Formando médicos para el siglo XXI: El rol crucial de la educación basada en competencias / Training physicians for the 21st century: The crucial role of competency-based education

A lo largo de la historia, el campo de la medicina se ha adaptado a las necesidades cambiantes de la sociedad y del sistema sanitario. Ante esa situación, surge la necesidad de plantear la transformación de la formación médica mediante un enfoque basado en las competencias y así definir el perfil de un médico para el siglo XXI. El presente artículo tiene por objetivo analizar y describir el rol de la formación basada en competencias en la formación médica en la preparación de los estudiantes de medicina. Para tal fin, se ha llevado a cabo una exhaustiva revisión bibliográfica en la que se analizan los conceptos clave de la formación médica basada en competencias. Los resultados destacan la importancia de integrar el desarrollo de habilidades en la formación médica teniendo en cuenta los factores sociales y culturales, así como fomentar la reflexión crítica en la formación médica. Se concluye que la educación médica debe adaptarse a las demandas cambiantes del campo, con la participación de diversas partes interesadas y la evolución de los métodos de enseñanza.

Throughout history, the field of medicine has adapted to the changing needs of society and the healthcare system. Faced with this situation, the need arises to consider the transformation of medical education through a competency-based approach and thus define the profile of a physician for the 21st century. The aim of this article is to analyze the role of competency-based training in medical education and its impact on the preparation of medical students. To this end, an exhaustive literature review has been carried out in which the key concepts of competency-based medical education are analyzed. The results highlight the importance of integrating skills development in medical education taking into account social and cultural factors, as well as encouraging critical reflection in medical education. It is concluded that medical education must adapt to the changing demands of the field, involving diverse stakeholders and evolving teaching methods.

Theodor Kocher (1841-1917) and his outstanding contributions to surgery

Theodor Kocher (1841-1917), an exceptional Swiss surgeon who described a technique for the safe removal of enlarged thyroid unraveled the true function of this endocrine gland but also made significant contributions to many other fields of surgery. Kocher was the first surgeon awarded the Nobel prize in Physiology and Medicine in 1909 for his work on the physiology, pathology, and surgery of the thyroid gland. He was professor and clinical director at Insel Hospital during 45 years. Kocher created the prominent Surgeon's School in Bern. He was the first president of the International Society of Surgery in 1903 and the founding president of the Swiss Society of Surgery in 1913.

Theodor Kocher (1841-1917), excepcional cirujano suizo que describió una técnica para la extirpación segura del agrandamiento del tiroides y desentrañó la verdadera función de esta glándula endocrina, pero también hizo importantes aportaciones a muchos otros campos de la cirugía. Kocher fue el primer cirujano galardonado con el premio Nobel de Fisiología y Medicina en 1909 por sus trabajos sobre la fisiología, patología y cirugía de la glándula tiroides. Fue profesor y director clínico del Hospital Insel durante 45 años. Kocher creó la destacada Escuela de Cirujanos de Berna. Fue el primer presidente de la Sociedad Internacional de Cirugía en 1903 y el presidente fundador de la Sociedad Suiza de Cirugía en 1913.

As receitas médicas de Hannah Woolley: prática cotidiana e autoridade feminina na Inglaterra do século XVII / The medicinal recipes of Hannah Woolley: everyday practice and female authority in seventeenth-century England

Resumo O artigo retrata os interesses de uma escritora inglesa do século XVII sobre cuidados médicos, e as razões que a levaram a publicar textos sobre essa matéria. Hannah Woolley tecia orientações sobre diversos assuntos do âmbito doméstico, entre os quais receitas para preservar a beleza e a saúde. O artigo investiga os princípios que regiam o preparo dessas receitas, as intenções de Woolley ao escrever sobre o tema, e a maneira como a medicina acadêmica era traduzida e praticada por mulheres no cotidiano da época. O delineamento dessas questões ajudará a elucidar o cenário de atuação das curadoras letradas e a natureza das relações que teceram com os médicos eruditos.

Abstract This article describes a seventeenth-century English woman writer's interests in medical care and the reasons that led her to publish texts on this topic. Hannah Woolley offered guidance on a wide variety of topics in the domestic sphere, including recipes for health and beauty. Here we investigate the principles that governed the preparation of these recipes, Woolley's intentions in writing on this topic, and the way in which academic medicine was translated and practiced by women routinely during this period. Defining these issues will help shed light on the scenario in which literate female healers worked and the nature of their relationships with learned physicians.

A "hostilidade para com a teoria" nos estudos do lazer produzidos no Brasil no século XXI / The "hostility to theory" in leisure studies produced in Brazil in the 21st century / La "hostilidad a lo teórico" en los estudios de ocio producidos en Brasil en el siglo XXI

RESUMO Orientado pelo materialismo histórico-dialético, investigamos a "hostilidade para com a teoria" nos Estudos do Lazer (EL) no século XXI, em um estudo teórico que se vale da análise bibliográfica. Para isso, analisamos a produção de alguns dos mais influentes autores brasileiros do período e o renovado debate sobre a origem do lazer.

ABSTRACT Guided by historical-dialectical materialism, we investigate "hostility to theory" in leisure studies (le) in the 21st century, in a theoretical study that resorts to bibliographical analysis. to do so, we analyze the production of some of the most influential brazilian authors in the period and the reinvigorated debate on the origin of leisure.

RESUMEM Guiados por el materialismo histórico-dialéctico, investigamos la "hostilidad a lo teórico" en los Estudios de Ocio (EL) en el siglo XXI, en un estudio teórico que recurre al análisis bibliográfico. Para ello, analizamos la producción de algunos de los autores brasileños más influyentes del período y el renovado debate sobre el origen del ocio.

Ejercer sin diploma, batallar por la licencia: encrucijadas en la historia de la profesionalización de la odontología en Colombia / Practicing without a diploma, battling for a license: crossroads in the history of the professionalization of dentistry in Colombia

Resumen Este artículo estudia la profesionalización de la odontología en Colombia en la primera mitad del siglo XX. Esta historia no puede comprenderse en todas sus dimensiones si se dejan de lado las tensiones entre los practicantes con diploma y los sin diploma. Como resultado de estas tensiones, los odontólogos ganaron autonomía profesional. Analizamos solicitudes de licencia para ejercer sin título profesional, entre ellas las de algunas mujeres. Los hallazgos muestran la transmisión de conocimientos por fuera de la enseñanza formal, el ejercicio sin título y sin restricciones por parte de un gran número de odontólogos "permitidos" que se enfrentaron a una pesada y centralizada burocracia diplomada.

Abstract This paper addresses the professionalization of dentistry in Colombia during the first half of the twentieth century. To fully comprehend such a process, we must consider the tensions between the practice of non-certified and certified dentistry. As an outcome of such tensions, dentists began to acquire professional autonomy. We analyze applications for license files to practice dentistry without a degree, some of which were of women. The findings show the informal transfer of knowledge outside formal apprenticeship and the unrestricted practice of dentistry by many non-professionals but "permitted" dentists who faced a centralized and powerful professional bureaucracy.

Do cuidado do corpo: imprensa e higiene no Rio de Janeiro oitocentista / On caring for the body: the press and hygiene in nineteenth-century Rio de Janeiro

Resumo A partir do século XIX, teve início no Rio de Janeiro um intenso processo de urbanização da cidade e de civilização de seus habitantes. Grande parte dos valores e hábitos da população sofreu um desprestígio em relação a um novo modo de vida que se difundiu. A imprensa era considerada um dos mais importantes instrumentos de civilização, publicando em suas páginas os mais diferentes saberes e novidades, que sugeriam à população um novo modus vivendi , considerado mais urbano e civilizado. O objetivo principal deste artigo é explicitar este discurso pedagógico construído nos periódicos oitocentistas, especificamente as prescrições que diziam respeito à higiene e ao cuidado com o corpo.

Abstract Intensive efforts to urbanize the city of Rio de Janeiro and civilize its inhabitants began in the nineteenth century. Many of the population's values and habits fell out of favor compared with the new way of life that was being disseminated. The press was considered one of the most important instruments in this process of civilization, publishing a wide variety of knowledge and novelties in its periodicals that suggested a new more urbane and civilized way for the population to live. This article examines the pedagogical discourse constructed during this period, specifically recommendations related to bodily hygiene and care.

Forgotten Poles in the history of neurology: from Flatau to Frey / Polacos olvidados en la historia de la neurología: de Flatau a Frey

Abstract With the majority of eponyms being removed from disease classification systems, it is even more difficult to remember the neurologists who influenced the development of techniques and understanding of the brain over the last centuries. Determining whether Polish researchers were given similar attention to Western equivalents based on eponymic presence in medical databases is an interesting way to provide an overview of unremembered Polish neurologists. This work aims to recognize the developments of forgotten Polish neurologists, whose work, although important, was not properly appreciated over the centuries.

Resumen Con la eliminación de la mayoría de los epónimos de los sistemas de clasificación de enfermedades, es aún más difícil recordar a los neurólogos que influyeron en el desarrollo de técnicas y comprensión del cerebro durante los últimos siglos. Determinar si los investigadores polacos recibieron una atención similar a la de los equivalentes occidentales en función de la presencia de los epónimos en las bases de datos médicos es una forma interesante de proporcionar una visión general de los neurólogos polacos no recordados. Este trabajo tiene como objetivo reconocer los desarrollos de los neurólogos polacos olvidados, cuyo trabajo, aunque importante, no fue debidamente apreciado a lo largo de los siglos.

La alimentación en el cuidado de pobres y enfermos. El registro de compras en el Hospital San Juan de Dios de La Serena (1796) / Feeding the poor and sick during the 18th century. The register of purchases at a hospital of La Serena, Chile

This article analyzes the feeding forms and care, in a record made by the nursing friars of the Hospital San Juan de Dios of La Serena in 1796. The food intake of both patients and hospital staff, is examined through a quantitative and qualitative perspective. In this context, it is proposed that food intake, in a monastic space dedicated to the care of the poor and sick, responded to doctrinal elements typical of the Western Catholic tradition, but above all to local economic conditions. It supported the poor who wandered in a city with economic and social growth at the end of the 18th century.

Estudiar la cultura material de la educación científica en la Argentina: mercado de consumo, circulación transnacional, prácticas educativas y apropiación local / Studying the material culture of science education in Argentina: consumer market, transnational circulation, educational practices, and local appropriation

Resumen El artículo tiene por objetivo dar a conocer parte de un proceso de investigación sobre la cultura material de la enseñanza científica, en particular de las ciencias naturales, en la Argentina, entre la segunda mitad del siglo XIX y comienzos del siglo XX. A través de algunas herramientas metodológicas que resultaron útiles para manejar las diversas fuentes, como la perspectiva biográfica de la vida cultural de los objetos, la noción de circulación de conocimientos e instrumentos científicos, se analiza el complejo entramado de relaciones entre los artefactos, los saberes y las prácticas científico-educativas locales. En este artículo se exponen algunos indicadores y ejemplos de los materiales científicos estudiados.

Abstract The article presents part of a research process on the material culture of science education, particularly natural sciences, in Argentina, between the second half of the nineteenth century and the beginning of the twentieth century. We used some methodological tools that were useful to manage the various sources, such as the biographical perspective of the cultural life of objects, the notion of circulation of knowledge and scientific instruments, the complex network of relationships between artifacts, knowledge, and local scientific-educational practices. This article shows some indicators and examples of the scientific materials studied.

O enfermeiro-mor nas Santas Casas da província de Minas Gerais: entre a administração e a assistência / The enfermeiro-mor (head-nurse) in Santas Casas in the province of Minas Gerais: between care and administration

Resumo Este artigo trata da percepção da enfermagem como uma ocupação de baixo prestígio no século XIX. A história da enfermagem produzida pelos profissionais da área reforçou essa concepção. No entanto, o perfil do cargo de enfermeiro-mor, presente nas Santas Casas, indica um espectro social mais amplo para a profissão de enfermagem. As autoras defendem a hipótese de que essa avaliação negativa se baseia apenas em atividades de cuidado ao paciente que eram mais visíveis. A presença do enfermeiro-mor exemplifica os limites de uma generalização da desvalorização social da enfermagem. A conclusão é que a suposição generalizada de que a enfermagem se limitava a cuidados básicos de saúde não se sustenta.

Abstract This article focuses on the perception of nursing as a low-prestige occupation in the 19th century. The history of nursing produced by professionals in the area supported this understanding. However, the profile of the enfermeiro-mor (head nurse), a position in the Santas Casas, demonstrates that the nursing profession was present throughout a broader social spectrum. The authors support the hypothesis that the typical negative assessment is based only on the more visible patient care activities. The presence of the enfermeiro-mor exemplifies the limits of a generalization of the social undervaluation of nursing. The conclusion is that the generalized assumption that nursing was only about basic health care is not acceptable.

Conocimiento y poder: el papel de la astronomía en la expansión territorial de Chile, 1883-1890 / Knowledge and power: the role of astronomy in the territorial expansion of Chile, 1883-1890

Resumen El artículo analiza el rol que jugó el Observatorio Astronómico Nacional en la expansión territorial de Chile a fines del siglo XIX, a través de la relación que sostuvo con tres exploraciones geográficas asociadas a este proceso. Se propone que el Observatorio cumplió un papel central para estas exploraciones geográficas, ayudando a obtener coordenadas geográficas precisas en pos de producir mapas exactos de los territorios anexados al norte y sur de Chile. Los resultados permiten afirmar que el Observatorio Astronómico Nacional fue una institución que prestó servicios estratégicos durante la expansión territorial y, a su vez, que la geografía fue parte importante de sus trabajos científicos institucionales.

Abstract The article analyzes the role played by the National Astronomical Observatory (Observatorio Astronómico Nacional) in the territorial expansion of Chile at the end of the nineteenth century, through the relationship with three geographical explorations associated with this process. It is proposed that the Observatory played a central role in these geographic explorations, helping to obtain precise geographic coordinates to produce accurate maps of the territories annexed to the north and south of Chile. The results allow us to affirm that the National Astronomical Observatory provided strategic services during territorial expansion, and geography was an important part of its institutional scientific work.

Mujeres e higiene industrial en el México posrevolucionario: el informe de Juan de Beraza sobre "La Perfeccionada" (25 de octubre, 1919) / Women and industrial hygiene in post-revolutionary Mexico: Juan de Beraza's report on "La Perfeccionada" (October 25, 1919)

Resumen En octubre de 1919, en medio de la construcción de las instituciones posrevolucionarias de protección de la salud en México, Juan de Beraza, oficial ayudante de la Secretaria de Industria, Comercio y Trabajo, redactó un documento sobre las condiciones de 479 obreras de una fábrica de la capital. El informe presentó un resumen de los problemas de higiene y de acoso sexual que las mujeres experimentaron en los espacios laborales. El documento ofrece información relevante para la historia de las mujeres dentro del "mundo del trabajo" en las primeras décadas del siglo XX. Se publica una transcripción del informe precedida de una presentación del mismo.

Abstract In October 1919, during the construction of post-revolutionary health protection institutions in Mexico, Juan de Beraza, an office assistant to the Secretary of Industry, Commerce, and Labor, wrote a document about the conditions of 479 women workers in a factory in the capital. The report had a summary of hygiene and sexual harassment problems that women experienced in their workplaces. The document offers relevant information about the history of women in the "world of work" in the first decades of the twentieth century. A transcript of the report is published, preceded by a presentation of the report.

Educación en medicina del dolor a finales del siglo XX / Education in pain medicine at the end of the 20th century

Resumen: El autor describe desde la conformación de la primera clínica del dolor en México y su desarrollo fundamental, así como la integración de otras clínicas del dolor en el país y su desarrollo en los diferentes ámbitos de la algología hasta finales del siglo XX.

Abstract: A description of de first Pain Clinic in Mexico, by the author, and its fundamental developing, as also other Pain Clinics in the Country, and its multidisciplinary developing in Algology ambit, just at finish Twenty Century.

Training of neurologists for the 21st century: cultural and professional skills / O treinamento do Neurologista para o século XXI: habilidades profissionais e culturais

Abstract Training of neurologists for the near future is a challenge due to the likely advances in neuroscientific methods, which will change much of our knowledge on diagnosis and treatment of neurological diseases. Objective: to comment on what may be more likely to be a constant in the very near future and to recommend how to prepare the neurologist for the 21st century. Methods: through a critical review of recent articles on the teaching of Neurology, to present a personal view on the subject. Results: Diagnostic methods and therapeutic resources in Neurology will be greatly improved, but the central core of teaching young neurologists will continue to be the clinical/anatomical correlation. The neurologist must be prepared to be the primary physician in the care of patients with neurological disorders, although the roles of consultant and clinical neuroscientist must also be considered. In addition to technical knowledge, the neurologist must be prepared to discuss not only distressing issues related to the specialty, such as the risks of genetic diseases for family members of their patients, the inexorable progression of some diseases and the need for palliative care, but also problems not directly related to Neurology that cause anxiety and depression in the patient or that are the main reason for the initial consultation. Conclusion: neurology will be an even more important area of medicine and the neurologist must be well prepared to be the primary doctor to diagnose, treat and follow the patient with neurological disorders. In addition to technical knowledge, training in doctor-patient relations should be highlighted.

Resumo A formação do neurologista para o futuro próximo é um desafio devido aos prováveis avanços nos métodos da neurociência, que mudarão muito do nosso conhecimento sobre diagnóstico e tratamento de doenças neurológicas. Objetivo: comentar o que pode ser mais constante no futuro próximo e propor como preparar o neurologista para o século XXI. Métodos: por meio de uma revisão crítica de artigos recentes sobre o ensino da Neurologia, apresentar uma visão pessoal sobre o assunto. Resultados: Os métodos diagnósticos e os recursos terapêuticos em Neurologia serão muito aprimorados, mas o núcleo central do ensino de jovens neurologistas continuará sendo a correlação clínico-anatômica. O neurologista deve estar preparado para ser o médico principal no atendimento de pacientes com distúrbios neurológicos, embora os papéis de consultor e neurocientista clínico também devam ser considerados. Além do conhecimento técnico, o neurologista deve estar preparado para discutir não apenas questões angustiantes relacionadas à especialidade, como os riscos de doenças genéticas para os familiares de seus pacientes, a progressão inexorável de algumas doenças e a indicação de cuidados paliativos, mas também problemas não diretamente relacionados à Neurologia que causam ansiedade e depressão no paciente ou que são a principal causa da consulta. Conclusão: a neurologia será uma área ainda mais importante da medicina e o neurologista deve estar bem-preparado para ser o médico principal para diagnosticar, tratar e acompanhar o paciente com distúrbios neurológicos. Além do conhecimento técnico, a formação humanística deve ter destaque.

Hildegard von Bingen: El sustrato de la salud y la enfermedad / Hildegard von Bingen: the substratum of health and disease

Hildegard von Bingen, abadesa benedictina alemana del siglo XII, escribió Causas y remedios, libro en que expuso su sistema sobre la estructura y funcionamiento del ser humano. Este consta de un componente material: los cuatro elementos del universo y cuatro humores del cuerpo. Interviene un componente fisiopatológico, representado por el efecto de las cualidades de los elementos y los humores (flemas y livores) que activan el funcionamiento normal y anormal. El conjunto está regido por un componente espiritual: el alma. Von Bingen desarrolla su pensamiento desde una perspectiva teológica basada en Dios creador del universo y de la humanidad. En cambio, los autores hipocráticos precedentes se circunscribían al ámbito del hombre y de la naturaleza. Los humores hipocráticos conservaban cada uno sus propiedades; los hildegardianos modificaban sus cualidades dependiendo de la condición, sucesión, o mezcla en que participaban. La autora destaca la función de la médula ósea, las venas y la sangre por las reacciones que ocurrían en ellas entre los elementos y los humores. La médula imprimía fuerza y color rojo a la sangre; a veces formaba la sangre. Según Hildegard, la sangre fluía en las venas. En el siglo II Galeno pensaba que la sangre intravascular tenía un movimiento de flujo y reflujo, y que en su mayor parte se consumía en las venas después de transferir nutrientes al cuerpo. Actualmente se percibe, en algunos países, un interés creciente por recurrir a medicinas alternativas o complementarias: entre ellas se incluye la terapia hildegardiana.

Hildegard von Bingen. An XII century german benedictine abbess wrote Causes and remedies, exposing her system about the structure and functioning of the human being. It consists of a material component: the four elements of the universe and four types of humour of the body. A physiopathologic component takes part: the properties of elements and humour that activate normal and abnormal functioning. This ensemble is governed by a spiritual constituent: the soul, inspired by God, since von Bingen displays her thinking from a theologic point of view, based on a God creator of the universe and humanity. Precedent Hippocratic writers, however, dealt with the scope of man and nature. Each Hippocratic humour preserved its properties, whereas Hildegardian ́s changed its attributes depending on condition, succession, a mixture between them. She emphasises the function of bone marrow, veins, and blood, explaining that they are the site of reactions of elements and humour. The marrow stamps strength and a red hue in blood and sometimes make blood. According to Hildegard, blood flowed inside veins. In the 2nd century, Galen thought that intravascular blood had a flux and reflux motion, and for the most part, it consumed itself in the veins after transferring nutrients to the body.Currently, in some countries, a growing interest in alternative or complementary medicinal practices is perceived: Hildegardian therapy is included among them.

Ser e dever ser médico: a Gaceta Médica de México como um manual "não sistematizado" de saberes, 1860-1890 / On being a physician: the Gaceta Médica de México as an unsystematized manual of knowledge, 1860-1890

Resumo Discute-se neste artigo o papel desempenhado pela Gaceta Médica de México no processo de institucionalização e profissionalização da medicina científica no país entre 1860 e 1890. A partir da noção de tecnologia literária utilizada por Steven Shapin e Simon Schaffer e da análise qualitativa de relatórios médicos com enunciados típicos, examina-se o modo como os membros da Academia Nacional de Medicina, instituição responsável pelo periódico, e da Escola Nacional de Medicina coletivizaram suas experiências e prescreveram formas de ser e agir por meio de suas publicações. Busca-se demonstrar o caráter de "manual não sistematizado" da publicação, importante instrumento de normatização e regulação dos saberes médicos no México nesse período.

Abstract This article discusses the role played by the Gaceta Médica de México in the process of institutionalizing and professionalizing scientific medicine in Mexico from 1860 to 1890. From the notion of literary technology utilized by Steven Shapin and Simon Schaffer and qualitative analysis of medical reports containing typical discourse, we examine how members of the Mexican National Academy of Medicine (the institution responsible for this journal) and the National School of Medicine collected their experiences and prescribed ways of being and acting through their publications. The aim is to demonstrate how this periodical acted as an unsystematized manual, an important instrument for normalizing and regulating medical knowledge in Mexico during this period.

Vozes de uma Reforma Sanitária: trabalhadores, sanitaristas e suburbanos na imprensa carioca da Primeira República / Voices of a Sanitary Reform: workers, public health phisicians and suburbanites in the Rio de Janeiro press of the First Republic

A partir da compreensão que a formação de valores públicos e a cultura política são partes constituintes da política e dos processos de mudança histórica, a presente tese aborda o debate sobre o saneamento em jornais comerciais e populares como parte integrante do processo de politização da saúde que desembocou na Reforma Sanitária de 1920. A análise de diferentes periódicos comerciais do período aponta que os integrantes do Movimento Pró-Saneamento se articularam à imprensa por meio de suas redes de sociabilidade e fizeram da comunicação um instrumento político para a efetivação de mudanças institucionais para a saúde pública. Entre 1916 e 1920, a interpretação que repunha a saúde como problema central para a formação nacional e responsabilidade do governo federal se sedimentou no debate público e se estabeleceu como parte do senso comum, antecipando a consolidação do aparato institucional. A vocalização pública dos argumentos e propostas do Movimento Pró-Saneamento não encontrou um público apático ou indiferente entre os grupos populares. A consideração de periódicos produzidos por trabalhadores e moradores dos subúrbios cariocas publicados no período anterior à publicização do argumento pró-saneamento identificou que a saúde era objeto de reivindicações e se articulava a diferentes pautas de lutas populares. Suas formulações sobre a saúde e o adoecimento antecipavam elementos que estariam presente nas teses do movimento pró-saneamento, tais como as relações entre abandono pelo Estado e adoecimento e entre as condições de vida, de trabalho e saúde. Durante o período de maior publicização do argumento sanitarista, trabalhadores e suburbanos estabeleceram afinidades e críticas à proposta de saneamento. O saneamento ao qual esses diferentes grupos de trabalhadores se referiam guardava aproximações e cruzamentos com a proposta dos sanitaristas ao mesmo tempo em que apontava para outros sentidos, vinculados a uma gramática de luta própria. Por meio do periodismo, parcelas mais amplas da população politizaram a saúde, apontaram contradições e lacunas existentes entre os argumentos e as práticas das autoridades sanitárias, imprimiram novos sentidos a palavra saneamento e reivindicaram melhorias em suas condições de vida e trabalho. Por fim, a tese argumenta que o processo de Reforma Sanitária colocado em curso na década de 1920 pode ser compreendido como um momento que não se encerrou nas formulações e ações de uma determinada elite política e intelectual, mas que abrigou também a agência de grupos sociais subalternizados.

Based on the understanding that the formation of public values and political culture are constituent parts of politics and processes of historical change, this thesis addresses the debate on sanitation in commercial and popular newspapers as an integral part of the process of politicization of health that led to the Brazilian Sanitary Reform of 1920. The analysis of different commercial journals of the period points out that the members of the Pro-Sanitation Movement articulated themselves to the press through their networks and made of this communication media a political instrument to effect institutional changes for public health. Between 1916 and 1920, the interpretation that repositioned health as a central problem for national formation and responsibility of the federal government became sedimented in the public debate and established as a part of the common sense, anticipating the consolidation of the institutional apparatus. The public vocalization of the Pro-Sanitation Movement's arguments and proposals did not find an apathetic or indifferent audience among the popular segments. The consideration of the newspapers produced by popular segments and published in the period before the publicizing of the pro-sanitation argument identified that health was an object of claims and articulated with different agendas of popular struggles. Their formulations on health and illness anticipated elements that would be present in the theses of the pro-sanitation movement, such as the relations between abandonment by the State and illness, as well as between life and working conditions and health. During the period of greater publicization of the pro-sanitation argument, workers and residents of the suburbs established affinities and criticisms to the sanitation proposal. The sanitation to which the workers referred kept approximations and intersections with the health reformers proposal, while it pointed to other meanings linked to its own grammar of struggle. Through journalism, wider segments of the population politicized health, pointed out contradictions and gaps between the arguments and practices of health authorities, gave new meanings to the word sanitation and claimed improvements in their living and working conditions. Finally, the thesis argues that the process of Sanitary Reform set in motion in the 1920s can be understood as a moment that did not end in the formulations and actions of a particular political and intellectual elite, but also harboured the agency of subalternized social segments.

Acerca de la muerte de Hernando de Magallanes: efectos de una flecha envenenada

Ferdinand Magellan's maritime expedition that resulted in the circumnavigation of the Earth and the discovery of the strait that bears his name is among the greatest feats in history. The trip, which took more than three years, was not completed by Magellan, who died on the island of Mactan, Philippines in a scuffle with the locals. As reported in Magellan's voyage journal written by Pigafetta, Magellan died after receiving a poisoned arrow in his right leg. This study reviews the main compounds used by indigenous from the Philippines and Southeast Asian to poison their arrows, their agents, and effects. These poisons are mainly derived from Aconitum and other species, such as Strychnos, Lophopetalum, Beaumontia, and Strophanthus. They contain cardiac alkaloids and glycosides, which can produce neurological and cardiac effects in just a few minutes. We argue that these toxic effects hindered the withdrawal of Magellan from the beach, facilitating his death in hands of the locals.

La oposición a la Homeopatía desde una perspectiva histórica. Análisis de sus causas / The opposition to Homeopathy from a historical perspective. Analysis of its causes

La contextualización del momento histórico en el que surgió la Homeopatía, la postura que tomó Samuel Hahnemann ante aquellos que la criticaban y algunos de los conceptos que se utilizaron para descalificar el ejercicio de este método médico clínico terapéutico son los fundamentos de este texto. Se destaca, de manera primordial y a la luz de la Historia, el rechazo que sufrió la Homeopatía al interior de algunos grupos de médicos convencionales del siglo XVIII, postura que fue secundada por asociaciones de farmacéuticos que se sintieron amenazados por la posibilidad de que los homeópatas fueran, al mismo tiempo, agentes boticarios responsables de la preparación de sus propios medicamentos.

The following elements are the basis of this text: The contextualization of the historical moment in which Homeopathy arose, the posture taken by Samuel Hahnemann to those who criticized him, and some of the concepts that were used to discredit the practice of this therapeutic clinical method (Homeopathy). In a primordial manner, as shown by history, Homeopathy's rejection inside of some groups of conventional physicians in the 18th century is highlighted. This position was seconded by pharmaceutical associations, which felt threatened by the possibility that homeopaths could also be apothecary agents responsible for the elaboration of their own medications.

Epidemias e os avisos surdos da história / Epidemics and the silent warnings of history / Epidemias y los sordos avisos de la historia

Neste artigo, analisamos o impacto das epidemias em duas cidades portuguesas ­ a capital, Lisboa, e a cidade do Porto, nodo de uma rede comercial intensa, de meados do século XIX até ao final da primeira década do século XX. Sendo ambas cidades portuárias de um país europeu, periférico, mas com um vasto império colonial, a prevenção e a aplicação de medidas de combate às epidemias, foram, e continuam a ser, fundamentais na gestão, muitas vezes precária, das crises sanitárias. Não temos dúvidas que as reflexões que estes dois casos de estudo nos proporcionam podem ser facilmente recuperadas e readaptadas para a análise da pandemia global daCOVID-19. Podemos usar a investigação histórica sobre a forma como temos lidado, enquanto sociedade, com as epidemias e pandemias para melhor atravessarmos os actuais momentos de incerteza e de espanto e definirmos acções futuras que sejam eficazes na alteração das condições que levaram a, em pleno século XXI, parar o mundo. Se é, naturalmente, impossível prever datas e contornos exactos da ocorrência das próximas epidemias, é possível criar as condições locais, nacionais e globais, tanto ao nível ambiental e social, como institucional e político para que lhes possamos responder com muito maior eficácia. Mais que reagir, teremos que ser capazes de antecipar.

In this article we analyze the impact of epidemics in two Portuguese cities ­ Lisbon, the capital city, and the city of Porto, the hub of an intense commercial network ­ from mid-19th century to the end of the first decade of the 20th century. As port cities of a peripheral European country with a vast colonial empire, the prevention and application of measures to combat epidemics were fundamental in the, often precarious, management of health crises. They still are. We argue that the reflections provided by these two case studies can be easily recovered as guides in the analysis of the present global COVID-19 pandemic. Historical research on how societies have dealt with epidemics and pandemics in the past help to understand current moments of uncertainty and astonishment, and to outline effective future actions to avoid the adverse conditions that put the whole world to a halt, in 2020. Of course, it is impossible to predict the exact dates and contours of the occurrence of the next epidemics, but it is necessary to create the local, national and global conditions, both at the environmental and social, as well as institutional and political levels, which will enable us to respond to them effectively. More than react, we need to anticipate.

En este artículo analizamos el impacto de las epidemias en dos ciudades portuguesas ­ Lisboa y Oporto, nodos de una red comercial intensa ­ desde mediados de siglo XIX hasta finales de la primera década de siglo XX. Siendo ambas ciudades portuarias y de un país europeo periférico,pero con un vasto imperio colonial, la prevención y aplicación de medidas para combatir las epidemias fueron (y continúan siendo) fundamentales en la gestión (muchas veces precaria) de las crisis sanitarias. No tenemos duda que las reflexiones que estos dos casos nos proporcionan pueden ser fácilmente recuperadas y adaptadas para el análisis de la pandemia de COVID-19. Podemos usar la investigación histórica sobre la forma como hemos lidiado, en cuanto sociedad, con las epidemias y pandemias para atravesar, de la mejor manera posible, los momentos actuales de incertidumbre y de desconcierto, y poder definir efectivas acciones futuras que puedan alterar las condiciones que llevaron a parar el mundo en pleno siglo XXI. Si bien es naturalmente imposible prever las fechas y devenires exactos de los acontecimientos de las próximas epidemias, es posible crear las condiciones locales, nacionales y globales, tanto a nivel ambiental y social, como institucional y político, para que podamos responder con mucha más eficacia. Más que actuar, tenemos que ser capaces de anticipar.