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History lessons from Dr. Pedro Nava

Author of memoirs addresses the meanders of the training of physicians in Brazil

In amongst the commemorations of the centenary of the birth of physician and author of memoirs Pedro Nava (1903-1984), the good news is the reissue of Território de Epidauro, for so long out of print. Published in 1947, it circulated amongst doctors and a restricted public. In spite of the essays addressing themes relating to the history of Brazilian medicine, we cannot read this book today without comparing it with his Memórias [Memories] (1972-1983). Outlining the origins of our medicine, with his involving prose, Nava seeks to understand what are the meanders in the education of doctors in the country and the peculiar behavior of the sick. To assess the effectiveness of a medicine, he teaches, the beliefs of the population for which it is intended should be known. They are both, therefore, manifestations of the same culture and, in this way, maintain connections between themselves, even though at first they seem incongruous.

If medicine began to impose itself amongst us as a “scientific activity” following the 19th century, under the influence of France, does not mean that it did not exist before. On the contrary, there were several curing arts, and the credit for such flourishing was due, according to Nava, to the colonizer who brought from Portugal the so-called popular and erudite learning. The question is that for a long time the two spheres shared the same secrets and formulations. A medicine concerned with curing the physical ills, but looking on them as a work of divine wrath or of demoniacal craft.

Accordingly, alongside useful recipes, tested and approved, prescriptions are to be found dictated by superstition and by supernatural conceptions of diseases. Hence the various rituals of purification associated with the ingestion of medicine, some even wrapped up in a “sacrificial stain”, like the 24th prescription from the manuscript from the end of the 18th century and beginning of the 19th by the Portuguese who lived in Paracatu and a transcription of whom Nava brings at the end of the volume. Beliefs ingrained in us as a result of the chronic shortage of academic doctors, of the great territorial expanse, of the difficulty in importing medicines, of the long journey that rendered them useless, opening up the terrain for a “fabulous, unreal and absurd” medicine.

Counterbalancing this, in the 19th century modern medicine was introduced into the country, following the lines of the French medical school, with the systematic teaching of physiology, pathology, and general practice. Teaching based on a “school spirit”, which, however, contemporary medicine has lost in the name of specialization. If the doctor ought not to forget that medicine arises from the experience “of the first ones who became doctors by means of thought: I have seen a like ailment before, cured with so-and-so remedy” it makes no sense, according to Nava, to adopt the examination of the “organicistic and local detail”, to the detriment of a “conception of the organism as a functional synergic and global whole”.

Specialization is fruitful only when it concentrates its theoretical basis, by means of constant and integral learning, on a set of kindred areas, always bearing in mind the individual as a whole. Pertinent observations even today, when the advances in genetic and digital information tend to lead to the obsolescence of the human body.What do the sick desire when they look to the doctor? According to Nava: attention, comfort, confidence and, even, the cure for their ills. They are not then so different from those ancient Greeks who made their way to Epidaurus, seeking the intercession of Esculapius. Território de Epidauro has much to teach doctors, but historians as well, and those who dedicate themselves to literary studies, for its human dimension is this age of ours pregnant with tragedies.

Maria Luiza Medeiros Pereira is a doctor in Literary Theory and History, from the Literary Studies Institute of the Campinas State University (Unicamp)

Território de Epidauro [Territory of Epidaurus]
Pedro Nava
Ateliê Editorial
248 pages
R$ 25.00