Entre febres, comas e convulsões: as terapias biológicas no Hospital do Juquery administrado por Pacheco e Silva (1923-1937)

Abstract

This research analyzes the Biological Therapies, as fevertherapy, convulsivetherapy, hypoglycemic comas and the psychosurgeries, deployed and used widely in the Juquery Hospital between the years 1923 and 1937. This period corresponds to the direction of Juquery by Antonio Carlos Pacheco e Silva, influential medical from São Paulo, which introduced these therapies in national psychiatry and built a large institutional trajectory, bound by the most conservative sectors of São Paulo's society. Thus, the analysis is developed aiming to highlight the links between political, scientific and morals concepts of Pacheco e Silva with the application of the therapies mentioned in individuals hospitalized in Juquery. This research discusses the relationship between the application of biological therapies and the consolidation of psychiatry as a respectable medical area, since he sought to express a more "scientific" psychiatry to the extent that their diagnosis and its treatment, supposedly, were determined from anatomopathological criteria. For this purpose, the source of this research is to document medical records of hospitalized individuals in Juquery the period mentioned above, in publications of the doctors who worked in Juquery in scientific journals of the time, as well as in several texts published by Pacheco e Silva throughout his long career.

Psychiatric nursing: analysis of the Manual Cuidados aos Psychopathas

“…With his conservative ideology, a characteristic reflected in his lectures and publications, Pacheco e Silva reaffirmed the maintenance of the status quo of society's most wealthy groups, by imposing the ideological and moral order of the Brazilian elite at the time. Associated with the organicist theories for explaining mental disorders, Pacheco e Silva was, throughout his career, opposed to the use of psychoanalysis and other non-medical therapies, and introduced most of the so-called biological therapies, such as electroconvulsive therapy, in Brazil (Tarelow, 2012). Pacheco e Silva started his medical training at the first Faculty of Medicine of São Paulo, in the private Universidade Livre de São Paulo.…”

“…In Switzerland, he took courses taught by Eugen Bleuler , the Swiss psychiatrist known for introducing the term schizophrenia to designate what was formerly known as dementia praecox. In Germany, he learned with Emil Kraepelin , the psychiatrist who is commonly considered as the founder of modern psychiatry, psychopharmacology and psychiatric genetics, and who argued that psychiatric disorders were caused by genetic and biological disorders (Tarelow, 2012). Mental disorder is perceived as a disturbance at the level of passions and will, which explained the need for medical intervention and nursing care.…”

História crítica da hipnose na psiquiatria da Faculdade de Medicina da Universidade de São Paulo, Brasil, entre 1930-1970

“…Por exemplo, em 13 Chama atenção que psiquiatras experimentados realmente acreditassem no poder de suas falas, como mencionado acima, com a literatura científica já disponível em sua época. Diante de situações clínicas complexas como o alcoolismo, é digno de curiosidade pensar o que levaria estes médicos a sustentarem ideias já superadas há mais de sessenta anos, como a de que seria possível incutir no paciente um reflexo que o impedisse de ingerir álcool.…”

Convulsive therapy in Brazilian psychiatric practice

“…The so-called biological therapies emerged in psychiatry during the 1910s and 1930s. Although at the time little was known about the mechanism of action of these psychiatric therapies, they were considered effective, and their practice was widely spread (Talerow, 2011). Convulsive therapies were another type of treatment.…”

“…All these therapies triggered seizures, which resulted in a remission of mental disorder symptoms, leading to the belief that a cure was possible. At first, these therapies were tested and used for the treatment of progressive general paralysis and schizophrenia (Talerow, 2011). Nurses being present in places of hospitalization and treatment of psychiatric patients allowed the implementation of convulsive therapies.…”