Abstract

As a presentation of the dossier “From Independence to Empire: health and disease in Brazil in the nineteenth century,” the article contrast “modern Brazil” imagined by the medical and political elites on the occasion of the First Centenary of Independence in 1922 with the numerous problems and challenges in the field of health that the republic, in its third decade, had inherited from the colonial and Imperial periods. In addition, it highlights issues in the history of health in the 19th century that allow the readers of the dossier to reflect on the unfulfilled civilizational promises of 1822-1922 in light of the immense challenges of the year 2022 when Brazil completes two hundred years of political sovereignty.

Key words:
Public health; History; Republic; Imperial Brazil; Medicine

In September 1923, a special edition of the Almanak Laemmert was published on the topic of the centennial of the independence of Brazil. The month chosen for the publication closed a cycle of solemnities and tributes begun a year earlier, with the apex being the inauguration of the International Exhibition in Rio de Janeiro¹1 Livro de ouro comemorativo do Centenário da Independência do Brasil e da Exposição Internacional do Rio de Janeiro. Rio de Janeiro: Anuário do Brasil, Almanak Laemmert; 1923.. The publication was in harmony with the laudatory spirit that permeated the initiatives related to the great milestone year of 1922. Its purpose was to announce the notable civilizing advances made by the nation during its first century of independence. In other words, Republican Brazil had finally entered modernity.

Along de chapters, prominent members of the capital city’s intelligentsia - including Capistrano de Abreu, Afrânio Peixoto, Barbosa Lima Sobrinho and Gustavo Barroso - celebrated the achievements of an independent Brazil in the domains of culture, science, economics and religion, among others, predicting a wonderful future for the nation. Antônio Austregésilo, a renowned professor of neurology at the University of Brazil, was responsible for the chapter on medicine that described national medical contributions to the field of public health and to the progress of the nation:

The self-congratulatory tone and the evolutionary, positive narrative regarding the role of physicians and medicine during the century since independence - both in the texts and at the 1922 international exhibition - concealed many issues and silenced a variety of actors. First, it emphasized the role of physicians, all men and members of the elite who saw society in a hierarchical way and looked down on other important health professions, such as pharmacists and nurses. When celebrating progress, the physicians playing the role of historians eliminated from their texts any signs of the “backwardness” that, according to them, had been overcome: the care and healing practices and the healers of African and indigenous origin who continued to be important social agents. The population itself is an amorphous actor in these celebrations: it has no voice, race or gender. There is also no mention of the legacy of the colonial experience, political violence during the Empire, regional differences or slavery, whose abolition had occurred a little over three decades earlier. For physicians trained between the end of the Empire and the beginning of the Republic, public health had evolved due to the foundation of medical schools and healthcare institutions, with the arrival of the Portuguese Court in 1808 as a milestone. And always under the leadership of the “wise” and qualified physicians.

The history of Brazilian medicine, focusing on the discoveries and ingenuity of the men and institutions responsible for the triumph of medical knowledge over rural and urban diseases, was transformed by historians and social scientists in the last quarter of the twentieth century into a polyphonic, contextualized history of public health in Brazil. A history that emphasizes the deep connections between healing knowledge, concepts of the body, experiences related to illness, health policies and social, economic, political and cultural aspects of our society²2 Teixeira LA, Pimenta TS, Hochman G, organizadores. História da saúde no Brasil. São Paulo: Hucitec; 2018..

In consonant with this perspective, this dossier resumes analysis of the Independence period from the perspective of public health and reflects some of the extraordinary expansion of research themes arising from new theoretical and methodological viewpoints and perspectives. In the following pages, you will find studies on the health of the enslaved; the bitter jurisdictional disputes between academic medicine and the traditional healing arts; the relationships between society and the State through policies related to vaccination and dealing with epidemics; and the establishment of institutional spaces for debate and the identity affirmation of the local medical community. Rio de Janeiro, which was then the capital of the Empire, is no longer the only reference. This decentering appears in the articles that analyze important regional and local experiences, including some of an innovative nature. These are issues that - although practically invisible in traditional analyses by physicians and health professionals - must not be excluded from any current assessment of the history of public health on the occasion of the bicentennial of Brazil’s independence. The majority of the articles focus on the nineteenth century, with many discussing the effects of the political emancipation of Brazil and the process of institutionalizing healthcare institutions during the Imperial period. However, some studies advance up until the beginning of the twentieth century, emphasizing some of the continuities, contradictions and instabilities that marked healthcare during the early Republican period.

The year of the first centennial brought celebrations, but also political, economic and electoral crises. One century later, in 2022, this dossier intends to contribute by critically examining the civilizing promise of medicine and public health - although unfeasible because it was exclusionary - celebrated in 1922.

References

Publication Dates

History