CRUZ, OSWALDO GONçALVES

(b. São Luís de Paraitinga, São Paulo, Brazil, 5 August 1872; d. Metropolis. Rio de Janeiro, Brazil, 11 February 1917)

public health, medicine.

Cruz’s contributions to public health and medicine were closely intertwined. As the “sanitize” of Rio de Janeiro, he rid that city of yellow fever and bubonic plague; and as director of what became known as the Oswald Cruz Institute, he created the first important center for medical research in Brazil. His career is thus of considerable interest to scholars concerned with the growth of science in developing countries.

Cruz was the son of Bento Gonçalves Cruz, a physician who was active in public health work for the imperial government. In 1877 the family moved to Rio de Janeiro, where Cruz attended medical school, completing the M.D. requirements in 1892 with a thesis on waterborne bacteria. In 1896 Cruz was able to continue his studies in experimental medicine. He went to Paris, where he worked at several institutions, the most important being the Pasteur Institute. Cruz also specialized in the clinical field of urology but, as he wrote to a friend, he detested clinical medicine and planned to use his training in microbiology, pathology, histology, and chemistry to set up a laboratory in Brazil where he would perform medical diagnoses. Cruz returned to Rio de Janeiro in the fall of 1899. A highly trained medical scientist and nationalist, he believed firmly that science could play an important role in his native country.

Shortly after his return he was appointed to the staff of a small laboratory on the outskirts of the city. The laboratory had not been founded as a center of research. The municipal authorities in Rio had opened the laboratory to produce plague vaccine and serum to fight an epidemic that had spread from Santos. A little later the federal government took control and renamed it the Serum Therapy Institute of Manguinhos. By 1902 Cruz had become director.

Until 1903 the institute was a classic crisis laboratory, that is, one designed to respond to a specific challenge. Such laboratories often have overly restricted functions, budget, and staff, and cannot expand their activities once the immediate medical crisis has passed. The Serum Therapy Institute escaped this fate when Cruz took charge of Brazil’s first large-scale and systematic “sanitation” campaign in Rio de Janeiro. From 1903 to 1909 the institute was an integral part of the campaign.

Francisco de Paula Rodriguez Ales was elected president of Brazil in 1902. He had campaigned on the need to reform Brazilian culture and to eliminate the epidemic diseases that had given Rio de Janeiro the reputation of being one of the least healthy cities in South America. In 1903 he entrusted the supervision of sanitation to Cruz, who proposed an ambitious program against bubonic plague, smallpox, and yellow fever, basing the extinction of yellow fever on the recent work of the Reed Commission in Havana. Cruz organized the yellow fever prophylaxis service, the purpose of which was to police zones of infection, eradicate the Aides aegypi mosquito, and identify, register, and isolate yellow fever victims.

Although Cruz enjoyed the political support of Aves, many factors contributed to making the campaign controversial. Opposition to compulsory vaccination was strong and although it became mandatory by law in 1904, many people were not vaccinated and in 1908 the city experienced one of its worst outbreaks of smallpox. The campaigns against yellow fever and the plague, however, were successful. As early as 1906 Cruz reported that yellow fever no longer existed in epidemic form in Rio.

In 1903 Cruz had asked the Brazilian Congrèss to make his institute a “Pasteur Institute,” where preparation of vaccines and serums, teaching, and research would be combined. His proposal was rejected as costly and unnecessary. As director of the nation’s public health program, however, Cruz was able to steer money, materials, and people to Man-guinhos, and in 1907 with the sanitation campaign already a success, the Congrèss granted his request. The Serum Therapy Institute became the Institute of Experimental Pathology, and its budget was tripled. That year Cruz was honored with the gold medal at the International Congress on Hygiene and Demography at Berlin, and in 1908 the institute was renamed the Cruz Institute by presidential decree.

Although it is clear that the sanitation campaign had a decisive impact on the institute, its survival after Cruz resigned from the directorship of public health in 1909, and its growth into a productive research institution, must be viewed as the result of his shrewd institution-building.

Several factors explain his success. As a nationalist trained at a first-rate European institution of medical science, he enjoyed great scientific prestige. As the director of one of the most influential government agencies of the day, Cruz was able to attract technicians and students to the sanitary sciences. His decision to use the Serum Therapy Institute as a strategic arm of the public health campaign meant that technicians came to the institute to prepare vaccines and serums, physicians came to carry out research, and medical students came to prepare their theses.

Cruz published thirty-six scientific papers during his lifetime-some describing new species of mosquitoes or diseases caused by protozoa, others concerning measures of prophylaxis against epidemic disease-but scientific writing slowly took second place to organization and teaching. With his young staff he was stern but supportive, stressing the value of both basic and applied research as well as practical hygiene. He was excellent in directing the staff toward fruitful problems for research. To encourage familiarity with foreign work in the field, Cruz instituted regular seminars during which scientific articles in foreign journals were discussed. He created the first library in Latin America that specialized in microbiology, and he supervised the production of glass equipment for the institute.

From among the doctors and students recruited and trained from 1903, Cruz chose the first official staff in 1907. All of the eight original staff members were Brazilians, and five —Carlos Chagas, Henrique da Rocha Lima, Artur Neiva, Henrique de Beaurepaire Aragão, and Antônio Cardoso Fontes—achieved fame in medical research. In 1908 Rocha Lima left Brazil to continue his career in Germany. His place in pathology was taken by Caspar Vianna, who studied yellow fever and leishmaniasis until his accidental death in 1914. The distinguished protozoologist and entomologist Adolfo Lutz joined Cruz in 1908. In 1909 the informal methods of training were replaced by a formal course in microbiology, based on the cours de microbie technique taught by Émile Roux at the Pasteur Institute, That year the Cruz Institute also began publication of Memorias do Instituto Oswal-do Cruz, long regarded by medical scientists as one of the few significant Latin American medical journals.

Although Cruz is not remembered for original contributions to medicine, he established the first solid institutional base for research in Brazil and assembled a team of outstanding medical researchers. In 1908 the staff began the move to the new and imposing laboratories of the Oswaldo Cruz Institute, where research on yellow fever, malaria, leishmaniasis, and other tropical diseases flourished.

After 1908 Cruz was increasingly incapacitated by renal disease and early in 1916 he retired to Petrópolis, outside Rio de Janeiro. He was appointed mayor, but continued illness soon led him to relinquish his official duties. He died the next year.

BIBLIOGRAPHY

I. Original Works. Cruz’s papers have been republished as Opera omnia (Rio de Janeiro. 1972); this vol. includes his two surveys of the Amazon, Consideraçoes gerais sôbre as condições sanitarias do Rio Madeira (Rio de Janeiro, 1910); and Relatório sôbre as condições médico-sanitárias do Valle do Amazonas (Rio de Janeiro, 1913). A collection of documents concerning the sanitary campaign, and letters from Cruz to his colleague Henrique da Rocha Lima (1901- 1915), have been published in connection with the centennial celebrations of Cruz’s birth see Edgard Cerqueira Falcāo, Oswaldo Cruz: Monumetua histórica, 3 vols. (São Paulo, 1971-1973). Twenty-five files containing documents, many of them the official notes exchanged between the institute and the government (and in Cruz’s hand), are at the Museum of the Oswaldo Cruz Institute.

II. Secondary Literature. The standard biography, E. Sales Guerra, OsvaldoCruz (Rio de Janeiro, 1940), and thebiography by Clementino Fraga, Vida e obra de Osvaldo Cruz (Rio de Janeiro, 1972), are fairly useful but have no references. More important are the accounts of Cruz’s work by colleagues at the institute. See especially Henrique de Beaurepaire Aragao, Oswaldo Cruz e a escola de Manguinhos (Rio de Janeiro. 1945) and Noticia histórica sôbre afundafdo do Instituto Oswaldo Cruz (Rio de Janeiro, 1950); Ezequiel Caetano Dias, OInstitute Oswaldo Cruz: Resumo histórica 1899-1918 (Rio de Janeiro, 1918) and Traços hiogrdji-cos de Oswaldo Cruz (Rio de Janeiro, 1950); and Henrique da Rocha Lima, “Com Oswaldo Cruz em Manguinhos,” in Ciência e cultures4 , no. 1-2 (1952). 15-38.

A good analysts of the institute’s scientific work is Olympio da Fonseca, “A escola de Manguinhos: Contribuição paraoestudo do desenvolvimento da medicina experimental no Brasil.” in Faleao, op. cit., pp. 24- 128. On the public health campaign, see Octavio G. de Oliveira, Oswaldo Cruz e suas atividades na dire f So da saude publico brasileira (Rio de Janeiro, 1955); and Donald B. Cooper,” Oswaldo Cruz and the Impact of Yellow Fever in Brazilian History” in Bulletin of the Tit-lane Medical Faculty.26 (1967), 49-52. Much of the original sanitation legislation organized by Cruz is repr. in the work prepared during his directorship of public health: Placido Barbosa and Cassio Barbosa de Rezende, Os serviços de saúde pública no Brasil, especialmente na cidade do Rio de Janeiro de 1808 a 1907 (Esboço hisiorico e legislação), 2 vols. (Rio de Janeiro. 1909).

Two sources in English are Nancy Stepan, “initiation and Survival of Biomedical Research in a Developing Country: The Oswaldo Cruz Institute of Brazil, 1900-1920” in Journal of the History of Medicine and Allied Sciences, 30 (1975), 303-325; and Beginnings of Brazilian Science: Oswaldo Cruz Medical Research and Policy. 1890- 1920 (New York, 1976).

Nancy Stepan

Oswaldo Gonçalves Cruz

Oswaldo Gonçalves Cruz (1872-1917) was a Brazilian microbiologist, epidemiologist, and public health officer who founded experimental medicine in Brazil and directed controversial programs to eradicate yellow fever and smallpox from Rio de Janeiro.

Oswaldo Cruz was born in the province of São Paulo, the son of a doctor. He completed medical school at the age of 20, perhaps as much because of the elementary nature of medical instruction then provided in Brazil as because of his brilliance. In 1896 he went to Paris, where he worked at the Pasteur Institute for 3 years. Cruz returned to Brazil as the bearer of an entirely new outlook on medical problems. His understanding of modern principles regarding contagion was perhaps not unique even in Brazil, but he was exceptional in his ability to surmount the political obstacles to the application of this understanding to public health. He almost immediately demonstrated these abilities in the coastal city of Santos, where he stopped an epidemic of bubonic plague in mid-course in 1899.

In 1902 Cruz became the Brazilian director general of public health. Brazil's progress and effort to secure international respect had so far been severely hampered by the frequent epidemics that ravaged the population, discouraged immigration, upset the normal patterns of trade, and debilitated both workers and managers. With the President's backing, Cruz launched a vigorous campaign aimed at imposing sanitary standards first of all upon the capital city. He especially worked to eradicate the mosquito responsible for the transmission of yellow fever. Simultaneously he pushed through the Brazilian congress a law requiring compulsory smallpox vaccination of all citizens.

These programs encountered the resistance of a superstitious and conservative population. Alarmed by these newfangled ideas and the invasion of their privacy and individual freedom, the people were easily manipulated by opponents of the regime: urban riots and even an unsuccessful military revolt were the result. The President, however, continued to give Cruz his full support, and the campaign was successful. As of that time Rio de Janeiro ceased to be a synonym for epidemic disease.

Meanwhile, Cruz also became director of the newly formed Institute of Experimental Pathology. His energetic and progressive leadership soon made it world-famous in the field of tropical medicine. He personally conducted field experiments in the upper Amazon and began the long process by which malaria was effectively restricted in Brazil. His career was cut short by Bright's disease.

Further Reading

Very little has been written in any language on Cruz. He is discussed briefly in Fielding H. Garrison, An Introduction to the History of Medicine (1913; 4th rev. ed. 1929), and in Arturo Castiglioni, A History of Medicine (trans. 1941; 2d rev. ed. 1947). □