[The Bernardino Álvarez Farm Hospital and Farm School: antecedents to Instituto Nacional de Neurología y Neurocirugía]. / El Hospital Granja y la Escuela Granja Bernardino Álvarez: antecedentes del Instituto Nacional de Neurología y Neurocirugía.

By 1960, México's Manicomio General (General Asylum) could no longer fulfill the functions for which it was created so implementation of the so-called Castañeda Operation began, an initiative designed to close down and relocate psychiatric patients to other institutions. At that time, Dr. Manuel Velasco-Suárez was in charge of the General Direction of Neurology, Mental Health and Rehabilitation, and planned to create the Institute of Neurology on a site he already possessed for its construction. The Asylum was a dependency of the aforementioned Direction and Velasco- Suárez decided that some patients at the Castañeda could be moved to the old hacienda house that stood on that terrain. Thus was born the Bernardino Álvarez Farm Hospital. A year later, in 1961, the Farm School for the Weak-Minded, also named Bernardino Álvarez was established there as well. This paper examines the history of these two institutions as antecedents to the Instituto Nacional de Neurología y Neurocirugía.

María Cristina García-Sancho y Álvarez-Tostado: Primera neurocirujana en Latinoamérica / María Cristina García-Sancho y Álvarez-Tostado: first female neurosurgeon in Latin America

Neurosurgery is one of the most complex branches of medicine. In most countries, a trained physician requires a minimum of five years of additional preparation to become a neurosurgeon. Though in modern times women have entered almost every area of medicine, the field of neurosurgery continues to be clearly male-dominated. In 2009, for example, the National Institute of Neurology and Neurosurgery, the most important institution in Mexico for the training of neurologists and neurosurgeons, had only one female physician registered to become a neurosurgeon, while in previous years the presence of women was almost null. Given this background, a study of the first woman neurosurgeon in Mexico and, in fact, all of Latin America, constitutes an attractive topic. This woman is María Cristina García-Sancho y Álvarez-Tostado, who began her brilliant career in the 1940's. García-Sancho y Álvarez-Tostado has a most dignified and pleasant demeanor, with expressive blue eyes and an appearance that belies her real age. Tall and thin, she possesses a natural beauty. Photographs show a very attractive woman. María Cristina García-Sancho y Álvarez-Tostado de Penichet (her married name) was born on May 22nd 1919 in Guadalajara, Jalisco. Her parents were Luis García-Sancho and Ana Álvarez-Tostado Robledo. While still a young girl, her family had to move to Mexico City in search of a better future because of the difficult economic situation that reined in Guadalajara after the Mexican Revolution. The young María Cristina studied high school at the Colegio Motolinía and was then admitted to the School of Medicine at the UNAM (National Autonomous University of Mexico), where she belonged to the 1941-1947 generation of students, one made up of 85 women and 850 men. A brilliant student, her interest in neurology began almost from her first day at medical school. It was there that she began to really appreciate the wondrous nature of the human body in general and, above all, of the brain, and came to see the understanding of that organ as a true challenge. She graduated in 1947 with a thesis entitled The Effects of Cephalic-Cranial Trauma (La secuela del traumatismo encéfalo cráneano). Her thesis adviser was Mariano Vázquez, and her brilliant defense won a honorable mention. She went on to study her Master's and Ph.D. degrees in neurosurgery from 1949 to 1951, under the direction of Alfonso Asenjo Gómez, a prestigious, internationally known neurosurgeon at the Institute of Neurosurgery and Cerebral Research in Santiago de Chile (Instituto de Neurocirugía e Investigaciones Cerebrales). At that time, this institute was an obligatory reference in everything related to neuroscience, especially clinical medicine and surgery. This Chilean physician was a magnificent teacher and their academic relationship developed later into a solid friendship that lasted until his death. During her training, García-Sancho took courses on neurology, neuropathology, neuro-otology, neuro-ofthalmology, and neuroradiology. At the conclusion of her studies, she had acquired the knowledge and experience needed to perform neurosurgery. Once again, the Chilean government offered a fellowship for her to continue her studies, this time in Europe. So, she spent three months in Germany with Wilhelm Tönnis and Joachim Zülch, and visited several neurosurgery clinics, including the Hôtel-Dieu in Paris with Jacques Le Beau and Jean Tavernier, and Madrid's Institute of Neurosurgery with Sixto Obrador Alcalde. In Portugal, she visited the clinic of Egas Moniz, the inventor of angiography, at the Department of Neurology from the Coimbra University. In all, she was in Europe for over a year. After that period overseas, she returned to Mexico, where she first joined the staff of the La Raza Hospital for a few months. However, she was soon named to the position of Head of Neurosurgery Services at the National Institute of Oncology, where she attended from 1952 more than 63 000 patients and performed operations for pain control such as peripheral blocks, rhizotomies, cordotomies, topectomies and medial, radiotherapeutic and physical treatments. The maturing and consolidation of the Neurosurgery Service under her guidance soon led to publications, congresses, teaching, and the supervision of aspiring neurosurgeons, including such important figures as Mario Echegaray Naveda, Manuel Mandujano, Estela Mandujano, José Carlos Palacios Márquez, María Teresa Ramírez Ugalde, Ramón Cerón Uribe, C. Freigó, Manuel Montoya, Miguel Ángel Hernández Absalón, José Gutiérrez Cabrera, Amelia Cabrera, and Alfonso Peña Torres, the latter four at the Institute of Neurosurgery in Santiago. The experience she acquired in several surgical techniques designed to relieve pain and, more fundamentally, her interest in this topic, led García-Sancho to improve the cordotomy procedure while working in the United States with Irving Cooper, a distinguished neurosurgeon whose main interest was functional neurosurgery. Cordotomy is a procedure used in cases of intolerable pain that resist all other kinds of treatment. It involves sectioning the anterolateral cord of the medulla. Perfecting this technique was just one of García-Sancho's achievements and contributions to Mexican neurosurgery. In fact, the technique is known as «the García-Sancho One-step Bilateral Cordotomy¼, and she used it in more than 1600 cases at the National Institute of Oncology and at the Women's Hospital in cases of cancer. Earlier, the cordotomy was a two-step procedure, but the variant that García-Sancho introduced consisted in cutting the sensitive roots of the medulla in just one intervention: after identifying the anterior roots, a cut is made on the posterior part in the posteroanterior direction in the space between the exit of the posterior root and the emergence of the anterior root in the medulla. García-Sancho's studies of pain and her extensive experience in that field led her to write the book Pain: Diagnosis and Treatment (Dolor, diagnóstico y tratamiento; 1974), which she dedicated to her husband and daughter, and in which she explains such topics as the anatomical channels of pain, its origin, and pain in oncologic processes. In addition to this book, she has published articles in national and international journals, some of them in Neurocirugía, a journal founded by Asenjo. Though García-Sancho is known mainly for her contributions to the understanding and surgical treatment of pain, she is also well-versed and skilled in the use of arteriography, a technique she learned in Portugal at the service of its discoverer, Moniz. García-Sancho also successfully combined her professional career with family life. In April 1954, she married Manuel Penichet, an industrialist, and they had a daughter, María Cristina Penichet García-Sancho, now a practicing psychotherapist. Today, García-Sancho, a widow since 1999, also enjoys the love and achievements of her granddaughter, a lawyer, and grandson, a business administrator. Also worth mentioning is that she studied a second career: Law at the Women's University of Mexico, where she graduated in 1989 with a thesis entitled Current Laws on the Problem of Insemination and in Vitro Fertilization (Las leyes actuales frente al problema de la inseminación y fertilización in vitro). She is also a member -in some cases a founder- of several national and international scientific societies. García-Sancho was not only Mexico's first female neurosurgeon, but also the first in Latin America. She stood out in an especially complex branch of medicine, one dominated by men. Moreover, she perfected a technique that renowned neurologists like Martín, Spiller, Froeser, Asenjo and Le Beau had been performing since 1912. Though her gender made it difficult for her to aspire to certain positions, her other professional activities gave her the intellectual satisfaction and maturity that are so evident in her demeanor.

La neurocirugía es una de las subdisciplinas más complejas de la medicina y pocas mujeres han incursionado en ella. Así pues, resulta muy atrayente estudiar a la primera neurocirujana mexicana y también de Latinoamérica, cuya labor brilló a partir de los años cuarenta del siglo XX. María Cristina García-Sancho y Álvarez-Tostado de Penichet, nació el 22 de mayo de 1919 en Guadalajara, Jalisco. Sus padres fueron los señores Luis García-Sancho y Ana Álvarez-Tostado Robledo. Por motivos económicos su familia emigró a la Ciudad de México en busca de un futuro mejor. María Cristina realizó los estudios preparatorios en el Colegio Motolinía y posteriormente ingresó a la Facultad de Medicina de la UNAM. Pertenece a la generación 1941-1947, que estaba formada por 85 mujeres y 850 hombres. Brillante estudiante, su interés por la neurología se inició desde su ingreso a la Escuela de Medicina. Entonces percibió lo maravilloso que es el cuerpo humano, pero sobre todo el cerebro, cuyo conocimiento consideraba un reto. En 1947 obtuvo el título con la tesis «La secuela del traumatismo encéfalo cráneano¼, dirigida por el doctor Mariano Vázquez y por cuya destacada defensa ganó mención honorífica. La doctora García-Sancho realizó la maestría y el doctorado en neurocirugía de 1949 a 1951, bajo la dirección del doctor Alfonso Asenjo Gómez, prestigioso neurocirujano de fama internacional, en el Instituto de Neurocirugía e Investigaciones Cerebrales en Santiago de Chile. En esa época, el Instituto era referencia obligada en lo relativo a las neurociencias, sobre todo en la clínica y la cirugía. El Gobierno de Chile la volvió a becar para continuar su preparación en Europa. En Alemania permanece durante tres meses con los doctores Wilhelm Tönnis y Joachim Zülch. En el Hôtel-Dieu de París estudió con Jacques le Beau y Jean Tavernier; en España con Sixto Obrador Alcalde, en el Instituto de Neurocirugía en Madrid, y en Portugal, en el servicio de Egas Moniz, donde aprendió la técnica de la arteriografía. En total permaneció un año más en Europa. A su regreso a México se incorporó por unos meses al Hospital «La Raza¼, del Instituto Mexicano del Seguro Social, y posteriormente ingresó como jefa del Servicio de Neurocirugía, en el Instituto Nacional de Cancerología, donde desde 1952 atendió más de 63 000 consultas y realizó múltiples y variadas operaciones para controlar el dolor. Su interés en el tema la llevó a mejorar la cordotomía en Estados Unidos, con Irving Cooper, distinguido neurocirujano. La cordotomía es la sección o corte del cordón anterolateral de la médula en casos de dolor intolerable y resistente a cualquier tratamiento. Su aportación a la neurocirugía mexicana es el perfeccionamiento que hizo a esta maniobra, la que se conoce como «Cordotomía bilateral en un solo tiempo, técnica García-Sancho¼. La autora empleó esta técnica en más de 1600 casos de cáncer en el Instituto Nacional de Cancerología y en el Hospital de la Mujer. El estudio y el dominio que tiene sobre el dolor dieron pie a que escribiera: «Dolor, diagnóstico y tratamiento¼ (1974). En abril de 1954 se casó con el industrial Manuel Penichet y tuvieron una hija, María Cristina Penichet García-Sancho, quien ejerce como psicoterapeuta. Es digno de enfatizar que estudió una segunda carrera, la de Derecho, en la Universidad Femenina de México, titulándose en 1989 con la tesis: «Las leyes actuales frente al problema de la inseminación y fertilización in vitro¼. La doctora María Cristina García-Sancho no sólo fue la primera neurocirujana en México, sino también en Latinoamérica. Sobresalió en una rama de la medicina particularmente compleja, de predominio masculino, y además perfeccionó una técnica que brillantes neurocirujanos practicaban desde 1912. La doctora es de trato muy fino y agradable, de expresivos ojos azules, representa una edad menor de la que realmente tiene. Alta y delgada, guarda una belleza natural. Las fotografías muestran una mujer sumamente atractiva. Su condición de género le dificultó acceder a ciertas posiciones, pero en otras actividades de su ejercicio profesional encontró la satisfacción intelectual y la madurez que son evidentes en su trato.

El Instituto de Neurocirugía e Investigaciones Cerebrales de Santiago de Chile y la primera neurocirujana en Latinoamérica / The Institute of Neurosurgery and Cerebral Research in Santiago de Chile and the first neurosurgeon woman in Latinamerica

La mexicana María Cristina García-Sancho de Penichet (1919- ) fue la primera neurocirujana en América Latina. Estudió medicina en una época en que la inserción de la mujer en esta disciplina todavía era baja y se decidió por una especialidad, inclusive difícil para los mismos hombres; la neurocirugía. Se preparó en este campo con uno de los grandes neurocirujanos de la época, Alfonso Asenjo Gómez (1906-1980) y en uno de los mejores lugares del mundo, el Instituto de Neurocirugía e Investigaciones Cerebrales en Santiago de Chile. Su aportación a la neurocirugía fue haber modificado el proceso quirúrgico de la cordotomía, operación para controlar el dolor y que tradicionalmente se hacía en dos tiempos. La doctora García-Sancho propuso realizarla en un solo paso.

María Cristina García-Sancho de Penichet (1919- ), a Mexican, was the first woman neurosurgeon in Latin America. She studied medicine at a time when women’s participation in medicine was limited, yet she chose specialization that was considered difficult even for men: neurosurgery. She trained in this discipline with one of the great neurosurgeons of the time, the Chilean Alfonso Asenjo Gómez (1906-1918), and at one of the most prestigious establishments in the world: the Institute of Neurosurgery and Cerebral Research in Santiago de Chile. Her main contribution to the field of neurology consisted in modifying the surgical procedure called cordotomy, an operation for pain control that traditionally required a two-step procedure, but which Dr. García-Sancho showed could be performed in just one step.

Salud y humanismo: medicina republicana / Health and Humanism: Republican Medicine

Es el resultado de un notable trabajo de investigación, compilación y análisis de las diferentes etapas por las que ha transitado la medicina mexicana. En este sentido debemos reconocer la invaluable labor de distinguidos investigadores, académicos y reconocidos universitarios, todos expertos en este campo, y que han colaborado con sus interesantes textos. Asimismo deseamos expresar nuestro agradecimiento a Laboratorios Bayer, cuya vocación promotora de la cultura médica queda una vez más demostrada con el libro Medicina republicana que presentamos en esta ocasión

La investigación biomédica en la segunda mitad del siglo XIX / Biomedical research in the second half of the XIX century

En México proliferaron sociedades, academias, revistas, museos, instituciones; lo que de cierta forma significó el reconocimiento a una comunidad, validar la actividad científica y su aceptación social. Había de mejorar las condiciones de higiene, fomentar la salud pública y combatir las enfermedades (AU)

[Women members of the Mexican National Academy of Medicine. An analysis of their membership and place in the medical elite]. / Las mujeres en la Academia Nacional de Medicina de México: análisis de su inserción y ubicación en la élite médica.

This article analyzes women's admission to Mexico's National Academy of Medicine (NAM) originally an all-male institution. We describe the demographic characteristics of female members of the NAM. By the year 2006, the NAM had 536 academic members, 62 of them were women. Data gathered included date of entry to the NAM, members' age at time of admission, current age, whether they had children and the field and or area to which they were assigned. We also analyzed membership to the "National System of Researchers" (Sistema Nacional de Investigadores, SNI). Women admitted to the NAM were all competitive scholars who planned their career choices, sought and achieved positions of power yet gender issues still determined their professional careers.

Las mujeres en la Academia Nacional de Medicina de México: análisis de su inserción y ubicación en la élite médica / Women members of the Mexican National Academy of Medicine: an analysis of their membership and place in the medical elite

Se analiza la inserción de la mujer en la Academia Nacional de Medicina de México (ANM), un ámbito originalmente masculino, y las características del grupo femenino. Hasta el año 2006, la ANM tenía 536 académicos, de los cuales 62 eran mujeres. Se investigó fecha de ingreso a la ANM y edad en ese momento, edad actual, si tenían hijos, el departamento y área donde se ubicaban y su pertenencia al Sistema Nacional de Investigadores (SNI). Se identificó que las académicas planean sus carreras, son competitivas, buscan y ocupan posiciones de poder, pero las cuestiones de género aún determinan sus decisiones profesionales.

This article analyzes women's admission to Mexico's National Academy of Medicine (NAM) originally an all-male institution. We describe the demographic characteristics of female members of the NAM. By the year 2006, the NAM had 536 academic members, 62 of them were women. Data gathered included date of entry to the NAM, members' age at time of admission, current age, whether they had children and the field and or area to which they were assigned. We also analyzed membership to the [quot ]National System of Researchers[quot ] (Sistema Nacional de Investigadores, SNI). Women admitted to the NAM were all competitive scholars who planned their career choices, sought and achieved positions of power yet gender issues still determined their professional careers.

Despertar de la medicina social en México; los establecimientos de beneficencia en el Porfiriato / Awakening of social medicine in Mexico: health care establishments during the Porfiriato

Se estudian las instituciones de beneficencia durante el Porfiriato, nombre con el que se conoció a la gestión presidencial de Porfirio Díaz. Por fuentes dispersas, se sabe que en esa época existían doce establecimientos que cubrían los servicios a la salud de la población en la ciudad de México.(AU)

II. Daniel Vergara Lope Escobar, una vida y una obra que se perdieron en la historia / II. Daniel Vergara Lope Escobar: Life and Opus Lost in History

Se destaca la vida y la obra del fisiólogo Daniel Vergara Lope, como uno de los pioneros de la ciencia médica mexicana. El doctor Vergara Lope fue el primero en describir los mecanismos fisiológicos de adaptación a la altura y su ciencia se distingue por permear un profundo sentimiento nacionalista. Las crisis históricas, sociales y personales que vivió, así como su personalidad compleja, fueron determinantes en el sitio mediocre que la historia le asignó.

This article focuses on the life and work of the Mexican physiologist Daniel Vergara Lope, a pioneer of Mexican medical science. Vergara Lope was the first to describe the physiologic mechanisms of adaptation to high elevations in a scientific opus that resounds with a profound sense of nationalism. The historical, social, and personal crises he experienced during his life and his own complex personality were determining factors in the mediocre status that history has assigned to him.

[Scientific controversy at the National Academy of Medicine: a view from history]. / La controversia científica en la Academia Nacional de Medicina: una visión desde la historia.

This essay deals with two scientific discussions that occurred at the National Academy of Medicine, one in the 19th century and the other, in the 20th century. Our goal was to emphasize that the National Academy of Medicine offers the space for scientific discussion related to medical problems.

The Mexican response to high altitudes in the 1890s: the case of a physician and his "magic mountain"

Modern criteria are used to analyse some of Dr. Daniel Vergara Lope Escobar`s experimental results. For almost thirty years, this doctor studied the bodies of his compatriots with the main objective of proving that they were not inferior just because they lived on Mexico`s high plateau. Accoding to European physiologists of the period, the low barometric pressure and high elevation of the area meant the the inhabitants breathed a kind of `rarified` air which was believed to have a lower oxygen concentration that caused physical lethargy and `cerebral` anaemia. When he began his research, Vergara Lope studied cardio-respiratory physiology, but he devoted the later years of his career mainly to the study of anthropometry. His intention was always the same, however: to prove that the Mexican race was not inferior because of the environment in which it lived.(AU)

Daniel Vergara Lope and Carlos Monge Medrano: two pioneers of high altitude medicine.

Daniel Vergara Lope from Mexico and Carlos Monge Medrano from Peru were brilliant scientists in their own countries. Both scientists studied high altitude physiology and defined the physiological and anatomical mechanisms of adaptation to high elevations. The Mexican physiologist proposed his ideas 40 years before his Peruvian counterpart. This paper studies the contribution of Vergara Lope and Monge Medrano to the understanding of high altitude medicine and proposes explanations of why history has given priority to Monge, whereas Vergara Lope is relegated to anonymity.

Los médicos como gremio de poder en el Porfiriato / Physicians as a group of power in the Porfiriato

Se desarrollan dos experiencias de la medicina como estructura de poder que, surgieron y prácticamente se consolidaron al finalizar el siglo XIX; influyendo en la ciencia y su organización gremial. (AU)