On December 5, 1852, doctors, Catholic officials, Emperor Dom Pedro I, and other members of the royal court celebrated the inauguration of the first national public mental asylum, the Hospicio Dom Pedro II, in Rio de Janeiro. The lavish ceremony was seemingly a success as the press touted the institution “a great triumph of philanthropic ideas” that placed the city on the “path of material progress,” marking “a notable era in the civilization of the country.” Prior to the second half of the nineteenth century, the mentally ill were treated according to their means. The wealthy, if relatively tranquil, were treated at home and sometimes sent to Europe by their families under the advisement of doctors. Their poor and working-class counterparts were placed under the care of their families or housed in one of the multifunctional jails or poorhouses that held societal castoffs such as beggars, prostitutes, orphans, and vagrants. The mad were treated much the same as other marginalized sectors of Brazilian society.

By the mid-nineteenth century, however, the insane were sharply distinguished from other “problem populations.” They were incarcerated in a state-supported asylum system that isolated them both physically and symbolically from the larger society. The Hospicio de Dom Pedro II contained only the mentally ill with the aim of medically treating and rehabilitating them through methods that affected the psyche. Over the course of the mid-nineteenth and early twentieth centuries, a new set of experts, the alienists, later known as psychiatrists, introduced the Brazilian public to a series of treatments and initiatives to treat the mad. They also hoped to instill sound mental hygiene practices among their fellow citizens. How and why, then, did an asylum, the first in Latin America, come about? How did psychiatrists emerge to become one of the primary knowledge experts to manage the presumed mentally ill? Explaining these remarkable shifts is the central task of this book. This project investigates how professional psychiatry emerged in Rio de Janeiro. A seemingly innocuous protest led by doctors over the spread of a mysterious “fever” outside Rio de Janeiro in 1830 paved the way for a larger critique of public health institutions and measures.