, bajo el primer período del gobierno presidido por el general y licenciado, Antonio Guzmán Blanco, se adelantan un conjunto de iniciativas orientadas a modernizar la sociedad, el gobierno y el Estado venezolano. La ciudad de Caracas es el escenario privilegiado para ejecutar una variedad de obras y medidas reformistas que buscan convertir a la ciudad capital en un espacio urbano que se corresponda con las características de las principales ciudades europeas. El ejercicio y enseñanza de la medicina, las medidas orientadas hacia un mejoramiento de las condiciones sanitarias y la manifestación expresa de una disposición para atacar por medio de normas y resoluciones legales las enfermedades que más daño ocasionaban entre los caraqueños, se ubican entre las principales medidas que se desarrollan en estos años. El gobernante y la elite profesional que lo rodea intentan crear las condiciones adecuadas para atraer el capital y los esperados inmigrantes europeos.

    Abstract in English:

    Between 1870 and 1877, under General Antonio Guzmán Blanco's first period of government, a set of measures was inaugurated with the intent of modernizing Venezuelan society, government, and the State. The city of Caracas was a prime setting in which to undertake a series of reformist works and measures meant to transform the capital into an urban space boasting features similar to Europe's major cities. Standing among the years' main developments are the practice and teaching of medicine, measures seeking to improve public health conditions, and the express desire to use legal norms and resolutions to attack the principle diseases afflicting Caracas residents. The government and its circle of professional elites sought to set the stage to attract capital and European immigrants.
  • The tropics, microbes, and vectors

    Caponi, Sandra

    Abstract in Spanish:

    Analizamos el modo como los investigadores argentinos y brasileños, de fines del XIX e inicios del XX, construyeron sus programas de investigación referidos a las enfermedades tropicales. Aun cuando la higiene brasileña y argentina fueron herederas directas de los programas y principios pasteurianos, Brasil enfrentó sus problemas sanitarios con un nuevo programa de investigación donde se integraban la bacteriología, la parasitología y la preocupación con los vectores. Argentina, por su parte, desconsideró los problemas presentados por las enfermedades tropicales e insistió en reducir todos sus problemas sanitarios a aquellos que podían ser pensados en un paradigma donde se integraban los estudios microbiológicos y las estrategias "aeristas" propias de la higiene clásica.

    Abstract in English:

    The article analyzes how Argentinean and Brazilian researchers designed their tropical disease research programs in the late 19th and early 20th centuries. Even though Brazilian and Argentinean hygiene were direct descendants of Pasteurian programs and principles, Brazil addressed its public health problems through a new research agenda that embraced bacteriology, parasitology, and a concern with vectors. Argentina, on the other hand, disregarded the problems caused by tropical disease, insisting instead on reducing all of its health issues to those that could be approached through a paradigm embracing microbiology studies and the "aerista" strategies typical of classic hygiene.
  • Medical teaching under debate: São Paulo, 1890 through 1930 Análise

    Silva, Márcia Regina Barros da

    Abstract in Portuguese:

    O objetivo deste trabalho é analisar os projetos de criação de instituições de ensino médico em São Paulo, entre 1890 e 1930. O caso paulista é específico no Brasil em dois aspectos: primeiro, a inexistência de uma escola médica até o início do século XX; segundo, a defasagem entre a primeira lei que previa a instalação da instituição, em 1891, e a instalação de fato de uma faculdade oficial no estado, em 1913. A perspectiva adotada é de que esse processo deveu-se essencialmente a uma tentativa de homogeneização do campo médico local. Por um lado, pelo esforço de sobrepor a fala médica à de outros grupos relacionados à saúde, principalmente o farmacêutico. Por outro lado, pela procura de caracterizar a produção de conhecimento local nos moldes de uma medicina laboratorial, tanto em seu viés terapêutico quanto no experimental. A conclusão é que somente após a obtenção de consenso sobre esses temas foi possível a criação de uma escola médica em São Paulo na qual se pudessem relacionar ensino e medicina experimental.

    Abstract in English:

    The aim of this article is to evaluate the idealizations of medical education institutions and their implementation between 1890 and 1930. The case of the state of São Paulo is particular. Firstly, for the absence of a medical school until the beginning of the 20th century. Besides, for the gap between the law, of 1891, which forsaw the installation of such a school, and the effective creation of an official faculty in the state, in 1913. Our point of view considers that this process is a consequence of an attempt of the local medical field uniformization. For one hand, it was searched by trying to enhance the medical speech when compared with others health professional groups speeches, mainly the pharmaceutical one. For other hand, by seeking to gave the local medical knowledge production process a laboratorial profile, which was considered both in a therapeutic and in an experimental point of view. Our conclusion is that the establishment of a medical faculty in São Paulo was made possible only after a relative consensus about these issues, allowing the relationship between medical education and experimental medicine.
  • Physicians, prostitution, and venereal disease in Colombia (1886-1951)

    Obregón, Diana

    Abstract in Spanish:

    Este trabajo examina la lucha del cuerpo médico colombiano contra las enfermedades 'venéreas' entre 1886 y 1951. En este período, Colombia sufrió procesos de urbanización, crecimiento de población, nacimiento de la industria y aparición de una clase media y de un proletariado urbano. Los médicos encontraron una conexión estrecha entre la difusión del contagio de la sífilis y la gonorrea, y el aumento del ejercicio de la prostitución en las ciudades. A finales del siglo XIX, los médicos y los organismos de higiene asumieron la prostitución como inevitable; en 1907 consiguieron reglamentarla y fundaron dispensarios para aplicar los tratamientos de mercurio y compuestos arsenicales. Hacia los años 1930 y 1940, la curación de las enfermedades venéreas se asumió como un deber estatal de defensa de la raza y a favor de la civilización y del progreso. Hacia 1950, el uso eficaz de la penicilina hizo que la cuestión de la prostitución se volviera a plantear en términos más morales y estéticos, y se impuso la abolición de las normas que regulaban su ejercicio, por lo menos en Bogotá.

    Abstract in English:

    The article examines the Colombian medical field's fight against so-called venereal diseases between 1886 and 1951, a period when the country was undergoing processes of urbanization, population growth, and the emergence both of industry as well as of a middle class and an urban proletariat. Physicians found a close connection between the spread of syphilis and gonorrhea and the rise of prostitution in cities. At the close of the 19th century, doctors and public health bodies assumed prostitution was inevitable. In 1907 they managed to have it legalized and they opened clinics to dispense mercury therapy and treatment with arsenic compounds. Starting in the 1930s and 1940s, treatment of venereal diseases was viewed as the State's duty, necessary to protect "la raza" and safeguard progress and civilization. As of 1950, the efficient use of penicillin once again caused the question of prostitution to be posed in more moral and aesthetic terms and brought an end to the regulations governing its practice, at least in Bogota.
  • "Milonguitas" in Buenos Aires (1910-40): tango, social ascent, and tuberculosis

    Armus, Diego

    Abstract in Spanish:

    En las primeras tres décadas del siglo XX, al calor de los cambios urbanos que harían de Buenos Aires una metrópolis, la poesía, el cine, el teatro y las letras de tango trabajaron con insistencia la trayectoria protagonizada por la muchacha de barrio que, lanzándose al mundo de la noche y al cabaret del centro, apuesta sacar ventajas de una sociedad donde el ascenso social, limitado pero real, era parte de la experiencia urbana. Las letras de tango, escritas mayoritariamente por hombres, hablan de ese viaje en clave de condena y la tuberculosis aparece como la materialización de un castigo para esas mujeres jóvenes que han osado desafiar su lugar en el mundo doméstico y barrial. Así, el tango ofrece a su audiencia no sólo un registro fuertemente moralizante sino también la imagen de una enfermedad que parece ser exclusivo patrimonio de las mujeres cuando, en realidad, se trataba de una enfermedad que afectaba tanto a hombres como a mujeres.

    Abstract in English:

    During the first three decades of the 20th century, in the fervor of urban change that transformed Buenos Aires into a metropolis, poetry, cinema, theater, and the lyrics of the tango repeatedly portrayed the path of muchachas de barrio who, by taking to nightlife and the downtown cabarets, placed their stakes on a society where social ascent - limited yet real - was part of the urban experience. For the most part written by men, the lyrics speak of these journeys in a tone of censure, and tuberculosis is cast as a form of punishment for these young women who dared to question their place in the domestic world and the world of the barrio. The tango thus offers its audience not only a highly moralizing account but also paints an image of an illness that seems unique to women although it in fact affected male and female alike.
  • Healthy, legitimate children: on marriage and social assistance in Argentina (1935-1948)

    Di Liscia, María Silvia

    Abstract in Spanish:

    Este artículo analiza las formas que asumió la ayuda social en el período 1935-48, considerando especialmente los aspectos diferenciales de la mortalidad infantil y los índices de natalidad en las áreas urbanizadas del litoral argentino. Diferentes instituciones sanitarias estatales, como institutos de pediatría y maternidades, llevaron a cabo una tarea asistencial entre madres solteras en la cual tenía un papel importante la enseñanza moral, con insistencia en el papel regulador del matrimonio - incluso religioso - para evitar las altas tasas de ilegitimidad de los hijos. En esta tarea, médicos, visitadoras y asistentes sociales de instituciones estatales coincidían con la jerarquía eclesiástica y con intelectuales católicos, ya que ambos sectores consideraban esencial la legitimidad matrimonial para limitar el descenso demográfico nacional.

    Abstract in English:

    This analysis of the forms of social protection available in Argentina during 1935-48 pays special attention to the distinguishing aspects of infant mortality and birthrates in urbanized areas along the country's coastline. Different government public health institutions - such as pediatric and maternity institutes - undertook assistance work among single mothers, where moral teachings played an important role and where marriage was encouraged for its regulatory role in avoiding high rates of illegitimacy. In this task, physicians, visiting nurses, and social assistants from government institutions agreed with the church hierarchy and Catholic intellectuals, since both sectors considered matrimonial legitimacy vital to limiting a decline in the national birthrate.
  • Malaria in pictures: images from Brazil's Public Health campaigns in the first half of the Twentieth Century Imagens

    Hochman, Gilberto; Mello, Maria Teresa Bandeira de; Santos, Paulo Roberto Elian dos

    Abstract in Portuguese:

    O artigo apresenta e discute um conjunto de fotografias sobre as ações, técnicas, práticas e campanhas contra a malária em três arquivos pertencentes ao acervo da Casa de Oswaldo Cruz/Fundação Oswaldo Cruz que são exemplares de momentos cruciais e distintos da história da luta contra a malária no Brasil do período de 1918 a 1956: Arquivo Belisário Penna, Arquivo Fundação Rockefeller (série Serviço de Malária do Nordeste) e Arquivo Rostan Soares. Relaciona os registros fotográficos sobre a malária com os contextos histórico-sanitários específicos e os modelos e estratégias de campanhas representados por cada um dos arquivos e sugere relações com a própria história do meio fotográfico no século XX. Considera que as imagens da malária constituem fontes privilegiadas para a construção de uma história visual da doença no país ao longo do século XX e da história da saúde pública no Brasil.

    Abstract in English:

    The article discusses a set of pictures that illustrate public health activities, practices, and campaigns against malaria in Brazil from 1918 through 1956. Exemplary of certain key moments in this history, the illustrations belong to three archives from the Casa de Oswaldo Cruz/Fundação Oswaldo Cruz collection: Arquivo Belisário Penna, Arquivo Fundação Rockefeller ("Serviço de Malária do Nordeste" series), and Arquivo Rostan Soares. The article links these photographic records to their specific historical-public health contexts and to the campaign models and strategies represented by each archive. It also draws relations with the 20th-century history of the photographic medium itself. It is argued that these images of malaria constitute prime sources in constructing a visual history of the disease in 20th-century Brazil and of the country's public health history.
  • Sources for the history of health sciences in Brazil (1808-1930) Fontes

    Fonseca, Maria Rachel Fróes da

    Abstract in Portuguese:

    O objetivo deste estudo é apresentar um panorama das fontes documentais e dos arquivos, bibliotecas e centros de documentação representativos para a história das ciências da saúde no Brasil (1808-1930). O historiador, notadamente aquele que investiga a história das ciências biomédicas no país, depara-se com um conjunto de fontes bastante amplo e diversificado. E é justamente desta convergência de diferentes testemunhos que viabilizamos a investigação histórica. Esta diversidade de registros e testemunhos caracteriza o repertório de fontes potencialmente relevantes para a história das ciências biomédicas e da saúde.

    Abstract in English:

    The article presents a panorama of documental sources and of the most representative archives, libraries, and documentation centers pertinent to the history of health sciences in Brazil (1808-1930). Historians, especially those investigating the biomedical sciences, will find here a broad and diversified set of sources. It is precisely from such a convergence of different witnesses that historical investigation is viable.
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