El final del Hospital Rawson y la diáspora finochiettista. A 45 años de estos hechos / The end of the Rawson Hospital and the finochiettista diaspora. 45 years after these events

La Asociación Médica Argentina (AMA) reconoce el valor de la Escuela Quirúrgica de los hermanos Finochietto y por tal motivo efectúa un homenaje anual desde el año 2002. En este artículo se hace una breve reseña histórica del Hospital Rawson, donde se inició y desarrolló dicha escuela. Se resaltan dos hechos: por un lado, el término "diáspora finochiettista", porque la dispersión de los cirujanos fue obligada y tuvieron que abandonar su lugar de procedencia original, el Hospital Rawson y, por el otro, que dicho nosocomio nació y murió como consecuencia de movimientos políticos cívico-militares. (AU)

The Argentine Medical Association (AMA) recognizes the value of the Surgical School of the Finochietto brothers, and for this reason has paid an annual tribute since 2002. Tthis article provides a brief historical review of the Rawson Hospital, where the school was initiated and developed. Two facts are highlighted: on the one hand, the term "Finochiettista diaspora" because the dispersal of the surgeons was forced and they had to leave their original place of origin, the Rawson Hospital; and on the other hand, the fact that this hospital was born and died as a consequence of civil-military political movements. (AU)

Historia de la medicina chilena: ¿Cómo, dónde y cuándo habría nacido la cirugía moderna chilena? / ¿How, where and when modern chilean surgery would have been born?

The challenge of knowing the events surrounding the modern origins of the different specialties of Chilean medicine should be of interest to the specialists of these specialties. Thus, in the case of surgery, fortunately in Chile there are testimonial documents, which reviewed and analyzed can suggest this question, mentioning the one who today is considered the world father of modern surgery, whose important surgical teachings were delivered to Chilean disciples who introduced it in our country. In the context of the War of the Pacific, in the year 1879, a "blood hospital" was built in Santiago, donated by Domingo Matte, a Chilean politician, to receive the many war wounded who were transported from the north. It was Dr. Manuel Barros Borgoño, a young surgeon recently graduated from the Faculty of Medicine in Paris, with a degree revalidated in Chile, who in 1880 took charge of this hospital, and together with his team, began to apply his experience in listerian methods learned in Paris from his teacher Dr. Just Lucas Champonniere. Just Lucas Champonniere, giving beginning to the Chilean antiseptic surgery, managing to reduce the mortality of surgeries to 3%, compared to 80% of other Chilean hospitals that refused to change, and continued with the use of sponge soaked in cerato (lard).

El hospital y el enfoque de derechos / The hospital and rights approach

La pandemia por SARS-CoV-2 puso de forma abrupta al sistema de salud en la agenda pública. Evidenciando sus problemas y requiriendo acciones de emergencia para poder dar cuenta del desafío de responder social y sanitariamente a esta crisis. La respuesta hospitalaria fue el eje y centro de atención de la pandemia, casi con exclusividad. Relegando las otras posibilidades o dispositivos asistenciales, como el primer nivel de atención y la salud comunitaria. Por lo tanto, nos proponemos reflexionar sobre esta organización sanitaria, tan arraigada en el modelo médico social y el marco del enfoque de derechos. Definiremos el hospital, describiremos sus antecedentes, sus características y propondremos como repensarlo críticamente para aportar a su crecimiento en el marco del enfoque de derechos. La salud como derecho es el marco legal, político y teórico que proponemos para abordar esta reflexión y al hospital, tanto como singularidad histórica como pluralidad o multiplicidad de organizaciones en función de cada contexto donde se desarrolla, como una organización social y sanitaria que formar parte de un conjunto de organizaciones y políticas destinadas a garantizar ese derecho (AU)

The SARS-CoV-2 pandemic abruptly put the health system on the public agenda. Evidencing their problems and requiring emergency actions to be able to account for the challenge of responding socially and healthily to this crisis. The hospital response was the axis and center of attention of the pandemic, almost exclusively. Relegating the other possibilities or assistance devices, such as the first level of care and community health. Therefore, we intend to reflect on this health organization, so rooted in the social medical model and the framework of the rights approach. We will define the hospital, describe its background, its characteristics and propose how to rethink it critically to contribute to its growth within the framework of the rights approach. Health as a right is the legal, political and theoretical framework that we propose to address this reflection and the hospital, both as a historical singularity and as a plurality or multiplicity of organizations depending on each context where it is developed, as a social and health organization that is part of a set of organizations and policies aimed at guaranteeing that right (AU)

"Hipnóticos" na metrópole: africanos no Hospital Colonial de Lisboa nas primeiras décadas do século XX / "Hypnotics" in the metropolis: Africans in the Colonial Hospital of Lisbon during the early twentieth century

Resumo No início do século XX, alguns médicos portugueses foram à África estudar a chamada doença do sono. Entre eles estava Ayres Kopke, membro da primeira missão médica à África Ocidental Portuguesa. De regresso a Lisboa, o professor da Escola de Medicina Tropical continuou suas pesquisas, inclusive por meio da observação de doentes trazidos para a metrópole. Desde 1903, as repartições de saúde nas colônias estavam incumbidas de enviar doentes com determinadas patologias exóticas para o Hospital Colonial de Lisboa. Com base em documentos desse hospital, incluindo fotografias dos doentes, então chamados de hipnóticos, o artigo aborda a importância das experiências com humanos na metrópole para o avanço da medicina tropical durante o colonialismo.

Abstract At the start of the twentieth century, some Portuguese physicians traveled to Africa to study sleeping sickness (African trypanosomiasis). One was Ayres Kopke, a member of the first medical mission to Portuguese West Africa and professor at the School of Tropical Medicine. After returning to Lisbon, Kopke continued his research, which included observation of patients brought to the metropolis. Starting in 1903, health departments in the colonies were responsible for sending patients with certain exotic diseases to the Colonial Hospital of Lisbon. Based on documents from this hospital including photographs of patients (who at that time were called "hypnotics"), this article discusses the importance of human experiments in Lisbon for advances in tropical medicine during the colonial period.

O Hospital Proletário João Pessoa: limites e possibilidades para a saúde do trabalhador (Paraíba, anos 1930) / The Hospital Proletário in João Pessoa: limits and possibilities for worker healthcare (Paraíba, 1930s)

Resumo Discutimos a tentativa de organização do Hospital Proletário na capital da Paraíba nos anos 1930. Para tanto, problematizamos a cobertura do jornal A União sobre esse episódio. O envolvimento de diferentes atores - trabalhadores, associações e médicos - revela a emergência de uma nova forma de pensar e praticar as políticas de saúde. Conforme o projeto varguista de construção nacional, tais ações visavam à formação de trabalhadores saudáveis, aptos para o mercado e úteis para a nação. Apesar de seu fracasso, o projeto do hospital evidencia as diferentes concepções sobre a saúde dos trabalhadores na Era Vargas. Apropriamo-nos dos conceitos de "interdependência sanitária", "medicina social", "cidadania regulada" e "trabalhismo".

Abstract We discuss the attempt to establish the Hospital Proletário in the capital of the state of Paraíba in the 1930s. To this end, we problematized the coverage in the newspaper A União on this episode. The involvement of different actors - workers, associations and physicians - reveals the emergence of a new way of thinking and implementing healthcare policies. According to the Vargas government's national construction plan, actions like this were intended to ensure healthy workers - ready for the market and useful for the country. Despite its failure, the hospital project provided evidence of the different concepts of worker health during the Vargas Era. We identified the concepts of "health interdependence," "social medicine," "regulated citizenship" and the "labor movement."

La atención a la salud en Mesoamérica antes y después de 1519 / Health care in Mesoamerica before and after 1519

Resumen En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Abstract This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

Past, present and future of university hospitals.

Objectives: Health care systems worldwide are changing and taking new forms. The old, more hierarchically oriented, model with individual institutional and bilateral interactions between primary, secondary, tertiary and quaternary care is being replaced by an integrated and dynamic network model. We aim to look at what role university hospitals will play in this future organization of health care.Method: In this paper, we look at the relevant literature on the history of academic medicine and university hospitals. Subsequently, we look at the challenges university hospitals are facing according to contemporary literature on the topic.Results: Our current model of academic medicine with its university hospitals finds its origin in the institutionalization of the academic mission in the late 18th century. Currently, the sustainability of the model is under immense pressure. University hospitals are facing economic challenges, teaching challenges and research challenges. However, there is reason to believe that they can continue to play a role of importance in tomorrow's medicine. The organization of health care is undergoing two important changes. The first is the evolution towards a more dynamic and integrated network model. University hospitals can become an important hub within this network. The second change is an evolution towards evidence based medicine and translational research.Conclusion: Due to their unique tripartite mission, we argue that university hospitals can continue to play an important and critical role in promoting evidence-based medicine and speedy translation of new evidence.

Fontes para uma história do Hospital de Manguinhos / Sources for a history of the Manguinhos Hospital

Resumo O estudo apresenta fontes para uma história do Hospital de Manguinhos, atual Instituto Nacional de Infectologia, reunidas, em sua maior parte no Departamento de Arquivo e Documentação da Casa de Oswaldo Cruz, mas também no acervo constituído na Direção do próprio instituto (em caixas classificadas de maneira ainda informal), assim como na hemeroteca da Biblioteca Nacional, nas Memórias do Instituto Oswaldo Cruz e no Centro Técnico Audiovisual do Ministério da Cultura. Apresenta, também, uma tipologia dessas fontes, assim como revela seu potencial analítico para a história das ciências da saúde, mais especificamente, da pesquisa clínica, da medicina e da saúde pública no Brasil, entre 1918 e 2018.

Abstract The present study presents sources for a history of the Manguinhos Hospital (today the Brazilian National Institute of Infectious Diseases), which for the most part are found in the Archives and Documentation Department of the Casa de Oswaldo Cruz, but also in the administration's own collection (in boxes which are still classified informally) as well as the collection of the Brazilian National Library, in the Memórias do Instituto Oswaldo Cruz, and in the Brazilian Ministry of Culture's Audiovisual Technical Center. It also presents a typology of these sources, and shows their analytical potential for the history of health sciences and more specifically, of clinical research, medicine, and public health in Brazil between 1918 and 2018.

Conflitos, assistência e redes de poder em torno da fundação da Santa Casa de Misericórdia de Campos dos Goytacazes, 1786-1795 / Conflicts, welfare, and power networks in the founding of Santa Casa de Misericórdia of Campos dos Goytacazes, 1786-1795

Resumo O artigo propõe uma discussão a respeito da fundação da Santa Casa de Misericórdia de Campos dos Goytacazes e seus desdobramentos na sociedade local, além de um breve estudo sobre os dois primeiros provedores e suas redes (1792-1795). A instituição foi inaugurada em 1792, no auge das transformações ocorridas na Europa. Em Portugal, o intendente-geral da Polícia de dona Maria I, Diogo Inácio de Pina Manique, planejava reformas à frente da administração da saúde pública. Analisam-se, dentro desse contexto, as questões que motivaram a instalação da referida Misericórdia e suas relações com as dinâmicas sociais e políticas típicas de Antigo Regime, ainda enraizadas na sociedade colonial e que adentrariam o século XIX.

Abstract A discussion is proposed concerning the founding of Santa Casa de Misericórdia of Campos dos Goytacazes and its ramifications in local society, as well as a brief study of its first two directors and their networks (1792-1795). The institution was opened in 1792 at the height of upheavals in Europe. In Portugal, the chief of police under Maria I, Diogo Inácio de Pina Manique, planned reforms for the public health administration. An analysis is proposed of the issues that motivated the founding of said institution and how it related to the social and political dynamics typical of the ancien régime, which were still deep-rooted in colonial society, and which remained intact into the nineteenth century.

História da assistência hospitalar em São Paulo: a subvenção do Estado às misericórdias paulistas / History of hospital care in São Paulo: State grants to the misericórdia charitable associations

Resumo O artigo analisa como as santas casas de misericórdia do estado de São Paulo foram subvencionadas pelos governos municipais, provincial e estadual na passagem do século XIX para o XX. Para tanto, são discutidas as dotações orçamentárias realizadas de 1838 a 1915, com o fim de avaliar o repasse e a ampliação de verbas nesse ínterim. É possível notar que foi criada uma rede de assistência fortemente apoiada pelo Estado, mas efetivada pela assistência filantrópica. Essa rede de atendimento hospitalar permanece com o mesmo formato até pelo menos o primeiro terço do século XX, contexto em que se incluíam as misericórdias criadas pelo interior do estado paulista.

Abstract This article investigates how the santas casas de misericórdia charitable associations in the state of São Paulo were subsidized by the municipal, provincial, and state governments at the turn of the twentieth century. Budget appropriations from 1838 to 1915 were examined to evaluate these charitable grants as well as the growth in funding during this period. While a care network created with strong state backing, it was put into action by philanthropic assistance. This network of hospital care retained the same format until at least the first third of the twentieth century, and included misericórdia establishments created within the interior of the state of São Paulo.

A History of the Frenchay Hospital Plastic Surgery Unit, Bristol, United Kingdom.

Frenchay Hospital has long since been established as the center for plastic surgery in Bristol, providing care to the city and its surrounding catchment area. From humble origins in the Second World War when the site took on the role of a large military hospital providing reconstructive surgery for the victims of war to a busy modern-day National Health Service establishment, the plastic surgery unit at Frenchay Hospital has grown and developed through in parallel with the genesis and development of the specialty. Recent centralization of care in Bristol has seen a massive reorganization of services, and with it the closure of Frenchay Hospital. Because the plastic surgery unit establishes a new home at Southmead Hospital, this review documents the foundations of reconstructive surgery in Bristol and the South West United Kingdom.

Origins of Gender Affirmation Surgery: The History of the First Gender Identity Clinic in the United States at Johns Hopkins.

BACKGROUND: Gender-affirming care, including surgery, has gained more attention recently as third-party payers increasingly recognize that care to address gender dysphoria is medically necessary. As more patients are covered by insurance, they become able to access care, and transgender cultural competence is becoming recognized as a consideration for health care providers. A growing number of academic medical institutions are beginning to offer focused gender-affirming medical and surgical care. In 2017, Johns Hopkins Medicine launched its new Center for Transgender Health. In this context, history and its lessons are important to consider. We sought to evaluate the operation of the first multidisciplinary Gender Identity Clinic in the United States at the Johns Hopkins Hospital, which helped pioneer what was then called "sex reassignment surgery." METHODS: We evaluated the records of the medical archives of the Johns Hopkins University. RESULTS: We report data on the beginning, aim, process, outcomes of the clinic, and the reasons behind its closure. This work reveals the function of, and the successes and challenges faced by, this pioneering clinic based on the official records of the hospital and mail correspondence among the founders of the clinic. CONCLUSION: This is the first study that highlights the role of the Gender Identity Clinic in establishing gender affirmation surgery and reveals the reasons of its closure.

A assistência psiquiátrica a crianças anormais no Hospital Colônia Sant'Ana (Santa Catarina, Brasil, 1940) / Psychiatric care for abnormal children at the Hospital Colônia Sant'Ana (Santa Catarina, Brazil, 1940s)

Resumo O artigo apresenta pesquisa centrada na assistência psiquiátrica destinada a crianças e jovens ditos anormais em Santa Catarina. Inicialmente, analisa-se o surgimento da ideia de "criança perigosa", ou da categoria "menor", a partir da discussão de Foucault sobre a noção de "indivíduo perigoso", para então abordarem-se as dificuldades apresentadas na institucionalização da minoridade anormal em Santa Catarina. A seguir, são questionados os vínculos existentes entre as teorias que permitem identificar as crianças ditas anormais com as ideias eugênicas. Por fim, problematiza-se a dinâmica institucional que envolvia os menores ditos anormais internados no Hospital Colônia Sant'Ana na década de 1940.

Abstract Research into the psychiatric care for so-called abnormal children and youths in the Brazilian state of Santa Catarina is presented. The emergence of the idea of the "dangerous child" or the category of "minor" is discussed, drawing on Foucault's discussion of the notion of the "dangerous individual." This is followed by a presentation of the difficulties faced in the institutionalization of abnormal minors in the aforementioned state. The links between theories that enable so-called abnormal children to be identified and the ideas of eugenics are then questioned. Finally, the institutional dynamics involving so-called abnormal children admitted to the Hospital Colônia Sant'Ana in the 1940s are scrutinized.

[Diets and social inequality in the Spanish nutritional transition: the Hospital Provincial of Valencia and the hospital Sant Jaume of Olot, 1900-1936]. / Dietas y desigualdad social en la transición nutricional española: el Hospital Provincial de Valencia y el Hospital Sant Jaume de Olot; 1900-1936.

INTRODUCTION: studies about the Nutritional Transition in Spain (NTS) until the mid-20th century are based on direct, and heavily aggregated, consumption estimates, a methodology that obscures important aspects of this process. OBJECTIVE: to show the new possibilities of study opened by the analysis of hospital diets and to suggest new NTS indicators based on the menus provided by the Hospital Provincial in Valencia (HPV) and the Hospital Sant Jaume in Olot (HSJO), between 1900 and 1936. METHOD: we have calculated food and nutrient consumption among patients and hospital staff as well as among different groups of the population, and compared the results thus obtained with those calculated for the whole of Spain in the previous article in this supplement. RESULTS: hospital menus contributed to disseminate certain strategic foodstuffs for the NTS: milk, eggs and fresh meat first, and fish, vegetables and fruit later. The public dissemination of these foodstuffs was, however, uneven, and deficits in the intake of micro- and macro-nutrients intake decreased at different paces, according to social group. CONCLUSIONS: hospital diets confirm that nutrition in Spain improved in the decades that preceded the Civil War, as well as the pioneering role that sanitary institutions played in this process. The data also suggests that the process operated at different paces in the reduction of deficits in the intake of certain nutrients according to age groups and socio-economic status.

Introducción: los estudios sobre la transición nutricional española (TNE) hasta mediados del siglo XX se basaban en estimaciones indirectas y muy agregadas del consumo que no permiten conocer aspectos importantes de aquel proceso.Objetivo: mostrar las nuevas posibilidades de estudio que proporcionan las dietas hospitalarias y proponer nuevos indicadores de la TNE a partir de las estimadas en el Hospital Provincial de Valencia (HPV) y en el Hospital Sant Jaume de Olot (HSJO) entre 1900 y 1936.Método: calculamos el consumo de alimentos y nutrientes de pacientes y empleados en aquellos hospitales y en diferentes subgrupos de población del primero. Contrastamos nuestros resultados con los obtenidos para España en el artículo anterior de este suplemento.Resultados: las dietas hospitalarias contribuyeron a difundir alimentos estratégicos de la TNE: primero, leche, huevos y carne fresca, y después, pescado fresco, verduras y frutas. La difusión de estos alimentos, sin embargo, fue desigual entre la población y no redujo con la misma intensidad los déficits en la ingesta de macronutrientes y micronutrientes.Conclusiones: las dietas hospitalarias confirman la mejora del estado nutricional de la población española en las décadas anteriores a la Guerra Civil y el papel pionero que tuvieron las instituciones sanitarias en este proceso. No obstante, también muestran diferentes cronologías en la reducción de los déficits de importantes nutrientes entre grupos de edad y estatus socioeconómico.