5 - Breaking Out of the Asylum: Rio de Janeiro’s Mental Hygiene Movement, 1903–37

Summary

Antônio Dias Barros replaced Dias Carneiro as the National Insane Asylum director on July 12, 1902, following a litany of complaints and criticisms from the press and state officials about the institution's functioning. Instead of expressing pleasure at the prestige of this appointment, Dias Barros lamented that “any person to assume this position would already be doomed to failure, and publicly dismissed for incompetence, but [he would] be charged in error, when it should be the asylum itself, in this situation [as it is] due to internal excesses of every kind, [perpetrated] after the declaration of the Republic under the authority of those who more worthily should have defended and solidified, in the spirit of [the] public, their claims and spirits.” In many ways, his assessment was accurate, and his tenure lasted only a year. When Dr. Juliano Moreira succeeded Barros in 1903, he brought an unprecedented series of political and medical techniques to the asylum, which ushered in an era of institutional optimism despite the asylum's reputation as a failure under republican rule. No longer a site devoted to the passive stewardship of the mad, the asylum began to carry out the dual, and perhaps somewhat contradictory, goals of containment and treatment. Treatment techniques included hydrotherapy, light therapy, and suggestive therapies. Although evidence does not suggest that these methods were particularly effective in curing mental illness, they reflected a paradigm shift within Brazilian psychiatry. Historians have discussed the evolution of scientific medicine over the course of the nineteenth century and analyzed the institutional, social, and cultural changes that followed the well-known epistemological shift in medicine most commonly associated with post-revolutionary Paris. Beginning in the second half of the century, the asylum, in addition to the general hospital, underwent a fundamental transformation from a place of respite for the poor or the sick to a site defined by science. Historians have also demonstrated that in the world of early twentieth-century medicine, research, education, and the making of careers all became bound to the hospital. Laboratory training and bedside instruction at a university-affiliated hospital largely displaced the medical apprenticeship, and the identity of Brazilian physicians rested increasingly not on traditional therapeutics but on shared educational experiences and a claim to specialized scientific knowledge.