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The Alienist

Juliano Moreira was the first to publicize Freud in Brazil and to transform psychiatry into a medical specialty

FÁTIMA VASCONCELLOS archiveMoreira (with arms crossed) with Einstein, during the physicist’s visit to Brazil in 1925FÁTIMA VASCONCELLOS archive

A young physician from Salvador was the first to divulge in Brazil the rather different works of another physician, from Vienna. According to the reports available today, Juliano Moreira expounded for pupils from the Faculty of Medicine of Bahia the still controversial novelties from Sigmund Freud in 1899. His friend and also a physician – as well as politician and writer – Afrânio Peixoto makes reference to the fact in 1993, in the post-mortem homage to Moreira: “Freud, a novelty today, was studied 30 years ago by him [Juliano Moreira] in Bahia”. Ronaldo Jacobina, a researcher from the Federal University of Bahia and an expert on the life and work of Moreira, says: “The 30 years is an approximate reference, it may be 1903, 1900 or even 1899”. It is Mariazilda Perestrello who talks of this last year, hence before the publication of The Interpretation of Dreams, citing as her primary source psychoanalyst Danilo Perestrello. Years later, in 1914, Moreira made an official communication about psychoanalysis to the Brazilian Society of Neurology, Psychiatry and Legal Medicine. It was 150 years of Freud, commemorated in May, that brought to light this first citation relating to psychoanalysis in Brazil.

Juliano Moreira (1873-1933) is an exception case in Brazilian medicine. He was a half-breed, poor, northeastern, sick – he caught tuberculosis early – and son of a housemaid and a municipal civil servant, who was late in recognizing him, according to Fátima Vasconcellos, a psychiatrist from Rio, former president of the Rio de Janeiro Psychiatry Association and author of a dissertation about him. He was extremely precocious, intelligent and determined; he entered the College of Medicine of Bahia when 13 years old, which was permitted for excellent pupils of those days, and graduated at the age of 18, in 1891, with the thesis Etiology of early malignant syphilis.

In 1900, on the second time he went to Europe, got to know laboratories and researchers from various countries connected with psychiatry, dermatology and studies in syphilis, according to Ana Maria Oda, from the State University of Campinas, also a specialist on the subject. And in 1903, he became director of the National Hospice for the Alienated, in Rio de Janeiro.

In the 27 years that he headed up the institution, Moreira constructed psychiatry as a medical specialty in Brazil, with new ideas and practices. Inspired on the Munich Clinic, run by Emil Kraepelin, he abolished straightjackets and removed the iron bars from the windows. He separated interned adults and children, and installed a laboratory for pathological anatomy and biochemical analyses. To the clinical staff, he brought neuropsychiatrists and specialists in clinical medicine, pediatrics, ophthalmology, gynecology and dentistry, and set the school up for training psychiatric nurses. He published over a hundred works. He had an influence on the legislation for improving assistance for the sick. He was cofounder of medical periodicals and institutions like the Brazilian Society for Psychiatry, Neurology and Kindred Sciences, and he presided the  Brazilian Academy of Sciences – where he received Albert Einstein in 1925 – and was vice-president of the National Academy of Medicine.

But, above all, Moreira was a physician. “He would say that the ‘alienated’ ought to be treated like any other patient, which demonstrated his lack of prejudice in relation to mental illness”, concludes Fátima Vasconcellos.