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 Reasoning against Madness
Psychiatry and the State in
Rio de Janeiro, 1830–1944

Manuella Meyer

Meyer.indd iii 5/15/2017 5:46:52 PM

 The University of Rochester Press gratefully acknowledges generous support from
the University of Richmond.

Copyright © 2017 by Manuella Meyer

All rights reserved. Except as permitted under current legislation, no

part of this work may be photocopied, stored in a retrieval system,
published, performed in public, adapted, broadcast, transmitted,
recorded, or reproduced in any form or by any means, without the
prior permission of the copyright owner.

First published 2017

University of Rochester Press

668 Mt. Hope Avenue, Rochester, NY 14620, USA
www.urpress.com
and Boydell & Brewer Limited
PO Box 9, Woodbridge, Suffolk IP12 3DF, UK
www.boydellandbrewer.com

ISBN-13: 978-1-58046-578-6
ISSN: 1526-2715

Library of Congress Cataloging-in-Publication Data

Names: Meyer, Manuella, author.

Title: Reasoning against madness : psychiatry and the state in Rio de Janeiro,
1830–1944 / Manuella Meyer.
Description: Rochester, NY : University of Rochester Press, 2017. | Series: Rochester
studies in medical history, ISSN 1526-2715 ; v. 41 | Includes bibliographical
references and index.
Identifiers: LCCN 2017014092 | ISBN 9781580465786 (hardcover : alk. paper)
Subjects: LCSH: Psychiatry—Brazil—Rio de Janeiro—History—19th century. |
Psychiatry—Brazil—Rio de Janeiro—History—20th century.
Classification: LCC RC451.B62 R657 2017 | DDC 362.1968900981/53—dc23 LC
record available at https://lccn.loc.gov/2017014092

A catalogue record for this title is available from the British Library.

This publication is printed on acid-free paper.

Printed in the United States of America.

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 In Loving Memory of Reynold Meyer

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Meyer.indd vi 5/15/2017 5:46:54 PM
 Contents
Acknowledgments ix

Note on Brazilian Orthography and Terminology xiii

Introduction 1

1 Sanity in the South Atlantic: The Myth of Philippe Pinel and

the Asylum Campaign Movement, 1830–52 16

2 “Of Grand Intentions” and “Opaque Structures”: The Fight

for Psychiatric Management of the Hospício Pedro II during
Brazil’s Second Empire, 1852–90 41

3 The Government of Psychiatry: The National Insane Asylum’s

Interior Lives, 1890–94 67

4 “The Service of Disinterested Men”: Psychiatrists under State

and Civil Scrutiny, 1894–1903 93

5 Breaking Out of the Asylum: Rio de Janeiro’s Mental Hygiene

Movement, 1903–37 112

6 Mad Spirits of Progress, 1927–44 145

Conclusion 176

Notes 181

Bibliography 221

Index 241

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Meyer.indd viii 5/15/2017 5:46:54 PM
 Acknowledgments

It is a great pleasure to acknowledge the many people who have supported

me throughout this project. I owe an enormous debt of gratitude to Stuart
B. Schwartz, Gilbert M. Joseph, Alondra K. Nelson, and John Harley Warner,
my advisers at Yale University. They’ve guided my work wisely and gener-
ously while inspiring me through their writing and teaching.
In recent years, my University of Richmond colleagues David
Brandenberger, Joanna Drell, John Gordon, Robert Kenzer, Tze Loo, David
Routt, Nicole Sackley, Carol L. Summers, John Treadway, Sydney Watts,
Hugh West, Yücel Yanikdağ, and Eric Yellin have provided me with an intel-
lectually enriching and nurturing environment. Deborah Govoruhk, the
most thoughtful and supportive department administrative assistant one
could ever hope for, deserves special mention. She provided me with end-
less technical support, useful advice, and kindness.
The staffs of libraries and archives in the United States and Brazil guided
me through the challenges of the research process. In the United States, I
would like to thank César Rodriguez at Yale and the staff of the Hispanic
Division at the Library of Congress. In addition, Mary Lou Reker, Jason
Steinhauer, and Carolyn Brown at the John W. Kluge Center of the Library
of Congress, along with Jeannine Keefer, visual resource librarian at the
University of Richmond, provided critical support and encouragement dur-
ing the last stage of research.
Individuals too numerous to list assisted me in my research in Brazil,
including the amazing staff of the Arquivo Nacional, the Arquivo Geral
da Cidade do Rio de Janeiro, the Biblioteca Nacional, and the Arquivo
Público do Estado do Rio de Janeiro. The staff at Oswaldo Cruz Foundation
(Fiocruz) and the Academia Nacional de Medicina proved indispensable to
the project. Moreover, they always welcomed me warmly and enthusiastically.
Cátia Mathias, the head librarian at the Psychiatry Institute of the Federal
University of Rio de Janeiro, and Cristiana Facchinetti, scholar extraordi-
naire of the history of Brazilian psychiatry, were also invaluable to this proj-
ect. I am very grateful for their help.
My research would not have been possible without support from the Jacob
K. Javits Fellowship, Fulbright-Hayes Fellowship, Yale University Graduate

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 x • acknowledgments

School, Yale Council on International and Area Studies, Yale Department

of History Mellon Research Grant, the Yale Latin American Studies Mellon
Fund, and the Ann Plato Fellowship program at Trinity College. The David
K. Larson Fellowship in Health and Spirituality through the John W. Kluge
Center at the Library of Congress and the Faculty Research Committee at
the University of Richmond funded my final forays into the archive.
En route to becoming a part of this volume, an earlier version of chapter
1 appeared as “Sanity in the South Atlantic: The Mythos of Philippe Pinel
and the Asylum Movement in Nineteenth-Century Rio de Janeiro,” Atlanic
Studies 7, no. 4 (2010): 473–92. An earlier version of chapter 2 appeared
as “‘Of Grand Intentions’ and ‘Opaque Structures’: Managing the Hospício
Pedro II during Brazil’s Second Empire (1852–90),” Bulletin of the History
of Medicine 89, no. 4 (Winter 2015): 733–60, © 2015 by the Johns Hopkins
University Press. I wish to thank the publishers of these works for their kind
permission to reprint.
Ted Brown, series editor of the Rochester Studies in Medical History, and
the anonymous readers vastly improved this book with their many insightful
suggestions. A particular note of thanks to Ted for believing in this project
and patiently teaching this novice author about the process of producing a
book. Sonia Kane and Ryan Peterson at the University of Rochester Press
shepherded this book through its various stages.
Friends have provided deep support over the years and across conti-
nents. I owe my most enthusiastic thanks for solidarity, friendship, and
intellectual support to Louise Walker, Ryan D. Crewe, Amy Chazkel, Brandi
Hughes, Alison Bruey, Jay Driskell, Emmanuel Raymundo, Martine Jean,
Kari Zimmerman, Melissa Stuckey, Emily Musil, Vijay Prashad, Okezi Otovo,
Colin Jones, Marc Hertzman, Sonia Song-Ha Lee, and Tara Tappert. As I
type out the letters of your names, I picture conversations over coffee, walks
to restaurants, chats in office hallways, and email exchanges offering pro-
ductive criticism on a chapter draft or advice on book preparation. I hope
that you each read between the lines your important individual contribu-
tions to this book.
The idea of this book most likely began when I was five years old in Port-
au-Prince, Haiti. My mentally ill uncle Raynold and I talked to each other
for hours on end. While many failed to fully comprehend my most reliable
and dear confidante, he was always intelligible to me. In more ways than
one, this project begins and ends with him. Bearing witness to the ways in
which my grandmother and father cared for him left an indelible imprint
on my mind about resilience, courage, and love. Both my mother and father
have given me so many things for which I am grateful, especially their insis-
tence that I pursue my passions and their unwavering support. I would also
like to acknowledge my supportive siblings, Natacha and Hans Karl, along
with my in-laws on all sides of the family.

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 acknowledgments • xi

Last but certainly not least, I would like to thank my son, Miles, and
my husband, Will Machin. Miles bore the brunt of the time I put into fin-
ishing this book with grace and good humor. Will, my critic, editor, men-
tor, and best friend, has been with this project and in my life through its
inception, development, and conclusion. I am grateful for his support,
love, and patience.

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Meyer.indd xii 5/15/2017 5:46:54 PM
 Note on Brazilian
Orthography and Terminology

The Brazilian Portuguese language had not yet been orthographically stan-
dardized in the nineteenth and early twentieth centuries. For all proper names
of persons, I used the spelling that most frequently appeared in the contem-
poraneous documentation. I spelled all proper names of places according to
present-day conventions. For all other words, I hew to today’s standard.
The translation of racial labels from Brazilian Portuguese to English is
a difficult task. The terms that denote some form of African ancestry (e.g.,
negro, preto, pardo, mulato, etc.) do not have clear equivalents in English.
Racial categories and labels in any language are messy and problematic as
racial categories in and of themselves can be. In the pages that follow, I fre-
quently use “Afro-Brazilian” and “black,” familiar terms to most US readers
and others with accessible Brazilian Portuguese equivalents such as negro or
preto. In addition, I use “African-descended,” “men and women of color,”
and so on. As much as possible, I have preserved these, and other, labels in
direct quotations, and in my own prose, I have attempted to use terms that
establish a balance between Brazilian and US conventions. However, it is
important to note that English terms do not represent a pristine reproduc-
tion of the language used by the men and women that appear in this book.

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 0 1 2 miles N
0 1 2 kilometers
W E

Guanabara
Bay

Campo de
Santana
Cidade Nova
Mangue
Praça Largo da
Onze Carioca
Estácio
Catumbi
Glória

Catete

Laranjeiras

Botafogo

Copacabana

ATLANTIC
OCEAN

Rio de Janeiro, ca. 1890. The map here represents a general spatial overview of
the city’s key neighborhoods and landmarks. Map by Bruno Carvalho and Bert
Barickman, in Marc A. Hertzman, Making Samba: A New History of Race and Music
in Brazil (Durham, NC: Duke University Press, 2013), 16. © Duke University Press.
Reproduce by permission.

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 Introduction

On December 5, 1852, doctors, Catholic officials, Emperor Dom Pedro I,

and other members of the royal court celebrated the inauguration of the
first national public mental asylum, the Hospício Dom Pedro II, in Rio de
Janeiro. The lavish ceremony was seemingly a success as the press touted the
institution “a great triumph of philanthropic ideas” that placed the city on
the “path of material progress,” marking “a notable era in the civilization of
the country.”1 Prior to the second half of the nineteenth century, the men-
tally ill were treated according to their means. The wealthy, if relatively tran-
quil, were treated at home and sometimes sent to Europe by their families
under the advisement of doctors. Their poor and working-class counterparts
were placed under the care of their families or housed in one of the mul-
tifunctional jails or poorhouses that held societal castoffs such as beggars,
prostitutes, orphans, and vagrants. The mad were treated much the same as
other marginalized sectors of Brazilian society.
By the mid-nineteenth century, however, the insane were sharply distin-
guished from other “problem populations.” They were incarcerated in a
state-supported asylum system that isolated them both physically and sym-
bolically from the larger society. The Hospício de Dom Pedro II contained
only the mentally ill with the aim of medically treating and rehabilitating
them through methods that affected the psyche. Over the course of the mid-
nineteenth and early twentieth centuries, a new set of experts, the alienists,
later known as psychiatrists, introduced the Brazilian public to a series of
treatments and initiatives to treat the mad. They also hoped to instill sound
mental hygiene practices among their fellow citizens. How and why, then,
did an asylum, the first in Latin America, come about? How did psychiatrists
emerge to become one of the primary knowledge experts to manage the
presumed mentally ill? Explaining these remarkable shifts is the central task
of this book. This project investigates how professional psychiatry emerged
in Rio de Janeiro. A seemingly innocuous protest led by doctors over the
spread of a mysterious “fever” outside Rio de Janeiro in 1830 paved the way
for a larger critique of public health institutions and measures. By under-
mining the legitimacy of existing state institutions that purported to care for
the mentally ill, and by extension, the constitutional monarchy’s inability

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 2 • introduction

to secure the health of its citizens-subjects, doctors compelled state officials

to authorize the creation of an asylum lest these officials confirm the state’s
tenuous obligation to its population during a critical time of state formation.
Unlike the wave of independence movements finding success throughout
Spanish America during the early nineteenth century, the political leader-
ship in Brazil followed its own peculiar path when Emperor Pedro I formally
broke with Portugal in 1822. In one of its many points of divergence with
its Spanish American counterparts, Brazil became the only Latin American
country to gain independence by imperial decree and to establish itself as a
constitutional monarchy until the declaration of the republic in 1889. Many
historians of Brazil noted that the fear of democratic revolution after inde-
pendence ushered in a political process wherein politicians chose to recon-
cile differences and conflicts as a means to safeguard the political system
from supposed unpredictable forces. As the politics of conciliation became
a hallmark of Brazilian political culture during the latter half of the nine-
teenth and early twentieth centuries, its complex, uneasy, and sometimes
unwieldy workings could prominently be seen through the professionaliza-
tion of psychiatry.
The emergence of psychiatry in Brazil as a discrete medical specialty can
be situated within the processes of bureaucratization and secularization. The
professionalization of medicine and the application of more stringent stan-
dards in teaching and practice, the priorities of state building, the construc-
tion of national identities, the centralization of state power, and the reduction
of the role of the church in public life were dominant themes in the medi-
calization of madness and the emergence of psychiatry.2 But the particular
way that madness was modernized in Brazil highlights several previously unex-
plored social and political dimensions of Brazilian psychiatry. The profession-
alization processes of numerous occupational groups in the latter half of the
nineteenth century had much in common with that of psychiatrists. They, like
lawyers, journalists, and businessmen, among others, sought to prove their
professional legitimacy in the public sphere by virtue of their possession of a
specific form of expertise. However, among the multitude of medical special-
ties that became institutionalized, Brazilian psychiatry distinguished itself as
its professionals stressed the existence of a public under threat from explicit
and implicit mental ailments. This study then, reconstructs how, after having
garnered a certain level of professional legitimacy, psychiatrists sought more
influence by focusing on efforts to project a psychological mindset onto the
Brazilian public in order to produce a disciplined and a mentally hygienic
citizenry. A therapeutic society was not thrust upon Cariocas, as residents of
Rio de Janeiro are called, by a conspiracy of medical experts who hid behind
a screen of technical jargon. Psychiatrists did attempt to expand their sphere
of influence, but they were often encouraged to do so by jurists, senators, and
others who guided society and culture.

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 introduction • 3

This book thus traces the kinds of sociopolitical arrangements that

allowed for the identification and transformation of the problem of mental
illness into a dilemma of postcolonial governance. In doing so, it examines
the rise of psychiatry as a distinct medical specialty in mid-nineteenth and
early twentieth century Rio de Janeiro, primarily through the trials, tribula-
tions, maneuverings, and actions of its practitioners. The book chronicles
their battles over the causes, management, and treatments of madness with
competing knowledge experts while seeking to obtain legitimacy for psychia-
try as a medical field and public utility. The thread of this narrative connects
a cast of varied characters in an unstable context: psychiatrists, Catholic offi-
cials, candomblé healers,3 Kardecist spiritists,4 politicians, and the mentally
ill in the shifting landscape of modern state formation. As medical training
and education were being reformed after the declaration of the republic in
1890, doctors began to insert themselves more consciously into the public
sphere as both shapers and enforcers of public policies. Psychiatrists under-
stood insanity not only as an illness but as a socially destabilizing force that
threatened the progress and prosperity of the capital city and, by extension,
the nation.
As a sociopolitical history of psychiatry, Reasoning against Madness:
Psychiatry and the State in Rio de Janeiro, 1830–1944 argues that an early twen-
tieth-century Brazilian psychiatry, marked by a new focus on the collective
and the social environment, both transformed liberal politics alongside
notions of mental hygiene and, crucially, forged new connections between
the two. It describes the processes through which doctors transformed mad-
ness from an unremarkable, if troubling, dimension of human experience
into a serious sociopolitical problem; a public health dilemma; an intellec-
tual conundrum; and, above all, a problem that medicine promised, and
failed, to solve. As doctors, Catholic officials, Kardecist spiritists, and can-
domblé healers with competing visions of the causes and treatments for
insanity each sought to wrest interpretive control from the others as well
as from their subjects, psychiatric assertions of authority over mental illness
failed to achieve broad assent.
When nineteenth-century Brazilian doctors turned their attention to
madness in all its forms—from mild neuroses to full-blown insanity, from
depression to hysteria, from trying to fathom the motives of murderers and
suicides—they became deeply implicated in governmentality by “producing
new forms of knowledge, inventing new notions and concepts that contrib-
uted to the ‘government’ of new domains of regulation and intervention.”5
The operation of governmentality in Rio de Janeiro that began in the early
nineteenth century with the implementation of reforms orchestrated under
the arrival of the Portuguese court observed by many historians continued
exponentially over the course of the early twentieth century.6 Reforms aimed
at transforming personal behaviors were intended to reorient personal

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 4 • introduction

conduct damaging to individual and public health. Drinking, gambling,

prostitution, forms of public leisure and entertainment, and an unsanitary
urban milieu became objects of concern because of their presumed harmful
effects. These behaviors not only damaged individual health but threatened
Brazil’s social progress and restrained its economic prosperity. As people had
to be trained or taught that they had an obligation to care for themselves,
part of being a responsible and productive subject required “self-care” and
entailed “shifting responsibility for social risks, illness, unemployment, pov-
erty into a domain of individual choice and responsibility for the self.”7 The
creation of a public in need of care that necessitated considerable medical
and state intervention did not preclude the public’s acceptance of public
health and medical reforms. Indeed, it is not at all clear that psychiatrists
achieved a great deal of success training individuals in self-governance. The
effects of psychiatric thought are difficult to measure and assess, but the
view from the asylums and outpatient mental hygiene clinics alongside the
ways in which doctors wrote about mental illness and its causes strongly sug-
gest that while psychiatric ideas were influential in shaping specific public
policies, they had limited effects in their diffusion and acceptance.
Focusing upon the complex social and political status of psychiatrists
leads me to not overestimate their roles as been acknowledged in Brazil and
elsewhere. Where it has been considered at all by historians of Brazil, men-
tal illness has usually been treated in relation to or as a variation on the
state’s concern with maintaining social order, providing more efficient polic-
ing of the city and enforcing new laws on disruptive public behavior, espe-
cially drunkenness, violence and prostitution. The mad have been portrayed
as little more than criminals, deviants, and of concern to authorities only
because of the threat they posed to social order. This study takes a slightly
different perspective, focusing less on the role of the insane and more on
the role that psychiatrists played in structuring relationships between them-
selves, patients, the public, and the state.
I do not showcase the perspectives and experiences of the mentally ill.
Mental illness was real, terrifying, and destructive for its sufferers. However,
I faced a paucity of sources on the perspectives of the mentally ill, finding
few that would lend themselves to an analysis that would truly shed light
on their experiences. Although this book understands madness both as a
medical fact and a personal reality, it concentrates on the intellectual and
cultural construction of madness as a field of knowledge, thereby making
psychiatrists the subjects under the academic gaze.
My methodology draws on works propelling sociopolitical and cultural
discursive analyses that lie in the intersections of history, political theory,
and anthropology and aims to oppose the disaggregating of medicine from
politics, society, and culture. In this manner, I make extensive use of a wide
variety of sources that include asylum records, medical journals, government

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