One-hundred years of Henrique Roxo as Full Professor of Psychiatry at the Federal University of Rio de Janeiro and the Publication of his Psychiatric Manual

Guimarães, Patricia Machado Quintaes; Mathias, Catia Maria; Gomes, Marleide da Mota; Nardi, Antonio Egidio

doi:10.1590/0047-2085000000347

Henrique de Brito Belford Roxo (1877-1969) (Figure 1) was a full professor of the psychiatric clinic (1921-1945), the first director of the Institute of Psychiatry of Rio de Janeiro (1938-1945), and professor emeritus of the University of Brazil (1946). His advisor and great influencer was the psychiatrist João Carlos Teixeira Brandão (1854-1921), a professor at the University and the first appointed Chair of the Psychiatric Clinic and Nervous Diseases (April 25^th, 1883)¹. In 1900, Roxo graduated from the Faculty of Medicine of Rio de Janeiro with the doctoral thesis entitled “Duration of Elementary Psychic Acts in the Alienated.” As a great admirer of the French School of Psychiatry, in 1907, he became one of the founding members of the Brazilian Society of Neurology, Psychiatry, and Legal Medicine. Additionally, Henrique Roxo joined Juliano Moreira (1873-1933) and other distinguished psychiatrists in the creation of the first nosological classification of Brazilian psychiatry between 1908 and 1910². Throughout his career, Roxo authored several books and published roughly 140 papers in the main national medical journals, such as Brasil Médico, as well as in foreign scientific journals, like the L’Encéphale (France) and Revista de Criminologia, Psiquiatria Y Medicina Legal (Argentina). He published numerous articles in the Arquivos Brasileiros de Psiquiatria, Neurologia e Ciências Afins, the first Brazilian journal specialized in psychiatry created in 1905, which sought to establish a relationship between mental illness and cerebral alterations or dysfunctions³. On top of his academic work, the doctor, worked to disseminate to the public and the medical community the importance of psychiatry in the medical sciences and its role in preventing mental illness⁴. His work as a professor at the Faculty of Medicine of Rio de Janeiro (1905-1945) contributed to the formation of an entire generation of Brazilian psychiatrists. His career was respected and valued in Brazil’s psychiatric field and othercountries in Latin America, Europe, and the United States of America⁵. On September 20, 1921, Henrique Roxo became the Chair of the Psychiatric Clinic of the Faculty of Medicine of Rio de Janeiro and was responsible for managing the Observation Pavilion. As the appointed Chair, the doctor organized theoretical and practical classes of psychiatry, hired new professors, promoted academic debates and training to the new specialists, and disseminated psychiatric knowledge³. In 1925, the discipline of psychiatry became mandatory in the Faculty of Medicine, increasing the number of students dedicated to the field of Psychiatry. Driven by this, an amphitheater for classes was inaugurated in 1929, in addition to specialization courses. In 1938, inspired by the ideals of organic psychiatry from the German doctor Emil Kraepelin (1856-1926), who tried to correlate mental disorders to somatic alterations, Henrique Roxo founded the Institute of Psychiatry (IPUB), which was linked to the University of Brazil. Seeking inspiration, he then visited the Germanic Institute for Psychiatric Research on three occasions, leading to the increased discussion and incorporation of the German psychiatric practices into his studies and work. At the newly created IPUB, the priorities were teaching, research, and therapeutic proposals aimed at the organic dimension of the patient³. He was interested in studying Brazilian medicinal plants and used them as part of the patient’s treatment. As a dedicated teacher, Henrique Roxo documented his classes and clinical cases with most of his patients treated at the Institute of Psychiatry. His findings were then taught to his students as part of their education as psychiatrists. In the same year that he took charge as the chair of Psychiatry, Roxo published the Manual of Psychiatry, which combined 20 years of experience with patients from the National Asylum for the Alienated with modern concepts about mental illnesses (Figure 2)³. Its later editions were published in 1925, 1938, and 1946, with the first three editions published by the Francisco Alves bookstore and the last by Editora Guanabara³. This manual was a work of great importance in the academic environment, acting as a key source of knowledge and guidance for medical students during their training. The book covered modern themes and techniques, making updated concepts and practices available to aspiring psychiatrists. Rising new topics from contemporary psychiatry were added to each new edition, such asoccupational therapy, psychotherapy, application of electroencephalogram in the differential diagnosis of mental illnesses, issues of forensic psychiatry, as well as the interface between psychiatry and other medical specialties, like endocrinology. The manual written by Henrique Roxo also highlighted the role of sexuality in mental illness by mentioning Freud’s ideas and psychoanalysis³. Newspapers from the time, such as A Noite and Correio da Manhã, published favorable manual critics, reinforcing that it was a work of great interest to doctors, students, and lawyers³. In 1936, he gave lectures promoting Brazilian psychiatry at the Clinic of Mental Diseases of the University of Paris, the Psychological Medical Society, and the Society of Neurology in France. Four years later, he attended the 8^th American Scientific Congress, presenting his work “How is treated the insane at Rio de Janeiro, in the Institute of Psychiatry,” which helped disseminate Brazilian psychiatry and the medicinal use of plants in the United States. The psychiatrist then created a journal in 1942 entitled Anais do Instituto de Psiquiatria, documenting and disseminatingto the scientific community the results from theresearch carried out at the then newly created Institute of Psychiatry³. Although Roxo retired in 1945, he continued to work until he was 90 years old. He passed away at the age of 92 in 1969, leaving behind an incalculable legacy for the Brazilian psychiatric field⁴.

Figure 1
Henrique Roxo. Source: Collection of the National Academy of Medicine, Rio de Janeiro, Brazil.

Figure 2
Title page of the Psychiatry Manual, 1921. Source: Collection of the Library of the Casa de Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

REFERENCES

¹ Facchinetti C, Venancio ATA. Entre a psicanálise e a degenerescência: sexualidade e doença mental no início do século XX no Brasil. Rev Latinoam Psicopat Fundam. 2006;19(1):151-61.
² Venancio ATA. Classificando diferenças: as categorias demência precoce e esquizofrenia por psiquiatras brasileiros na década de 1920. Hist Ciênc Saúde-Manguinhos. 2010;17(Supl 2):327-43.
³ Mathias CM. O Pavilhão de Observação na psiquiatria do Distrito Federal: a gestão de Henrique Roxo (1921-1945) [dissertação]. Rio de Janeiro: Fundação Oswaldo Cruz, Casa de Oswaldo Cruz; 2017.
⁴ Mathias CM. Henrique Roxo (1877-1969). In: Vianna C, Engel, MG, (Orgs.). Trajetórias e sociabilidades intelectuais no Rio de Janeiro: séculos XIX e XX. Rio de Janeiro: Contra Capa; 2017. p. 179-88.
⁵ Venancio ATA. Os alienados segundo Henrique: ciência psiquiátrica no Brasil no início do século XX. Culturas Psi. 2012;0:29-44. Available at: https://www.arca.fiocruz.br/handle/icict/23907
» https://www.arca.fiocruz.br/handle/icict/23907