Medicine has been called a science, as well as an art or a craft, among other terms that express aspects of its practical nature. Medicine is not the abstract pursuit of knowledge. Medical researchers and clinical practitioners aim primarily to help people. As a first approximation then, given its practical focus on the person, the most important question in medicine is: what works? To answer that question, however, we need to understand how we know what works. What are the standards, methods and limits of medical knowledge? That is the central focus and subject of this inquiry: how we know what works in medicine. To explore medical knowledge and its limits, this thesis examines the common notion that laughter is the best medicine. Focusing on laughter provides a robust case study of how we know what works in medicine; it also, in part, reveals the thin, perhaps even non-existent, distinction in medicine between empirically-grounded knowledge and intuition. As there is no single academic discipline devoted to laughter in medicine, the first chapter situates and charts the course of this unusual project and explains why inquiry into laughter in medicine matters. In the following chapters, we encounter claims from distinguished sources that laughter and humor are the best medicine. These claims are examined from a variety of perspectives including not only the orthodox view of evidence-based medicine, but also from narrative, evolutionary and complexity views of medicine. The rarely explored serious negative side of laughter is also examined. No view provides a firm foundation for belief in laughter medicine. A general conclusion from this inquiry is that none of the approaches effectively tame the complexity of medical phenomena; indeed each starkly reveals a greater complexity than found at first glance. A narrower conclusion is that providing a basis for claims about laughter in medicine poses its own specific challenges. A third conclusion is that, as things stand, none of the existing approaches seems up to the task of determining whether something such as laughter is the best medicine.

Submitted by Luanna Matias (lua_matias@yahoo.com.br) on 2015-05-19T13:32:15Z No. of bitstreams: 2 Tese - Maria Dailza da Conceição Fagundes - 2014.pdf: 2823974 bytes, checksum: 6bff7878e220ce489ede3f90794deab9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luanna Matias (lua_matias@yahoo.com.br) on 2015-05-19T14:26:06Z (GMT) No. of bitstreams: 2 Tese - Maria Dailza da Conceição Fagundes - 2014.pdf: 2823974 bytes, checksum: 6bff7878e220ce489ede3f90794deab9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-05-19T14:26:06Z (GMT). No. of bitstreams: 2 Tese - Maria Dailza da Conceição Fagundes - 2014.pdf: 2823974 bytes, checksum: 6bff7878e220ce489ede3f90794deab9 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-12-11 / This thesis proposes an analysis of the relations among medical knowledge and power via Arnau de Vilanova (1240 – 1311) path and his medical performance taking care of king James II of Aragon's (1291 – 1327) health and of his family's as well as his role as an aragonese court Ambassador. He was an example of physician, master and intellectual of the period. Therefore, he was a character that did not only follow closely the transformations by which society was passing trough, but influenced his time by his medical and religious writings. It was brought together a diversified documentary corpus composed by: medical works written by Arnau de Vilanova, the official Aragon Crown correspondence, his testament (1305), the inventory (1312) of books and goods from his personal library and a contemporary culinary book. It is debated the process of construction of his authority as an intellectual, in the years dedicated to teaching at the Medicine Faculty in Montpelier, which granted him the professional appreciation and privileges, that allowed him to circulate around the Royal and Pontifical Court while exercising medicine. Besides offering a collection of a physician and a master, the inventory of his library allow us to identify the ancient and Arabian matrices of the Arnau de Vilanova dietetics: Hippocrates, Galen, Rhazes and Avicenna. Thus, Arnau de Vilanova composed the Regimen to the conservation of the king's health, seeking to adapt these auctoritates' knowledge with the individuality of his patient. On this writing the preventive and therapeutic precepts destined to heal the monarch's chronic diseases center itself on a diet, with orientations not only concerning the food that he could consume, but also how to prepare them. His other dietetic writing, the Regimen Castra Sequentium, connected with military preventive medicine, it's destined to the kings' and its army health, which, on 1309's summer, besieged the Muslim city of Almeria on the Aragonese crusade opposite to nazari kingdom of Granada. / Esta tese tem como proposta analisar as relações entre o saber médico e o poder, por intermédio da trajetória de Arnaldo de Vilanova (1240 – 1311) e de sua atuação médica nos cuidados com a saúde do rei Jaime II de Aragão (1291 – 1327) e com a de sua família e como embaixador da corte aragonesa. Ele foi exemplo de físico, mestre e intelectual do período. Trata-se, portanto, de personagem que não somente acompanhou de perto as transformações pelas quais passava a sociedade, como também influenciou sua época por meio de escritos médicos e religiosos. Reuniu-se um corpus documental variado, composto por: obras médicas arnaldianas, a correspondência oficial da Coroa de Aragão, seu testamento (1305), o inventário (1312) de livros e de bens de sua biblioteca pessoal e um livro de culinária coevo. Discute-se o processo de construção de sua autoridade como intelectual, nos anos dedicados ao ensino na Faculdade de Medicina, em Montpellier, os quais lhe concederam a valorização profissional e privilégios, o que permitiu que ele circulasse pelas cortes régias e pontifícias no exercício da Medicina. Além de fornecer o acervo de um físico e mestre, o inventário de sua biblioteca permite-nos identificar as matrizes antigas e árabes da dietética arnaldiana: Hipócrates, Galeno, Razis e Avicena. Destarte, Arnaldo de Vilanova compôs o Regimen para a conservação da saúde do rei, buscando adequar os saberes dessas auctoritates com a individualidade de seu paciente. Nesse escrito, os preceitos preventivos e terapêuticos destinados aos cuidados com a enfermidade crônica do monarca centram-se na dieta alimentar, com orientações não somente acerca dos alimentos que ele poderia consumir, mas também do modo de prepará-los. Seu outro escrito dietético, o Regimen Castra Sequentium, ligado à Medicina preventiva militar, é destinado à saúde do rei e de seu exército que, no verão de 1309, sitiou a cidade muçulmana de Almeria, na cruzada aragonesa contra o reino nazari de Granada.

Criada em 1864, a Academia Nacional de Medicina passou diversas transformações ao longo da segunda metade do século XIX em decorrência das mudanças no cenário sociopolítico mexicano e da própria dinâmica das ciências médicas no mundo Ocidental. Nesta dissertação, busca-se compreender como ocorreu o processo de institucionalização da medicina acadêmica no México a partir da trajetória da Academia Nacional de Medicina e como foram produzidos determinados saberes entre as décadas de 1860-1880. Assim, foram estudados o processo de consolidação de uma deontologia médica, além da produção, regulação e normatização de saberes médicos relacionados à concepção de vida e aos procedimentos de partos. À luz de uma perspectiva microssociológica e contextualista, demonstram-se como os embates e as controvérsias científicas serviram à organização da academia, às normas de produção e à formulação de saberes sobre vida e parto. Esta pesquisa também apontou como tais saberes serviram à estruturação do Estado mexicano durante a segunda metade do século XIX. Foram analisados os relatórios clínicos e as atas publicados na Gaceta Médica de México (periódico da Academia), os códigos civil e penal sancionados na virada das décadas de 1860-70 e os manuais de medicina legal e medicina obstétrica elaborados pelos médicos Luis Hidalgo y Carpio e Juan María Rodríguez. / Created in 1864, the Academia Nacional de Medicina went through several transformations during the second half of the 19th century as a result of changes at the mexican sociopolitical scenario and the dynamics of medical science in the Western World. Within this dissertation, it is searched to understand how did the process of institutionalization of academic medicine happen in Mexico starting from the trajectory of the Academia Nacional de Medicina and how certain knowledge were produced during the decades of 1860-1880. Therefore, were studied process of consolidation of a physician deontology, in addition to the production, regulation and normatization of medical knowledge related to the conception of life and childbirth procedures. At the light of a microsociological and contextualist perspective, it is shown how the dispute and the scientific controversy served to the organization of the academy, to its norms of production and to the formulation of knowledge about life and childbirth. This research also pointed how such knowledge served to the structuring of the mexican State during the second half of the 19th century. Were analysed clinical reports and minutes published in the Gaceta Médica de México (Academias journal), the civil and criminal Codes sanctioned at the turn of the 1860-70 decade and the manuals of legal medicine and obstetrical medicine made by the physicians Luis Hidalgo y Carpio and Juan María Rodríguez.

Description Logics (DLs) are a family of knowledge representation formalisms used for terminological reasoning. They have a wide range of applications such as medical knowledge-bases, or the semantic web. Research on DLs has been focused on the development of sound and complete inference algorithms to decide satisfiability and subsumption for increasingly expressive DLs. Non-standard inferences are a group of relatively new inference services which provide reasoning support for the building, maintaining, and deployment of DL knowledge-bases. So far, non-standard inferences are not available for very expressive DLs. In this paper we present first results on non-standard inferences for DLs with transitive roles. As a basis, we give a structural characterization of subsumption for DLs where existential and value restrictions can be imposed on transitive roles. We propose sound and complete algorithms to compute the least common subsumer (lcs).

A insatisfação dos médicos está associada ao distanciamento entre sua prática e as imagens idealizadas do médico-sacerdote e do médico-cientista. Investiguei como os ideais de cuidar humanamente dos indivíduos doentes e de conhecer cientificamente os processos de doença e de cura se apresentam na medicina moderna. Para tanto, fiz uma leitura das cinco principais revistas científicas de medicina, de 1990 a 2009. Privilegiei os temas do conhecimento médico e do cuidado relacionados à clínica, e não à saúde pública. Iniciei a leitura por uma amostra sistemática, para aprofundá-la, a seguir, em questões que julguei exemplares, ou especiais. Minhas observações estão entremeadas com citações indiretas de artigos das revistas, para oferecer ao leitor as bases de minhas impressões. Observei que o discurso sobre o conhecimento ocupa maior espaço, é mais complexo e mais elaborado do que o discurso sobre o cuidado. Ao lado de impressionantes avanços da ciência médica e do otimismo positivista da maioria dos artigos, as revistas apresentam incertezas, contradições e limitações dos métodos e das teorias. Há uma tensão entre a fé na ciência, os esforços para tornar a medicina científica, e as dificuldades lógicas e metodológicas de adequar decisões médicas singulares às evidências apresentadas pelas pesquisas. O conhecimento médico se apresenta como um mosaico em permanente reconstrução, incapaz de produzir certezas. E sua produção e divulgação são influenciadas por interesses e crenças de pesquisadores, financiadores e editores. O discurso sobre o cuidado, embora consistente, só ganha proeminência onde falta conhecimento, como em relação ao doente em fase terminal. Os médicos-cientistas, enredados em protocolos e estatísticas, não se ocupam do cuidado. Mas, se adoecem, queixam-se da falta de cuidado. É possível ler propostas de unir evidências científicas e narrativas de doentes e médicos, na construção de uma prática de conhecimento-cuidado curativa para ambos. Mas essas propostas não parecem merecer atenção sequer dos demais autores das próprias revistas. / Dissatisfaction with medical practice is related to the discrepancy between the reality of the practice and the physicians expectations of working like a dedicated priest and like a well-trained scientist. I investigated how the ideals of caring compassionately for the patients and of using all knowledge about disease and cure are presented in modern medicine. In this intent, I read a sample of the Big Five medical journals, from 1990 to 2009. I privileged themes about medical knowledge and care in relation to clinic and not to public health. I began by reading a systematic sample, and then I extended it, studying some points I considered to be special or illustrative. My commentaries are intercalated with citations of articles from the journals, to offer the reader the bases of my impressions. I observed that the discourse on knowledge was given a bigger space, and it is more complex and elaborated than that on care. Beside the impressive advances in medical science, and the optimistic positivism in most papers, the journals show the uncertainties, the contradictions, and the limitations of methods and theories. There is a tension between the faith in science, the efforts to turn medicine into a science, and the logical and methodological difficulties to adequate single medical decisions to the scientific evidence. Medical knowledge appears as a mosaic, permanently reconstructed, and not capable of producing certainties. And the production and divulgation of knowledge are influenced by the beliefs and interests of researchers, supporters and editors. The discourse on care shows consistency; but gains prominence only where knowledge is lacking, as when discussing terminal care. The medical scientists, imprisoned in a labyrinth of guidelines and statistics, do not care about care. But, whenever they get sick, they complain about lack of care. There are also proposals of joining scientific evidence and narratives from patients and doctors in the construction of a knowledge-and-care practice that may be curative for both. But these proposals get no attention, not even from other authors of the same journals.

A insatisfação dos médicos está associada ao distanciamento entre sua prática e as imagens idealizadas do médico-sacerdote e do médico-cientista. Investiguei como os ideais de cuidar humanamente dos indivíduos doentes e de conhecer cientificamente os processos de doença e de cura se apresentam na medicina moderna. Para tanto, fiz uma leitura das cinco principais revistas científicas de medicina, de 1990 a 2009. Privilegiei os temas do conhecimento médico e do cuidado relacionados à clínica, e não à saúde pública. Iniciei a leitura por uma amostra sistemática, para aprofundá-la, a seguir, em questões que julguei exemplares, ou especiais. Minhas observações estão entremeadas com citações indiretas de artigos das revistas, para oferecer ao leitor as bases de minhas impressões. Observei que o discurso sobre o conhecimento ocupa maior espaço, é mais complexo e mais elaborado do que o discurso sobre o cuidado. Ao lado de impressionantes avanços da ciência médica e do otimismo positivista da maioria dos artigos, as revistas apresentam incertezas, contradições e limitações dos métodos e das teorias. Há uma tensão entre a fé na ciência, os esforços para tornar a medicina científica, e as dificuldades lógicas e metodológicas de adequar decisões médicas singulares às evidências apresentadas pelas pesquisas. O conhecimento médico se apresenta como um mosaico em permanente reconstrução, incapaz de produzir certezas. E sua produção e divulgação são influenciadas por interesses e crenças de pesquisadores, financiadores e editores. O discurso sobre o cuidado, embora consistente, só ganha proeminência onde falta conhecimento, como em relação ao doente em fase terminal. Os médicos-cientistas, enredados em protocolos e estatísticas, não se ocupam do cuidado. Mas, se adoecem, queixam-se da falta de cuidado. É possível ler propostas de unir evidências científicas e narrativas de doentes e médicos, na construção de uma prática de conhecimento-cuidado curativa para ambos. Mas essas propostas não parecem merecer atenção sequer dos demais autores das próprias revistas. / Dissatisfaction with medical practice is related to the discrepancy between the reality of the practice and the physicians expectations of working like a dedicated priest and like a well-trained scientist. I investigated how the ideals of caring compassionately for the patients and of using all knowledge about disease and cure are presented in modern medicine. In this intent, I read a sample of the Big Five medical journals, from 1990 to 2009. I privileged themes about medical knowledge and care in relation to clinic and not to public health. I began by reading a systematic sample, and then I extended it, studying some points I considered to be special or illustrative. My commentaries are intercalated with citations of articles from the journals, to offer the reader the bases of my impressions. I observed that the discourse on knowledge was given a bigger space, and it is more complex and elaborated than that on care. Beside the impressive advances in medical science, and the optimistic positivism in most papers, the journals show the uncertainties, the contradictions, and the limitations of methods and theories. There is a tension between the faith in science, the efforts to turn medicine into a science, and the logical and methodological difficulties to adequate single medical decisions to the scientific evidence. Medical knowledge appears as a mosaic, permanently reconstructed, and not capable of producing certainties. And the production and divulgation of knowledge are influenced by the beliefs and interests of researchers, supporters and editors. The discourse on care shows consistency; but gains prominence only where knowledge is lacking, as when discussing terminal care. The medical scientists, imprisoned in a labyrinth of guidelines and statistics, do not care about care. But, whenever they get sick, they complain about lack of care. There are also proposals of joining scientific evidence and narratives from patients and doctors in the construction of a knowledge-and-care practice that may be curative for both. But these proposals get no attention, not even from other authors of the same journals.

Facteur clé du développement des nations, la médecine et son organisation se trouvèrent au centre des préoccupations des autorités politiques qui se sont succédées en Argentine et en Uruguay dès que ces territoires ont été conquis par l’Espagne. Pourtant, une fois l'indépendance acquise, des crises économiques répétées et une situation politique chaotique ont fait que, dans les deux rives de la Plata, la médecine a peiné à s’éveiller et à se consolider. Tandis qu’en Uruguay l’érection de la faculté de médecine ne fût possible qu’en 1875, celle de Buenos Aires, érigée en 1821, fonctionna de manière chancelante jusqu’en 1852, à cause de la situation politique troublée que connut le pays avec la dictature de Juan Manuel de Rosas. De ce fait, bon nombre d'Uruguayens et Argentins sont partis entamer ou parfaire leur formation médicale à la Faculté de Paris. En même temps, et en dépit des agitations politiques et de l’instabilité économique de la région, de nombreux médecins français ont, dès la première moitié du 19ème siècle, décidé de s’établir dans les rives de la Plata. Ce travail se penche sur les liens que les médecins séjournant de part et d’autre de l’Atlantique entre 1828 et 1886 ont noués, entretenus et renforcés au fil du siècle. Cette dynamique circulatoire des savoirs, des pratiques et des techniques médicaux, énergique et permanente, bénéficia à la médecine de part et d’autre de l’Atlantique. Cette circulation est abordée, en particulier, par l’analyse de la gestion effectuée, par le corps médical de Montevideo et Buenos Aires, des épidémies de choléra et de fièvre jaune lorsqu’elles firent irruption dans ces villes et des connaissances qui, à leur sujet, ont circulé dans la région avant et après leur apparition. Nous étudions également l’accueil accordé par les membres des sphères médicales française et rioplatense aux discours liés à la crémation des cadavres - système qui provoqua l’engouement du corps médical européen au tournant des années 1860 - et à sa mise en place. Nous montrons que la médecine de part et d’autre de l’Atlantique s’est vue enrichie par le contact et les échanges réciproques que ces médecins ont entretenus. En effet, si la médecine de la Plata a connu dans une grande mesure son éveil par la contribution des acteurs médicaux français qui ont amené dans la région leurs connaissances et leur savoir-faire, la médecine française a été, à son tour, alimentée par le séjour des médecins de l’Hexagone dans les rives de la Plata. Indépendamment de la durée de leurs séjours dans la région, les diverses explorations qu’ils ont effectuées et leur confrontation directe à la pathologie locale ont permis aux médecins français d'accroître leurs connaissances et d’acquérir une expérience singulière. Cette expérience a eu un impact significatif, non seulement dans leur pratique quotidienne, mais aussi dans l’adoption de pratiques innovantes indispensables au progrès médical français dans le dernier quart du 19ème siècle. / As a key factor in the development of nations, medicine and its organization were at the center of the preoccupations of the political authorities who succeeded one another in Argentina and Uruguay as soon as these territories were conquered by Spain. Yet, once independence has been achieved, repeated economic crises and a chaotic political situation have meant that medicine on both sides of the Plata has struggled to awaken and consolidate. While in Uruguay the erection of a faculty of medicine was not possible until 1875, that of Buenos Aires, erected in 1821, functioned in an intermittent manner until 1852, because of the troubled political situation in the country with the Juan Manuel de Rosas's dictatorship. As a result, many Uruguayans and Argentines have gone to begin or perfect their medical training at the Faculty of Paris. At the same time, in spite of the political unrest and the economic instability of the region, many French doctors decided to establish themselves on the banks of the Plata in the first half of the 19th century.This work examines the links that physicians living on both sides of the Atlantic between 1828 and 1886 developed, maintained and strengthened over the course of the century. This dynamic circulation of knowledge and medical techniques, energetic and permanent, benefited the medicine on both sides of the Atlantic. More specifically, we approach these exchanges by an analysis of the management carried out by the medical corps of Montevideo and Buenos Aires of the epidemics of cholera and yellow fever when they broke out in these towns and of the knowledge that circulated in the area before and after their appearance. We also study the reception given by the members of the French and Rioplatense medical spheres to the speeches related to the crematist system and its establishment, a system that excited the European medical profession at the turn of the 1860s. We show that medicine on both sides of the Atlantic has been enriched by the contact and reciprocal exchanges that these doctors have maintained. Indeed, while Plata's medicine has to a large extent been awakened by the contribution of the French medical actors who brought their knowledge and know-how to the region, French medicine was in turn fueled by the stay of doctors of the Hexagon in the banks of the Plata. Regardless of the length of their stay in the region, the various explorations they have carried out and their direct confrontation with the local pathology have allowed French physicians to increase their knowledge and acquire a singular experience. This experience had a significant impact, not only in their daily practice, but also in the adoption of innovative practices essential to French medical progress in the last quarter of the 19th century. / Factor esencial para el desarrollo de las naciones, la medicina y su organización se encontraron en el centro de las preocupaciones de las autoridades políticas del Río de la Plata (Argentina y Uruguay) desde el momento mismo de la conquista española. Sin embargo, una vez adquirida la Independencia, las crisis éconómicas y la inestabilidad política fueron permanentes en los dos países, En consecuencia, el despliegue y la consolidación de la medicina de parte y parte de la Plata se vieron fuertemente comprometidos. Mientras que en Uruguay la facultad de medicina fue creada apenas en 1875, la facultad de Buenos Aires, instalada desde 1821, funcionó de manera irregular hasta 1852, puesto que el régimen dictatorial de Juan Manuel de Rosas entorpeció la enseñanza y puso freno al movimiento científico establecido desde principios de siglo 19. Fue por eso que, con el objetivo de formarse o especializarse en la facultad de medicina de París, numerosos uruguayos y argentinos viajaron a Francia. Paralelamente, y a pesar de las múltiples agitaciones políticas y de la economía vacilante de la Plata, varios médicos franceses decidieron establecerse en la región desde la primera mitad del siglo. Este trabajo explora las relaciones establecidas y consolidadas con el paso del tiempo entre los médicos y estudiantes en medicina rioplatenses y franceses que viajaban entre el viejo continente y la Plata, y que dieron paso a la instauración de una circulación énergica y permanente de saberes, de prácticas y de técnicas médicas, que benefició tanto a la medicina rioplatense como a la medicina francesa. Dicha circulación es ejemplificada a través de la actuación concreta de los cuerpos médicos de Buenos Aires y Montevideo en los momentos en que el cólera y la fiebre amarilla irrumpieron en estas ciudades de forma epidémica, asi como también de la circulación de saberes que, sobre estas enfermedades exóticas, tuvo lugar en la región antes y después de su aparición en la Plata. Asimismo, se analiza la recepción de los discursos y la puesta en práctica de la cremación de cadáveres – sistema que provocó el entusiasmo del cuerpo médico europeo desde finales de los años 1860 – en las esferas médicas francesa y rioplatense. Se espera así recalcar que la medicina de parte y parte del Atlántico se vió enriquecida por el contacto y los intercambios científicos enfectuados entre los médicos franceses y rioplatenses. En efecto, si los médicos franceses, llevando sus conocimientos y su experiencia a la Plata, jugaron un rol clave y estimularon el desarrollo de la medicina rioplatense, la medicina francesa fue, a su turno, alimentada por la estadía de los médicos franceses en la región. En efecto, sin importar el tiempo pasado en la Plata, las múltiples exploraciones geográficas y la confrontación directa avec la patología local enriquecieron los conocimentos de esos médicos y les aportaron una experiencia singular cuyo impacto, altamente significativo en el ejercicio cotidiano de su profesión, repercutió igualmente en el desarrollo de la médicina nacional, estimulando la adopción de prácticas innovantes indispensables al progreso médico francés en el último cuarto del siglo 19.

Submitted by Johnny Rodrigues (johnnyrodrigues@ufcg.edu.br) on 2018-06-12T15:02:07Z No. of bitstreams: 1 JOSÉ MAXSUEL LOURENÇO ALVES - DISSERTAÇÃO PPGH 2015..pdf: 63315973 bytes, checksum: 4248aeaa557b5572b16ef9102aea670d (MD5) / Made available in DSpace on 2018-06-12T15:02:07Z (GMT). No. of bitstreams: 1 JOSÉ MAXSUEL LOURENÇO ALVES - DISSERTAÇÃO PPGH 2015..pdf: 63315973 bytes, checksum: 4248aeaa557b5572b16ef9102aea670d (MD5) Previous issue date: 2015-04 / Capes / Este trabalho analisa as estratégias educativas feitas pela Fundação Movimento Brasileiro de Educação - MOBRAL, na produção de seus Programas educativos, com ênfase na apropriação dos saberes médicos, entre os anos 1970 e 1985. Nele problematizamos como e por que. no interior dos governos militares, emergiu uma instituição que se destinava à alfabetização de adultos e à educação para a saúde, bem como as complexas relações que estão em jogo no modo como ele se propõe a produzir subjetividades salubres e ordeiras. Neste sentido, analisamos especialmente as estratégias educativas e as linhas de fuga, que astuciosamente burlavam tais estratégias, que lidavam com dois eixos fundamentais: a produção de livros didáticos para a "Alfabetização Funcional e Educação Permanente" e a execução do "Programa de Educação Comunitária para a Saúde". Para realizar esta empreitada foram analisadas publicações como: cartilhas para a alfabetização e leitura, manuais do professor, relatórios oficiais do MOBRAL, matérias de revistas e jornais, fotografias, leis, decretos, relatórios de uma CPI e das V,VI e VII Conferências Nacionais de Saúde e os áudios dos programas de rádio Domingo MOBRAL, Você pergunta e o MOBRAL responde e Vila da Boa Saúde. Além disso, para contribuir com a reflexão sobre este objeto dc estudo, fizemos uso de parte das reflexões presentes no arcabouço teórico produzido por Roger Chartier e Michel de Certeau, entre outros; tendo em vista a intensidade com a qual eles afetaram o campo historiográfico com seus estudos sobre a História do Livro e da leitura e a produção de uma "cultura ordinária". Enquanto isto, do ponto de vista metodológico, apropriamo-nos da análise do discurso proposta por Montenegro e da antropologia do visual produzida por Georges Didi-Hubcrman. / This papcr analy/es the educational strategies made by the Bra/.ilian Movcment Education Foundation - MOBRAL. in the production of its educational programs. with emphasis on apropriation of medicai knowledge. between the years 1970 and 1985. In it we question how and why, within the military govcrnments emerged an institution that was intended for adult literacy and health education as well as the complex relations that are at stake in how it sets out to produce wholesome and subjectivities orderly. In this sensc. espccially analyzed the educational strategies and lines of flight that cleverly mocked such strategies, dealing with two main arguments: the production of textbooks for the "Functional Literacy and Continuing Education" and the implementation of the "Community Education Program for Health ". To accomplish this endeavor publications were analyzed as primers for literacy and reading. teacher manuais, offkial reports of MOBRAL. materiais from magazines and newspapers, photographs, laws, decrees, reports of a CPI and the National Health Confcrcnce and the áudios Domingo MOBRAL of radio programs, Você Pergunta c o MOBRAL Responde and Vila da Boa Saúde n addition, to contribute to the discussion on this subject matter , we made use of the reflections present in the theoretical framework produced by Roger Chartier and Michel de Certeau . among others; in view of the intensity with which they affected the historiographical field with his studies on the history of books and reading and the production of a " common culture " . Meanwhile, from a methodological point of view, we apropriamo us of discourse analysis proposed by Montenegro and visual anthropology produced by

[pt] Nesta tese, à luz do prisma filosófico, empreendemos um olhar que abrangeu o pensamento médico filosófico desde a Antiguidade até a Revolução Terapêutica. Nosso olhar contemplou: na Antiguidade, uma época em que houve uma estreita colaboração entre Filosofia e Medicina, baseada na pesquisa mútua dos aspectos etiológicos, quer da enfermidade da alma, quer daquela do corpo; foi a época do nascimento e apogeu da Analogia Médica; na Idade Média, identificou um estado de hibernação da Analogia Médica no século XII, seguido de um leve despertar no século XIII, a volta a um estado de adormecimento e o despertar definitivo, no século XV; na Renascença, captou a retomada dos textos médicos e a queda do saber galênico tradicional; na Modernidade, finalmente, diagnosticou o início do distanciamento entre os saberes filosófico e médico, com o respectivo definhamento da Analogia Médica. Desde então, nosso olhar aprofundou se nas idas e vindas do saber médico filosófico, especulando as causas e consequências desse distanciamento, e chegou à conclusão de que o legado deixado pelo pensamento médico moderno orientou e orienta a Medicina contemporânea para um sentido de desumanização em relação à pessoa do paciente. Por fim, depois de tanto ver, nossa razão assentiu para a necessidade de uma reforma na Medicina, principalmente em sua paidéia, baseada numa próxima colaboração com a Filosofia a fim de receber subsídios quando à questão central de qualquer procedimento terapêutico: qual é o ser do ser humano? / [en] In this Thesis, using the light of the philosophical prism, we undertake an examination embracing medical philosophical thought beginning in antiquity, continuing up until the Therapeutic Revolution. Our view contemplates: in antiquity, a time during which there was a strict collaboration between Philosophy and Medicine, based upon mutual research of the etiological aspects of disease not only of the soul but also of the body; it was the time of the birth and apogee of the Medical Analogy; during the Middle Ages it was possible to identify that the Medical Analogy had entered a state of hibernation in the twelfth century, followed by a slight awakening in the thirteenth century, returning to a state of sleep, with the final awakening occurring in the fifteenth century; during the Renaissance it captured a return to the medical texts and the fall of traditional Galenic knowledge; finally during the Modern era we have diagnosed the initial phases of a distancing between philosophical and medical knowledge, with a respective weakening of Medical Analogy. Since the Modern era our examination has focused upon the vacillations of medical philosophical knowledge, speculating upon the causes and consequences of this distancing, and our examination found that the legacy left by modern medical thought has oriented and continues to orient Modern Medicine towards a dehumanization in relation to the person of the patient. Finally, we concluded that medical reform is needed, principally, in its Paideia, based upon a closer collaboration with philosophy, with the intent to provide subsidies to help answer the central question of any therapeutic procedure, which is: what is the nature of the being of the human being?

Le retrait du Mediator®, médicament des Laboratoires Servier en vente de 1976 à 2009, s’effectue après l’identification de pathologies spécifiques des valves cardiaques : les valvulopathies médicamenteuses. Depuis, l’évènement est abordé sous l’angle du scandale médico-sanitaire, des défaillances du système de régulation et des méthodes d’influence d’un industriel sur des décideurs (politiques ou prescripteurs). Une procédure juridique pour établir des probables infractions aux lois pénales est en cours. Pour comprendre les origines et les conséquences de l’affaire du benfluorex – au-delà des champs de compétence juridiques et politiques – ce travail de thèse propose une analyse du processus de non-reconnaissance d’un effet indésirable grave d’un médicament pendant plus de 30 ans et surtout les effets de ce non-repérage sur ceux qui sont directement concernés : les personnes l’ayant consommé. À partir des données issues de deux enquêtes par questionnaire distinctes adressées l’une à des usagers du Mediator® et l’autre à des cardiologues notre travail établit six différentes « figures » théoriques et analytiques des personnes exposées à la molécule se trouvant au centre de notre enquête. / The withdrawal of Mediator®, a drug sold by Laboratoires Servier between 1976 and 2009, occurred after specific pathologies of cardiac valves were identified: the drug induced valvular heart disease. Since then, the incident has been approached from the angle of health and medical scandal, regulation failure and the influence of an industrial company on decision makers (political figures or prescribers). A legal procedure to establish probable violations of criminal laws is under way. To understand the origins and consequences of the benfluorex affair - beyond the fields of legal and political jurisdiction - this thesis proposes an analysis of the process of non-recognition of a serious adverse side effect of a drug for over 30 years and, above all, the effects of this non-recognition on those directly concerned: the people having taken it. Using data from two separate surveys, one of Mediator® users and the other of French cardiologists, this study establishes six different theoretical and analytical "figures" of people exposed to the molecule at the center of the investigation.