Dynamis

Dynamis en acceso abierto (OJS)

Female cancers: a perspective from the Latin South

Aristides Maltez Hospital and the control of cervical cancer in Brazil

O Hospital Aristides Maltez (HAM) foi inaugurado em 1952 na cidade de Salvador (Bahia). O hospital era uma instituição filantrópica pertencente à Liga Baiana Contra o Câncer. Centro especializado no tratamento de variados tipos de câncer, o HAM tinha sua atenção voltada prioritariamente para os cânceres femininos, principalmente o câncer do colo do útero. A instituição tornou-se referência nas ações de controle da doença na Região Nordeste do Brasil. A proposta deste artigo é analisar o processo de criação e consolidação do hospital como espaço de tratamento, pesquisa e formação profissional, avaliando seu papel na rede de discussões e ações em relação ao câncer do colo do útero formada no país em meados do século XX. A instituição foi uma das pioneiras no processo de transição na utilização de ferramentas de diagnóstico e implementação de campanhas de controle do câncer da doença em municípios interioranos.

The Aristides Maltez Hospital in Salvador (Bahia) was inaugurated in 1952. The hospital was a philanthropic institution of the Bahian League Against Cancer. The Aristides Maltez Hospital specialised in cancer treatment, especially cervical cancer, and became a reference centre for the control of cancer in northeastern Brazil. This article follows the creation and consolidation of the hospital as a treatment, research, and training centre, evaluating its role in discussions and action networks on cervical cancer in the mid-20th century. The institution has been a space of transition in the use of diagnostic tools and the organisation of campaigns to control cancer in municipalities of the hinterland.

Technology and disciplinary fields: cytotechnicians and implementation of the Pap test in Brazil

A apropriação e utilização do teste de Papanicolaou como tecnologia fundamental para o controle do câncer de colo do útero no Brasil foi fruto de escolhas, acordos e embates entre determinados grupos profissionais (médicos de diferentes especialidades, farmacêuticos, biólogos, biomédicos e citotécnicos). Na primeira parte do trabalho apresentamos o processo de formulação das primeiras campanhas de rastreamento populacional com uso do teste Papanicolaou no país e, consequentemente, o surgimento da profissão de citotécnicos (profissionais dedicados a leitura das lâminas de Papanicolaou). Num segundo momento, partimos de algumas questões levantadas pela historiografia internacional no campo da história das ciências e das técnicas para discutimos as peculiaridades do processo de apropriação do teste Papanicolaou no contexto brasileiro. Priorizamos as questões relativas aos debates entre diferentes grupos profissionais envolvidos com a lógica desse exame e às relações entre os setores públicos e privados de saúde. Demonstramos que as visões distintas sobre essa tecnologia no campo de diferentes disciplinas e a relação destas com a dinâmica do mercado de trabalho moldam a trajetória da profissão de citotécnico e a forma como o teste de Papanicolaou foi (e está sendo) apropriado como tecnologia central para o rastreio do câncer de colo do útero no Brasil.

The implementation of the Pap test as a primary technology in the control of cervical cancer in Brazil was the result of choices, agreements and disputes among certain professional groups, including physicians from various specialisations, pharmacists, biologists, biomedical scientists and cytotechnologists. The first part of the paper describes the process of formulating Brazils first screening campaigns using the Pap smear, and the subsequent emergence of the profession of cytotechnology, whose practitioners interpret this test. Second, based on questions raised by international historiography in the field of science and technology, we explore in detail how the adoption of the Pap smear transpired within the Brazilian context, focussing on the debates among the various professional groups with an interest in the suitability of the test and on the relationships between the public and private healthcare sectors. We show that the professional career of cytotechnologists and the way in which the Pap smear has been implemented as a central technology for cervical cancer screening in Brazil have been shaped by the conflicting views of this technology held by different disciplines as well as by the relationship between these disciplines and labour market dynamics.

Controlling female cancer in Argentina: divergent initiatives and the road to fragmentation

This article analyses the organisation of cancer control in Argentina, with a special focus on the initiatives, institutions, and models that targeted female or gynaecological cancers. It identifies and examines the main factors in the process of elaborating a national policy to control the disease drawing on a series of actors and instruments such as the state, medical professionals, institutions and services, and the use of technology (notably diagnostic tools) for the detection of the disease. It traces the developments in the organisation highlighting its transformations from a centralising to a decentralised model of service provision. Using the concept of "path-dependence" the article examines the continuities and changes observed in the organisation of female cancer critically signalling the particular time at which a path was taken where "fragmentation" became consolidated within the health system. It also argues that it was within the field of cancer diagnosis that Argentinian doctors first sought to create the foundational structures of cancer organisation. The article contends that the path-dependence analytical approach helps us acknowledge the importance of historical analysis in the identification of factors that led to the lack of service coordination, including the persistent strain between national/provincial states that hampered the development of comprehensive programmes, aspects that have continued to mark efforts in the elaboration of cancer policies to the present day.

Viva Mulher: constructing a cervical cancer control program in Brazil

Through a number of isolated initiatives that began in the 1960s, Brazil accumulated knowledge and experience that in the late 1990s culminated in the implementation of the first nationwide public health action meant to coordinate health bodies and personnel from the federal, state, and municipal administrative levels to address a chronic degenerative disease. The main goal of this article is to analyze the process of construction of this public policy for cancer control in Brazil -more specifically, organized screening for the control of cervical cancer in the form of the Viva Mulher program. Our analytical approach relies on elements from the history of public policy and from the history of institutions, combining the use of documental sources, scientific literature, and interviews with managers involved in the process under study. Our analysis endeavors to show how and to what extent this national process incorporated the experiences of local projects and responded both to pressure from the social movement and to the country's political environment. It further shows how the new context, shaped by changes in the organization of the Brazilian health system, influenced this process.

Diego Alcorta y la difusión de saberes médicos en Buenos Aires, 1821-1842

Este artículo tiene como objetivo analizar los saberes médicos que impulsa el doctor Diego Alcorta derivados de la tradición francesa, en particular los provenientes de la corriente denominada Ideólogie, en el contexto de la Universidad de Buenos Aires entre 1821-1842. Se analiza el proceso de circulación de dichas enseñanzas sumadas a las de la Escuela de Montpellier adaptadas y situadas en el plano local y su paulatino impacto en el ámbito académico, constituyendo un fenómeno relevante en la incipiente conformación de la profesión médica porteña. Alcorta retoma, en especial, la importancia de la observación como método de diagnóstico y curación en el tratamiento de las enfermedades y, la inauguración, en la enseñanza e investigación médicas, de una orientación empírica que introdujo una actividad práctica específica: la clínica hospitalaria. Asimismo, se examina la transmisión de un lenguaje fisiológico y su alcance en las generaciones posteriores preguntándonos qué ocurrió con estos procedimientos prácticos y la difusión de los nuevos saberes fisiológicos. Para responder a esta pregunta compleja se analizan las tesis presentadas y defendidas en el Departamento de Medicina de la Universidad de Buenos Aires durante la época, las que permiten tanto confirmar la presencia del lenguaje sensualista y fisiológico de las enseñanzas de Alcorta como su impacto dentro del mismo ejercicio de la medicina.

The aim of this article is to analyse the medical knowledge that Dr Diego Alcorta derived from the French tradition, especially from the Idéologie movement, in the context of the University of Buenos Aires between 1821 and 1842. It analyses the circulation of these teachings alongside those of the Montpellier School, which were adapted and located at the local level, and their gradual impact on academia as an important phenomenon in the incipient formation of the medical profession in Buenos Aires. Alcorta emphasised the importance of observation as a diagnostic and therapeutic method and called for an empirical approach to medical teaching and research, which introduced a specific practical activity, i.e., hospital clinical work. This article also examines the transmission of a physiological «language» and its relevance to subsequent generations, asking what happened to these practical procedures and the dissemination of new physiological knowledge. This complex question is addressed by discussing the PhD theses developed in the Department of Medicine of the University of Buenos Aires during this period, which provide confirmation of the presence of the sensualist and physiological language derived from the teachings of Alcorta and its impact on the practice of medicine.

Un acercamiento a la historia de la documentación científica en Cataluña: la labor de María Serrallach Juliá (1905-1992) en el Seminario de Química de la Universidad de Barcelona (1937-1984)

En este trabajo se ofrece un estudio sobre María Serrallach Juliá (1905-1992) una de las primeras bibliotecarias especializadas de nuestro país que, entre 1937 y 1975, dirigió el Seminario de Química de la Universidad de Barcelona (SQUB), una biblioteca resultante de la fusión de las de las Facultades de Farmacia y Químicas de la Universidad de Barcelona. Serrallach convirtió el SQUB en un moderno centro de documentación científica, pues ofertó servicios que eran prácticamente inexistentes en el resto de España. En el artículo se estudian también las publicaciones y la actividad docente de Serrallach y se analiza la evolución del SQUB hasta 1984, en que se transformó en la Biblioteca de las Facultades de Física y Química de dicha Universidad catalana.

This article contributes a study of Maria Serrallach Juliá (1905-1992), one of the first specialised librarians in Spain. Between 1937 and 1975, she directed the Seminary of Chemistry of the University of Barcelona (initials in Spanish, SQUB), the name given to the space that resulted from the merger of the libraries of the Faculties of Pharmacy and Chemistry of the University. Serrallach turned the SQUB into a modern scientific documentation centre offering services that were practically non-existent in the rest of Spain. The publications and educational activity of Serrallach are also analysed. The history of the SQUB is studied until 1984, when SQUB was transformed into the Library of the Faculties of Physics and Chemistry of the University of Barcelona.

Prescripciones dietéticas para las élites rectoras del reino de Navarra durante la primera mitad del siglo XVI: los casos de Juan Rena y Juan de Alarcón

Se analizan y transcriben cuatro prescripciones dietéticas para el clérigo de origen veneciano Juan Rena y su servidor Juan de Alarcón, fechadas en la primera mitad del siglo XVI y conservadas en el Archivo General de Navarra. Muestran el interés de médicos y pacientes por la dietética, entendida como el conjunto de medidas higiénico-sanitarias basadas en las res naturales y res non naturales galénicas. Estas cuatro prescripciones están estrechamente relacionadas con un género de literatura médica (regímenes de salud ad personam o consilia) hasta ahora poco estudiado para la España renacentista. Los casos que aquí se exponen evidencian el aprecio entre las clases altas por la posesión de recursos terapéuticos adaptados a las necesidades individuales, que se copiaban y recopilaban para un uso personal.

The aim of this article is to present and analyse four dietary prescriptions from the 16th century prepared for Juan Rena, a cleric of Venetian origin, and his servant Juan de Alarcón, which are kept at the Archivo General de Navarra. These documents demonstrate the interest of the patients and physicians in dietetics, understood as a group of health and hygienic measures based on the Galenic res naturales and res non naturales. These four prescriptions are closely related to the ad personam or consilia health regimens, which represent a genre of medical literature whose significance in Renaissance Spain has received little attention. The cases studied reveal the high esteem in which the elites held the possession of therapeutic resources adapted to their individual needs, which were compiled and copied for personal use.

Shaping biomedical objects across history and philosophy: a conversation with Hans-Jörg Rheinberger

Historical epistemology, according to the historian of science Hans-Jörg Rheinberger, is a space through which "to take experimental laboratory work into the realm of philosophy". This key concept, together with the crucial events and challenges of his career, were discussed in a public conversation which took place on the occasion of Rheinberger's retirement. By making sense of natural phenomena in the laboratory, the act of experimenting shapes the object; it is this shaping which became the core of Rheinberger's own research across biology and philosophy into history. For his intellectual agenda, a history of the life sciences so constructed became "epistemologically demanding".