Covid-19 y gripe de 1918-1919: paralelos históricos, preguntas y respuestas / Covid-19 and the 1918-1919 influenza: historical parallels, questions and answers

Resumen El desarrollo de la pandemia de la covid-19 ha motivado un renovado interés por la gripe de 1918-1919 para buscar elementos que facilitaran la comprensión de la experiencia presente, pero también como oportunidad para reevaluar la grave crisis sanitaria del siglo XX a la luz de lo que estamos viviendo. En este contexto y con ese objetivo se inserta esta reflexión histórica sobre estos dos fenómenos pandémicos, que muestra los paralelismos existentes y la necesidad de una toma de conciencia de que nuestro modelo de sociedad está en crisis y se requiere una transformación profunda.

Abstract The rise of the covid-19 pandemic has led to renewed interest in the 1918-1919 influenza in search of aspects that might help us understand the current situation, but also as an opportunity to re-evaluate the serious twentieth-century health crisis in light of what we are experiencing now. In this context and with that goal, this historical reflection shows the parallels that exist and the need for a realization that our model of society is undergoing a crisis and requires profound transformation.

Florence Nightingale e a arte de enfermagem: texto e contexto da Inglaterra Vitoriana / Florence Nightingale y el arte de la enfermería: texto y contexto de la Inglaterra Victoriana / Florence Nightingale and the art of nursing: text and context of Victorian England

Resumo Objetivo refletir sobre a figura pública de Florence Nightingale, suas realizações, Reforma Sanitária e a criação da Escola de Enfermeiras, e compreender o nascimento da enfermagem como profissão. Método partiu-se da literatura de um quadro das pressões sociais que agiam sobre o comportamento individual de Florence Nightingale e dos marcos divisórios aparentes, que entendemos como a densidade das relações sócio-históricas, e o seu tempo social. Análise sócio-histórica da história de vida de Florence Nightingale e da literatura social de Charles Dickens. O marco temporal compreendeu da promulgação da New Poor Law (1.834) à revogação (1.601). Resultados Florence Nightingale foi uma mulher adiante do seu tempo que, contrariando as teorias do Darwinismo social de sua época, criou a profissão da enfermeira, e produziu uma clivagem na profissão definindo-a como ciência e arte. Conclusão e implicações para a enfermagem ao criar a figura emblemática da Dama da Lâmpada, Florence Nightingale gravou no cuidado de enfermagem, o zelo, o desvelo e a compaixão, aqui entendida como empatia e piedade com o sofrimento do outro acompanhada do desejo de minorá-lo, uma participação espiritual na dor do outro.

Resumen Objetivo reflexionar sobre la figura pública de Florence Nightingale, sus logros, Reforma Sanitaria y la creación de la Escuela de Enfermeras, y comprender el nacimiento de la enfermería como profesión. Método se partió de la literatura de un cuadro de las presiones sociales sobre el comportamiento individual de Florence Nightingale y de los marcos divisorios aparentes que se entiende como la densidad de las relaciones socio histórico y su tiempo social. Análisis socio histórico de la historia de vida de Florence Nightingale y de la literatura social de Charles Dickens. El marco temporal se comprendió entre la promulgación del New Poor Law en 1834 y su revocación promulgada en 1601. Resultados Florence Nightingale fue una mujer adelante a su tiempo que, contrariando las teorías del Darwinismo social de su época, creó la profesión de enfermera, y produjo una mirada embrionaria en la profesión definiéndola como ciencia y arte. Conclusión e implicaciones para la enfermería al crear la figura emblemática de la Dama de la Lámpara, Florence Nightingale registró en el cuidado de enfermería, el celo, el cuidado y la compasión, entendido aquí como empatía y piedad con el sufrimiento del otro acompañado del deseo de una disminución, una participación espiritual en el dolor del otro.

Abstract Objective to reflect on Florence Nightingale's public figure, her achievements, Health Care Reform and the creation of the School for Nurses, and understand the birth of nursing as a profession. Method a framework of the social pressures acting on Florence Nightingale's individual behavior and the apparent dividing marks, which we understand as the density of socio-historical relations, and her social time, was drawn from the literature. This is a socio-historical analysis of Florence Nightingale's life story and Charles Dickens' social literature. The time frame spanned from the enactment of the New Poor Law (1834) to the repeal (1601). Results Florence Nightingale was a woman ahead of her time who, going against the theories of social Darwinism of her time, created the nurse profession, and produced a divide in the profession by defining it as science and art. Conclusion and implications for nursing by creating the emblematic figure of the Lady of the Lamp, Florence Nightingale engraved in nursing care, zeal, devotion, and compassion, here understood as empathy and pity for the suffering of others accompanied by the desire to alleviate it, a spiritual participation in the pain of others.

Higiene como prática individual e como instrumento de Estado / Hygiene as individual practice and as an instrument of the State

Resumo O estudo esboça algumas compreensões sobre a palavra "higiene". A partir do Renascimento, a ideia advinda da Grécia Antiga voltou a ser trabalhada, primeiramente como método para uma organização dietética e moral da vida que visava ao seu prolongamento. De uma espécie de cuidado de si, transformou-se em conceito de governança, cujo objetivo era o prolongamento da vida dos súditos/cidadãos. O debate teórico sobre o que era higiene pública mostra sua faceta eminentemente política: não apenas era um ramo da economia política, mas também eram analisadas as propostas dos higienistas de acordo com seu maior ou menor impacto na política. A batalha político-científica resultou na vitória de certas compreensões de ação estatal, e no esquecimento e na negligência de outras.

Abstract This study outlines some understandings of the word "hygiene." The notion that originated in ancient Greece first began to be adopted as a system of diet and morals to prolong the lifespan. From a type of self-care, this idea transformed into a concept of governance to extend the lives of subject-citizens. The theoretical debate about what public hygiene used to be shows its eminently political side: not only was hygiene a branch of the political economy, the ideas of hygienists were also analyzed as to the degree of impact they had on policy. After political and scientific battles, certain understandings of government action emerged victorious, while others were forgotten and neglected.

Protomedicatos y lazaretos como instituciones de control de la higiene pública en Chile entre 1879 y 1920 / Colleges of royal physicians and isolation hospitals to control public hygiene in Chile from 1879 to 1920

El presente artículo indaga la aparición de dos instituciones de control de la higiene pública en Chile entre los años 1879 y 1920: los protomedicatos y lazaretos. El objeto de estudio utiliza como caso la presencia de la viruela en La Araucanía. Se abordan las características y contexto que adquirió la instalación de estos dispositivos que permitieron al Estado de Chile operacionalizar el asunto de la higiene pública, lo que interpeló a los profesionales de la salud para avanzar a mayores niveles de perfeccionamiento del ejercicio profesional de la medicina. El Estado liberal positivista de fines de siglo XIX comprendió que el tema de la higiene no era solamente una cuestión de responsabilidad individual, sino que tenía una dimensión social, pública y medio ambiental. No sólo había personas que eran higiénicas, sino también ambientes higiénicos y antihigiénicos. Por tanto, se estudia la higiene, el tribunal del protomedicato, la hoja sanitaria, lazaretos, médicos y vacunadores; quienes estuvieron en permanente tensión con las autoridades del gobierno central debido a los insuficientes recursos proporcionados por el Estado para la atención de los enfermos contagiados con viruela. El estudio se orienta desde una metodología cualitativa con un diseño historiográfico con alcances descriptivos densos. Se han utilizado fuentes primarias y secundarias disponibles en archivos en Chile y Alemania. Los resultados evidencian que la presencia de viruela apareció violentamente en el centro sur de Chile en la segunda mitad del siglo XIX y permaneció en la Araucanía hasta la primera mitad del siglo XX. La violencia con que se desarrolló la viruela generó miedo e incertidumbre afectando a personas de diferentes clases sociales, y tuvo como una de sus causas principales las precarias condiciones de salubridad de la población.

This article investigates the emergence of two institutions for the control of public hygiene in Chile between 1879 and 1920: colleges of royal physicians and isolation hospitals using the case of smallpox in La Araucanía, a region located in the South of Chile. We cover the characteristics and context of these institutions that allowed the State of Chile to address the problems of public hygiene and to prompt health professionals to professionalize the practice of medicine. The liberal positivist state of the late nineteenth century understood that the issue of hygiene was not only a matter of individual responsibility but had a social, public, and environmental dimension. People practiced hygiene alongside the existence of hygienic and anti-hygienic environments. Therefore, hygiene, the royal colleges of physicians, health records, isolation hospitals, doctors, and vaccinators are studied. All of these components of the health care system of the time were in permanent tension with the central government authorities due to the insufficient resources provided by the state for the care of infected patients with smallpox. The study follows a qualitative methodology with a descriptive historiographic design. We used archival primary and secondary sources available in Chile and Germany. The results show that the presence of smallpox appeared ferociously in South-Central Chile in the second half of the 19th century and remained in La Araucanía until the first half of the 20th century. The extent to which smallpox spread, spawning fear and insecurity in people of different social classes, had as one of its leading causes the precarious conditions of health and hygiene of the population.

La ética y la medicina social: la perspectiva de Michel Foucault / Ethics and social medicine: Michel Foucault's perspective

Resumen La preocupación de Michel Foucault por la medicina, su historia y su impacto en la sociedad, es una constante en su obra. El objetivo de este trabajo es contrastar el contenido de las conferencias que Foucault impartió en Río de Janeiro, en octubre de 1974, con los materiales preparatorios de las mismas que forman parte de los fondos adquiridos por la Biblioteca Nacional de Francia. Una de las cuestiones clave en dichas conferencias es la relación entre la ética y la medicina social contemporánea. Esa cuestión, analizada desde el punto de vista de Foucault, constituye el trasfondo e interés último del presente trabajo.

Abstract Michel Foucault's preoccupation with medicine, its history and its impact on society, is a constant in his work. The goal of this study is to contrast the content of the lectures Foucault gave in Rio de Janeiro, in October 1974, with the preparatory notes for them which are part of the archival holdings acquired by the National Library of France. One of the key questions in those lectures is the relationship between ethics and contemporary social medicine. This question, analyzed from Foucault's point of view, constitutes the background and ultimate interest of this article.

De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX / From "culprits" to "victims": the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century

RESUMEN Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

ABSTRACT From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Viviendo entre miasmas: en torno a la cuestión social, Chile de 1880 a 1920 / Living in the midst of miasmas: the social issue of Chile between 1880 and 1920

INTRODUCCIÓN: La cuestión social tiene su origen en la acumulación de problemas sociales, producto de los movimientos migratorios del campo-ciudad y zonas mineras. Las ciudades no contaban con las condiciones higiénicas necesarias para recibir a los migrantes, lo cual provocó problemas de vivienda y salubridad entre la población. OBJETIVO: Analizar los problemas de vivienda, higiene y salubridad en Chile entre los años 1880 y 1920. MÉTODO: Es un estudio cualitativo, analítico e interpretativo, se utilizaron fuentes primarias para las categorías de análisis en torno a la vivienda, higiene y salubridad de las siguientes ciudades de Chile: Santiago, Valparaíso, Concepción y Chillán. Resultados: La modernización económica permitió el desarrollo de obras públicas en las principales ciudades de Chile, pero también experimentaron un fenómeno demográfico conocido como migración campo - ciudad, con un crecimiento urbano nunca visto. CONCLUSIÓN: En las ciudades se presentaron problemas de vivienda, higiene y salubridad para los sectores populares urbanos. El Estado, a través de leyes, reguló las condiciones de los conventillos y espacios públicos con el propósito de mitigar enfermedades y vicios de la población.

INTRODUCTION: The social issue in Chile stems from an accumulation of social problems resulting from the migratory movements of the countryside-city and mining areas. The cities did not have the hygienic conditions necessary to receive migrants, which caused housing and health problems within the population. OBJECTIVE: To analyze the problems of housing, hygiene, and health in Chile between 1880-1920. METHOD: We conduct a qualitative, analytical, and interpretive study using primary sources for the categories of analysis around housing, hygiene, and health of the following cities in Chile: Santiago, Valparaíso, Concepción and Chillán. Results: The economic modernization led to the development of public works in the main cities of Chile, which also experienced a demographic phenomenon known as field-city migration, with urban growth never before seen. In the cities, there were problems of housing, hygiene, and health for the popular urban sectors. CONCLUSION: The State passed laws to regulate the conditions of the conventillos and public spaces to mitigate diseases and vices of the population.

[Eloísa Díaz: between medicine, psychology and education]. / Eloísa Díaz Inzunza: entre la medicina, la psicología y la educación.

Eloísa Díaz Insunza, the first Latin American female physician, completed her studies in Medicine and Surgery at the University of Chile in 1887 and worked a large part of her life as Medical Inspector of Public Schools of Santiago, Chile. In this article, the focus is placed on her "Test Memorandum" (1886) and her first Reports to the Ministry of Public Education (1899-1905), to appreciate the hygienist perspective that characterizes her proposals. We describe her intervention project that sought to integrate medical practice with psychology and education, to solve a social problem such as the degeneration of the Chilean race.

Eloísa Díaz Inzunza: entre la medicina, la psicología y la educación / Eloísa Díaz: between medicine, psychology and education

Eloísa Díaz Insunza, the first Latin American female physician, completed her studies in Medicine and Surgery at the University of Chile in 1887 and worked a large part of her life as Medical Inspector of Public Schools of Santiago, Chile. In this article, the focus is placed on her "Test Memorandum" (1886) and her first Reports to the Ministry of Public Education (1899-1905), to appreciate the hygienist perspective that characterizes her proposals. We describe her intervention project that sought to integrate medical practice with psychology and education, to solve a social problem such as the degeneration of the Chilean race.

Salud pública, espacio urbano y exclusión social en la España de posguerra: la epidemia de tifus exantemático en la ciudad de Valencia, 1941-1943 / Public health, urban space and social exclusion in postwar Spain: the exanthematic typhus epidemic in the city of Valencia, 1941-1943

Resumen Tras la Guerra Civil, las deficientes condiciones higiénico-dietéticas de gran parte de la población española favorecieron la aparición de enfermedades epidémicas. El tifus exantemático puso en jaque a las autoridades sanitarias, especialmente durante la primavera de 1941, cuando el ciclo epidemiológico de la enfermedad y la falta de infraestructuras se aliaron para provocar una grave crisis sanitaria. El régimen franquista, consciente de que esta situación dificultaba su legitimación, no dudó en utilizar la exclusión social como parte de su política sanitaria contra esta epidemia. El artículo analiza en profundidad el caso de Valencia, una ciudad que durante la guerra, por hallarse en la retaguardia republicana, había acogido sucesivas oleadas de refugiados a medida que avanzaban las tropas franquistas.

Abstract After the Spanish Civil War, poor hygiene and nutritional deficiencies among a large part of Spain's population contributed to the rise of epidemic diseases. Exanthematic typhus posed a challenge to the health authorities, especially during the spring of 1941, when the epidemiological cycle of the disease and the lack of infrastructures combined to create a serious health crisis. The Franco regime, aware that this situation posed a threat to its legitimacy, promptly used social exclusion as part of its health policy against the epidemic. This article provides an in-depth analysis of the case of Valencia, a city that was behind Republican lines during the war, and therefore received successive waves of refugees as Franco's troops advanced.

Como manter saudáveis nossos imigrantes: preceitos higienistas na constituição da Hospedaria de Imigrantes da Ilha das Flores / Keeping our immigrants healthy: hygienist doctrine in the Hospedaria de Imigrantes da Ilha das Flores

Resumo A criação da Hospedaria de Imigrantes da Ilha das Flores, em 1883, esteve de acordo com os preceitos higienistas vigentes na época. O isolamento de imigrantes na costa leste da baía de Guanabara ocorreu em virtude das epidemias de febre amarela que retornavam à capital do Império todo verão, desde 1849-1850. Higienistas atribuíam a doença à precária condição sanitária da cidade do Rio de Janeiro, que propiciava a multiplicação do germe e infeccionava a atmosfera. Na medida em que os médicos reinterpretavam a doença à luz da teoria pasteuriana, foram sendo adotados novos procedimentos para a recepção de imigrantes, alterando a estrutura e o funcionamento da Hospedaria da Ilha das Flores.

Abstract The Hospedaria de Imigrantes (Immigrant Lodgings) da Ilha das Flores was established in 1883 in accordance with the hygienist thinking of the time. Immigrants were isolated on the east coast of Guanabara Bay because of the epidemics of yellow fever which returned to the Imperial capital every summer since 1849-1850. Hygienists attributed the disease to the precarious health conditions in the city of Rio de Janeiro, which enabled germs to multiply and infect the atmosphere. As physicians reinterpreted the disease in light of Pasteurian theory, new procedures were adopted to receive immigrants, changing the structure and function of the facility on Ilha das Flores.

State Hygiene School as a Department of Education in the National Institute of Hygiene in Warsaw

The article presents the history of the establishment of the State School of Hygiene (PSH) in Poland after the First World War. The difficulties faced by the public health service in a country destroyed by war and created after the reunification of the lands, which for over 150 years remained under the control of three powers, were pointed out. It discusses how the foundations of modern teaching in the field of public health were created in the National Institute of Hygiene (PZH) in Warsaw, an institution to which the Ministry of Public Health entrusted tasks related to health education in the country. The State School of Hygiene was built by the Polish Government with a significant financial contribution from the John Davison Rockefeller Foundation. The official opening ceremony took place on 20 April 1926. The State School of Hygiene in Warsaw was the first such school in Europe. It educated professional staff for the health service in Poland, especially sanitary physicians, sanitary inspectors, nurses and staff to work in health offices. The importance and scope of influence of the State School of Hygiene as the Department of Education in the National Institute of Hygiene was constantly increasing, as evidenced by the number of students (about 800 per year) participating in courses, especially in the first years after its establishment. By the end of 1935, 6,389 students had completed the courses, including 1,900 physicians. Apart from the teaching activities, the State School of Hygiene also carried out research work. The State School of Hygiene was supported by the Rockefeller Foundation, which funded scholarships for the employees of the National Institute of Hygiene at university centers in the USA

Entre a ciência e a política: ensino, atendimento e pesquisa no Instituto de Higiene de São Paulo (1916-1951) / Between science and politics teaching, healthcare and research at Instituto de Higiene de São Paulo (1916-1951)

Esta pesquisa mostra o caminho percorrido pelo Instituto de Higiene de São Paulo para a sua consolidação no campo científico e político, entre 1916 e 1951. O personagem principal é o seu 3º diretor: o farmacêutico e médico Geraldo Horácio de Paula Souza, que teve destacada atuação nas negociações com a Fundação Rockefeller para a concretização do Instituto e, no gerenciamento daquele que se transformaria na Faculdade de Higiene e Saúde Pública da Universidade de São Paulo em 1945. A periodização é delimitada pelos primeiros acordos entre a Fundação Rockefeller e a Faculdade de Medicina e Cirurgia de São Paulo (1916) para a instalação do laboratório de higiene e a morte precoce de Paula Souza (1951), encerrando seus quase trinta anos à frente do antigo Instituto de Higiene. Esta consolidação se deu em três frentes de atuação: o ensino da higiene, a pesquisa científica na área e o atendimento à população, campos que deixaram legados para a saúde pública brasileira.

This research depicts the path taken by Instituto de Higiene de São Paulo, between 1916 and 1951, to consolidate itself in the scientific and political field. Our main character is the Institute's third director: Geraldo Horácio de Paula Souza. Being a pharmacist and a doctor, he played a major role negotiating with the Rockefeller Foundation for the consolidation of the Institute in Brazil, and also in the management of what would become the Faculdade de Higiene e Saúde Pública of the Universidade de São Paulo, in 1945. The timeline of our research is defined by the first agreements between the Rockefeller Foundation and the Faculdade de Medicina e Cirurgia de São Paulo (1916), for the creation of the laboratory of hygiene, and Paula Souzas's early death (1951) after leading the former Instituto de Higiene for almost thirty years. Such consolidation had three main areas of action: the teaching of hygiene, the scientific research on this field and providing healthcare for the population. Those three main areas left important legacies for the Brazilian public health.

O higienismo no campo da Educação Física: estudos históricos / Hygiene in the field of Physical Education: Historical Studies / El higienismo en el campo de la Educación Física: estudios históricos

Com intuito de contribuir para o conhecimento e a produção científica sobre o higienismo e as teorias de assepsia nas áreas da saúde e das ciências humanas, o presente artigo tem como objetivo verificar como estão configurados os estudos históricos sobre o movimento higiênico no campo da Educação Física. Os textos foram localizados e coletados nos sites eletrônicos da CAPES e SciELO, os quais têm contribuído para a divulgação do conhecimento científico em diversas áreas de pesquisa. Foi revelado um total de 141 artigos, dos quais 104 (74%) eram pesquisas históricas e os demais 37 (26%) são gerais. Do total, apenas 30 (21,27%) possuíam ligação como campo da Educação Física, 21 (70%) pertencem à temática histórica e os restante 9 (30%) generalizam temáticas com o campo em questão. Conclui-se que, apesar dos discursos higiênicos estarem historicamente presentes na legitimação da Educação Física, este é ainda pouco explorado na área.

In order to contribute to the knowledge and scientific production on Hygiene and asepsis theories in the areas of Health and Human Sciences, this article aims to verify how the historical studies about the hygiene movement in the field of Physical Education are configured. The texts were located and collected on the electronic websites of CAPES and SciELO, which have contributed to the dissemination of scientific knowledge in several research areas. It was reveled a total of 141 articles, of which 104 (74%) were historical research and the other 37 (26%) are general. From the total, just 30 (21.27%) were connect the Physical Education field, 21 (70%) belong to the historical theme and the rest 9 (30%) generalize thematic with the field in question. It is concluded that, although the Hygienic discourses are historically present in the legitimation of Physical Education, this is still a few explored in the area.

Para contribuir al conocimiento y la producción científica en el Higienismo y las teorías de la asepsia en las áreas de Ciencias de la Salud y Humanas, este artículo tiene como objetivo determinar cómo los estudios históricos sobre el movimiento hihienista están configurados en el campo de la educación física. Los textos fueran localizados y recogidos en los sitios electrónicos que han contribuido a la difusión de los conocimientos científicos en diversas áreas. Se reveló un total de 141 artículos, de los cuales 104 (74%) fueron la investigación histórica. Del total, sólo el 30 (21,27%) tenían conexión con el campo de la Educación Física, 21 (70%) pertenecen al tema histórico y el restante 9 (30%) generalizar los problemas con el campo en cuestión. Por lo tanto, a pesar de los discursos higienistas son históricamente presente en la legitimación de la educación física, esto sigue siendo un área relativamente inexplorada.

Ideario salubrista de Fidel Castro como continuidad del legado martiano a la medicina revolucionaria cubana / The health care ideology of Fidel Castro as a continuity of José Martí legacy in Cuban revolutionary medicine

El trabajo sustenta la tesis de que las ideas del Apóstol constituyen un verdadero legado histórico, sirviendo de referente a la Generación del Centenario para sentar las bases de los postulados esenciales que rigen el Sistema de Salud en la Cuba revolucionaria: acceso, equidad y solidaridad de la medicina cubana, lo que representa un logro inigualable y un orgullo para todos los cubanos. El mismo se propone exponer alguna de las aristas del pensamiento revolucionario de José Martí acerca de la Medicina y la Salud, así como su influencia en el ideario fidelista, tan importante en la transformación del Sistema Nacional de Salud en la Cuba revolucionaria y resalta la decisiva visión y acción estratégica del líder histórico de la Revolución cubana en esta importante esfera, inspirado en la continuidad del pensamiento martiano, constituyendo un sentido homenaje al eterno Comandante en Jefe Fidel Castro Ruz (AU).

This term sustains the thesis that the Apostle´s ideas are a true historical legacy, serving as a referent for the Generation of the Centenary to set the basis of the essential postulates ruling the Health System in the revolutionary Cuba: Cuban medicine access, equity and solidarity, representing an exceptional achievement and a proud for all the Cuban people. The purpose was exposing some of the aspects of José Marti's revolutionary thoughts on Medicine and Health, and also its influence on Fidel Castro ideology, so important in the transformation of the National Health System in the revolutionary Cuba. It is highlighted the decisive action and strategic vision of the Cuban Revolution historical leader in this important sphere inspired in the continuity of Jose Marti´s thoughts. Serve it as a deep homage to eternal Comandante en Jefe Fidel Castro Ruz (AU).

Higienismo en el Perú del siglo XIX. Sebastián Lorente y el catecismo de higiene / Orthopathy in 19th century Peru: Sebastián Lorente and the Catechism of hygiene

RESUMEN El higienismo se manifiesta en el Perú del siglo XIX de diversas maneras y en distintas esferas que trascienden la actividad de los médicos. Sebastián Lorente, médico y educador promovió la educación higiénica de los escolares a través de la publicación de un Catecismo de higiene que tuvo múltiples ediciones en la segunda mitad del siglo. La estructura y contenidos del "Catecismo" se vincula a tradiciones médicas europeas como la interpretación miasmática de la enfermedad, pero también locales como la topografía médica de Hipólito Unanue, ambas en el marco de una visión de imposición de comportamientos "saludables" a la población, que lo asimilan a la obra de Johan Peter Frank.

ABSTRACT Orthopathy appeared in Peru in the 19th century in various guises and different spheres that transcended the activities of doctors. Sebastián Lorente, a doctor and educator, promoted hygiene education for schoolchildren through the publication of a Catechism of Hygiene, which went through multiple editions in the second half of the century. The structure and content of the Catechism is linked to European medical traditions such as the miasmatic interpretation of diseases, but also to local traditions like the medical topography of Hipólito Unanue, both of which had a vision of imposing "healthy" behaviors on the population, which assimilated the work of Johann Peter Frank.