Special issue of the Brazilian journal História, Ciências, Saúde – Manguinhos is dedicated to “Hospice and Psychiatry in the First Republic – Diagnosis in Historical Perspective”.

Grand mal seizures in the Cemetery of the Living: the diagnosis of epilepsy at Brazil’s National Hospital for the Insane by Margarida de Souza Neves. The abstract reads:

This study in the social history of medical thought analyzes the articles on epilepsy published in the journal Archivos Brasileiros de Psychiatria, Neurologia e Medicina Legal in 1915 and 1918. Through these texts, I identify some of the ways in which early twentieth-century Brazilian medicine addressed this syndrome, particularly the direct association that medical science then drew between epilepsy and a propensity to violence and crime. The texts, which contain clinical observations on patients diagnosed as epileptics, also afford us a brief glimpse into these individuals’ life stories.

Nervousness as a nosographic category in the early twentieth century by Luiz Fernando Duarte The abstract reads:

The paper presents the conceptual framework surrounding the category of nervousness in Brazilian psychiatry in the early twentieth century as represented in an article by Henrique Roxo published in Arquivos Brasileiros de Psiquiatria, Neurologia e Medicina Legal in 1916, and contextualizes it in the history of psychiatric classifications and representations about nerves and the nervous system. As such, it intends to contribute towards mapping out physicalistic naturalism (or epiphenomenalism), which can be seen throughout the representations of the human person and their disturbances in modern western culture.

Classifying differences: the dementia praecox and schizophrenia categories used by Brazilian psychiatrists in the 1920s by Ana Teresa A. Venancio. The abstract reads:

This article analyzes how the Brazilian psychiatrists Henrique Roxo and Murillo de Campos understood and differentiated between the diagnostic categories dementia praecox and schizophrenia at the end of the 1920s in scientific articles published in the principal psychiatric journal of the time. We note how the aforementioned psychiatrists incorporated the European knowledge that created these diagnostic categories and how they represented them in the context of the institutionalization of psychiatry in Brazil. We seek to understand how this scientific diagnostic naming and defining process developed in conjunction with the definition of the difference between what should and should not be considered phenomena, with respect to mental pathologies.

The emergence of manic depressive psychosis as a diagnosis in Brazil by Joel Birman. The abstract reads:

This essay examines the early twentieth-century interpretation of manic depressive psychosis in Brazil, during a moment when Brazilian psychiatry witnessed a theoretical shift from the French to German traditions. It calls special attention to how the problem of hysteria was replaced by manic depressive psychosis within this historical context.

Hysteria and psychiatry under Brazil’s First Republic by Sílvia Alexim Nunes. The abstract reads:

The article problematizes Brazilian psychiatric thought on hysteria in the early decades of the twentieth century, a time when a biopolicy of population management was lending impetus to the growth of social medicine. This notion is situated within the context of the nineteenth-century debate on hysteria that took place in major European centers and served as the main reference for Brazil’s fledgling field of psychiatry. The debate found expression in Brazilian psychiatric discourse as part of the era’s project for medical reform and prevention in Brazil. The work of Brazilian neurologist Antônio Austregésilo (1876-1960) within this project is also addressed, since he played a fundamental role in dismantling hysteria as a diagnostic category in psychiatry, a process that continued through the entire Old Republic.

Syphilis and the aggiornamento of organicism in Brazilian psychiatry: notes on a lesson by Dr. Ulysses Vianna by Sérgio Carrara and Marcos Carvalho. The abstract reads:

Taking as its point of departure the lesson published by Brazilian psychiatrist Ulisses Vianna in the Arquivos Brasileiros de Neuriatria e Psiquiatria in 1919, the article analyzes the development of that day’s medical discussions about ‘syphilis of the nervous system’ and ‘cerebral syphilis,’ situating Vianna’s work within its broader intellectual scenario. The article also examines the impact of this disease category on psychiatric thought, especially how it strengthened the organicist or somatological concepts of mental illness and adjusted them to the new scenario created by bacteriology.

Alcoholism and psychiatric medicine in early twentieth-century Brazil by Fernando Sergio Dumas dos Santos and Ana Carolina Verani. The abstract reads:

Based on a study of the construction of psychiatric knowledge and practices regarding alcoholism, the article explores the development of psychiatry in Brazil from the close of the nineteenth century through the first three decades of the twentieth. It examines both the role that psychiatry assigned to alcohol in manifestations of madness as well as the hypothesis that the concept of “alcoholic psychosis” was an attempt to encompass the symptoms and problems triggered within someone with chronic alcoholism. Defining the latter as a “social disease” tended to link it with the lower classes and their customs, practices, and living conditions. In an analysis of confinement to asylums, the article also captures echoes of the era’s medical discussions and uses the reflections of writer Lima Barreto as a counterpoint to medical knowledge at that time.

Psychasthenia by Rafaela Teixeira Zorzanelli. The abstract reads:

The article analyzes the medical category of psychasthenia, used by French psychiatry from the late nineteenth through the early twentieth centuries. It describes the clinical profile of psychasthenia and the main hypotheses meant to account for symptoms as defined and advanced by Pierre Janet, the central figure in systematization of this category. The article also looks at how this diagnosis was used in Brazil and how it related to the profile of neurasthenia within the context of Brazilian psychiatry.

Neurasthenia by Rafaela Teixeira Zorzanelli. The abstract reads:

The article addresses the medical category of neurasthenia, developed in the United States by neurologist George Beard at the close of the nineteenth century. Points of discussion include the principle features of the category’s clinical presentation, the main hypotheses advanced to account for symptoms, and the treatment alternatives suggested in Beard’s works. The article also looks at how the diagnosis was received outside the United States, both in Europe and, more specifically, in Brazil.

The degenerate by Octavio Domont de Serpa Jr. The abstract reads:

The article discusses the theory of degeneration as presented in the works of Benedict-Augustin Morel, situating it within the scientific and cultural context of its day. It underscores the roles played by the notions of heredity and environment in grounding this theory and how it related to the mid-nineteenth century French understanding of psychiatric medicine. It also explores the ramifications of this theory, particularly the works of Valentin Magnan, with the ultimate progressive transition from the notion of degeneration to that of degenerate. Other points of analysis include French psychiatry’s concepts of imbalance and constitution and German psychiatry’s concept of endogeneity as heirs to degeneration in twentieth-century psychiatry, as well as the Neo-Lamarckian appropriation of this debate in Brazil.

Emil Kraepelin and the problem of degeneration by Sandra Caponi. The abstract reads:

When Kraepelin laid the foundations of what we now understand as psychiatry, he was faithful to the nineteenth-century hygienist’s penchant for approaching social problems in terms of medical categories. With Kraepelin’s writings on the issue of degeneration as a backdrop, the article analyzes how the methodology he introduced for researching psychiatric illnesses is indebted to Morel’s theory of degeneration. The article explores not only Kraepelin’s concern with defining a classification of mental pathologies just as well grounded as the classifications of biological pathologies, but also his use of comparative statistics and his explanations of morbid heredity.

Bringing order to the Babel of psychiatry: Juliano Moreira, Afrânio Peixoto, and paranoia in Kraepelin’s nosography (Brazil, 1905) by Ana Maria Galdini Raimundo Oda. The abstract reads:

The article explores the meanings of paranoia and its use as a disease category. Juliano Moreira and Afrânio Peixoto’s article “A paranoia e as síndromes paranoides” is used to show how these two scientists differentiated between this clinical construct and dementia praecox. Delineating the diagnostic boundaries of “legitimate” paranoia was their way of demarcating their theoretical stances and their alignment with Kraepelin, thereby justifying the scientific stance that they deemed essential to making Brazilian psychiatry modern. The article also discusses aspects of the conceptual history of paranoia (its relation to personality) in terms of the theoretical references used by the Brazilian authors of the article.

This study in the social history of medical thought analyzes the articles on epilepsy published in the journal Archivos Brasileiros de Psychiatria, Neurologia e Medicina Legal in 1915 and 1918. Through these texts, I identify some of the ways in which early twentieth-century Brazilian medicine addressed this syndrome, particularly the direct association that medical science then drew between epilepsy and a propensity to violence and crime. The texts, which contain clinical observations on patients diagnosed as epileptics, also afford us a brief glimpse into these individuals’ life stories.