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Tropical apprenticeship

140 years ago, the Bahian Tropicalist School was born

One of the most important changes in the course of Brazilian medicine began with a small group of three foreign physicians in the then Province of Bahia, some 140 years ago. During the decade of the 1860’s, Otto Edward Henry Wucherer, of German descent, born in Portugal; John Ligertwood Paterson, a Scot; and José Francisco da Silva Lima, Portuguese, would meet every fortnight, at night, at the house of one of them to discuss clinical cases and the available scientific literature. Soon to join them were four doctors from Bahia, Ludgero Rodrigues Ferreira, Manoel Maria Pires Caldas, Antônio José Alves (the father of poet Castro Alves) and Antônio Januário de Farias – the last two, professors at the School of Medicine in Salvador. They were all united by the same interest: research into tropical pathology.

The work carried out by the group, which came to have 14 researching physicians, became known as the Bahian Tropicalist School and marked an era. In the 1860’s, the practice of medicine had advanced little since 1808, when the Portuguese court moved to Brazil and Dom João VI created the anatomy and surgery courses in the military hospitals of Salvador and Rio de Janeiro. Before medical education was organized, indigenous, African and Jesuit practices predominated – alongside the barbers, bloodletters and faith healers. It so happens that the European methods adopted here were based on the medico-philosophical theories of the 18th century. The lessons given at the colleges of Salvador and Rio were discursive, with an emphasis on racial and climatological determinism. The idea in force was that the inhabitants of the tropics would degenerate naturally and irreversibly.

The tropicalist physicians challenged these precepts with new clinical methods. Instead of merely classifying diseases by means of a combination of their symptoms, they would observe and determine the origins of the sickness, with its set of symptoms. They would use a microscope to investigate microorganisms as the causers of diseases – something rare in the country – and published their works in the Gazeta Médica da Bahia – (Bahian Medical Gazette), which was founded by them, and even in a few specialized periodicals abroad. “The tropicalists formed the first medical research group to be set up in Brazil,” explains clinician Rodolfo dos Santos Teixeira, a retired professor from the Federal University of Bahia. The Gazette had a first phase, from 1866 to 1934, and another, from 1966 to 1976. Teixeira took part in the second.

All the issues were digitalized and are available in two CD-ROMs and a book, after an exhaustive work carried out by researcher Luciana Bastianelli. The tropicalists discovered pathologies that were common in the 19th century, like beriberi and ainhum, described unknown worms, and carried out studies on epidemics of those days, such as cholera and yellow fever. The influence and importance of these physicians were to be recognized later by Carlos Chagas, the mythical discoverer of Trypanosoma cruzi, as a center of innovation in Brazilian medicine.