Homage to some pioneers in psychiatry in Rio Grande do Sul

ABOUT THE COVER

Homage to some pioneers in psychiatry in Rio Grande do Sul

Ellis D'Arrigo Busnello

Retired professor, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

The picture above, taken in 1940, shows a group of authorities, medical professors (among whom is the Director of Hospital Psiquiátrico São Pedro) and students of Children's Biopsychology, a course that was developed in that hospital.

In the first row, from left to right: Dr. Álvaro Difini (1), Dr. José Garrastazú Teixeira (2) (representing the Governor), Dr. Jacintho Godoy (3) (Director of Hospital Psiquiátrico São Pedro and President of Sociedade de Psiquiatria do Rio Grande do Sul), Dr. Bonifácio Paranhos da Costa (4) (Secretary of Health of the former State Health Department - DES), Dr. Alvorino Mércio Xavier (5) (Assistant Secretary of Health).

In the second row, from left to right: Dr. Mário Martinez Martins (6), Dr. Vitor de Brito Velho (7), Dr. Ciro dos Santos Martins (8), Dr. Álvaro Murilo da Silveira (9), Dr. Raimundo Godinho (10), Dr. José Barros de Araújo (Head of Professional Inspection). In the last row: Dr. Poli Marcelino Espírito (11) (from the Department of Health).

At the back, in the last three rows: Dr. Leônidas Escobar (12), Dr. Dyonélio Machado (13), Dr. Fernando Pombo Dornelles (14), Prof. Décio Soares de Souza (15).

Dr. Cyro dos Santos Martins, Dr. Jacintho Godoy Filho, Dr. Jacintho Saint-Pastous Godoy and Dr. Ellis D'Arrigo Busnello helped in the identification.

Dear Carmem and Flávio, Editors of Revista de Psiquiatria do Rio Grande do Sul,

I present the identification I was able to perform of the photograph you have appropriately and wisely chosen to illustrate the cover of our prestigious Revista. Due to the experience I had in researching about the photograph and the characters included in it, I would like to suggest the Editors to make this a routine, owing to the richness of teachings implied by the exercise of reconstitution.

I had already identified part of the people and the fact regarding the photograph, since it has previously illustrated the back cover of Jornal da Sociedade de Psiquiatria do Rio Grande do Sul.1

I hold Chair 34 in our modest but vigorous Academia Sul-Rio-Grandense de Medicina, headed by Dr. Jacintho Godoy, of whom I wrote a biography. At that time, I learned a lot about him and about Hospital Psiquiátrico São Pedro.2 I was proudly the Director of Hospital Psiquiátrico São Pedro during the democratically elected government of Dr. Jair de Oliveira Soares. With that invaluable experience, I was able to see the fact and the photograph with the eyes of a person who loves and has the greatest respect for that hospital, as well as for the doctors who have worked in it throughout the years. I take this opportunity you have offered me to thank every doctor who works with mentally ill patients (or, using modern language, with patients who present mental and behavioral disorders), and not the so-called "psychic suffering" - because this is present in any person, animal or thing. Therefore, I am filled with admiration for those who apply humanity in their medical activity, especially those who practice our specialty, due to the respect and effort they put into helping people who were injured in what is most characteristic of men: their mind. In times when our medical science and the specialty we work in, Psychiatry, have been so misunderstood, the task I was assigned soon changed from a chore in this busy end of the year into a reason for joy and maturity. I, who no longer thought it was possible, at my age, to be able to increase my understanding of what Psychiatry still has to face, what it accomplished, its ups and downs, and what it still has to do to bring the highest level of mental health to individuals and to human populations.

The photograph shows a group of Children's Biopsychology students practically developed for women, identified by Cyro Martins as teachers of public schools, who are graciously and elegantly dressed according to their time, wearing hat and suits that, as can be seen, were made by local shops, most of them certainly copied by local dressmakers who saw them in magazines and movies that kept them updated. Surely, as could be said nowadays, "dressing up" to register that they had attended a course in Children's Biopsychology at Hospital Psiquiátrico São Pedro, since in those good old times, important facts demanded elegant suits and postures. I suppose they were proud of their achievement. It can also be seen the presence of the Representative of the State Governor, the Health Secretary, who was the man summoned by Rio Grande do Sul to set up the structure of Health Services in the State, or State Health Department (DES). The presence of authorities gives a clue of the environment of respect for the work being done at Hospital Psiquiátrico São Pedro. I stress the spirit that motivated prestigious people and psychiatrists who are part of the history of psychiatry in Rio Grande do Sul, by encouraging teaching activities for laypeople in that hospital. Today, better understood among health activities, they would be called measures of primary prevention in mental health - in that case, health promotion - by educating the population in terms of health.

Some details in that photograph should be highlighted: the very best of psychiatry professionals either worked or often went to Hospital Psiquiátrico São Pedro. I will make some comments about those who were photographed, opening a cultural and scientific path for the understanding of the paths that are sometimes followed by psychiatry throughout time.

Mário Alvarez Martins and Cyro dos Santos Martins were part of the first group of psychoanalysts that founded our Sociedade Psicanalítica de Porto Alegre. They specialized (nowadays we would say lato sensu graduate training) in Buenos Aires. Cyro Martins was the psychiatrist I sought for my training in psychoanalysis, at times in which formalities were maintained, such as that of maintaining a certain distance between analyst and patient, an impossible mission for people like me and him, who feel extreme pleasure in exchanging words and ideas. With Mário, my so-called "first psychoanalysis case" was supervised for 2 years. During that period, and many years afterward, I was granted a great amount of knowledge about people, hospital's life and people with whom we shared experiences in several psychiatric and psychoanalytic groups and in those connected to the culture of our Province, which was not provincial at that time. We used to talk to them and to some other people who appear in the photograph, directly or by what was written about them and about those who experienced psychiatry at that time, trying to know their history. Acquiring information about those characters made me learn a lot about life, about our profession, about human beings and about the human mind and its greatness and vicissitudes.

With Dyonélio Machado, Décio de Souza, Raymundo Godinho, who are in the photograph, and with Dr. Paulo Luis Vianna Guedes, Dr. Luiz Pinto Ciulla, Dr. David Zimmermann and Dr. Jacintho Godoy Filho among others who are not in the photograph, but also used to go to Hospital Psiquiátrico São Pedro, I learned about the incredible innovations and efforts being done in that hospital to, according to the lack of proper knowledge people at that time had on diagnosis, etiology, treatments and rehabilitation of mental patients, try to apply the most modern psychiatric knowledge, the best one could do for the comfort of patients and well-being of their relatives.

Vitor de Brito Velho, who is in the photograph, was a Professor of Psychology, a profession to which he dedicated his acute intelligence at the former Faculdade de Filosofia, Ciências e Letras at the former Universidade do Rio Grande do Sul, now UFRGS, where I attended his memorable classes.

Wearing dark glasses, beside Cyro, is Álvaro Murilo da Silveira, to whom a whole article could be dedicated. He was the first psychiatrist to use convulsive therapy for the treatment of mental diseases, firstly using metrazol (1937). Later, certainly due to that inventive courage of our people, with the aid of Engineer Olmiro Ilgenfritz, based on articles that included the design of the first devices of electric convulsive therapy used in Italy by Cerletti and Bini to obtain electric convulsion (1938), he set up a device in Porto Alegre. He and Cyro Martins, as Cyro himself told me, tried to trigger some convulsions, firstly in dogs, naturally, since they were instinctively ethical. Experiments on humans were only approved 8 years later, in Nuremberg, and then universalized in Helsinki, and currently regulate experiments on human beings and animals. They soon started using electric convulsive therapy in human beings, which has been the best treatment of severe major depression so far. Either associated with monotherapy or with Sakel's insulin therapy, they were able to observe the miraculous recoveries of major depressions, severe manic conditions and acute psychotic schizophrenic attacks.

Décio Soares de Souza, a privileged medical brain, was Professor of Psychiatry in our Medical School, a position which I would later hold, after he moved to London for his psychoanalytic specialization. He personified the presence of university professors at Hospital Psiquiátrico São Pedro, since there was no Psychiatric Ward at Irmandade Santa Casa de Misericórdia, which was then a teaching hospital of the Medical School at Universidade do Rio Grande do Sul. From its basement came forty patients who were sent to Hospital São Pedro in 1884, recently created by the Imperial Regime. This created a necessary rupture, today replaced by the creation of psychiatric wards in large hospitals, especially in teaching hospitals.

Dr. Dyonélio Machado, whose book Os ratos [The rats] I consider one of the densest and deepest works in the Brazilian literature, considered the idea about another work on the biological conception of crime.

That house did not lack intelligence, and psychiatry in Rio Grande do Sul did not, and does not, lack the awareness of how much we know about the nature of diseases that affect the human mind, of how poor our preventive and therapeutic alternatives, which greatly contrasts with the effort being made now and at that time to assist, teach and research on psychiatry or on mental health.

While I researched only to find out the names of those in the photograph, it suddenly occurred to me the idea that I had to remind our readers, whom I consider being "those who come later" as Berthold Brecht used to say, that if some mistakes were made and still are, it is because our ancestors lived (as we, the descendants, still live) hard times in developing preventive, healing and rehabilitating activities in our specialty. I soon realized that we both deserve the indulgence that Berthold Brecht asks for "those who come later." Also, I cannot be falsely modest not to consider what has already been done to ease the suffering of those who have lost or suffer due to mental and behavioral disorders.

I have been talking about the need of making science increasingly more precise, in the sense of being exact as navigation, according to Pompey's (apud Plutarch) ancient advice given to fearful sailors that refused to leave under a storm threat: navigating is precise, it is necessary. Navigation, even at that time, was more precise than living. The art and science of navigating was precise, thanks to the stars that guided navigators; life had no stars to guide its path. I am one of these people who, at least over the 20 years, have been encouraging the association of patients' care with teaching and research, to make our work increasingly more exact and precise. We already have some guiding stars in our science, but there is still much to be known. As I have become a dean in psychiatry in Rio Grande do Sul and Brazil, I am entitled to encourage new generations to work harder in search of more and better knowledge to always make our prevention, healing and rehabilitation methods more efficient and efficacious. Great part of humanity is out there waiting for us and wishing us to be more exact and precise, both as scientists and humanists.

I repeat that I did not think I would be so happy to remember important things to record names in a photograph legend.

I am not able to mention, for lack of space, the commitment of people who are in the photograph and others related to it, who were committed to the treatment of nervous system syphilis, which had no response with arsenic and bismuth, introducing Wagner von Jaureg's malaria therapy. In addition, there were others working with the diagnostic use of brain lesions through neuroradiology, neurophysiology and neurosurgery; assessing the electroshock treatment; providing the first descriptions of marijuana intoxication2 and considerations on psychosurgery; as well as the first clinical and experimental trials with penicillin.3,4 But there are data, and they were exposed and mentioned here, and there are people who, because they had contact with out predecessors or with their relatives, are able to rescue more epic moments of the history of psychiatry in Rio Grande do Sul, whose richness made me see our ancestors with respect, pride, compassion and passion.

I thank the Editors for inviting me to perform such an intense work, which has soon become a great pleasure; for that reason, I should thank you more than you should thank me.

I also take this opportunity to acknowledge the invaluable help by Dr. Jacintho Godoy Filho, for providing data about his father and about the time in which he lived, and also Dr. Jacintho Saint-Pastous Godoy, for granting access to photographs, magazines and documents belonging to himself and to Clínica São José.

REFERENCES

1. Primeiro Curso de Biopsicologia Infantil. In: Jornal da Sociedade de Psiquiatria do Rio Grande do Sul. 1994;15:12.

2. Busnello ED. Jacintho Godoy, Biografia de Patrono da Cadeira 34. Porto Alegre: Academia Sul-Riograndense de Medicina; 2000.

3. Rio Grande do Sul, Departamento Estadual de Saúde. (Redator-chefe: Faillace JM; Comissão de redação: Machado LS, Ciulla L, da Silva NN). [Vários arquivos]. Porto Alegre: Oficinas Gráficas da Imprensa Oficial; 1943.

4. Rio Grande do Sul, Departamento Estadual de Saúde. (Redatores-chefes: Faillace JM, Ciulla L; Comissão de redação: Machado LS, da Silva NN). [Vários arquivos]. Porto Alegre: Oficinas Gráficas da Imprensa Oficial; 1944.

Publication Dates

  • Publication in this collection
    04 Apr 2007
  • Date of issue
    Dec 2006
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