Aim: This article analyses the medical protagonism in social medicine and school medicine was disseminated by the Medical Journal of Paraná, aiming at the regeneration of the population. School medical discourse outlined practices to protect and care for primary school students such as for the prophylaxis of school illnesses and physical activity practices and established new conformation for the school space. The period is the years 1930.

Method: This is a qualitative research with documentary analysis from the perspective of the history of Education. The sources of research are the Medical Journal of Paraná in the 1930s and the Government Reports. The sources of research are evidence that publicized the medical discourse for childhood and the actions of the State to sanitize, discipline and homogenize the population. The use of documentary sources in the research in History of Education makes it possible to broaden the understanding of objects, the dimension of time and their historical and sociocultural relationship. The theoretical contributions of Cultural History guide the analysis of the documentary references, in the discussion with Foucault and Vidal.

Results and discussion: In the period under review, the attention and vigilance of the authorities were to teach personal care with the mouth, the hair, the hands and sexuality also received special attention because syphilis was an individual and public health problem. Alcohol, smoking and addictions, which degrade moral values ​​and should be prevented and controlled by the school, also became policy objects. Education and health were considered the driving force behind progress and included in a broader proposal to redeem the nation and consolidate the Republic in the first decades of the twentieth century.
Conclusion: During the period under review, the attention and vigilance of teachers was to supervise, examine and teach personal hygiene, healthy nutrition, prevention of addictions and teaching love of work. The set of documentary sources surveyed allowed to analyze the importance of medical journals as educational devices for the historiography of education and also to understand the scope of educational policies aimed at the nation's redemption for health, hygiene and citizenship.

Keywords: education, health, school medicine, hygiene

In Brazil, in the early twentieth century education and health aimed to redeem the nation and consolidating the Republic. In the 1930s, the health care of the Brazilian people began to form the discussions about the formation of the Brazilian nation including educational policies. Education and health were considered essential to generate progress and also have public policies for children. Ending illiteracy and leading to health meant lead the civilizing process and regenerate the population, especially the native population, symbols of backwardness. At that time, the attention and vigilance of the authorities were to teach personal care with the mouth, lice and hands. Syphilis was a health problem, so the sexuality of children and young people was also cause for concern. Combating alcohol, smoking and other addictions, which degrade moral values, were the subject of policies and should be prevented by the school. The objective of this study is to analyze the importance of education and health in the 1930s, in the formation of the population, manifested in the Medical Journal of Paraná and also the social medical protagonism, aiming at the regeneration of the population. The school medical discourse outlined practices to protect and care for elementary school students, such as disease prophylaxis, physical activity practices and new conformations established for the school space. Doctors dedicated themselves to spreading a discourse of modernity, indicating education and health as the ways to achieve civilization and progress, with Europe as a reference. The Medical Journal of Paraná is the main source of research, since it was the periodical where the doctors divulged their eugenic discourse, directed towards the school infancy.  Brazil received thousands of European immigrants in the nineteenth century, who replaced the native population with their customs representative of barbarism.¹ This denotes that the racial issue brought the representation of the immigrant that would lighten the skin color of the population. The bleaching of the Brazilian population was idealized by a white and European population, which brought the ideas and re-presentation of work and civilization.² The state of Paraná, the site of this research, is located in southern Brazil and at the end of the 19th century and, at the beginning of the 20th century, received thousands of European immigrants (Poles, Ukrainians, Germans, Italians, Russians) for work in agriculture and was part of the policy of civilizing the nation. In the political field the eugenic and bleaching theories of the Brazilian population gained space in Brazil and the state of Paraná, since they had the pretension to improve the physical and mental constitution of the population.^3‒5 But this did not occur because miscegenation is a broader issue involving the social and economic situation. Eugenics can be understood as the "study of the means of social control that can benefit impair the racial qualities of future generations, both physically and mentally".⁶  This is a qualitative research, with documentary analysis. The sources of research are the Medical Journal of Paraná (1931-1935)¹ published by the Medical Society of Paraná and Government Reports. The set of documentary sources researched made it possible to analyze the importance of medical journals as educational devices for the historiography of education and also to understand the scope of education policies that in the period analyzed aimed at redemption of the nation for health, hygiene and citizenship. This article is part of the History of Education and the sources of research make it possible to extend the understanding of objects, the dimension of time and their historical and sociocultural relationship.⁷ The Medical Journal of Paraná was organized in several sections, it disseminated scientific articles, lectures, events and pronouncements of the Professors of the Federal University of Paraná. It is the interest of this research to know the eugenic discourse of physicians, in a more 'softened' version, on hygiene and school medicine (from a prophylactic perspective). The Medical Journal of Paraná highlights the social role of physicians engaged in population improvement policy.

The sources of research will evidence⁸ to understand eugenic politics, beginning with childhood in the perspective of race/nation regeneration.⁹ For Certeau¹⁰ "the establishment of the sources also calls for a founding gesture represented yesterday as the combination of a place, an apparatus and techniques." Foucault's cultural history guides the analysis of documentary sources.

¹Organ of the Medical Society of the Hospitaes of Paraná , founded in December 1930, began its activities in December 1931 with the physician Milton Macedo Munhoz as editor. The Journal maintains its periodicity until the present day, now under the seal of the Medical Association of Paraná. The numbers searched are available in the Public Library of Paraná

Brazil is a racially mixed country, formed by Portuguese, indigenous and Afro descendants and received more than four million European immigrants in the period under study. There was a policy of bleaching the skin of the population, bringing the European immigrant. While there is legal equality, there has been racial discrimination against the black population. Social doctors and intellectuals, in the first decades of the twentieth century , believed that to modernize Brazil, it was necessary to educate, sanitize and clean up the people. "To vitalize by education and hygiene", as affirmed the doctor Miguel Couto.¹¹ In this sense, medical intellectuals and educators such as Afrânio Peixoto, Fernando de Azevedo, Belisário Penna and others, associated the whiteness of the skin with virtue, strength and health.¹² In this sense, subjects could escape from the social category of blackness by improving health, education and culture.¹³ In this way, racial degeneration was understood as a source of moral degeneration, for the poor classes, considered perishables that did not control their instincts, increased the miserable offspring. So there were alternatives to "improving" the population, monitoring and controlling sexuality, inculcating new hygiene habits, beginning with schooling. For intellectuals, eugenic theories have become a possibility of rehabilitating the nation and improving race.^4,5,14,15 The main health concerns of Brazilian students in the period under analysis were the care of individual hygiene, receiving vaccines, lack of good eating habits, the prevention of contagious diseases, sexually transmitted diseases and addictions. Historically, school health was created in Brussels (1874), being incorporated later in Paris (1879), Japan (1903), to arrive in Brazil with similar structures and plans: service to students, architecture specifications and furniture schooling to meet the precepts of ergonomics and hygiene, nutritional assessment and complementation, screening and vision problems.¹⁶  

Health in the Brazilian school has followed world trends in education and health. The policy of framing low-income classes was supported by the hygienist movement to control contagious diseases, preventing them from reaching the school environment.¹⁷ In the eugenic-hygienist sense, health was thought in physical, mental and moral terms. The doctors argued that the people should be informed and saved from ignorance. The population should incorporate new habits and healthy living practices.¹⁸ In this sense, health education sought the development of the healthy race, from the disciplining of childhood, as well as correcting deviations from conducts. Thus, in a civilizational perspective, doctors, teachers, nurses and others idealized to sanitize and moralize individually the subject and also the city.

In the period of this study, there was the expansion of school education and also the formation of the feeling of Brazilianness.^19,20 The school space has become the 'laboratory' for the training of future citizens , as well as the center of education policies for healthy, hygienic and educated subjects, in line with the nation's health, eugenic and training policies.⁴ Eugenic policies were translated into hygiene and health policies. In order to make this situation real, several measures were implemented in schools, such as the creation in 1920 of the National Department of Public Health and in Paraná in 1921 the Medical School Inspection Service was created , which was supposed to meet "schools and groups, examining their students and teachers alike".²¹ In this sense, the Federal Constitution of 1934, Article 138 stated that the Federal Government, states and municipalities should encourage the eugenic education, care for the mental and social health and take steps to restrict morality and l Infant morbidity. The school was systematized medicine by doctors performed by teachers, to 'save' the childhood and youth of the evils of diseases and addictions.⁴ The school acted preventively to take the students the way of vices and make them productive individuals and molding them morally and socially, through the school medical service, classes of moral and civic education, physical education and work manuals.

The school incorporated the medical hygienist discourse/sanitarian with the school medical inspection, monitoring the physical aspects and hygiene of school buildings, examining students through the anthropometric examination (anthropometric test is to measure height and weigh the children) and physical examinations.⁴ Foucault²² analyzes that the school became a kind of 'uninterrupted examination apparatus' joining the techniques of the pedagogical examination to those of the health examination, reinforcing the techniques of hierarchy that establishes vigilance to those of the sanctioning normative. In this sense, anthropometry and psychometry were constituted in the sciences "par excellence of education and the records and the anthropometric examinations, together with the sanitary passbooks, in the instrument from which any decision is taken on the future of the scholar".²³ The circulation of these ideas and the implementation of the School Medical Service allows m understand state policies, while policies of social medicine, education and population control, biopolitics. The state through biopolitics controls the social bodies, regulates and controls the actions and "life and its mechanisms enter into the domain of explicit calculations, making power-knowledge an agent of transformation of human life".²⁴ The child and the youth were the custodians of the future. The authorities directed health policies to specific segments of the population, especially "the caboclo from the coast to the settler of the interior", according to the Education Inspector, César P Martinez.²⁵ These were afflicted by diseases resulting from the lack of hygiene, malnutrition and good life habits that compromised student learning.

The medical discourse on school health in the Medical Journal of Paraná-MJP

The Medical Journal of Paraná (Figure 1) was published by the Medical Society of Paraná, in the 1930s, informing the doctor's on the news in science, the discourses on school medicine and the discussion of the binomial "health / disease - society." The first years of publication were selected when the social performance of physicians for the regeneration of the population was intense. This Journal is an important source of research in education and health as it reveals the relationships between doctors and teachers in teaching, in surveillance and in the healthy formation of childhood. The following will analyze some articles that address the engagement of physicians in medicine and school health. In the article “Childcare”, published in Medical Journal of Paraná, signed by the doctor Dr. Mario Gomes, instructed parents and teachers in the education of the small children and school age. The concern and care of childhood went beyond medical knowledge, included moral lessons on the role of family, the value of work, obedience and care with hygiene. The author taught how parents and teachers should take care of food, hygiene, vaccines, sleep and also impose discipline and respect. In eugenic perspective, the author taught that the woman in the role of mother, was the first educator and argued on subjects such as moral education, respect, diligence, moral principles (such as honesty, respect and given orders They were to be met without delay) and on the dignity to work. In line with state education policies, he justified the importance of the medical record that should be filled by the Medical School Inspection Service. In this article, the author addressed about the importance of the teacher in monitoring the hygiene of the student (garments, head, body, teeth, hands) of food and school hygiene (the courtyard, private and also indicates that the school should be illuminated , airy and clean). Physical school activities should be practiced. The doctor assumed the role of educator and the MJP the educational device. The action of the school extends beyond the walls because it has an expanded social performance , while it is an institution that produces, discloses and legitimizes identities, skills and ways of life and delegitimizes others.²⁶

Public health and sexually transmitted diseases were the concern of doctors. In Article The Sanitation of the Coast, Dr. Marceliano de Miranda, warned about the maladies caused by impaludism, verminoses, tuberculosis and syphilis , since they were considered social evils that should be combated in the broadest sense of the population as a whole. This article demonstrated the social role of sanitary doctors working in the nation-building project. The author was in favor of health education, considering the school as the ideal place for its application , analyzing that 'the best sanitized is the alphabet'. Little by little, medicine gained the confidence of the population by effectively combating numerous physical and social pathologies, proposing and legitimizing new behaviors, working to eliminate extreme poverty, crime , alcoholism and reverse the degeneration of the Brazilian people.²⁷ In the article entitled 'The Doctor in Schools', Teacher José Pereira, addressed the need for health in school space , health education, hygiene education and prophylactic medicine. The edge goes the relations between family, doctor and teacher in education. It would bring arguments of leading educators like John Dewey, Anisio Teixeira and Maria Montessori in favor school as a proper environment for children. He announced that the healthy school environment should include hygiene of the environment (classrooms, patio, bathroom and others ) and reverberate in the community, changing habits.

Figure 1 Medical Journal of Paraná.

In the article 'Health through Education' the Teacher of the Faculty of Medicine, Milton Munhoz, the author argued favorably by partnership between doctor, teacher and hygienist in Sanitary Education and Hygienic Education. It brought arguments from the doctor and teacher Afrânio Peixoto on the social importance of the doctor to teach the teachers how to proceed in the prevention of health and hygiene education. It defended the actions of the Health Platoons. In this sense, school education, according to this journal, should prepare the child for" social life: by physical education making it a strong and robust entity; by instruction he transmits knowledge and by moral education and accustoms to attention, reflection and willpower". Accordingly, medicalization of the population is analyzed by Foucault^22,23 as a biopolitic, an associate policy to combat diseases that are persistent and that when untreated, subtract energy, decrease the performance of work and has economic cost. Physical education was indicated by physicians as an object of strengthening , body regeneration and training of a fit subject for work. Thus, the Jecas Tatus,¹syphilitics, alcoholics should evidence the ideal Brazilian to be built. They needed to be cured, disciplined, standardized and then accompanied by systematic physical practices, gymnastics and games.²⁵ Thus, medicalized thinking uses means of correction that are means of transforming individuals and a whole technology of human behavior is linked to them. Therefore, changing behaviors was a basic premise for 'regenerating' the nation.

The regulatory objective biopower and conform the population and in the period, exer acid by the state, through canismos bio-regulators and also by medical institutions, who entered the school environment in order to 'shape' the citizen. Thus, in addition to the school, a set of coordinated actions in the construction of the city, in the school architecture, in the imposition of norms of conduct and action on the space, normalizing behaviors the documentary sources constitute records show as medicine acted beyond the school space , making hygiene and prophylaxis social actions. The school was the instance of practices and representations that enhance, design and recreates school culture.²⁶ The teachers taught and supervised the hygiene, the physical and moral formation of their students, building more able and working citizens , in a project of nation drawn in the political sphere.

¹Character of Brazilian literature, created by Monteiro Lobato, in 1918 and represented the sick, indolent and lazy Brazilian.

School medicine in Brazil, was inserted into a larger project, which was part of the standardization policy and hygiene of the population. The movement for education and health, in the first decades of the twentieth century, should regenerate the nation. The school, while the space for the diffusion of knowledge, incorporated the discourse and norms of school medicine, taught by doctors and implemented by teachers. The school was the privileged space of state action for the implantation of medical health services and the teachers were the disseminators of the good news that should be inculcated in the students, producing cultural changes. The documents and policies that guide education in the country are elaborated by the State. The school space, in the period under review, became the 'laboratory' for training future citizens. The school entered the medical hygienist discourse/sanitation and implemented measures for the formation of healthy citizens, such as the Medical School Inspection Service, monitoring of the physical and hygienic aspects of school buildings and supervision to students through anthropometric examinations, physiological exams and physical exams. The medical discourse entered the school through the surveillance of space and bodies, accompanied by tests, records, statistics and health indicators, demonstrating the implementation of biopower.

The medical protagonism in social medicine and school medicine was disseminated by the Medical Journal of Paraná , aiming at the regeneration of the population. School medical discourse outlined practices to protect and care for primary school students such as for the prophylaxis of school illnesses and physical activity practices and established new conformation for the school space. The set of documentary sources researched made it possible to analyze the importance of medical journals as educational devices for the historiography of education and also to understand the scope of education policies that in the period analyzed aimed at redemption of the nation for health, hygiene and citizenship.

None

Author declares that there is no conflict of interest.

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