Ramón Carrillo (7 March 1906 – 20 December 1956) was an
Argentine
Argentines (mistakenly translated Argentineans in the past; in Spanish (masculine) or (feminine)) are people identified with the country of Argentina. This connection may be residential, legal, historical or cultural. For most Argentines, s ...
neurosurgeon
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peri ...
,
neurobiologist
A neuroscientist (or neurobiologist) is a scientist who has specialised knowledge in neuroscience, a branch of biology that deals with the physiology, biochemistry, psychology, anatomy and molecular biology of neurons, neural circuits, and glial c ...
, physician, academic, public health advocate, and from 1949 to 1954 the nation's first
Minister of Public Health
The Minister for Public Health and Women's Health is a junior ministerial post in the Scottish Government. The minister is not a member of the Scottish Cabinet, however, they report to the Cabinet Secretary for NHS Recovery, Health and Social Care. ...
.
Early life and education
Carrillo was born in
Santiago del Estero
Santiago del Estero (, Spanish for ''Saint-James-Upon-The-Lagoon'') is the capital of Santiago del Estero Province in northern Argentina. It has a population of 252,192 inhabitants, () making it the twelfth largest city in the country, with a surf ...
on 7 March 1906 into an
Afro-Argentine
Afro-Argentines are people in Argentina of primarily Sub-Saharan African descent. The Afro-Argentine population is the result of people being brought over during the transatlantic slave trade during the centuries of Spanish domination in the reg ...
family. He attended the
University of Buenos Aires
The University of Buenos Aires ( es, Universidad de Buenos Aires, UBA) is a public university, public research university in Buenos Aires, Argentina. Established in 1821, it is the premier institution of higher learning in the country and one o ...
Faculty of Medicine
A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, M ...
and obtained a degree in 1929 with a Gold Medal as best student in his class.
He showed a preference for
neurology
Neurology (from el, wikt:νεῦρον, νεῦρον (neûron), "string, nerve" and the suffix wikt:-logia, -logia, "study of") is the branch of specialty (medicine), medicine dealing with the diagnosis and treatment of all categories of co ...
and
neurosurgery
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peri ...
, collaborating with eminent neurosurgeon Manuel Balado, a
Mayo Clinic
The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...
alumnus and like Carrillo a student of Christfried Jakob at the University of Buenos Aires. Under Balado, Carrillo published his initial scientífic articles. After graduation he obtained a travel grant in order to further his studies in
Europe
Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
, where he worked in the best neuroscience laboratories,
Cornelius Ariëns Kappers's and
Carl Vogt
August Christoph Carl Vogt (; 5 July 18175 May 1895) was a German scientist, philosopher, popularizer of science, and politician who emigrated to Switzerland. Vogt published a number of notable works on zoology, geology and physiology. All his l ...
's among them.
Career in social medicine
He returned to
Buenos Aires
Buenos Aires ( or ; ), officially the Autonomous City of Buenos Aires ( es, link=no, Ciudad Autónoma de Buenos Aires), is the capital and primate city of Argentina. The city is located on the western shore of the Río de la Plata, on South ...
in the mid 1930s. Known in Argentina as the "
Infamous Decade
The Infamous Decade () was a period in Argentinian history that began with the 1930 coup d'état against President Hipólito Yrigoyen. This decade was marked on one hand by significant rural exodus, with many small rural landowners ruined by ...
," Carrillo described this period in Argentine history as the "systematic sacking and destruction of his fatherland, a period characterized by the leaders' deep moral decadence, in which self-imposed corruption, economic felonies, the selling out of the national patrimony, and the impoverishment of the population's majority prevail" (Ordóñez).
Disillusioned with
liberal democracy
Liberal democracy is the combination of a liberal political ideology that operates under an indirect democratic form of government. It is characterized by elections between multiple distinct political parties, a separation of powers into diff ...
, Carrillo adhered to the locally rising ''
nacionalista
The Nacionalista Party (Filipino and Spanish: ''Partido Nacionalista''; ) is the oldest political party in both the Philippines and in Southeast Asia in general. It is responsible for leading the country throughout the majority of the 20th ce ...
'' thought and complemented his scientific research with evolving political ideas and cultural education. He enjoyed friendships with numerous leading names in Argentine tango culture and the new nationalist ideas, including poet and songwriter
Homero Manzi
Homero Nicolás Manzione Prestera, better known as Homero Manzi (November 1, 1907 – May 3, 1951) was an Argentine tango lyricist, author of various famous tangos.
He was born on November 1 of 1907 in Añatuya (province of Santiago del Ester ...
(an erstwhile elementary school friend), as well as nationalist activists
Arturo Jauretche
Arturo Martín Jauretche (Lincoln, Buenos Aires, November 13, 1901 – Buenos Aires, May 25, 1974) was an Argentine writer, politician, and philosopher.
Early years
Jauretche spent his childhood and adolescence in the city of Lincoln before ...
and
Raúl Scalabrini Ortiz
Raúl Scalabrini Ortiz (February 14, 1898 – May 30, 1959) was an Argentine writer, philosopher, journalist, essayist and poet, friend of Arturo Jauretche and Homero Manzi, and loosely associated with the political group ''Fuerza de Orientaci ...
, and
tango
Tango is a partner dance and social dance that originated in the 1880s along the Río de la Plata, the natural border between Argentina and Uruguay. The tango was born in the impoverished port areas of these countries as the result of a combina ...
and theater composers Armando Discépolo y
Enrique Santos Discépolo
Enrique Santos Discépolo (''Discepolín'') (27 March 1901 – 23 December 1951) was an Argentine tango and milonga musician and composer, author of famous tangos like ''Cambalache'' and many others performed by several of the most important s ...
. He also maintained close academic links with prominent
German Argentine
German Argentines (german: Deutschargentinier, es, germano-argentinos) are Argentines of German ancestry as well as German citizens living in Argentina. They are descendants of Germans who immigrated to Argentina from Germany and elsewhere in E ...
neurobiologists such as his former professor Christfried Jakob and two leading figures in Argentine neuropsychiatric science, Drs.
José Borda and
Braulio Moyano Braulio is a given name.
*Braulio Estima, a Brazilian jiu-jitsu practitioner and mixed martial artist
*Braulio García, a Spanish singer-songwriter who is often credited as "Braulio".
*Braulio Guerra, Mexican politician
*Braulio Mari, a Spanish sin ...
.
Research
Between 1930 and 1945 Carrillo contributed valuable original research on
glial cell
Glia, also called glial cells (gliocytes) or neuroglia, are non-neuronal cells in the central nervous system (brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses. They maintain homeostasis, form mye ...
s and the method for staining and observing them under the
microscope
A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisibl ...
, as well as on their evolutionary origin (
phylogeny
A phylogenetic tree (also phylogeny or evolutionary tree Felsenstein J. (2004). ''Inferring Phylogenies'' Sinauer Associates: Sunderland, MA.) is a branching diagram or a tree showing the evolutionary relationships among various biological spec ...
), and the comparative
anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
of the brain across the several classes of
vertebrate
Vertebrates () comprise all animal taxa within the subphylum Vertebrata () ( chordates with backbones), including all mammals, birds, reptiles, amphibians, and fish. Vertebrates represent the overwhelming majority of the phylum Chordata, ...
s. He also contributed novel techniques for
neurological
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
diagnosis: he refined iodine-contrasted ventriculography, called iodoventriculography, and discovered signs in it for several diseases; developed tomography, which by lack of electronic means at the time was prevented from integrating computation yet was a precursor of what is today known as computerized
tomography
Tomography is imaging by sections or sectioning that uses any kind of penetrating wave. The method is used in radiology, archaeology, biology, atmospheric science, geophysics, oceanography, plasma physics, materials science, astrophysics, quantu ...
; and achieved its combination with
electroencephalogram
Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex ...
, termed tomoencephalography.
Carrillo also produced a body of research into brain
herniation
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin herni ...
s protruding into blood cisterns (cisternal herniations) and the
syndrome
A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek σύνδρομον, meaning "concurrence". When a syndrome is paired ...
s occurring after a
brain contusion
Cerebral contusion, Latin ''contusio cerebri'', a form of traumatic brain injury, is a bruise of the brain tissue.
Like bruises in other tissues, cerebral contusion can be associated with multiple microhemorrhages, small blood vessel leaks into ...
; he discovered what became known as "Carrillo's disease," or acute
papillitis; described in detail the
cerebral scleroses, during whose research he performed many cerebral transplants (
brain grafts) between living rabbits; and
histologically
Histology,
also known as microscopic anatomy or microanatomy, is the branch of biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single ...
reclassified the cerebral
tumor
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
s and the inflammations of the innermost brain envelope (
arachnoid mater
The arachnoid mater (or simply arachnoid) is one of the three meninges, the protective membranes that cover the brain and spinal cord. It is so named because of its resemblance to a spider web. The arachnoid mater is a derivative of the neural c ...
) known as
arachnoiditis
Arachnoiditis is an inflammatory condition of the arachnoid mater or 'arachnoid', one of the membranes known as meninges that surround and protect the nerves of the central nervous system, including the brain and spinal cord. The arachnoid can be ...
. He also proposed a widely used, pre-
DSM
DSM or dsm may refer to:
Science and technology
* Deep space maneuver
* Design structure matrix or dependency structure matrix, a representation of a system or project
* Diagnostic and Statistical Manual of Mental Disorders
** DSM-5, the fifth ed ...
classification of mental illnesses. Against considerable opposition from conservative colleagues, in 1942 and at the age of 36 Carrillo became the Chair of Neurosurgery at the University of Buenos Aires School of Medicine. Among the influential Argentine physicians he trained were Germán Dickmann, Raúl Matera, D. E. Nijensohn, Raúl Carrea, Fernando Knesevich, Lorenzo Amezúa, Jorge Cohen, Jacobo and Leon Zimman, Rogelio Driollet Laspiur, Juan C. Christensen, and Alberto D. Kaplan.
Later career
During those years Carrillo exclusively dedicated himself to research and teaching, until becoming Head (1939) of the Neurology and Neurosurgery Service in the
Central Military Hospital. This post afforded him a deep acquaintance with the real situation of public health in Argentina, which like his own province reflected a state of neglect in much of the countryside. He became well informed on the clinical files of all young men examined for enrollment into military service, and became aware of the high prevalence of poverty-linked diseases (especially in recruits from the poorest provinces). He carried out statistical studies showing that the country only had 45% of the required hospital beds, and that these were moreover unevenly distributed.
Carrillo was at the height of his medical career when he became acquainted with the Colonel
Juan Domingo Perón
''Juan'' is a given name, the Spanish and Manx versions of ''John''. It is very common in Spain and in other Spanish-speaking communities around the world and in the Philippines, and also (pronounced differently) in the Isle of Man. In Spanish, t ...
, a patient at the Central Military Hospital with whom Carrillo shared long talks. Colonel Perón was the increasingly influential Labor Minister in the nationalist military regime that took power after the
1943 Argentine coup d'état
The 1943 Argentine coup d'état, also known as the Revolution of '43, was a coup d'état on 4 June 1943 that ended the government of Ramón Castillo, who had been fraudulently elected to the office of vice-president before succeeding to the presi ...
, and during these talks persuaded Carrillo to help plan national health policies. Carrillo, at age 39, briefly served as Dean of the School of Medicine, acting as a go-between in a fierce, highly politized, Left-Right university conflict, which ultimately forced him to quit his faculty post.
Argentina's first health minister
Juan Perón was elected to the nation's presidency in
February 1946
The following events occurred in February 1946:
February 1, 1946 (Friday)
*Trygve Lie was sworn in as the first Secretary General of the United Nations.
* Syria and the Soviet Union secretly signed a treaty for military advisers to come to ...
, appointing Carrillo as head of the State Secretary of Public Health; when President Perón promoted this latter office to a cabinet-level ministry, Carrillo was sworn in as the nation's first
Minister of Public Health
The Minister for Public Health and Women's Health is a junior ministerial post in the Scottish Government. The minister is not a member of the Scottish Cabinet, however, they report to the Cabinet Secretary for NHS Recovery, Health and Social Care. ...
on 11 March 1949.
Carrillo appointed leading figures in Argentine medicine such as Salomón Chichilnisky, the neuroscientist Braulio Moyano, and his own brother, Santiago Carrillo (who had worked extensively with Moyano at
Borda Hospital
The Hospital Interdisciplinario Psicoasistencial José Tiburcio Borda (alternate: Municipal Hospital of José Tiburcio Borda; nickname: El Borda) is the largest and most notable psychiatric hospital in Argentina. Situated on , El Borda is located ...
), to administrative posts in the new Health Ministry. Longtime colleagues at the University of Buenos Aires, Chichilnisky and the new Health Minister had become close friends during the latter's illness in 1937, and as Secretary of Health in the early 1950s he helped Health Minister Carrillo commission hundreds of public hospitals in Argentina. Perón's wife,
Evita Evita may refer to:
Arts
* Evita (1996 film), ''Evita'' (1996 film), a 1996 American musical drama film based on the 1976 concept album of the same name
* Evita (2008 film), ''Evita'' (2008 film), a documentary about Eva Péron
* Evita (album), ''E ...
, also contributed to his tenure by coordinating public health policy at the well-funded
Eva Perón Foundation
The Eva Perón Foundation was a charitable foundation begun by Eva Perón, a prominent Argentine political leader, when she was the First Lady and Spiritual Leader of the Nation of Argentina. It operated from 1948 to 1955.
Inspiration and Be ...
with Carrillo, helping advance and fund many of his works and initiatives.
His tenure would be marked by prolific, hitherto unsurpassed advances in Argentine public health. He increased the number of hospital beds in the country, from 66,300 in 1946 to 132,000 in 1954. He eradicated, in only two years, endemic diseases such as
malaria
Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
, by means of highly aggressive campaigns against the
vector
Vector most often refers to:
*Euclidean vector, a quantity with a magnitude and a direction
*Vector (epidemiology), an agent that carries and transmits an infectious pathogen into another living organism
Vector may also refer to:
Mathematic ...
.
Syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
and venereal diseases practically vanished. He built 234 free, public hospitals or policlinics, lowered the
tuberculosis
Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...
mortality rate from 130 per 100,000 to 36 per 100,000, ended epidemics such as
typhus
Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus. Common symptoms include fever, headache, and a rash. Typically these begin one to two weeks after exposure.
...
and
brucellosis
Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals, or close contact with their secretions. It is also known as undulant fever, Malta fever, and Mediterranean fever.
The ...
, and decreased drastically the nation's
infant mortality
Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five morta ...
rate from 90 to 56 per thousand live births.
[
As Health Minister Carrillo prioritized the development of preventive medicine, the hospitals' running organization, and concepts such as regulative centralization and executive decentralization (''centralización normativa y descentralización ejecutiva''). He did so without mandating decentralization with merely economic goals imposed by the markets. Corresponding by letter with ]Norbert Wiener
Norbert Wiener (November 26, 1894 – March 18, 1964) was an American mathematician and philosopher. He was a professor of mathematics at the Massachusetts Institute of Technology (MIT). A child prodigy, Wiener later became an early researcher i ...
, the creator of cybernetics
Cybernetics is a wide-ranging field concerned with circular causality, such as feedback, in regulatory and purposive systems. Cybernetics is named after an example of circular causal feedback, that of steering a ship, where the helmsperson m ...
, Carrillo applied it to the art of government with what he referred to as "cybernology" (''cibernología''), creating an ''Instituto de Cibernología'' (in effect, strategic planning
Strategic planning is an organization's process of defining its strategy or direction, and making decisions on allocating its resources to attain strategic goals.
It may also extend to control mechanisms for guiding the implementation of the st ...
) in 1951. He also partnered with Argentine Railways to establish a "Health Train" service equipped with mobile clinics to reach some of the most remote and impoverished regions in the country. The service was discontinued after his resignation.
Carrillo resigned on 16 June 1954, having lost support from the government in the aftermath of Eva Perón's death. He was succeeded by Raúl Bevacqua.
Personal life
Carrillo remained single, and supported his mother and ten younger brother and sisters. He suffered an acute illness in 1937 which left him with chronic hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
and progressively severe headaches. He was saved by Salomón Chichilnisky, who in his youth worked as stevedore
A stevedore (), also called a longshoreman, a docker or a dockworker, is a waterfront manual laborer who is involved in loading and unloading ships, trucks, trains or airplanes.
After the shipping container revolution of the 1960s, the number o ...
in the Port of Buenos Aires
The Port of Buenos Aires ( es, Puerto de Buenos Aires) is the principal maritime port in Argentina. Operated by the ''Administración General de Puertos'' (General Ports Administration), a state enterprise, it is the leading transshipment point fo ...
to support his parents, and despite these difficulties became a Chaired Professor of Neurology. They became close friends and colleagues afterward.[
Following the 1955 coup d'état against Perón and the subsequent persecution of peronists by the military regime, Carrillo was forced into exile. He died on 20 December 1956 in ]Belém do Pará
Belém (; Portuguese for Bethlehem; initially called Nossa Senhora de Belém do Grão-Pará, in English Our Lady of Bethlehem of Great Pará) often called Belém of Pará, is a Brazilian city, capital and largest city of the state of Pará in t ...
, Brazil, aged 50.
Legacy
Carrillo was ultimately recognized as the architect of Argentina's modern national health system. His name was then imparted to numerous Argentine hospitals and institutions related to public health. It is frequently ascribed to the embarrassment Carrillo's model produced in less competent politicians the fact that, afterwards, his biography, ideas, and contributions to science remained generally unknown, except for outlines in neurobiology in which Carrillo took part. He likewise left numerous large but incomplete skeletons for several hospitals that were discarded after his resignation, and even as late as 2004.
His brother Arturo Carrillo, still in hardship and without any official funding, published a biography detailing the magnitude of his achievements and sacrifices, ''Ramón Carrillo, el hombre, el médico y el sanitarista''. Professor Daniel Chiarenza also published a biography of Carrillo, ''El Olvidado de Belém'', in 2005. By Executive Order 1558 dated 9 December 2005, the Argentine Government decreed the full year 2006 as "Year of Honor to Ramón Carrillo."
Numerous authors agree that the most important heritage bestowed by Ramón Carrillo were the ideas, principles, and grounding motives which accompanied his deeds. "The problems of Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
as a branch of the State cannot be resolved while health policy
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society".World Health Organization''Health Policy'' accessed 22 March 2011(Web archive)/ref> According to the ...
is not backed by social policy
Social policy is a plan or action of government or institutional agencies which aim to improve or reform society.
Some professionals and universities consider social policy a subset of public policy, while other practitioners characterize soci ...
. Similarly, there cannot be an effective social policy without an economy organized to benefit the greater part of the population. In the field of health, scientific achievements are only useful when they reach the whole population."
References
Bibliography
*The State journal ''Electroneurobiología'', published by Borda Hospital
The Hospital Interdisciplinario Psicoasistencial José Tiburcio Borda (alternate: Municipal Hospital of José Tiburcio Borda; nickname: El Borda) is the largest and most notable psychiatric hospital in Argentina. Situated on , El Borda is located ...
in Buenos Aires, and in whose scientific tradition the biographied participated, published a set of articles on-line on Ramón Carrillo, including chapters of the biography written by his brother, voice files, and numerous photographs. All the written, graphic, and sound materials are of free reproduction on condition of acknowledging the source and its URL
http://electroneubio.secyt.gov.ar/
This Wikipedia article incorporate
from the Spanish Wikipedia as well as from articles by Mario Crocco and Marcos A. Ordóñez, originally published in Electroneurobiología 2004; 12 (2), pp. 144– 147 and Electroneurobiología 2006; 14 (1), pp. 173–179; of open access and distribution. See the Discussion page for a complete transcription of the copyright notice.
{{DEFAULTSORT:Carrillo, Ramon
1906 births
1956 deaths
People from Santiago del Estero
Afro-Argentine people
Afro-Argentine politicians
Argentine people of Spanish descent
University of Buenos Aires alumni
Argentine ministers of health
Argentine neurologists
Argentine neuroscientists
Argentine non-fiction writers
Academic staff of the University of Buenos Aires
20th-century Argentine physicians
20th-century Argentine writers
20th-century non-fiction writers