Biomedical research and public health in Brazil: The case of Chagas' disease (1909-50)

Social History of Medicine

Volumn 16, Issue 1, 2003, Pages 111-129

  Kropf, Simone Petraglia ^a   Azevedo, Nara ^a   Ferreira, Luiz Otávio ^a  

^a De Saúde Pública Fiocruz   (Brazil)

Author keywords

American trypanosomiasis; Biomedical research; Brazil; Cardiopathy; Chagas' disease; Endemic diseases; History of medicine; History of science; Parasitology; Public health

Indexed keywords

ARTICLE; BRAZIL; CHAGAS DISEASE; HISTORY; ORGANIZATION; PUBLIC HEALTH; RESEARCH; TRYPANOSOMIASIS;

ACADEMIES AND INSTITUTES; BRAZIL; CHAGAS DISEASE; HISTORY, 20TH CENTURY; PUBLIC HEALTH; RESEARCH; TRYPANOSOMIASIS;

EID: 0642278799     PISSN: 0951631X     EISSN: None     Source Type: Journal    
DOI: 10.1093/shm/16.1.111     Document Type: Review

References (102)

1. In Brazil, this insect is known to the rural population as barbeiro (barber) because it tends to bite people on the face. In other Latin American countries it is known as vinchuca and in the United States as kissing bug.
2. For basic information about the disease, see the WHO and the Centres for Disease Control and Prevention (CDC) websites: www.who.int/ctd/chagas; www.cdc.gov/ncidod/dpd/parasites/chagasdisease. See also M. Vinhaes and J. C. P. Dias, 'Doença de Chagas no Brasil', Cademos de Saúde Pública (Reports in Public Health), 16, suppl. 2 (2000), 7-12.
3. For basic information about the disease, see the WHO and the Centres for Disease Control and Prevention (CDC) websites: www.who.int/ctd/chagas; www.cdc.gov/ncidod/dpd/parasites/chagasdisease. See also M. Vinhaes and J. C. P. Dias, 'Doença de Chagas no Brasil', Cademos de Saúde Pública (Reports in Public Health), 16, suppl. 2 (2000), 7-12.
4. The Instituto Oswalde Cruz (or Instituto) de Manguinhos), formerly known as the Instituto Soroterápico Federal, was founded in 1900 in Rio de Janeiro, then the capital of Brazil, to produce immunobiological products to meet the requirements of public health and veterinary medicine at the time. Under the direction of Oswaldo Cruz (especially after 1908, when it became Instituto Oswaldo Cruz), it expanded its activities to become a centre for production and biomedical research and training in microbiology. On the importance of the IOC to Brazilian science, see N. Stepan, Beginnings of Brazilian Science: Oswaldo Cruz, Medical Research and Policy, 1890-1920 (New York, 1976); S. Schwartzman, A Space for Science: the Development of the Scientific Community in Brazil (Pennsylvania, 1991); J. L. Benchimol (ed.), Manguinhos do Sonho à Vida. A Ciência na Belle Époque (Rio de Janeiro, 1990); and J. L. Benchimol and L. A. Teixeira, Cobras, Lagartos & Outros Bichos: Uma História Comparada dos Institutos Oswaldo Cruz e Butantan (Rio de Janeiro, 1993).
5. The Instituto Oswalde Cruz (or Instituto) de Manguinhos), formerly known as the Instituto Soroterápico Federal, was founded in 1900 in Rio de Janeiro, then the capital of Brazil, to produce immunobiological products to meet the requirements of public health and veterinary medicine at the time. Under the direction of Oswaldo Cruz (especially after 1908, when it became Instituto Oswaldo Cruz), it expanded its activities to become a centre for production and biomedical research and training in microbiology. On the importance of the IOC to Brazilian science, see N. Stepan, Beginnings of Brazilian Science: Oswaldo Cruz, Medical Research and Policy, 1890-1920 (New York, 1976); S. Schwartzman, A Space for Science: the Development of the Scientific Community in Brazil (Pennsylvania, 1991); J. L. Benchimol (ed.), Manguinhos do Sonho à Vida. A Ciência na Belle Époque (Rio de Janeiro, 1990); and J. L. Benchimol and L. A. Teixeira, Cobras, Lagartos & Outros Bichos: Uma História Comparada dos Institutos Oswaldo Cruz e Butantan (Rio de Janeiro, 1993).
6. The Instituto Oswalde Cruz (or Instituto) de Manguinhos), formerly known as the Instituto Soroterápico Federal, was founded in 1900 in Rio de Janeiro, then the capital of Brazil, to produce immunobiological products to meet the requirements of public health and veterinary medicine at the time. Under the direction of Oswaldo Cruz (especially after 1908, when it became Instituto Oswaldo Cruz), it expanded its activities to become a centre for production and biomedical research and training in microbiology. On the importance of the IOC to Brazilian science, see N. Stepan, Beginnings of Brazilian Science: Oswaldo Cruz, Medical Research and Policy, 1890-1920 (New York, 1976); S. Schwartzman, A Space for Science: the Development of the Scientific Community in Brazil (Pennsylvania, 1991); J. L. Benchimol (ed.), Manguinhos do Sonho à Vida. A Ciência na Belle Époque (Rio de Janeiro, 1990); and J. L. Benchimol and L. A. Teixeira, Cobras, Lagartos & Outros Bichos: Uma História Comparada dos Institutos Oswaldo Cruz e Butantan (Rio de Janeiro, 1993).
7. The Instituto Oswalde Cruz (or Instituto) de Manguinhos), formerly known as the Instituto Soroterápico Federal, was founded in 1900 in Rio de Janeiro, then the capital of Brazil, to produce immunobiological products to meet the requirements of public health and veterinary medicine at the time. Under the direction of Oswaldo Cruz (especially after 1908, when it became Instituto Oswaldo Cruz), it expanded its activities to become a centre for production and biomedical research and training in microbiology. On the importance of the IOC to Brazilian science, see N. Stepan, Beginnings of Brazilian Science: Oswaldo Cruz, Medical Research and Policy, 1890-1920 (New York, 1976); S. Schwartzman, A Space for Science: the Development of the Scientific Community in Brazil (Pennsylvania, 1991); J. L. Benchimol (ed.), Manguinhos do Sonho à Vida. A Ciência na Belle Époque (Rio de Janeiro, 1990); and J. L. Benchimol and L. A. Teixeira, Cobras, Lagartos & Outros Bichos: Uma História Comparada dos Institutos Oswaldo Cruz e Butantan (Rio de Janeiro, 1993).
8. See especially C. Chagas, 'Über eine neue Trypanosomiasis des Menschen', Archiv für Schiffs und Tropen-Hygiene, 13 (1909), 351-3; idem, 'Nova Especie Morbida do Homem, Produzida por um Trypanozomal (Trypanozoma cruzi): Nota Prévia', Brazil-Medico, 23 (1909), 161; idem, 'Nouvelle espèce de trypanosomiase humaine', Bulletin de la Société de Pathologie Éxotique, 2 (1909), 304-7.
9. See especially C. Chagas, 'Über eine neue Trypanosomiasis des Menschen', Archiv für Schiffs und Tropen-Hygiene, 13 (1909), 351-3; idem, 'Nova Especie Morbida do Homem, Produzida por um Trypanozomal (Trypanozoma cruzi): Nota Prévia', Brazil-Medico, 23 (1909), 161; idem, 'Nouvelle espèce de trypanosomiase humaine', Bulletin de la Société de Pathologie Éxotique, 2 (1909), 304-7.
10. See especially C. Chagas, 'Über eine neue Trypanosomiasis des Menschen', Archiv für Schiffs und Tropen-Hygiene, 13 (1909), 351-3; idem, 'Nova Especie Morbida do Homem, Produzida por um Trypanozomal (Trypanozoma cruzi): Nota Prévia', Brazil-Medico, 23 (1909), 161; idem, 'Nouvelle espèce de trypanosomiase humaine', Bulletin de la Société de Pathologie Éxotique, 2 (1909), 304-7.
11. At the time, African trypanosomiasis or sleeping sickness attracted the interest of European researchers of so-called tropical diseases.
12. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
13. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
14. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
15. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
16. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
17. See, for example, E. Villela, 'Carlos Chagas', Memorias do Instituto Oswaldo Cruz, 29 (1934), i-xv; M. Carneiro, História da Doença de Chagas (Curitiba, 1963); C. Chagas Filho, 'Histórico sôbre a Doença de Chagas', in J. R. Cançado (ed.), Doença de Chagas por um Grupo de Colaboradores Especializados (Belo Horizonte, 1968), 5-21; C. Chagas Filho, Meu Pai (Rio de Janeiro, 1993); R. Lewinsohn, 'Carlos Chagas and the Discovery of Chagas' Disease (American Trypanosomiasis)'Journal of the Royal Society of Medicine, 74 (1981), 441-55; and J. C. P. Dias, 'Atualidade de Carlos Chagas. Os 90 Anos do Descobrimento e a Importância Social da Doença de Chagas', in Casa de Oswaldo Cruz/Fundação Oswaldo Cruz and Prossiga/CNPq, Biblioteca Virtual Carlos Chagas (Rio de Janeiro, 1999), (http://www.prossiga.br/chagas).
18. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
19. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
20. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
21. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
22. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
23. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
24. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
25. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
26. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
27. See Stepan, Beginnings of Brazilian Science; Schwartzman, A Space for Science; Benchimol and Teixeira, Cobras, Lagartos & Outros Bichos; M. Perleth, Historical Aspects of American Trypanosomiasis (Chagas' Disease) (Frankfurt am Main, 1997); M. Coutinho, 'Ninety Years of Chagas Disease: a Success Story at the Periphery', Social Studies of Science, 29 (1999), 519-49; M. Coutinho and J. C. P. Dias, 'A Reason to Celebrate: the Saga of Brazilian Chagologists', Ciência e Cultura Journal of the Brazilian Association for the Advancement of Science, 56 (1999), 394-410; idem, 'The Rise and Fall of the Chagas Disease', Perspectives on Science, 7 (1999), 447-85; and N. Stepan, 'Appearances and Disappearances', in idem, Picturing Tropical Nature (London, 2001), 180-207. For studies of the history of Chagas' disease from the perspective of historical epidemiology and anthropology, see, respectively, L. J. Silva, A Evolução da Doença de Chagas no Estado de São Paulo (São Paulo, 1999) and J. W. Bastien, The Kiss of Death. Chagas' Disease in the Americas (Salt Lake City, 1998).
28. On the public health movement and the reform of public health services in Brazil under the First Republic (1889-1930), see L. A. Castro-Santos, 'Power, Ideology and Public Health in Brazil (1889-1930)' (unpublished Ph.D. thesis, Harvard University, 1987); M. E. Labra, 'O Movimento Sanitarista nos Anos 20. Da Conexão Sanitária Internacional à Especialização em Saúde Pública no Brasil' (unpublished Ph.D. thesis, Fundação Getúlio Vargas, 1985); N. T. Lima and N. Britto, 'Saludy Nación: Propuesta para el Saneamiento Rural. Un Estudio de la Revista Saúde (1918-1919)', in M. Cueto (ed.), Salud, Cultura y Sociedad en America Latina: Nuevas Perspectivas Históricas (Lima, 1996), 135-58; N. T. Lima and G. Hochman, 'Condenado pela Raça, Absolvido pela Medicina: o Brasil Descoberto pelo Movimento Sanitarista da Primeira República', in M. C. Maio and R. V. Santos (eds), Raça, Ciência e Sociedade (Rio de Janeiro, 1996), 23-40; G. Hochman, A Era do Saneamento. As Bases da Política de Saúde Pública no Brasil (São Paulo, 1998);
29. On the public health movement and the reform of public health services in Brazil under the First Republic (1889-1930), see L. A. Castro-Santos, 'Power, Ideology and Public Health in Brazil (1889-1930)' (unpublished Ph.D. thesis, Harvard University, 1987); M. E. Labra, 'O Movimento Sanitarista nos Anos 20. Da Conexão Sanitária Internacional à Especialização em Saúde Pública no Brasil' (unpublished Ph.D. thesis, Fundação Getúlio Vargas, 1985); N. T. Lima and N. Britto, 'Saludy Nación: Propuesta para el Saneamiento Rural. Un Estudio de la Revista Saúde (1918-1919)', in M. Cueto (ed.), Salud, Cultura y Sociedad en America Latina: Nuevas Perspectivas Históricas (Lima, 1996), 135-58; N. T. Lima and G. Hochman, 'Condenado pela Raça, Absolvido pela Medicina: o Brasil Descoberto pelo Movimento Sanitarista da Primeira República', in M. C. Maio and R. V. Santos (eds), Raça, Ciência e Sociedade (Rio de Janeiro, 1996), 23-40; G. Hochman, A Era do Saneamento. As Bases da Política de Saúde Pública no Brasil (São Paulo, 1998);
30. On the public health movement and the reform of public health services in Brazil under the First Republic (1889-1930), see L. A. Castro-Santos, 'Power, Ideology and Public Health in Brazil (1889-1930)' (unpublished Ph.D. thesis, Harvard University, 1987); M. E. Labra, 'O Movimento Sanitarista nos Anos 20. Da Conexão Sanitária Internacional à Especialização em Saúde Pública no Brasil' (unpublished Ph.D. thesis, Fundação Getúlio Vargas, 1985); N. T. Lima and N. Britto, 'Saludy Nación: Propuesta para el Saneamiento Rural. Un Estudio de la Revista Saúde (1918-1919)', in M. Cueto (ed.), Salud, Cultura y Sociedad en America Latina: Nuevas Perspectivas Históricas (Lima, 1996), 135-58; N. T. Lima and G. Hochman, 'Condenado pela Raça, Absolvido pela Medicina: o Brasil Descoberto pelo Movimento Sanitarista da Primeira República', in M. C. Maio and R. V. Santos (eds), Raça, Ciência e Sociedade (Rio de Janeiro, 1996), 23-40; G. Hochman, A Era do Saneamento. As Bases da Política de Saúde Pública no Brasil (São Paulo, 1998);
31. On the public health movement and the reform of public health services in Brazil under the First Republic (1889-1930), see L. A. Castro-Santos, 'Power, Ideology and Public Health in Brazil (1889-1930)' (unpublished Ph.D. thesis, Harvard University, 1987); M. E. Labra, 'O Movimento Sanitarista nos Anos 20. Da Conexão Sanitária Internacional à Especialização em Saúde Pública no Brasil' (unpublished Ph.D. thesis, Fundação Getúlio Vargas, 1985); N. T. Lima and N. Britto, 'Saludy Nación: Propuesta para el Saneamiento Rural. Un Estudio de la Revista Saúde (1918-1919)', in M. Cueto (ed.), Salud, Cultura y Sociedad en America Latina: Nuevas Perspectivas Históricas (Lima, 1996), 135-58; N. T. Lima and G. Hochman, 'Condenado pela Raça, Absolvido pela Medicina: o Brasil Descoberto pelo Movimento Sanitarista da Primeira República', in M. C. Maio and R. V. Santos (eds), Raça, Ciência e Sociedade (Rio de Janeiro, 1996), 23-40; G. Hochman, A Era do Saneamento. As Bases da Política de Saúde Pública no Brasil (São Paulo, 1998);
32. On the public health movement and the reform of public health services in Brazil under the First Republic (1889-1930), see L. A. Castro-Santos, 'Power, Ideology and Public Health in Brazil (1889-1930)' (unpublished Ph.D. thesis, Harvard University, 1987); M. E. Labra, 'O Movimento Sanitarista nos Anos 20. Da Conexão Sanitária Internacional à Especialização em Saúde Pública no Brasil' (unpublished Ph.D. thesis, Fundação Getúlio Vargas, 1985); N. T. Lima and N. Britto, 'Saludy Nación: Propuesta para el Saneamiento Rural. Un Estudio de la Revista Saúde (1918-1919)', in M. Cueto (ed.), Salud, Cultura y Sociedad en America Latina: Nuevas Perspectivas Históricas (Lima, 1996), 135-58; N. T. Lima and G. Hochman, 'Condenado pela Raça, Absolvido pela Medicina: o Brasil Descoberto pelo Movimento Sanitarista da Primeira República', in M. C. Maio and R. V. Santos (eds), Raça, Ciência e Sociedade (Rio de Janeiro, 1996), 23-40; G. Hochman, A Era do Saneamento. As Bases da Política de Saúde Pública no Brasil (São Paulo, 1998);
33. G. Hochman, 'Moving Boundaries: When Rural Sanitation Becomes an Urban Problem (Brazil, 1910-1930)': paper presented at II Conference of The International Network of the History of Public Health/Annual Meeting of the Society for the Social History of Medicine (Liverpool, 1997).
34. Benchimol and Teixeira, Cobras, Lagartos & Outras Bichos; Coutinho, 'Ninety Years of Chagas' Disease'. Analysing medical photographs related to Chagas' disease in the context of debates on tropical medicine and national identity in Brazil in the 1910s and 1920s, Stepan corroborates the hypothesis of deconstruction, interpreting the representations in those pictures as an element related to this process. Stepan, 'Appearances and Disappearances'.
35. Benchimol and Teixeira, Cobras, Lagartos & Outras Bichos; Coutinho, 'Ninety Years of Chagas' Disease'. Analysing medical photographs related to Chagas' disease in the context of debates on tropical medicine and national identity in Brazil in the 1910s and 1920s, Stepan corroborates the hypothesis of deconstruction, interpreting the representations in those pictures as an element related to this process. Stepan, 'Appearances and Disappearances'.
36. Benchimol and Teixeira, Cobras, Lagartos & Outras Bichos; Coutinho, 'Ninety Years of Chagas' Disease'. Analysing medical photographs related to Chagas' disease in the context of debates on tropical medicine and national identity in Brazil in the 1910s and 1920s, Stepan corroborates the hypothesis of deconstruction, interpreting the representations in those pictures as an element related to this process. Stepan, 'Appearances and Disappearances'.
37. Chagas Filho, 'Histórico sôbre a Doença de Chagas', p. 7.
38. The issue Kraus raised was that, in spite of the large number of barbeiros infected, in some regions of Argentina he had not been able to identify human cases of the disease. Chagas' explanation was that probably, in these areas, the parasite had not yet adapted to human hosts.
39. See A. N. Silva et al., 'Parecer sobre a doença de Chagas: Sessão de 23 de novembre de 1923', in Boletim da Academia National de Medicina (1923), 728-46.
40. Chagas Filho, 'Histórico Sôbre a Doença de Chagas', p. 8.
41. F. Delaporte, La Maladie de Chagas. Histoire d'un Fléau Continental (Paris, 1999);
42. idem, 'Romaña's Sign', Journal of the History of Biology, 30 (1997), 357-66.
43. The author also proposes a critical analysis of traditionally-accepted historical narratives of the process of discovery of Chagas' disease. See F. Delaporte, 'Chagas, a Lógica e a Descoberta', História, Ciêndas, Saúde: Manguinhos, 1 (1995), 39-53.
44. B. Latour and S. Woolgar, The Laboratory Life: the Social Construction of Facts (London, 1979); B. Latour, La Science en Action (Paris, 1989).
45. B. Latour and S. Woolgar, The Laboratory Life: the Social Construction of Facts (London, 1979); B. Latour, La Science en Action (Paris, 1989).
46. On the same occasion, Oswaldo Cruz began to build a hospital at the IOC to study cases of Chagas' disease identified in Lassance. Inaugurated in 1918 as the Hospital Oswaldo Cruz, it was later renamed Hospital Evandro Chagas.
47. A. Neiva, 'Informações sobre a Biolojia do Conorhinus megistus Burm', Memories do Instituto Oswaldo Cruz, 2 (1910), 206-12.
48. C. Chagas, 'Nova Tripanozomiase Humana. Estudos sobre a Morfolojia e o Ciclo Evolutivo do Schizotrypanum cruzi n.gen. n.sp., Ajente Etiolojico de Nova Entidade Morbida do Homem', Memorias do Instituto Oswaldo Cruz, 1 (1909), 159-218.
49. G. Vianna, 'Contribuição para o Estudo da Anatomia Patolojica da Molesria de Carlos Chagas (Esquizotripanoze Humana ou Tireoidite Parazitaria)', Memorias do Instituto Oswaldo Cruz, 3 (1911), 276-94.
50. C. Chagas, 'Nova Entidade Morbida do Homem', Brazil-Medico, 24 (1910), 423-8, 433-7, 443-7.
51. In 1911, Chagas created a new, supra-renal clinical form. See C. Chagas, 'Molestia de Carlos Chagas: Conferencia Realizada em 7 de Agosto na Academia Nacional de Medicina', Brazil-Medico, 25 (1911), 340-3, 353-5, 361-4, 373-5. In 1916, he modified the clinical forms, eliminating the chronic form with acute exacerbations and replacing the forms called pseudo-myxedematous and myxedematous, respectively, with indeterminate form and hypothyroid form. See C. Chagas, 'Processus Patojenicos da Tripanozomiase Americana', Memorias do Instituto Oswaldo Cruz, 8 (1916), 5-35. In later papers, he refers only to cardiac, nervous, and supra-renal forms. Currently, the chronic phase of the disease is understood to include the indeterminate, cardiac, and digestive forms.
52. In 1911, Chagas created a new, supra-renal clinical form. See C. Chagas, 'Molestia de Carlos Chagas: Conferencia Realizada em 7 de Agosto na Academia Nacional de Medicina', Brazil-Medico, 25 (1911), 340-3, 353-5, 361-4, 373-5. In 1916, he modified the clinical forms, eliminating the chronic form with acute exacerbations and replacing the forms called pseudo-myxedematous and myxedematous, respectively, with indeterminate form and hypothyroid form. See C. Chagas, 'Processus Patojenicos da Tripanozomiase Americana', Memorias do Instituto Oswaldo Cruz, 8 (1916), 5-35. In later papers, he refers only to cardiac, nervous, and supra-renal forms. Currently, the chronic phase of the disease is understood to include the indeterminate, cardiac, and digestive forms.
53. C. Chagas and E. Villela, 'Forma Cardiaca da Trypanosomiase Americana', Memórias do Instituto Oswaldo Cruz, 14 (1922), 5-61.
54. C. Guerreiro and A. Machado, 'Da Reação de Bordet e Gengou na Moléstia de Chagas como Elemento Diagnóstico: Nota Prévia', Brazil-Medico, 27 (1913), 225-6.
55. E. Brumpt, 'Le Xénodiagnostique. Application au Diagnostic de Quelques Infections Parasitaires et en Particulier à la Trypanosomose de Chagas', Bulletin de la Société de Pathologie Éxotique, 7 (1914), 706-10.
56. E. Brumpt, 'Le Trypanosoma cruzi Évolue chez Conorhinus megistus, Cimex lectularius, Cimex bouetí et Omithodorus moubata. Cycle Évolutif de ce Parasite', Bulletin de la Société de Pathologie Éxotique, 5 (1912), 360-1.
57. See Casa de Oswaldo Cruz/Fundação Oswaldo Cruz, Science Heading for the Backwoods: Images of the Expeditions Conducted by the Oswaldo Cruz Institute to the Brazilian Hinterland - 1911/1913 (Rio de Janeiro, 1991); N. T. Lima, Um Sertão Chamado Brasil (Rio de Janeiro, 1999).
58. See Casa de Oswaldo Cruz/Fundação Oswaldo Cruz, Science Heading for the Backwoods: Images of the Expeditions Conducted by the Oswaldo Cruz Institute to the Brazilian Hinterland - 1911/1913 (Rio de Janeiro, 1991); N. T. Lima, Um Sertão Chamado Brasil (Rio de Janeiro, 1999).
59. B. Penna and A. Neiva, 'Viagem Cientifica pelo Norte da Bahia, Sudoeste de Pernambuco, Sul do Piauhi e de Norte a Sul de Goiáz', Memorias do Instituto Oswaldo Cruz, 8 (1916), 74-224.
60. During Carlos Chagas' lifetime, research was done in several Latin American countries, though in most cases it was isolated and scattered. By the beginning of the 1930s, when research in Argentina made decisive contributions to the identification and study of cases of the disease, most research emphasized issues related to the vector, and there were few descriptions of the disease in humans. In Brazil, with the exception of the work at the IOC, research also followed this trend. See Dias, 'Atualidade de Carlos Chagas'.
61. According to Stepan ('Appearances and Disappearances'), criticism of the thesis about chagasic aetiology of endemic goitre was motivated not only by scientific argument, but by the fact that photographs of individuals physically and mentally deformed by thyroid complications were disturbing, and were seen by many as extremely negative and damaging to representations of national identity. For studies of the significance attributed to the notion of disease in the debates and representations of national identity in the first decades of the twentieth century, see the bibliography cited in n. 8.
62. A goitre is an enlargement of the thyroid gland that is not associated with inflammation or cancer. There are different kinds of goitres. Endemic goitres occur within groups of people living in geographical areas with iodine-depleted soil, usually regions away from the sea coast. The modern use of iodized table salt prevents this deficiency.
63. Benchimol and Teixeira, Cobras, Lagartos & Outras Bichos.
64. According to Charles Rosenberg, this is a fundamental dimension of the process of social construction of diseases: 'In our culture, its existence as specific entity is a fundamental aspect of intellectual and moral legitimacy of disease. If it is not specific, it is not a disease.' C. Rosenberg, 'Framing Disease: Illness, Society and History', in idem, Explaining Epidemics and Other Studies in the History of Mediane (Cambridge, 1992), 310.
65. Although it does not go into depth, Perleth's Historical Aspects of American Trypanosomiasis presents the idea that limitations in the clinical comprehension and diagnostic methods of the disease were an important obstacle to Chagas' making his disease an object of public health policy at the time.
66. Benchimol and Teixeira, Cobras, Lagartos & Outras Bichos, p. 56.
67. Coutinho, 'Ninety Years of Chagas Disease', p. 519.
68. C. Romaña, 'Acerca de um Sintoma Inicial de Valor para el Diagnostico de la Forma Aguda de la Enfermedad de Chagas. La Conjuntivitis Esquizotripanózica Unilateral (Hipotesis sobre la Puerta de Entrada Conjuntival de la Enfermedad)', Publications MEPRA, 22 (1935), 16-28. The palpebral edema shows the infection's portal of entry, as it is an inflammation caused by the parasite's penetration of the tissue of that region, through the barbeiro's faeces.
69. A. V. Martins, V. Versiani, and A. Tupinambá, 'Sôbre 25 Casos Agudos de Moléstia de Chagas Observados em Minas Gerais', Memories do Instituto Ezequiel Dias, 3 (1940), 3-47. Since the thirty-odd acute cases diagnosed by Chagas until that time, only four or five cases had been recorded in the country. See Dias, 'Atualidade de Carlos Chagas'.
70. A. V. Martins, V. Versiani, and A. Tupinambá, 'Sôbre 25 Casos Agudos de Moléstia de Chagas Observados em Minas Gerais', Memories do Instituto Ezequiel Dias, 3 (1940), 3-47. Since the thirty-odd acute cases diagnosed by Chagas until that time, only four or five cases had been recorded in the country. See Dias, 'Atualidade de Carlos Chagas'.
71. In 1942, the SEGE became this department.
72. In five years, the use of the electrocardiograph contributed to identifying about 600 cases of chronic chagasic cardiopathy, separating them from cardiac alterations caused by other aetiological factors. See F. Laranja, E. Dias, and G. Nóbrega, 'Clínica e Terapêutica da Doença de Chagas', Memórias do Instituto Oswalde Cruz, 46 (1948), 473-529.
73. For the importance of records produced by apparatus used in laboratories to the construction of scientific facts, see the concept of literary inscription formulated by Latour and Woolgar in The Laboratory Life.
74. According to Francisco Laranja, the success of the group at the CEPMC was due to the use of electrocardiographical techniques and apparatus not available in Carlos Chagas' day. Although Chagas analysed disturbances in cardiac rhythm by recording heartbeat and the jugular and radial pulses, he did not have instruments able to make precise and repeatable examinations. See F. Laranja, 'Evolução dos Conhecimentos sôbre a Cardiopatia da Doença de Chagas. Revisão Crítica da Literatura', Memórias do Instituto Oswalde Cruz, 47 (1949), 605-69. The progress made on this point at Bambuí was circulated in the form of an article published in 1956 in the journal of the American Association of Cardiology; it became one of the most cited papers in the international literature on Chagas' disease. See F. Laranja, E. Dias, G. Nóbrega, and A. Miranda, 'Chagas' Disease: A Clinical, Epidemiologic and Pathologic Study', Circulation, 14 (1956), 1035-60.
75. According to Francisco Laranja, the success of the group at the CEPMC was due to the use of electrocardiographical techniques and apparatus not available in Carlos Chagas' day. Although Chagas analysed disturbances in cardiac rhythm by recording heartbeat and the jugular and radial pulses, he did not have instruments able to make precise and repeatable examinations. See F. Laranja, 'Evolução dos Conhecimentos sôbre a Cardiopatia da Doença de Chagas. Revisão Crítica da Literatura', Memórias do Instituto Oswalde Cruz, 47 (1949), 605-69. The progress made on this point at Bambuí was circulated in the form of an article published in 1956 in the journal of the American Association of Cardiology; it became one of the most cited papers in the international literature on Chagas' disease. See F. Laranja, E. Dias, G. Nóbrega, and A. Miranda, 'Chagas' Disease: A Clinical, Epidemiologic and Pathologic Study', Circulation, 14 (1956), 1035-60.
76. Laranja, 'Evolução dos Conhecimentos sôbre a Cardiopatia da Doença de Chagas', p. 615.
77. F. Laranja, E. Dias, and G. Nóbrega, 'Clínica e Terapêutica da Doença de Chagas', Memórial do Instituto Oswalde Cruz, 46 (1948), 473-529, pp. 476-7.
78. J. Muniz and G. Freitas, 'Estudo sobre a Imunidade Humoral na Doença de Chagas', Brasil-Médico, 60(1946), 337-41.
79. E. Dias, F. Laranja, and J. Pellegrino, 'Inquérito Clínico-epidemiológico sobre a Doença de Chagas Feito entre as Estações de Iguatama e Campos Altos, Oeste de Minas Gerais', Primeira Reunión Panamericana sobre Enfermidad de Chagas, l (1950), 33-4.
80. J. Pellegrino, 'A Doença de Chagas em Minas Gerais: Esboço Crítico dos Trabalhos Publicados até 1951', Memórias de Instituto Oswaldo Cruz, 51 (1953), 611-68, p. 631.
81. E. Dias, Um Ensaio de Profilaxia de Moléstia de Chagas (Rio de Janeiro, 1945).
82. E. Dias and J. Pellegrino, 'Alguns Ensaios com o Gammexane no Combate aos Transmissores da Doença de Chagas', Brasil-Médico, 62 (1948), 185-91.
83. See, for example, E. Dias, 'Doença de Chagas: um Problema de Saúde Pública', Brasil-Médico, 61 (1947), 162-4; idem, 'Considerações sôbre a Doença de Chagas', O Hospital, 37 (1950), 253-8.
84. See, for example, E. Dias, 'Doença de Chagas: um Problema de Saúde Pública', Brasil-Médico, 61 (1947), 162-4; idem, 'Considerações sôbre a Doença de Chagas', O Hospital, 37 (1950), 253-8.
85. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
86. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
87. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
88. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
89. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
90. The issue of public health was present in a number of national economic plans at the time, like the SALTE Plan (SALTE is the acronym for Health, Nutrition, Transportation and Energy) of the administration of President Eurico Caspar Dutra (1946-50), and programmes implemented by the governments of Getúlio Vargas (1951-4) and Juscelino Kubitschek (1956-61), in which the control of rural endemic diseases received special attention as a crucial factor for increased productivity of agricultural labour. On this period, see M. C. S. D'Araújo, O Segundo Governo Vargas (1951-1954): Democracia, Partidos e Crise Política (São Paulo, 1992); M. V. M. Benevides, O Governo Kubitschek: Desenvoluimento Econômico e Estabilidade Politico. 1956-1961 (Rio de Janeiro, 1976); O. Ianni, Estado e Planejamento Econômico no Brasil (1930-1970) (Rio de Janeiro, 1977); S. R. Mendonça, Estado e Economia no Brasil: Opção de Desenvolvimento (Rio de Janeiro, 1986); C. Lafer, JK e o Programa de Metas (1956-1961) (Rio de Janeiro, 2002); A. L. V. Campos, 'International Health Policies in Brazil: The Serviçe Especial de Saúde Pública, 1942-1960' (unpublished Ph.D. thesis, University of Texas, 1997).
91. See G. Rosen, A History of Public Health (Baltimore and London, 1993). The World Health Organization's campaigns in the 1950s, on several continents, to eradicate malaria were significant examples of this.
92. In 1946, a physician in Belo Horizonte linked to the CEPMC published data on cases of Chagas chronic cardiopathy he had treated. It was the first time a casuistics of the disease was studied and documented in a private clinic. A. Brasil, 'Forma Cardíaca Crônica da Doença de Chagas', O Hospital, 29 (1946), 199-224.
93. Greater knowledge by country doctors of the symptoms and clinical signs of Chagas' disease meant that many suspected cases were referred to the main hospitals in urban centres for clinical and laboratory confirmation. According to Anis Rassi, a cardiologist at the hospital in Goiânia, his interest in
94. Among the original contributions by researchers at the Faculty of Medicine of Ribeirão Preto (founded in 1952 as part of the Universidade de São Paulo) were the epidemiological studies of José Pedreira de Freitas and research by Fritz Köeberle on the pathology of the disease, carried out in the school's first decade of existence. In Goiânia, where the Faculty of Medicine of Goiás was founded in 1960, notable research was conducted by Joffre Rezende, establishing a new clinical, digestive form of the disease, and by Anis Rassi who investigated the cardiac form.
95. The first international congress on Chagas' disease was held in Rio de Janeiro in 1959.
96. This support was provided through the Integrated Program for Endemic Diseases, created by the CNPq in 1973 with the participation of many scientists in this field; it existed until the mid-1980s.
97. See C. M. Morel, 'Chagas Disease, From Discovery to Control - and Beyond: History, Myths and Lessons to Take Home', Memórias do Instituto Oswalds Cruz, 94, suppl. I (1999), 3-16.
98. In 1941, two years before the CEPMC was founded, National Services had been created, under the Ministry of Education and Health, to run campaigns to prevent the diseases that were thought to have the greatest social impact on the country. Chagas' disease was not included, an indication of the lack of public recognition of its social importance. Starting in 1948, when BHC was shown to be effective in combating the barbeiros, Dias was sharper in his criticism of this absence, saying that there were means available to undertake to control the disease.
99. Delaporte, La Maladie de Chagas; idem, 'Romaña's sign'.
100. Delaporte, La Maladie de Chagas; idem, 'Romaña's sign'.
101. Delaporte, La Maladie de Chagas, p. 18.
102. Stepan, 'Appearances and Disappearances', p. 270.