The emergence of tropical medicine in Portugal: The school of tropical medicine and the colonial hospital of lisbon (1902-1935)

Dynamis

Volumn 28, Issue , 2008, Pages 301-328

  Amaral, Isabel ^a  

^a Centro de Investigação em História e Filosofia da Ciência e da Tecnologia   (Portugal)

Author keywords

Colonial hospital of lisbon; History of tropical medicine; Lisbon school of tropical medicine; Portuguese tropical medicine

Indexed keywords

AFRICAN TRYPANOSOMIASIS; ARTICLE; EDUCATION; HISTORY; HOSPITAL; HUMAN; MEDICAL EDUCATION; MEDICAL RESEARCH; MEDICAL SCHOOL; POLITICAL SYSTEM; PORTUGAL; TEACHING; TROPICAL MEDICINE;

BIOMEDICAL RESEARCH; COLONIALISM; EDUCATION, MEDICAL; HISTORY, 20TH CENTURY; HOSPITALS; HUMANS; PORTUGAL; SCHOOLS, MEDICAL; TEACHING; TROPICAL MEDICINE; TRYPANOSOMIASIS, AFRICAN;

EID: 63849285113     PISSN: 02119536     EISSN: None     Source Type: Journal    
DOI: 10.4321/s0211-95362008000100013     Document Type: Article

References (72)

1. See Curtin, Philip. Disease and Empire: the health of European troops in the conquest of Africa. Cambridge: Cambridge University Press; 1998.
2. Palladino, Paolo; Worboys, Michael. Science and Imperialism. Isis. 1993; 84: 91-102.
3. For a more detailed analysis of Portuguese colonial medicine practices, see, for example, the publications on the Medical School of Goa, the oldest Portuguese colonial medical school: Bastos, Cristiana. O ensino da medicina na Índia colonial portuguesa: fundação e primeiras décadas da Escola Médico-Cirúrgica de Nova Goa. História, Ciências, Saúde-Manguinhos. 2004; 11 (supl. 1): 11-39;
4. Figueiredo, João. A Escola Médica de Goa e o Ultramar Português. O Médico. 1954; 149: 1-6
5. (separata); Corrêa, Alberto. História do Ensino Medico na India Portuguesa. Nova Goa: Imprensa Nacional; 1917;
6. Gracias, Fátima. Health and Hygiene in Colonial Goa (1510-1961). New Delhi: Xavier Centre of Historical Research-Concept Publishing; 1994;
7. Figueiredo, João. Escola Médico-Cirurgica de Goa: esboço histórico. Arquivos da Escola Médico- Cirúrgica de Goa, série A. 1960; 33: 119-237;
8. Figueiredo, João. Actividade da Escola Médico-Cirurgica de Goa, 1926-1950. Goa: Tipografia Fernandes; 1950;
9. Bombarda, Miguel. Escola de Nova Goa. A Medicina Contemporânea. 23 Mar 1902; 2 (5);
10. Mello, Froilano. History of Medicine in Portuguese India. Arquivos Escola Medico-Cirurgica Nova Goa, série B. 1930; 2: 723-730;
11. and Pandya, S.K. Medicine in Goa: a former Portuguese territory. Journal Postgraduated Medicine [serial publication in internet]. 1982; 28: 123-148.
12. Arnold, David, ed. Warm climates and western medicine: The emergence of tropical medicine 1500-1900. Amsterdam: Rodopi; 1996.
13. Worboys, Michael. The emergence of tropical medicine: a study in the establishment of a scientific speciality. In: Lemaine, Gerard; MacLeod, Roy; Mulkay, Michael, eds. Perspectives on the emergence of scientific disciplines. Mouton: The Hague; 1976, p. 75-98.
14. Arnold, David, ed. Imperial medicine and indigenous societies. Manchester: University Press; 1988;
15. Macleod, Roy; Lewis, Milton, ed. Disease, medicine and empire: Perspectives on Western medicine and the experience of European expansion. London: Routledge; 1988;
16. Haynes, Douglas. From periphery to the centre: Patrick Manson and the development of tropical medicine in Great Britain, 1870-1900. [doctoral thesis]. University of California; 1992
17. Beyond the European context, specifically in the American context, authors such as Marco Cueto or Warwick Anderson would be mandatory references. However, due to methodological reasons, only the European model of tropical medicine is here considered. See, for example, Anderson, Warwick. Colonial pathologies: American tropical medicine, race, and hygiene in the Philipines. London: Duke University Press; 2006;
18. and Cueto, Marcos. El regreso de las epidemias. Salud y sociedad en el Perú del siglo XX. Lima: Instituto de Estudios Peruanos; 1997.
19. For an overview of the political influence of Portugal in Africa since the independence of Brazil see, for example, Valentim, Alexandre. Vellho Brasil, Novas Áfricas: Portugal e o Império (1808-1975). Lisboa: Edições Afrontamento; 2000.
20. For an economic analysis of the Third Portuguese Colonial Empire, see Clarence-Smith, Gervase. The Third Portuguese Empire, 1825-1975: A study in economic imperialism. Manchester: Manchester University Press; 1985.
21. Thomaz, Omar. Ecos do Atlântico Sul: Representações sobre o terceiro império colonial português. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2002.
22. Amidst the various theoretical approaches in the fields of sociology and the history of science for the analysis of emerging disciplinary areas, the following illustrative texts are of value: Lemaine; MacLeod; Mulkay, n. 4, p. 75-98;
23. and Geison, Gerald. Scientific change. Emerging specialties, and research schools. History of Science. 1981 ; 19: 20-40.
24. In the Portuguese case, the research school of Marck Athias was the object of a larger investigation with respect to the emergence of biochemistry in Portugal. For further details, see Amaral, Isabel. The emergence of new scientific disciplines in Portuguese medicine: Marck Athias's Histophysiology research School, Lisbon (1897-1946). Annals of Science. 2006; 63: 85-110;
25. and Amaral, Isabel. As escolas de investigação de Marck Athias e de Kurt Jacobsohn e a emergência da Bioquímica em Portugal. Lisboa: Fundação Calouste Gulbenkian; 2006.
26. Caponi, Sandra. Coordenadas epistemológicas de la medicina tropical. História, Ciências, Saúde - Manguinhos. 2002; 10 (1): 113-149.
27. For the Portuguese case see the most emblematic synthesis elaborated by Carlos Vieira Ramos, a military physician, analysing the evolution of the Health Public Services in Portugal since the fifteenth century. The author emphasizes the teaching and the clinical training of the military physicians, in two volumes. With respect to the colonial war, see Ramos, Carlos Vieira. História da Medicina Militar Portuguesa. Vol. II, Lisboa: Estado Maior do Exército; 2004. p. 109-388, 511-589. See also several articles written by the Navy physician. Rui Abreu, for the Army Journal (Revista da Armada), an army Portuguese journal published since 1848.
28. For a more detailed account of this institution, see Power, Helen. Tropical medicine in the twentieth century: A history of the Liverpool School of Tropical Medicine, 1898-1990. London: Kegan Paul International; 1999.
29. For more about the history of this British medical school, see Wilkinson, Lise; Hardy, Anne. Prevention and cure: The London School of Hygiene and Tropical Medicine, a 20th Century quest for global public health. London: Kegan Paul; 2001.
30. The rapid diffusion of Pasteur Institutes throughout the world, as a result of the influence of Pasteurian science, is crucial to the emergence of tropical medicine and its specialization. See Moulin, Anne Marie. Patriarchal science: The network of the overseas Pasteur institutes. In: Petijean, Patrick; Jamie, Catherine; Moulin, Anne Marie. Sciences and Empires, London: Kluwer Academic Publishers; 1992, p. 307-322.
31. See Ribeiro, Pedro. A emergência da Medicina Tropical em Portugal (1887-1902). [Doctoral thesis]. Universidade Nova de Lisboa; 2002.
32. Bombarda, Miguel. A creação d'uma escola de medicina colonial. Jornal da Sociedade de Ciências Médicas de Lisboa. 1901; 65 (10): 334.
33. In Portuguese historiography, a couple of works should be highligted as reference texts for studying the emergence of tropical medicine. Both of them are focused on the history of its major institutions, namely, the Lisbon School of Tropical Medicine, founded in 1902, and the succeeding institutes, the Institute of Tropical Medicine, between 1935 and 1942, and the Institute of Hygiene and Tropical Medicine, since 1942. See Fraga de Azevedo, João. Cinquenta anos de actividade do Instituto de Medicina Tropical. Lisboa: Instituto de Higiene e Medicina Tropical; 1952;
34. Abranches, Pedro. O Instituto de Higiene e Medicina Tropical: um século de história 1902-2002. Lisboa: Instituto de Higiene e Medicina Tropical; 2004.
35. Decreto Lei de 24 Abril 1902.
36. Sessão Parlamentar de 26 Fevereiro 1902, p. 15.
37. Sessão Parlamentar de 28 Janeiro de 1902, p. 18.
38. Knowledge on the geographic conditions in the Portuguese colonies enabled the elaboration of maps of the main endemic zones comprising various tropical diseases, such as sleeping sickness and malaria, both transmitted by insects. Such endemic mapping, well known to the international scientific community, permitted, therefore, the evaluation of the proliferation of tropical diseases together with the description of their territorial delimitation, so as to control these endemic diseases. In such cases, the study missions, organized by different European schools of tropical medicine, constituted the real basis of colonial expansion.
39. For a general understanding of the beginnings of tropical medicine in Portugal, see Fraga de Azevedo, n. 18, p. 10-97.
40. Decreto Lei de 25 de Agosto de 1887.
41. See the Syllabus published by The London School of Tropical Medicine and the Seaman's Hospital printed by E. G. Berryman & Sons Stream Works Blackheath Road S:E, since 1899 to 1925.
42. Sleeping sickness is an African disease caused by protozoa of the genus Trypanosome and transmitted by the tsetse fly. This disease is extremely contagious and can decimate entire regions in a short period of time. The lymph nodes become greatly enlarged and lead to the degeneration of the central nervous system, which in turn provokes symptoms of profound fatigue, thus the name sleeping sickness. This disease concerned all colonising empires because it threatened the settlement of colonists and effective colonisation due to the lack of sufficient, healthy indigenous labour.
43. Aníbal Correia Mendes was the director of the Bacteriologic Laboratory of Luanda, Angola.
44. Arnaldo José Villela was the director of the Hospital of Praia, Cape Verde.
45. Bernardo Francisco Bruto da Costa was the director of the Bacteriological Laboratory, S. Tome.
46. António Damas Mora was the delegate of Health at the Island of Principe.
47. Atoxyl (p-aminophenylarsenic acid) is an arsenical derivative that was synthesized for the first time in 1859 by Antoine Béchamp. It was used by several authors for the treatment of syphilis and it was tested on laboratory animals. In 1905, Robert Koch discovered during an African expedition that Atoxyl could also be used to treat sleeping sickness. In 1906 Ayres Kopke announced his experimental results using Atoxyl and the subsequent treatment of patients with tripanosomiasis gambiense. Kopke, Ayres. Traitement de la maladie du sommeil. Archivos de Hygiene e Pathologia Exoticas. 1907; 1 (3): 299-349;
48. Amaral, Isabel; Barreira, Conceição. Chemistry applied to medicine: the School of Tropical Medicine of Lisbon (19021935). Proceedings 5th International Conference on History of Chemistry. Lisbon: Sociedade Portuguesa de Química; 2006, p. 493-501.
49. The island had a reduced territorial extension and population. The majority of the population remained constant, which permitted long-term patient follow-up.
50. Corrêa Mendes, Aníbal; Silva Monteiro; Damas Mora, António; Bruto da Costa, Bernardo. Relatorio Preliminar da Missão de Estudo da Doença do Somno na Ilha do Principe. Archivos de Hygiene e Pathologia Exoticas. 1909; 2 (1): 3-45.
51. Instrucções para a missão médica encarregada do estudo da doença do somno na Ilha do Príncipe. Lisboa: Imprensa Nacional; 1907.
52. Martin, Gustave; Leboeuf, Alexandre; Roubaud, Emile. Rapport de la Mission d'Étude de la Maladie du Sommeil au Congo Français, 1906-1908. Paris: Masson & Cia. Éditeurs; 1909.
53. Bruto da Costa, Bernardo. Relatorio-Trabalhos sobre a doença do somno na Ilha do Principe. Lisboa: A Editora Limitada; 1913.
54. These results were originally published in Portuguese in 1915, and in English -translated by John A. Wyllie- in 1916. See Bruto da Costa, Bernardo; Firmino Sant'Anna, José; Correia dos Santos, António; Araújo Alvares, M.G. Relatorio Final da Missão da doença do sono da Ilha do Príncipe. Arquivos de Higiene e Patologia Exóticas: 1915; 5, 1-250;
55. Bruto da Costa, Bernardo; Firmino Sant'Anna, José; Correia dos Santos, António; Araújo Alvares, M.G. Sleeping Sickness: A record of four years'war against it in Principe, Portuguese West Africa. London: Baillière, Tindall and Cox; 1916.
56. This stamp, designed by Alberto Cutileiro, was issued to commemorate the Military Naval Club's centennial in 1966. Source: Museu das Comunicaç ões, Lisboa.
57. Neves, Jaime. A Doença do sono, uma doença social. Anais da Escola Nacional de Saúde Pública e de Medicina Tropical. 1967; 1: 179-184.
58. Kopke, Ayres. Estudos Executados pela missão médica em Moçambique. Jornal da Sociedade das Sciências Médicas de Lisboa. 1928; 92 (9): 232-273.
59. Sant'Anna, Firmino. A Tripanosomíase humana na Rhodesia. Arquivos de Hygiene e Pathologia Exoticas. 1913; 4: 1-46.
60. Fraga de Azevedo, n. 18.
61. Photography obtained at the Overseas Portuguese Historical Archive.
62. Kopke, Ayres. Traitement de la maladie du sommeil. XlVème Congrès d'Hygiène. Berlin: 1907, p. 299-347.
63. Kopke, Ayres. Traitement de quelques cas de trypanosomiase humaine par le Salvarsan et le Néosalvarsan. XVIIth International Congress of Medicine. London: 1913. p. 195-200.
64. Ribeiro, Pedro. Ayres Kopke (1866-1944) and the dissemination of Portuguese research on tropical medicine in international meetings. Lisbon: STEP Meeting. Lisboa; 2000.
65. This building had been the site for the production of cables and sails for the Portuguese caravels since the sixteenth century.
66. Photography obtained at the Central Archives of the Portuguese Navy.
67. However, after the reorganization of the health services of the Portuguese Empire in 1943, the interest in maintaining a hospital unit with the characteristics of the Colonial Hospital grew and culminated with the inauguration of the Overseas Hospital in 1957. The name of this hospital was changed in 1974 due to the transference of guardianship from the Ministry of Overseas Affairs to the Ministry of Health. It came to be known as the Egas Moniz Hospital, in homage to the Portuguese doctor who was awarded the Nobel Prize for Medicine and Physiology in 1949.
68. Faria, João. O Hospital Colonial de Lisboa. Boletim clínico do Hospital Colonial e boletim estatistico. 1950.
69. Ayres Kopke carried out laboratory tests with Atoxyl on patients hospitalized at the Colonial Hospital. See, for example, Kopke, Ayres. Trypanosomiasis Humaine. Archivos de Hygiene e Pathologia Exóticas. 1905; 1: 159-188.
70. The Colonial Hospital continued to be the key organ for medical assistance in the Portuguese Empire, especially in the 1930s. With the proclamation of the Colonial Act and the publication of the Organic Letter of the Portuguese Colonial Empire, Government Decree 18: 570, 8 July 1930, a strongly nationalistic and centralized juridical-institutional panel was established.
71. Ricardo Jorge was a Portuguese physician and professor at the Medical School of Oporto. In 1884 he published the book entitled Higiene social aplicada à nação Portuguesa (social hygiene applied to the Portuguese nation), and became a pioneering organiser of Portuguese public health services according to modern hygiene precepts.
72. This scientific apostolate is clearly spread by Celestino da Costa, one of the most emblematic figures of the modernization of medical teaching in Portugal in the first decades of the twentieth century. For his interventions in the Council of National Education, together with his disciples' and with his partners' at the University, see Amaral, Isabel. A escola de Histofisiologia de Augusto Celestino da Costa (1911-1956). Actas do 1 o Congreso Luso-Brasileiro de História da Ciência e da Técnica. Évora: Universidade de Évora; 2000. p. 615-629.