More than two hundred European and North American men and women wrote and published about their travels or residence in Brazil during the nineteenth-century. The majority of travelers spent only a few weeks in Rio de Janeiro, often on route to other countries and continents, and left us their brief, first impressions. Rarely are these impressions very empathetic, especially in light of the prevalence of slaves until 1880s and dangerous epidemics after 1850. A handful of others lived for many years within Brazil and traveled extensively, getting to know Brazil better than most Brazilians. For historians, care must be taken to discern the impressionist accounts from those that achieve a much deeper understanding of Brazilian society, culture and religion. Furthermore, these travelers arrive with stereotypes of the countries they are visiting and, like all of us, they usually seek (unconsciously or consciously) to find evidence to support those preconceived views. Beyond these problems traveler narratives are often a rich source (and fun to read) because foreigners were more apt to describe aspects of Brazilian life that rarely appears in other sources. Foreign travelers saw the ordinary and banal—that which is excluded from the historical record because of its lack of intrinsic importance—as extraordinary and noteworthy. Their outside perspectives can give better explanations for events and facts that might seem inscrutable in other sources. Many travelers’ commented on public health of Brazil and prevailing diseases, making this an important type of source for this project.

Maps come in all scales and each level of representation opens different avenues for analyzing the appearance, frequency, and movement of diseases. For the post-colonial monarchical government of the nineteenth century, maps were a good way of measuring and controlling the vast Brazilian Empire. Cartographers also represented towns and cities on detailed maps and this is one of the best sources for getting a sense of the diversity and bustle of cities in the past. Engineers made maps of bridges and highways and by the end of the nineteenth century, architects and builders registered blueprints of houses and commercial buildings in local notary offices.

Mapping and spatial analysis is at the heart of this project because, up to this point, we know very little about where and when major diseases occurred in Brazil, despite the fact that epidemics had profound social, political and economic effects. I plan to use maps to document where and when epidemics struck within the borders of Imperial and early Republican Brazil. Medical historians have also used household maps with data on infirm family members to show infectiousness at the micro level and, depending on the sources I find, I may also narrow the focus to this intimate but broadly revealing level.

Brazilian hosptials mostly treated mariners and the destitute during the nineteenth century. People with even a small amount of savings paid for treatment in their home by a visiting doctor. For this reason, this source is largely limited to social groups with low income and status. Despite this limitation, this is one of the few places were we can learn about what hurt and made Brazilians sick. Most of these afflictions were not the same as those that commonly killed Brazilians, and the majority of hospital patients recovered. Depending on the hospital and time, between 10 and 25 percent of patients died. In this set of images are a few examples of books that registered the entry and exit (or death) of patients. In my records, I have copies of hospital registers from Santos (1861-1909), Porto Alegre (1844-1903), and Recife (1871). In the next few months I hope to add registers from Salvador and a city in Minas Gerais.

Much of this project has to do with terminology and nosology. I am examining categories of afflictions, as diagnosed by nineteenth-century doctors. Medical science has, of course, shifted much in the last 100-150 years and many of the terms that are listed in the historical sources are now archaic and arcane. In order to better understand these terms (categories), we have a number of useful books that can help translate and describe terms. This gallery contains several examples. Unlike the others, though, all of the sources are available for download through Google Books.

In 1850, the practice of burying corpses under the floors and in the backyards of churches was outlawed, thus ending a tradition of burial practices that dated to the Roman period. In liberal fashion, this imperial law also wrestled control over procedures of death from the hands of the Catholic church and put this ultimate responsibility more firmly in the hands of the townships. Cemeteries and the practice of burial was far from secular after 1850, however, since religious brotherhoods and sisterhoods and priests continued to control parts of the cemetery land and declare those parts particularly sacred for their members. The procedure of death registration was regularized and more carefully monitored by government officials. For example, when a body was sent to be buried, a death certificate, signed by a medic or official, had to be included. Cemetery record keepers copied the information from these small slips of paper into their register books, only adding the location of burial within the cemetery and whether fees had been paid. These records usually list the cause of death, allowing historians to discover the deadliest afflictions in this society. Of course, medicine has made advances and revisions, and some of the diseases that doctors listed were incorrect or were symptoms and not causes of the illness. But there is little doubt that the deadliest diseases, such as tuberculosis and smallpox, were identified correctly by nineteenth century doctors.

Big towns and cities were too large to know where everything was. Where could one find a good farrier or cobbler? For a place as large as Rio de Janeiro, the locals might only know those commercial establishments in their neighborhood. By the mid-nineteenth century, with printing presses becoming more common, entrepreneurs began publishing almanacs to help people find commericial establishments. These books also listed the names of elected and non-elected government officials or recently published laws, and many other types of information. For the history of medicine, this source gives us insight into the rapid growth of private medical care after 1860. In some instances, these almanacs give us an idea of where doctors, dentists, bloodletters, surgeons, and midwives lived and worked. Neighborhoods were far from homogeneous in the types of medical professions represented. Many Brazilians turned to folk healers instead of doctors, and this included slaves and African healers. Unfortunately, almanacs tell us very little about folk healers, a group that was often condemned by the physicians as charlatans.

During the nineteenth century, the Catholic church relinquished some of its control over the most important life rituals in society, including baptism, marriage, and death. Catholics still perform these rituals in the church today, but by the end of the nineteenth century, town governments were also keeping records of the birth, marriage and death of its citizens and then sending summaries of this information onto the provincial and federal governments. Despite its loss of power, church records remain one of the best sources for tracking epidemics and finding the most common causes of death. Unlike other sources, no social group was excluded.

Each year the presidential offices of each province was required to prepare a report that was sent to the Imperial capital, published, and disseminated fairly widely. It was not only a good way for the imperial government to keep track of its domain, but for the provincial governments to know what was happening in other parts of the empire. Most reports included a few pages on the health of its people. Since these reports were written by officials who either wanted to show that they ruled capably, or who wanted emergency money from Imperial coffers, the reports alternated from overly optimistic to overly grim. Nonetheless, no other source gives better information on the prevalence of epidemics at the provincial and national level.

Brazil had two prominent medical schools in the nineteenth century, one in Rio de Janeiro and the other in Bahia. To graduate, students were assigned a subject, which they researched in order to complete a thesis. During times of epidemics, there could be more than one student researching the cause of the scourge. All of the theses are available in a handful of Brazilian libraries, such as the National Library. They are useful for this project because they give many details about how epidemic and endemic diseases operated in Brazil. In addition, they help us confirm that doctors in the nineteenth century were identifying the major diseases correctly because they give detailed information on the physiology and symptoms of the diseases they identified. This information can be compared with contemporary descriptions of disease to confirm the category.

Newspapers can be a wonderful source for getting at quotidian aspects of the past and for finding all sorts of details about health and medicine. They can also be frustrating because, in all the pages of fine print, searching for certain articles or advertisements is like looking for a needle in a haystack. Care has to be taken to limit one's time, but when that time is spent well, this can be a rewarding source of information.