{"id":243832,"date":"2017-07-28T17:40:51","date_gmt":"2017-07-28T20:40:51","guid":{"rendered":"http:\/\/revistapesquisa.fapesp.br\/?p=243832\/"},"modified":"2017-07-31T16:07:32","modified_gmt":"2017-07-31T19:07:32","slug":"benvenuti-doctors","status":"publish","type":"post","link":"https:\/\/revistapesquisa.fapesp.br\/en\/benvenuti-doctors\/","title":{"rendered":"Benvenuti<\/em>, Doctors!"},"content":{"rendered":"
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CAPH-USP <\/span><\/a> Aerial view of the complex of buildings of the S\u00e3o Paulo School of Medicine and Surgery, established in 1912, situated on Avenida Dr. ArnaldoCAPH-USP <\/span><\/p><\/div>\n

The expansion of coffee-growing throughout the interior areas of S\u00e3o Paulo at the end of the 19th<\/sup> century sparked a surge in immigration of European workers, especially Italians, in search of better living conditions. The arrival of those immigrants to work on farms and in the factories that had begun to proliferate in S\u00e3o Paulo\u2019s cities contributed to the state\u2019s economic development and significant population growth. Little known, however, are the stories of the Italian physicians who also found their way to S\u00e3o Paulo, encouraged by the expansion of their arena of activity as a result of the establishment of public health care facilities. It is estimated that about 250 doctors who were trained in Italy settled in S\u00e3o Paulo between 1880 and 1930. Despite their relatively low numbers, quite of few of them played prominent roles in the formation and development of scientific research in S\u00e3o Paulo, leaving their mark on the history of health in that state.<\/p>\n

At the end of the 19th<\/sup> century, S\u00e3o Paulo began to have to deal with the same illnesses that were wreaking havoc in the city of Rio de Janeiro. Outbreaks of epidemics of yellow fever, Bubonic plague, smallpox, and other ailments brought about by extremely poor sanitary conditions and spread by the intense traffic of human beings between cities and the countryside altered sanitary conditions in the state. The Italian government, learning of the deterioration in the living conditions of a burgeoning population from reports by agents who had been sent to inspect the conditions under which immigrants lived and worked, went so far as to recommend that its people not move to Brazil. Pressured by an increase in outbreaks and epidemics that affected not only the population but economic progress, the S\u00e3o Paulo government conceived a series of ways to reform the public health system.<\/p>\n

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Collection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/a> Engraving of the Vaccinology Institute building by S\u00e3o Paulo artist Wasth RodriguesCollection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/p><\/div>\n

Those actions culminated in the establishment of institutions such as the Bacteriology Institute in 1893 and the Vaccinology Institute in 1894. Eventually those institutions would merge to become the Butantan Institute. However, when it detached from that institution in 1940, the Bacteriology Institute took the name Adolfo Lutz Institute. \u201cS\u00e3o Paulo was the state that invested most heavily in public health and in fighting epidemic diseases at the turn of the last century,\u201d says historian Claudio Bertolli Filho, a professor in the Graduate Program in Education for Science at the S\u00e3o Paulo State University (Unesp) in Bauru, in inland S\u00e3o Paulo State. According to Bertolli, the seriousness of the epidemics accelerated the pace of institutional advances in that field and increased the demand for health care professionals. Attracted by the improved conditions, Italian physicians who were already established in Brazil moved to S\u00e3o Paulo from other states or arrived directly from other countries.<\/p>\n

Businessmen of Italian origin like Francesco Matarazzo (1854-1937) played an important role in S\u00e3o Paulo spurring the establishment of hospitals, philanthropic health care centers, and mutual aid societies such as the Sociedade Italiana de Benefic\u00eancia in S\u00e3o Paulo\u2014which administered the Umberto I Hospital that functioned in the Bela Vista neighborhood between 1904 and 1993\u2014attracting even more foreign professionals. \u201cItalian doctors were already somewhat familiar with microbiology and tropical diseases,\u201d says Bertolli. \u201cOthers came here believing that their captive clientele would be made up of Italian immigrants, but soon began serving the entire population.\u201d<\/p>\n

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Collection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/a> Alfonso Bovero established and organized the Anatomy Department of the USP School of MedicineCollection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/p><\/div>\n

The status of Italian science and clinical medicine stood out from that of the rest of Europe in the late 19th<\/sup> century, as sociologist Maria do Ros\u00e1rio Rolfsen Salles, from the Anhembi Morumbi University reported in the book M\u00e9dicos italianos em S\u00e3o Paulo (1890-1930): Um projeto de ascens\u00e3o social<\/em> (Sumar\u00e9, 1997) [Italian physicians in S\u00e3o Paulo (1890-1930) \u2013 A study of upward social mobility]. According to the researcher, the secularization of health care that followed the Protestant Reformation in Europe did not affect Italy. \u201cChurch control over hospitals and medical practices made it hard for doctors to advance professionally and apply what they had learned,\u201d she says. Their decision to emigrate therefore found additional support in the conditions under which Italian science and medical practices were developing.<\/p>\n

At the time, S\u00e3o Paulo physicians were attending medical school in either Rio de Janeiro or in Salvador, Bahia State. In rare cases, they would study abroad. \u201cBy introducing and disseminating new knowledge and practices from Europe, Italian doctors played an important role in the education and medical research carried out in S\u00e3o Paulo,\u201d recalls sociologist Luiz Antonio de Castro Santos, a professor at the Institute of Humanities, Arts and Sciences of the Federal University of Southern Bahia (UFSB). Castro Santos, alongside Salles, studied the careers of the Italian physicians in S\u00e3o Paulo during the First Republic. One of the men profiled was Giovanni Sanarelli, known for having isolated the icteroid bacillus, then considered to be the cause of yellow fever. Today we know that the disease is caused by an arbovirus of the genus Flavivirus<\/em>.<\/p>\n

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Collection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/a> In the Bela Vista neighborhood of S\u00e3o Paulo, the Umberto I Hospital attracted Italian physicians who had settled in different parts of BrazilCollection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/p><\/div>\n

Sanarelli disembarked in S\u00e3o Paulo in 1898 and was an active participant in the campaign to eradicate yellow fever in S\u00e3o Carlos do Pinhal in the rural area of the state. Other physicians began arriving from Italy in 1900, including Alfonso Splendore. At age 22, Splendore became involved in activities at the Bacteriology Institute, then headed by physician Adolfo Lutz (1855-1940), researching and writing about toxoplasmosis, leishmaniasis, South American blastomycosis\u2014a kind of fungal infection\u2014and syphilis, one of the diseases considered to be the biggest threat to public health in Brazil in the first two decades of the 20th<\/sup> century.<\/p>\n

The high percentage of eye disease found among Italian immigrants was responsible for the arrival of ophthalmologists like Giuseppe Zaccaro, who helped end an epidemic of granular conjunctivitis, also known as trachoma, in the municipality of Taquaritinga. Trachoma affected a considerable number of people in inland S\u00e3o Paulo during that period. The swift propagation of the disease convinced state officials in 1906 to form committees on the treatment and prophylaxis of trachoma. It was a costly effort that required the installation of treatment clinics statewide in municipalities that in some cases were situated 400 km from the state capital.<\/p>\n

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Library of the Pasteur Institute <\/span><\/a> Fa\u00e7ade of the Pasteur Institute of S\u00e3o Paulo, inaugurated in the state capital in August 1903Library of the Pasteur Institute <\/span><\/p><\/div>\n

Three years earlier, in November 1903, Italian ophthalmologist Francisco Pignatari had already begun taking actions such as later adopted by the S\u00e3o Paulo Sanitary Service in caring for trachoma patients when he founded the Morro Vermelho Ophthalmic Hospital, the first in S\u00e3o Paulo according to researcher Soraya Lodola of the Geosciences Institute of the University of Campinas (Unicamp). The hospital had capacity for 314 patients, large gathering spaces, and rooms suited for accommodating patients suffering from a variety of ophthalmic diseases. \u201cWithin only a few months, the hospital became an important care center for trachoma sufferers,\u201d Lodola says. In 1906, she reports, 2,934 patients were served, 2,390 of whom had trachoma while 544 exhibited other ophthalmic diseases. \u201cPignatari\u2019s contributions were of enormous value in the history of battling against the trachoma epidemic,\u201d she says.<\/p>\n

The increase in interest in science associated with medicine and public health in S\u00e3o Paulo culminated in August 1903 with the establishment of the Pasteur Institute in the state capital. Devoted to the development of laboratory medicine through bacteriological research, instruction in microbiology, and production of immunization agents, the institute served as a forum for discussion, education, and scientific investigation, compensating to some extent for the absence of a medical school in S\u00e3o Paulo, which would not be established until 1912.<\/p>\n

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Reproduction from the book M\u00e9dicos italianos em S\u00e3o Paulo (1890-1930)<\/span><\/a> Physician Alfonso Splendore worked alongside Adolfo Lutz at the former Bacteriology InstituteReproduction from the book M\u00e9dicos italianos em S\u00e3o Paulo (1890-1930)<\/span><\/p><\/div>\n

The Pasteur institute was initially headed by Italian physician Ivo Bandi, but he left the post because of disagreements with infectious medicine specialist Em\u00edlio Ribas (1862-1925), then director of the S\u00e3o Paulo Sanitary Service. In 1906, Ant\u00f4nio Carini, an Italian bacteriologist and director of the Institute of Bacteriology, Serotherapy, and Infectious Diseases in Bern, Switzerland, accepted the position of director of the Pasteur Institute and expanded its work in the treatment of rabies. \u201cBrazilian doctors expected the Italians to display a more refined knowledge of medicine than what was taught in Brazilian medical schools,\u201d says Bertolli. \u201cThat is why they invited them to come to S\u00e3o Paulo.\u201d According to Castro Santos, those professionals were also expected to have had clinical training based on public health research, knowledge later used in training doctors at the Institute of Hygiene\u2014now the School of Public Health of the University of S\u00e3o Paulo (USP), established in 1918.<\/p>\n

In 1912, many Italian professionals left the Brazilian institutions where they were working to teach at the newly-created S\u00e3o Paulo School of Medicine and Surgery that opened its doors in 1913. Clinical subjects were usually taught by professors from the S\u00e3o Paulo medical elite, while basic disciplines such as parasitology, microbiology, physiology, pathology, and anatomical pathology were left to the foreign professors. Alessandro Donati became a professor of general and experimental pathology, and Carini left the Pasteur Institute in order to teach microbiology and immunology at the new school.<\/p>\n

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Collection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/a> In 1912, bacteriologist Ant\u00f4nio Carini (above<\/em>) left the post of director of the Pasteur Institute in order to teach at the S\u00e3o Paulo School of Medicine alongside pathologist Alessandro Donati (at left<\/em>)Collection of the Historical Museum of the University of S\u00e3o Paulo School of Medicine (FMUSP)<\/span><\/p><\/div>\n

Another important name in the consolidation of S\u00e3o Paulo medical education is that of Italian anatomist Alfonso Bovero, who joined the faculty of the new school at the invitation of physician Arnaldo Vieira de Carvalho (1867-1920), one of the organizers of the School of Medicine and Surgery. That school was among the units that combined to form USP in 1934. Bovero arrived in S\u00e3o Paulo as an \u201cacademic superstar\u201d owing to the prestige he had won in Europe. \u201cThe Italian anatomy expert founded and organized the school\u2019s Anatomy Department and was one of the first in Brazil to teach that anatomy as a discipline should be considered a separate field of knowledge that gained importance when associated with subjects like physiology and pathology,\u201d wrote Bertolli in an article published in the journal Hist\u00f3ria, Ci\u00eancia, Sa\u00fade \u2014 Manguinhos<\/em> and co-authored by psychologist Ana Carolina Talamoni that discussed the teaching of anatomy in Brazil in light of Bovero\u2019s ideas.<\/p>\n

Bovero also found a fertile field for research at the Umberto I Hospital and alongside other physicians and researchers he helped found the journal entitled Revista ARS M\u00e9dica. <\/em>According to Salles, that publication was an important vehicle for discussion of the results of studies carried out at the School of Medicine and at the same time brought the fields of education and research closer together, since many of the published works were submitted by professors who taught at the new S\u00e3o Paulo medical school. \u201cParticipation by the Italian doctors was a determining factor in formation of S\u00e3o Paulo\u2019s scientific community, the development of scientific research, and the dissemination of microbiological science,\u201d Salles concludes.<\/p>\n","protected":false},"excerpt":{"rendered":"Italian physicians contributed to research in S\u00e3o Paulo ","protected":false},"author":346,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[152],"tags":[226,241,247],"coauthors":[662],"class_list":["post-243832","post","type-post","status-publish","format-standard","hentry","category-retrospect","tag-education","tag-history","tag-medicine"],"acf":[],"_links":{"self":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/243832","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/users\/346"}],"replies":[{"embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/comments?post=243832"}],"version-history":[{"count":0,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/posts\/243832\/revisions"}],"wp:attachment":[{"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/media?parent=243832"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/categories?post=243832"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/tags?post=243832"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/revistapesquisa.fapesp.br\/en\/wp-json\/wp\/v2\/coauthors?post=243832"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}