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Ramón Carrillo (7 March 1906 – 20 December 1956) was an
Argentine Argentines, Argentinians or Argentineans are people from Argentina. This connection may be residential, legal, historical, or cultural. For most Argentines, several (or all) of these connections exist and are collectively the source of their ...
neurosurgeon Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system including the brain, ...
,
neurobiologist A neuroscientist (or neurobiologist) is a scientist specializing in neuroscience that deals with the anatomy and function of neurons, neural circuits, and glia, and their behavioral, biological, and psychological roles in health and disease. ...
, physician, academic, public health advocate, and from 1949 to 1954 the nation's first Minister of Public Health.


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 sur ...
on 7 March 1906 into an
Afro-Argentine Afro-Argentines (), also known as Black Argentines (), are Argentines who have predominantly or total Sub-Saharan African ancestry. The Afro-Argentine population is the result of people being brought over during the Atlantic slave trade, transat ...
family. He attended the
University of Buenos Aires The University of Buenos Aires (, UBA) is a public university, public research university in Buenos Aires, Argentina. It is the second-oldest university in the country, and the largest university of the country by enrollment. Established in 1821 ...
'
Faculty of Medicine A medical school is a tertiary educational institution, professional school, or forms a part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, ...
and obtained a degree in 1929 with a Gold Medal as best student in his class. He showed a preference for
neurology Neurology (from , "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 conditions and disease involving the nervous syst ...
and
neurosurgery Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the specialty (medicine), medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system ...
, collaborating with eminent neurosurgeon Manuel Balado, a
Mayo Clinic Mayo Clinic () is a Nonprofit organization, private American Academic health science centre, academic Medical centers in the United States, medical center focused on integrated health care, healthcare, Mayo Clinic College of Medicine and Science ...
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 continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, the Mediterranean Sea to the south, and Asia to the east ...
, where he worked in the best neuroscience laboratories, Cornelius Ariëns Kappers's and
Carl Vogt August Christoph Carl Vogt (; ; 5 July 1817 – 5 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. A ...
's among them.


Career in social medicine

He returned to
Buenos Aires Buenos Aires, controlled by the government of the Autonomous City of Buenos Aires, is the Capital city, capital and largest city of Argentina. It is located on the southwest of the Río de la Plata. Buenos Aires is classified as an Alpha− glob ...
in the mid 1930s. Known in Argentina as the "
Infamous Decade The Infamous Decade () was a period in Argentine 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 b ...
," 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, also called Western-style democracy, or substantive democracy, is a form of government that combines the organization of a democracy with ideas of liberalism, liberal political philosophy. Common elements within a liberal dem ...
, Carrillo adhered to the locally rising ''
nacionalista The Nacionalista Party (Filipino language, Filipino and Spanish language in the Philippines, Spanish: ''Partido Nacionalista''; , NP) is a political party in the Philippines which is the oldest existing party in the country and in Southeast Asi ...
'' 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 (an erstwhile elementary school friend), as well as nationalist activists Arturo Jauretche 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 Orient ...
, 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 from a combination of Arge ...
and theater composers Armando Discépolo y Enrique Santos Discépolo. He also maintained close academic links with prominent German Argentine neurobiologists such as his former professor Christfried Jakob and two leading figures in Argentine neuropsychiatric science, Drs. José Borda and Braulio Moyano.


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 (the brain and the spinal cord) and in the peripheral nervous system that do not produce electrical impulses. The neuroglia make up ...
s and the method for staining and observing them under the
microscope A microscope () is a laboratory equipment, 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 ...
, as well as on their evolutionary origin (
phylogeny A phylogenetic tree or phylogeny is a graphical representation which shows the evolutionary history between a set of species or Taxon, taxa during a specific time.Felsenstein J. (2004). ''Inferring Phylogenies'' Sinauer Associates: Sunderland, M ...
), and the comparative
anatomy Anatomy () is the branch of morphology concerned with the study of the internal 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 scien ...
of the brain across the several classes of
vertebrate Vertebrates () are animals with a vertebral column (backbone or spine), and a cranium, or skull. The vertebral column surrounds and protects the spinal cord, while the cranium protects the brain. The vertebrates make up the subphylum Vertebra ...
s. He also contributed novel techniques for
neurological Neurology (from , "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 nervous system, which comprises the brain, the s ...
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, cosmochemistry, ast ...
; and achieved its combination with
electroencephalogram Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The bio signals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neoc ...
, termed tomoencephalography. Carrillo also produced a body of research into brain
herniation A hernia (: hernias or herniae, from Latin, meaning 'rupture') is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal development of the in ...
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 language, Greek σύνδρομον, meaning "concurrence". When a sy ...
s occurring after a brain contusion; he discovered 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 that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...
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 cr ...
) 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 central nervous system. The outermost layer of the meninges is the dura mater (Latin for hard ...
. He also proposed a widely used, pre- DSM 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''. The name is of Hebrew origin and has the meaning "God has been gracious." It is very common in Spain and in other Spanish-speaking countries around the world and in the Philip ...
, 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 Revolution (also known as the 1943 Argentine coup d'état, the June Revolution or 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 ...
, 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, 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 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), 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, also contributed to his tenure by coordinating public health policy at the well-funded
Eva Perón Foundation The Eva Perón Foundation (Spanish: Fundación Eva Perón) was a charitable foundation begun by Eva Perón, a prominent Argentine political leader activist and actress, when she was the First Lady and Spiritual Leader of the Nation of Argent ...
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 disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
, by means of highly aggressive campaigns against the
vector Vector most often refers to: * Euclidean vector, a quantity with a magnitude and a direction * Disease vector, an agent that carries and transmits an infectious pathogen into another living organism Vector may also refer to: Mathematics a ...
.
Syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...
and venereal diseases practically vanished. He built 234 free, public hospitals or policlinics, lowered the
tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...
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 exposu ...
and
brucellosis Brucellosis is a zoonosis spread primarily via ingestion of raw milk, unpasteurized milk from infected animals. It is also known as undulant fever, Malta fever, and Mediterranean fever. The bacteria causing this disease, ''Brucella'', are small ...
, and decreased drastically the nation's
infant mortality Infant mortality is the death of an infant before the infant's first birthday. The occurrence of infant mortality in a population can be described by the infant mortality rate (IMR), which is the number of deaths of infants under one year of age ...
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 computer scientist, mathematician, and philosopher. He became a professor of mathematics at the Massachusetts Institute of Technology ( MIT). A child prodigy, Wiener late ...
, the creator of
cybernetics Cybernetics is the transdisciplinary study of circular causal processes such as feedback and recursion, where the effects of a system's actions (its outputs) return as inputs to that system, influencing subsequent action. It is concerned with ...
, 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 the activity undertaken by an organization through which it seeks to define its future direction and makes decisions such as resource allocation aimed at achieving its intended goals. "Strategy" has many definitions, but it ...
) 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, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
and progressively severe headaches. He was saved by Salomón Chichilnisky, who in his youth worked as
stevedore A dockworker (also called a longshoreman, stevedore, docker, wharfman, lumper or wharfie) is a waterfront manual laborer who loads and unloads ships. As a result of the intermodal shipping container revolution, the required number of dockwork ...
in the
Port of Buenos Aires The Port of 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 for the foreign trade of Arge ...
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 language, 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 the capital and largest city of the state of Par ...
, 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 Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
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(archived 5 February 2011) According ...
is not backed by
social policy Some professionals and universities consider social policy a subset of public policy, while other practitioners characterize social policy and public policy to be two separate, competing approaches for the same public interest (similar to MD a ...
. 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." A new 2,000 peso banknote, due to Argentina's high inflation, has been designed with Carrillo and
Cecilia Grierson Cecilia Grierson (22 November 1859 – 10 April 1934) was an Argentine physician, reformer, nurse educator, feminist and prominent Freethinker. She had the distinction of being the first woman to receive a Medical Degree in Argentina. Early l ...
on the front.


References


Bibliography

*The State journal ''Electroneurobiología'', published by Borda Hospital 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 Ministers of health of Argentina 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