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Revista Pan-Amazônica de Saúde

versão On-line ISSN 2176-6223

Rev Pan-Amaz Saude v.1 n.4 Ananindeua dez. 2010

http://dx.doi.org/10.5123/S2176-62232010000400002 

HISTORICAL ARTICLE

 

The School of Medicine and Surgery of Pará, Brazil: from establishment to federalization, 1919-1950

 

 

José Maria de Castro Abreu Junior

Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Pará, Brasil

Endereço para correspondência
Correspondence
Dirección para correspondencia

 

 


ABSTRACT

This study aims to chronologically present circumstances that took place from the establishment of the School of Medicine of Pará, Brazil, in 1919 to its federalization in 1950. Some historical facts are highlighted, contextualized, and compared to similar institutions and personalities that played a relevant role in these events, which have been obscured over time. Our intention is to relive the period through words when the School of Medicine of Pará was an isolated medical school in the extreme north of the country. It was the only one of its kind in the region that faced sanitary challenges, which are still far from being overcome today.

Keywords: History of Medicine; Schools, Medical; Health Services.


 

 

Medical education in Brazil dates back to 1808 with the migration of the Portuguese court to its most important colony. The migration took place because of Napoleon's troops invading Portugal. John VI of Portugal created the two Escolas de Anatomia, Medicina e Cirurgia (Schools of Anatomy, Medicine and Surgery) in February and November of that year in reply to a request from José Correia Picanço the Baron of Goiana, who was a surgeon born in Pernambuco and professor of Anatomy and Surgery in Coimbra. The first school was built in the city of Salvador and the second in Rio de Janeiro. In 1813, these schools were named Academias Médico-cirúrgicas (Medical-Surgical Academies); in 1832, both were raised to the level of Faculdades de Medicina (Medical Schools)1.

During the Portuguese empire, medical education remained public. It was not until the Republic proclamation and after support was garnered from the 1891 Constitution that other medical schools began to emerge from private initiatives. The third school started in 1898 in the city of Porto Alegre2 . However, the stimulus for medical education expansion in Brazil happened in the 20th century, specifically in 1911. The Lei Orgânica do Ensino (Organic Law of Education) was established by Decree N. 8.659 of April 5, 1911; it became known as the Rivadávia Corrêa Law in honor of its author. The law was extremely liberal and positivist, and provided total didactic and administrative autonomy to the higher education institutions3. Thus, the following institutions were created: The Faculdade de Medicina de Belo Horizonte (School of Medicine of Belo Horizonte) in 19114; The Faculdade de Medicina Hahnemanianna (Hahnemannian School of Medicine) in Rio de Janeiro3, with an emphasis on homeopathy*; the Faculdade de Medicina de São Paulo5 (School of Medicine of São Paulo)5; and the University of Paraná, which offered the medicine and surgery courses6. The three latter schools emerged during 1912.

The Rivadávia Law was so liberal that it enabled the emergence of the aforementioned schools, as well as for-profit institutions. The Federal Government tried to reverse this situation by issuing Decree N. 11.530, of March 18, 1915, which is known as the Maximiliano Law. This law required the institutions to maintain a program that was similar to that of official ones. In other words, all medical schools had to have a curriculum that was based on the programs of the Schools of Medicine of Rio de Janeiro and Bahia3.

It is under this more restrictive new legislation that the Faculdade de Medicina do Pará (School of Medicine of Pará) was created on January 9, 1919§. In contrast to other schools of the time, which emerged in an economically favorable period, due largely to the coffee5 and mate6 economies, the School of Medicine was created in a moment of local economic decadence caused by the rubber crisis; this economic cycle marked the so-called Amazonian Belle Epoque7.

In addition, another peculiarity marked the creation of the School of Medicine of Pará; unlike the other schools, whose founders were prominent local physicians, a dentist, Antônio Magno e Silva, professor and director of the Escola de Odontologia do Pará (Dentistry College of Pará), founded the first medical school in the Amazon, which was created in 19148. Magno e Silva was also the director of the Associação Científica (Scientific Association), an institution that had founded and supported the Dentistry College9.

Magno e Silva searched for support among physicians such as Hermógenes Pinheiro, Evaristo Silva, Carlos Arnóbio Franco, Álvaro Gonçalves, and Renato Franco10. Once together, they invited Camilo Henriques Salgado Juniorl l to be the director of the School. This was inevitable; Camilo was one of the most prestigious physicians in Pará during the first decades of the 20th century, and was well known in all social circles. Camilo would subsequently play an integral role in aggregating knowledge and establishing the college's credibility. He accepted the idea but not the direction; he nominated Antonino Emiliano de Souza Castro, The Baron of Anajás, for the position11.

The Baron was part of a generation of physicians, prior to Camilo, who built their careers during the time of the Empire. He had even been vice-governor of the Pará province under that regime. Camilo did not nominate the Baron only because of his credibility and respect. The Baron of Anajás was the father of a namesake physician who was better known as Dr. Souza Castro. Dr. Castro was one of the College's founding members and was also a militant for the same political party as Camilo Salgado. At that time, he was an ascending politician and, in the following year, he became State Governor12. Therefore, the director of the newly created College was not an old representative of an ancient regime, rather he was the father of the future governor of Pará. This fact tied the College to public power at a time when support was needed13.

The classes were initially scheduled to start on April 3 but were postponed due to the benevolent attitude of the College directors. The directors may have been searching for candidates and accepting those who had already graduated without requiring an entry exam. With 58 enrolled students, the first classes took place on May 1st, 1919 in the great hall of the Paes de Carvalho School. The newspapers from that time referred to that event as a simple ceremony for a select audience14. The Baron of Anajás inaugurated the session and concisely explained the advantages the new School of Medicine would bring to Pará and to "the development of Science and to the humanitarian work". He then gave the floor to the official speaker of the ceremony, Dr. Acylino de Leão, whose speech was reproduced as follows:

 

 

"... explained that the major problem in Brazil was the soil occupation, which is evidence of the abandonment of our sertões (backlands) whose populations are left to the influence of witches and medicine men, and considered the action of the medical science the solution for that problem, by bringing resources to those areas. Furthermore, the idea of the School of Medicine of Pará supports that theory, whose fruits are most precious. He shows that we need physicians, men of science who bring their activities to the interior of the country, redeeming those populations from witchcraft, caring for the health of those who work. He says that practice has demonstrated that the doctors who graduated in Colleges of the south of the country mostly go to Sâo Paulo, Minas and other capital cities where there is wealth and a profitable future, and so, he adds, only those graduated here could look after the countryside, motivated either by the work, by love to their home or by the family bonds that hold them there. He gave a historical background of what the Faculdade de Medicina do Rio de Janeiro (School of Medicine of Rio de Janeiro) was like ten years ago, where he, the speaker, had graduated, showing that we were able to offer the same physicians as those who graduated from that School. He showed that, at that time, there were several failures, that the medical chemistry was rudimentary, the bacteriology was superficial and even that anatomy, which is the main basis for the medical science, was deficient, in view of the great number of students at the Faculdade de Medicina. Nevertheless, there were decent physicians graduated by that Rio de Janeiro College. He explains in details that a successful medical career lies on hospital practice and that, under those conditions, we could have excellent graduates. He adds that the uproar is natural and mentions the foundation of the Law School that provoked a lot of controversy and questions - Why do we need so many lawyers? However, in a little time that School is proving its profitable result. In the countryside, where judges were always laymen and even illiterates, we can nowadays replace them by skilled graduates of the Law School. This is the role reserved to the School of Medicine of Pará, whose program he had just presented. He also says that Brazil complaints about agronomists and asks, How can we grow if those strong arms are not cared by the hands of medicine?"15.

The ceremony ended at eleven o'clock with the sound of the Firemen's band; after the celebrations, the first regular class took place on May 6. This class, on Natural History and Parasitology, was given by Professor Caribé da Rocha.

Soon, the Baron established the first bylaw of the College, which was based on the model from the Faculdade Nacional de Medicina (National Medicine College) of Rio de Janeiro and ordered from Bruno Lobo, a physician from Pará who lived in Rio, slides of normal and pathological histology, as well as collections of mineralogy and zoology for the Natural History classes16,13.

This was the beginning of a period marked by great instability in the newly created School. Once the initial euphoria was over, several professors, due to lack of remuneration or even of skills, started to resign; others, such as Prisco dos Santos and Renato Chaves13, started to go from one discipline to another and often assumed multiple simultaneous positions to keep the College active.

The classes were taught in a precarious physical area. The theoretical classes were taught in two rooms of the Paes de Carvalho School facing João Diogo Street, and the anatomy practical classes were held at the City Mortuary in front of the Ver-o-Peso Market13.

 

 

Teaching was very strict, with a high rate of failures, which was not an exclusive characteristic of the School of Medicine of Pará. Every new medical school that was created during the Old Republic attempted to gain respect from the Ministry of Justice and Interior Relations by proving that it was not a "diploma mill". According to Camilo Salgado, this moralistic criterion created at least one embarrassing situation17.

After a high number of failures in Microbiology, Anatomy, and Histology at the end of March 1922, the students felt persecuted and tried to get support from the director Baron of Anajás. He publically expressed his opinion that no student should fail; the examiners stood firm on their deliberations but felt disrespected and searched for support with Camilo Salgado who was in favor of the professors. The Baron, as expected, felt his authority was threatened and left his post and the College18. Camilo Salgado took over the lead of the institution and remained as its director until his death in 1938.

The students started to complete the basic disciplines. In an attempt to put them in contact with patients, Camilo soon signed a partnership with the Santa Casa de Misericórdia Public Hospital, which charged the School a fee to use its facilities. In the case that the School ever closed, its assets would be donated to that hospital.

Noticing that the School of Medicine of Pará needed its own headquarters, Camilo Salgado launched a strong campaign on January 1, 1923 in an attempt to get donations for a new building. The place that was chosen was the Santa Luiza Palace, which belonged to Mr. Adolph Kolb. Since 1900, the palace had been rented by the State Government as the "Wenceslau Braz" Elementary School. This was a good opportunity because the State Government was losing interest in the building, which was considered inadequate for an elementary school. In addition, the rubber crisis provoked a decrease in real estate prices13.

The newspapers started to publish extensive lists of donors, ranging from ordinary people to retailers, professionals, military and religious figures, and even big companies such as banks, pharmacies, and manufacturers. Everyone contributed diverse amounts. The donations crossed the borders of Belém city, and contributions were reported from several other cities and even from other states. During the same period, some professors gave up their salaries because of the campaign13.

With the massive support of the population, the School was able to buy its own building in June of 1923, and, after some reforms, it moved to Largo de Santa Luzia permanently on April 1, 192413.

In the old printed materials from the School of Medicine and Surgery of Pará, there is a reference to the dates of foundation and installation, as well as to the day it was declared equivalent to the Public Schools by the Ministry of Justice and Interior Relations on September 4, 1924. This was not unexpected, because the equivalence represented the recognition of the School of Medicine by the Federal Government. Consequently, it also represented the recognition of the graduates' diplomas in the entire country. Being on the same level as the other federal schools, the medicine schools of Rio and Bahia, was vital to the survival of any institution13.

 

 

It is important to highlight that the equivalence was not absolute and had to follow strict rules, which included the possibility of annulling a granted equivalence status. The School of Medicine and Surgery of Pará was granted the equivalence status in five years, which was a short time when compared to the time other medical schools of that period took (from 7 to 10 years)13.

Some attenuating facts were added to the process of equivalence of the School of Medicine of Pará. The law, for example, required a federal inspector to audit the program in compliance to its congeners; that inspector could not have affinities of any kind with the director or professors, and, if possible, should not live in the same city. Our inspector was a physician who worked at Santa Casa. Such benevolences were the result of the friendship between Camilo Salgado and the Senator Lauro Sodré, who was very close to the Baron of Ramiz Galvão. Galvão was an important member of the Conselho Superior de Educação (Brazil's Superior Education Council) at that time and the first Dean of the newly created Universidade do Brasil. It was not random that the first federal inspector assigned for the College was Dr. Lauro Sodré Filho13.

The College, now properly equipped, graduated the first students. From the initial 58, only four survived the strict approval system: Antônio Magno e Silva, the aforementioned "mentor" of the School of Medicine, who was a professor and director of the Dentistry School at that time; Bianor Penalber, journalist of the "Estado do Pará" newspaper and the "A Semana" magazine; Honorato Remigio de Castro Filgueiras, who was originally from Ceará and had studied at the Faculdade Nacional de Medicina (National Medicine College) in Rio de Janeiro. He transferred to Belém in the 4th year; and Hipolyto Carelli, a Greek student. Bianor Penalber and Magno e Silva defended their doctorate theses entitled, "Contribuição ao estudo do tratamento da filariose (Contribution to the study of Philariasis treatment)" and "Etiopatogenia das cirroses do figado (Etiopathogenesis of liver cirrhosis)", respectively, on April 14th, 1925. On April 16th, Honorato Filgueiras presented the theme "Docimasia Pulmonar - Método Icard Dávilla (Pulmonary Docimasia - Icard Davilla's Method)", and on April 18th, Hipolyto Carelli defended the theme "Higiene da tuberculose entre nós (Tuberculosis Hygiene Among Us)"13.

The College experienced difficulties in the 1 930s and ended the year in debt several times13. During these times, the College relied on donations from its faculty13. With the money granted through Lauro Sodré in 1932, the school was able to build an amended building with a great hall to host congregation meetings. Around 1937, the Santa Luzia Palace was renovated; the art noveau characteristics diminished as more modern with an art déco aspect became more prevalent.

In 1938, the institution began a new phase after the death of Camilo Salgado who had been the director since 1922. The institution was better financially organized and could expand with new pavilions during the 40s; on the other hand, the relationship between the students and the College was gradually deteriorating because of frequent tuition increases. The mediator was Dr. Olimpio da Silveira**, who had been secretary of the College since the beginning of the 1920s. Dr. Olimpio controlled the finances by saving every coin. He was always fighting for what he considered to be fair for the school, sometimes reaching to extremes19.

The Diretório Acadêmico de Medicina (Medicine Academic Board) (DAM) launched a campaign to help the College be expropriated by the Federal Government and become public. This was a tough challenge and the main focus for several leaderships of the DAM. For years, its president, including important student leaders like Abraão Levy, Pedro Amazonas Pedroso, and Jean Bittar, prioritized this issue13.

While the federalization draft bill was slowly advancing for approval, the College, under the direction of Lauro de Magalhães††, opened the new anatomy hall in 1940. It was called the Camilo Salgado hall. In 1949, an auditorium with two hundred and fifty seats was opened; it was described as the most modern auditorium in Belém at the time. In 1950, a vivarium was opened in addition to the cornerstone of the Instituto de Higiene (Hygiene Institute), the current Núcleo de Medicina Tropical (Tropical Medicine Center), that had already been set. This decade marked the period of strongest physical expansion of the School of Medicine13.

After approximately ten years of fights and negotiations, President Dutra signed Law N. 1.049 on January 3rd, 1950. This law federalized the School of Medicine and Surgery of Pará. The students were finally free from tuition fees, and the professors, who were now elders and had been working in the institution since the school opened were entitled to a retirement program13.

Moreover, the College closed a chapter as an institution and opened a new one with the federalization. New faculty were employed replacing the generation of 1919, and the students would begin another challenge that marked the following years: the creation of the University of Pará.

 

REFERENCES

1 Gomes MM, Vargas SS, Valladares AF. A Faculdade de Medicina Primaz do Rio de Janeiro em dois dos cinco séculos de História do Brasil. Rio de Janeiro: Atheneu; 2001. 3 p.

2 Rigatto M. Fogos de Bengala nos céus de Porto Alegre. A Faculdade de Medicina faz 100 anos. Porto Alegre: Tomo-Editorial; 1998. 33 p.

3 Borges MR. A História da Escola de Medicina e Cirurgia do Rio de Janeiro. Rio de Janeiro: Revinter; 2008. 819 p.

4 Campos MM. Cinquentenário da Faculdade de Medicina da Universidade de Minas Gerais. Belo Horizonte: EDUMG; 1961. 59 p.

5 Lacaz CS. Faculdade de Medicina - Reminescências, Tradição, Memória de minha escola. São Paulo: Atheneu; 1985.

6 Wachowicz RC. Universidade do Mate - História da UFPR. Curitiba: APUFPR; 1983. 41 p.

7 Weinstein B. A borracha na Amazônia: expansão e decadência, 1850-1920. tradução de Lólio Lourenço de Oliveira. São Paulo: Hucitec/Edusp; 1993. 371 p.

8 Folha do Norte, Belém: jan 1939.

9 Ribeiro PRC. A Faculdade de Odontologia como unidade predecessora da UFPA. In: Beckmann C, Côrrea RC, organizadores. Odontologia: 90 anos. Belém: Edufpa, Conselho Estadual de Cultura, Academia Paraense de Odontologia; 2005.

10 Beckmann CFR. A medicina no Pará no início do século XX e a instituição do ensino médico. Ver Cult Pará. 2003 jul;14(2):129-264.

11 Pará-Médico, vol III, anno VIII, no 10, set 1922.

12 Borges MR. A História da Escola de Medicina e Cirurgia do Rio de Janeiro. Rio de Janeiro: Revinter; 2008. 819 p.

13 Abreu Jr JMC. Miranda AG. Memória Histórica da Faculdade de Medicina Cirurgia do Pará, 1919-1950. Da Fundação à Federalização. Belém; 2009.

14 Folha do Norte, Belém: maio 1919.

15 Faculdade de Medicina e Cirurgia do Pará. Relatório do ano de 1944. Belém: Oficinas Gráficas da Revista de Veterinária; 1945.

16 Lobo BA. A Faculdade dos meus dias. Rio de Janeiro: Acess; 1994. 75 p.

17 Faculdade de Medicina do Pará. Trechos de relatórios apresentados à congregação. Belém: Typ. da Livraria Gillet; 1923.

18 Estado do Pará, mar 1922.

19 Rebello B, Silveira O. Província do Pará. Belém: nov 1968.

 

 

Correspondência / Correspondence / Correspondencia:
José Maria de Castro Abreu Junior
Trav. Mauriti, no 2218.
Bairro: Pedreira
CEP: 66087-680
Belém-Pará-Brasil
Tel.: +55 (91) 3226-0337/ 9982-3152
E-mail: josemcajr@yahoo.com.br

Recebido em / Received / Recibido en: 28/6/2010
Aceito em / Accepted / Aceito en: 26/8/2010

 

 

*Later, the education turned back to allopathy under the name of School of Medicine and Surgery of Rio de Janeiro. Currently, it is linked to the Uni-Rio3.

We decided to mention only the medical colleges that still exist, i.e., that survived. We did not mention the ones that closed such as those in São Paulo, Rio Grande do Sul, and the Medicine Course of the Manaus Autonomous University6.

There is the reference to the emergence of institutions such as the International School and University that offered long-distance courses in several knowledge areas including medicine6.

§The name School of Medicine and Surgery of Pará appeared in the 1920s13.

l lPhysician from Pará, born in 1874 and died in 1938. He began the medicine course in Bahia and graduated in Rio in 1896. He is known as a popular saint in Belém13.

Professor of Microbiology at the National Medicine College and Director of the National Museum16.

**Olimpio Cardoso da Silveira (1879-1968) from Sergipe graduated in Bahia and had lived in Pará since 1906.

††After Camilo Salgado’s death, until 1950, the College had the following directors: Lauro de Magalhães (1938-1943); Acylino de Leão (1944-1946); Lauro de Magalhães (1947-1954)11.