Desenmascarando a los impostores: Los médicos profesionales y su lucha contra los falsos médicos en Perú / Unmasking impostors: Professional physicians and their struggle against fake doctors in Peru

RESUMEN La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.

ABSTRACT The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.

Almas delirantes (1925) por Luís Cebola: a poética da psique humana e o médico como mediador entre o universo da doença mental e a sociedade / Almas delirantes (1925) by Luís Cebola: the poetics of the human psyche and the physician as mediator between the universe of mental illness and society

Resumo Luís Cebola publicou em 1925 o volume Almas delirantes, onde apresentava diversas psicopatologias não de um ponto de vista médico-científico, mas elaborando retratos metafóricos e líricos, demonstrando que a perceção que tinha sobre os doentes ultrapassava a de objetos de estudo científico, constituindo um processo de identificação, empatia e compaixão. Cebola definia os estados psicopatológicos por oposição à normalidade, salientando, todavia, que estas doenças poderiam surgir em qualquer indivíduo, funcionando o livro simultaneamente como um aviso aos leitores. O volume permitia-lhe ainda divulgar o Museu da Loucura, que criara na Casa de Saúde do Telhal, e a arte dos seus pacientes, colocando-se assim na posição de mensageiro entre o universo fechado do hospital psiquiátrico e a sociedade portuguesa.

Abstract Lúis Cebola's 1925 work Almas delirantes [Delusional Souls] presented various psychopathologies through metaphorical and lyrical portraits rather than from a medical/ scientific point of view, showing that he perceived his patients as more than objects of scientific study in a process of identification, empathy, and compassion. Cebola defined psychopathological states according to contrast with normality, but stressed that these diseases could arise in any individual, and the book simultaneously acted as a warning to readers. The text also publicized the Museum of Madness [Museu da Loucura], which he created at the Casa de Saúde do Telhal, and the art produced by his patients, positioning himself as a messenger between the closed universe of the psychiatric hospital and Portuguese society.

El espíritu de Baraguá en la medicina cubana / The spirit of Baraguá in Cuban medicine

Introducción: Baraguá representa la intransigencia revolucionaria del pueblo cubano y en este hecho se demostraron muchos de los valores humanos que siguen hoy los médicos cubanos en su diaria labor. Objetivos: caracterizar el contexto histórico de la Protesta de Baraguá y explicar su influencia en la labor de los médicos cubanos en la actualidad, utilizándose el método lógico-histórico y analítico-sintético. Métodos: se emplearon los métodos histórico-lógico y analítico-sintético para analizar los documentos y bibliografías sobre el tema. Resultados: se presenta un acercamiento a la vigencia que tuvo, tiene y tendrá el pensamiento y accionar de Antonio Maceo, junto a los patriotas que lo acompañaron, en el 138 aniversario de la Protesta de Baraguá. La contribución de su pensamiento revolucionario, como fuente inagotable de lecciones, revive el principio de que el futuro de la patria cubana será un eterno Baraguá que incluye el destino de nuestra práctica médica cotidiana. Conclusiones: los médicos cubanos honran el ejemplo de Antonio Maceo, cumplen con su labor diaria y las disímiles tareas que en materia de internacionalismo les son otorgadas. La disciplina, preparación y constancia de los trabajadores de la salud cubanos, unidos a sus principios de solidaridad, humanismo, valor y compromiso son el legado de los patriotas que como en Baraguá, hicieron frente a las injusticias hacia la patria cubana.(AU)

Introduction: Baraguá represents the revolutionary intransigence of the Cuban people, and in this event they showed many of the human values ​​that today the Cuban doctors follow in their daily work. Objectives: To characterize the historical context of the Protest of Baraguá and to explain its influence on the work of Cuban doctors today, using the logical-historical and analytical-synthetic method. Methods: Historical-logical and analytical-synthetic methods were used to analyze documents and bibliography on the subject. Results: An approach to the validity that the thought and action of Antonio Maceo have had, have and will have, along with those of the patriots who accompanied him, on the 138th anniversary of the Protest of Baraguá. The contribution of his revolutionary thought, as an inexhaustible source of lessons, revives the principle that the future of the Cuban fatherland will be an eternal Baraguá that includes the fate of our daily medical practice. Conclusions: Cuban doctors honor the example of Antonio Maceo, fulfill their daily work and the different tasks oriented in the field of internationalism. The discipline, training and perseverance of Cuban health workers, together with their principles of solidarity, humanism, courage and commitment, are the legacy of the patriots who, as in Baraguá, faced injustice against the Cuban homeland(AU)

Profesionalismo médico: aspectos históricos y religiosos / Medical professionalism: Historical and religious aspects

The essence of the medical profession resides in the medical act, whereupon a sick human being meets another with the power to heal him or her. The source of this power has evolved from the divinity itself through magic to science or acquired knowledge. This power implies acknowledgement of values that are inherent to the profession as well as responsibility toward one's own conscience and toward society, elements considered constitutive of what we now call professionalism. From antiquity these principles have evolved into behavioral codes containing variable components according to the different ages and cultures, but also permenent core values such as respect for life, altruism, and honesty, among others. Scientific and technological advances have magnified medical power but at the same time they have required that the philosophical and ethical principles that ought to inform professional practice be made explicit. This happens at a time when certitudes are questioned or abandoned, relativism and secularism pervade culture, and traditional medical values are challenged. Therefore, consensus attainment appears for some as the only legitimation of the ethics of professional medical acts, while for others the ancestral principles and values of medicine have permanent validity as objective goods based on the dignity of the human person.

El médico tratante: ¿concepto arcaico o necesidad imperiosa de la medicina actual / About the treating physician´s concept

El concepto de médico tratante (MT) implica importantes responsabilidades, funciones y actitudes que definen la práctica médica. En la actualidad su figura parece débil, desdibujada e incluso ausente, particularmente en el sector público del sistema de salud chileno. Surge la pregunta de si es necesario rescatar o reinventar al MT, y de cómo implementarlo. En el presente trabajo revisamos los cambios que ha sufrido la figura del MT a lo largo de la historia de la medicina chilena del último siglo. Luego analizamos sus características esenciales, entendiéndolo como fenómeno particular de vínculo, dentro de la relación médico-paciente. Desde esta base, proponemos una nueva definición operativa para el MT, centrada en su aspecto vinculante entre paciente y todo el sistema de salud, apreciando su rol protagónico en la toma de decisiones, desde un rol de líder de un equipo multidisciplinario de atención integral y coherente, administrando de manera óptima los recursos disponibles, y protegiendo tanto la autonomía como los derechos éticos y legales de su paciente.

Homenagem póstuma ao Professor Carlos da Silva Lacaz / Phosthumous homage to Professor Carlos da Silva Lacaz

Biografia do Prof. Carlos da Silva Lacaz, incluindo sua formação acadêmica, científica e profissional bem como, sua produção intelectual