Washington Luis Souza

PONTIFÍCIA UNIVERSIDADE CATÓLICA DE SÃO PAULO
PUC-SP
Washington Luis Souza
Da medicina não hospitalar ao hospital médico: uma leitura das análises

de Michel Foucault sobre a história da medicina
MESTRADO EM FILOSOFIA
SÃO PAULO
2008
PONTIFCIA UNIVERSIDADE CATÒLICA DE SÃO PAULO
PUC-SP
Washington Luis Souza
Da medicina não hospitalar ao hospital médico: uma leitura das análises

de Michel Foucault sobre a história da medicina
MESTRADO EM FILOSOFIA
Dissertação apresentada à Banca

Examinadora da Pontifícia Universidade
Católica de São Paulo, como exigência
parcial para obtenção do título de Mestre em
Filosofia, sob a orientação da Profª. Doutora
Salma Tannus Muchail.
SÃO PAULO
2008
Banca Examinadora
___________________________________
___________________________________
___________________________________
Com carinho e
agradecimento pela
compreensão, apoio e
incentivo dedico este
trabalho a Conceição,
Werneck e Wellington.
Agradecimentos
À minha orientadora Salma Tannus Muchail, pelo acompanhamento seguro e

atenção dedicada a esse trabalho.
Ao professor Márcio Alves da Fonseca, pelas discussões e importantes contribuições

para o desenvolvimento dessa dissertação.
Ao professor Carlos Arthur R. Nascimento, pelo exemplo profissional e por ensinar-

me Tomás de Aquino.
À Francine Sanches Chacon, pela leitura detida e sugestões.
A Carlos Eduardo Domingues Pinto, por ser um raro humanista.
A Elias José Balbino e Jorge de Oliveira, pela amizade e sinceridade.
Ao CNPq pelo suporte financeiro.

Resumo
Este estudo tem por objetivo, a partir da leitura da obra de Michel Foucault,
apresentar a transição da medicina clássica (séculos XVII e XVIII) à medicina
moderna (séculos XIX e XX), como momento de ruptura, em oposição à tese da
evolução teleológica proposta pela historiografia médica tradicional. No plano
institucional, serão abordadas as dicotomias entre as práticas médicas e as
instituições hospitalares clássicas, situando o nascimento do hospital médico
terapêutico como um fato próprio da modernidade.
Esta dissertação procura explicitar que a medicina clássica classificatória das

espécies patológicas, era um saber fundamentado na história natural e chegou ao
seu limite no final da Idade Clássica, quando saberes originários da biologia, a
exemplo da anatomia e da fisiologia, foram aplicados ao estudo das patologias
criando a medicina empírica moderna. A medicina moderna se constituiu como um
saber de outra ordem, com sujeito, objeto, conceitos e métodos absolutamente
distintos. Contudo, essa mutação não se deu em virtude do aperfeiçoamento dos
conhecimentos e das práticas, mas por meio de estudos desenvolvidos fora do
campo médico, alheios à intencionalidade da razão médica. Não se justificaria,
portanto, pensar a história da medicina em termos de continuidade evolutiva,
cabendo descrevê-la, ao contrário, como uma história descontínua e não
progressiva.
Palavras-chave: 1. Foucault, Michel. 2. Medicina-história. 3. Medicina-filosofia.

Abstract
This study aims to present, having Michael Foucault’s work as basis, to

present the transition from classic medicine (centuries XVII and XVIII) to modern
medicine (centuries XIX and XX), as a turning point, opposed to the teleologic
evolution thesis proposed by the traditional medical historiography. On institutional
basis, we will approach the dichotomy between medical practices and the classic
hospital institutions, placing the creation of therapeutic hospital as a fact of modern
age.
This dissertation tries to show that classic medicine which classifies

pathological species was a knowledge based in natural history and reached its top at
the end of Classic Age, when the knowledge from biology, such as anatomy and
physiology, were applied to the study of pathologies creating the modern empirical
medicine. Modern medicine was constituted as a different knowledge with subject,
object, concepts and methods completely distinct. However this change hasn´t
happened due to the improvement of knowledge and practice, but because of studies
that were developed outside the medical field, apart from the medical reason.
Therefore it is not justificable to think about the history of medicine in terms of
evolutionary continuity, being best described, on the contrary, as a discontinuous and
not progressive history.
Key-words: 1. Foucault, Michel, 2. Medicine-history 3. Medicine-philosophy.

SUMÁRIO
Introdução.......................................................................................... 1
Capítulo 1. A medicina e o hospital no Período Clássico

(séculos XVII e XVIII).
Primeiras considerações.................................................... 12
1.1. A medicina classificatória................................................ 13
1.2. O hospital no
classicismo............................................................................. 19
Últimas considerações........................................................ 22
Capítulo 2. As epidemias, a medicina social e o Antigo Regime.
2.1. As epidemias e o nascimento da medicina
social..................................................................................... 24
2.2. A medicina social e a medicina
classificatória......................................................................... 26
2.2.1. A medicina social na
Alemanha....................................................................... 27
2.2.2. A medicina social na
França............................................................................ 30
2.3. As epidemias e a consciência política da
doença................................................................................... 33
Capitulo 3. A Revolução Francesa, os hospitais e o nascimento
da clínica moderna.
3.1. O fim dos 37
hospitais.................................................................................
3.2. O fim dos estabelecimentos de ensino da 40
medicina................................................................................
3.3. O nascimento do hospital e da clínica 42
modernos...............................................................................
Últimas considerações. ...................................................... 50
Capitulo 4. O nascimento da clínica.
4.1. A protoclínica do século XVIII......................................... 52
4.2. A clínica do final do século XVIII..................................... 54
4.3. A anátomo-clínica do século
XIX........................................................................................ 60
4.4. As contribuições da fisiologia de François
Broussais.................................. 64
Conclusão. ........................................................................................ 69
Bibliografia......................................................................................... 75

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PONTIFÍCIA UNIVERSIDADE CATÓLICA DE SÃO PAULO

Washington Luis Souza

Da medicina não hospitalar ao hospital médico: uma leitura das análises

Washington Luis Souza

Da medicina não hospitalar ao hospital médico: uma leitura das análises

Dissertação apresentada à Banca

À minha orientadora Salma Tannus Muchail, pelo acompanhamento seguro e

Ao professor Márcio Alves da Fonseca, pelas discussões e importantes contribuições

Ao professor Carlos Arthur R. Nascimento, pelo exemplo profissional e por ensinar-

À Francine Sanches Chacon, pela leitura detida e sugestões.

A Carlos Eduardo Domingues Pinto, por ser um raro humanista.

A Elias José Balbino e Jorge de Oliveira, pela amizade e sinceridade.

Ao CNPq pelo suporte financeiro.

Esta dissertação procura explicitar que a medicina clássica classificatória das

Palavras-chave: 1. Foucault, Michel. 2. Medicina-história. 3. Medicina-filosofia.

This study aims to present, having Michael Foucault’s work as basis, to

This dissertation tries to show that classic medicine which classifies

Key-words: 1. Foucault, Michel, 2. Medicine-history 3. Medicine-philosophy.

Capítulo 1. A medicina e o hospital no Período Clássico

Capítulo 2. As epidemias, a medicina social e o Antigo Regime.

Capitulo 4. O nascimento da clínica.

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