Manuel de Abreu
Encyclopedia
Manuel Dias de Abreu was a Brazilian physician
and scientist
, the inventor of abreugraphy
, a rapid radiography
of the lungs for screening tuberculosis
. He is considered one of the most important Brazilian physicians, side by side with Carlos Chagas
, Vital Brazil
and Osvaldo Cruz
.
in medicine
at the Federal University of Rio de Janeiro in 1914.
Shortly afterwards, he travelled to France
, where he first worked in the service of Dr. Louis Gaston, at the Nouvel Hôpital de la Pitié, in 1915. Charged with photographing surgical pathology
specimens, Abreu quickly developed new and better devices and methods for this. In 1916, Abreu started to work at the Hôtel-Dieu
and had his first contact with medical radiography
, which had been discovered by the German physicist Wilhelm Röntgen just 20 years before. He became the director of the laboratory of radiology
of the hospital in substitution to the previous director, Dr. Jean Guilleminot, who was conscripted to fight in the First World War. It was in this position, by suggestion of Guilleminot, that Abreu became interest in fluorography, or the photographic recording of fluoroscopic
x-ray images of the lungs. He soon was able to perceive the immense diagnostic value of these images for tuberculosis and other pulmonary affections, and he began his photographic
studies of the lungs in 1918, now at the Laennec Hospital (also in France).
Abreu's first landmark contribution to the radiography of soft tissues (until then not much utilized as a diagnostic radiographical method, due to the low definition of images) was to develop a x-ray densitometry
method, by comparing the degree of white density of biological tissues to water's and to other highly dense references, such as bones, and to point out its value for radiodiagnosis. In 1921 he first published his pioneering work on the radiological interpretation of pulmonary injuries in pleuropulmonary tuberculosis, titled "Le Radiodiagnostic dans la Tuberculose Pleuro-Pulmonaire". This and his method of pulmonary densitometry gave him an invitation to join the prestigious Académie de Médicine de Paris.
In 1922 Abreu returned to Brazil and accepted a post as the head of the X-Ray Department at the Federal public health service for the prophylaxis of tuberculosis in Rio de Janeiro. The city was at that time going through a devastating epidemic
of tuberculosis. He intensified research on thoracic radiography for the purpose of early diagnosis of tubercular lesions, but the results were initially discouraging, due to the low quality of fluroscopic images at the time.
Abreu's ideas for a new mass screening radiography apparatus was made true by the construction of a first device by the Lohner House, a representative of Siemens
in Rio de Janeiro. The first service of Thoracic Census was established in 1937. The first results indicated the usefulness of abreugraphy: the screening of 758 asymptomatic and apparently sane individuals in July 1937 revealed that 44 of them had already tuberculosis lung lesions, which allowed for early treatment and a better survival. Mobile units were also employed, and soon abreugraphy became a mandatory examination for anyone applying to a public job or school in Brazil. By the end of the 40s, Dr. Manuel de Abreu could present the first positive impact of mass screening on tuberculosis mortality.
treatment and public health programs greatly decreased the incidence of the disease, and also out of fear of unnecessary exposure to x-rays, particularly in children and pregnant woman. The World Health Organization
recommended its discontinuance and the Brazilian health service stopped to pay for it in 1999.
Abreugraphy was not used in other countries so intensively as in Brazil and a few other Latin America countries. It received several different names, according to the country where it was adopted: mass radiography, miniature chest radiograph (United Kingdom
and USA), roentgenfluorography (Germany
), radiophotography (France
), schermografia (Italy
), photoradioscopy (Spain
) and photofluorography (Sweden
). The importance of abreugraphy was outlined by the creation of the Brazilian Society of Abreugraphy, in 1957, and the publication of the Revista Brasileira de Abreugrafia.
, an approach which he used to quantitate images of the mediastinum
, and which he named radiogeometry. His ideas where collected and published in 1928 in his book "Essai sur une nouvelle Radiologie Vasculaire". Furthermore, Abreu was instrumental in developing new techniques for x-ray planar tomography
of the thorax using the simultaneous exposure of several films, as well as the use of tracheobronchic washout as technique for precise detection of Koch bacilli in infected individuals.
Manuel Dias de Abreu lectured in the field of medical radiology in innumerable Brazilian and foreign scientific institutions, and was a member of the most important medical organizations of the world. He was awarded the French Légion d'Honneur
and several other scientific prizes, among them the Gold Medal of the American College of Chest Physicians
, in 1950 and the Gold Medal of the Argentinian Radiological Society, in 1953.
Besides several books on medicine, Abreu published also two poetical works: Substâncias, which was illustrated by famous Brazilian painter Emiliano Di Cavalcanti
and Poemas sem Realidade, illustrated by himself.
Tragically (and ironically, for a pneumologist), Dr Abreu died in 1962 from lung cancer
, probably caused by his long habit of smoking
.
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
and scientist
Scientist
A scientist in a broad sense is one engaging in a systematic activity to acquire knowledge. In a more restricted sense, a scientist is an individual who uses the scientific method. The person may be an expert in one or more areas of science. This article focuses on the more restricted use of the word...
, the inventor of abreugraphy
Abreugraphy
Chest photofluorography, or abreugraphy is a photofluorography technique for mass screening for tuberculosis using a miniature photograph of the screen of a x-ray fluoroscopy of the thorax, first developed in 1935.-History:Abreugraphy receives its name from its inventor, Dr...
, a rapid radiography
Radiography
Radiography is the use of X-rays to view a non-uniformly composed material such as the human body. By using the physical properties of the ray an image can be developed which displays areas of different density and composition....
of the lungs for screening tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. He is considered one of the most important Brazilian physicians, side by side with Carlos Chagas
Carlos Chagas
Carlos Justiniano Ribeiro Chagas, or Carlos Chagas , was a Brazilian sanitary physician, scientist and bacteriologist who worked as a clinician and researcher. He discovered Chagas disease, also called American trypanosomiasis in 1909, while working at the Oswaldo Cruz Institute in Rio de Janeiro...
, Vital Brazil
Vital Brazil
Vital Brazil Mineiro da Campanha, known as Vital Brazil was a Brazilian physician, biomedical scientist and immunologist, internationally renowned for the discovery of the polyvalent anti-ophidic serum used to treat bites of venomous snakes of the Crotalus, Bothrops and Elaps genera. He went on...
and Osvaldo Cruz
Osvaldo Cruz
For the Brazilian epidemiologist, see Oswaldo Cruz. For the neighbourhood in Rio de Janeiro, see Oswaldo Cruz .Osvaldo Cruz is a municipality in the Brazilian state of São Paulo. The population in 2004 was 30,023 and the area is 248.69 km². The elevation is 485 m...
.
Early career
Abreu got his M.D.Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
in medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
at the Federal University of Rio de Janeiro in 1914.
Shortly afterwards, he travelled to France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
, where he first worked in the service of Dr. Louis Gaston, at the Nouvel Hôpital de la Pitié, in 1915. Charged with photographing surgical pathology
Surgical pathology
Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by non-surgeons such as general internists, medical subspecialists,...
specimens, Abreu quickly developed new and better devices and methods for this. In 1916, Abreu started to work at the Hôtel-Dieu
Hôtel-Dieu
Hôtel-Dieu is the old name given to the principal hospital in French towns, for instance:*The Hôtel-Dieu de Lyon, created in 1478...
and had his first contact with medical radiography
Radiography
Radiography is the use of X-rays to view a non-uniformly composed material such as the human body. By using the physical properties of the ray an image can be developed which displays areas of different density and composition....
, which had been discovered by the German physicist Wilhelm Röntgen just 20 years before. He became the director of the laboratory of radiology
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
of the hospital in substitution to the previous director, Dr. Jean Guilleminot, who was conscripted to fight in the First World War. It was in this position, by suggestion of Guilleminot, that Abreu became interest in fluorography, or the photographic recording of fluoroscopic
Fluoroscopy
Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. In its simplest form, a fluoroscope consists of an X-ray source and fluorescent screen between which a patient is placed...
x-ray images of the lungs. He soon was able to perceive the immense diagnostic value of these images for tuberculosis and other pulmonary affections, and he began his photographic
Photography
Photography is the art, science and practice of creating durable images by recording light or other electromagnetic radiation, either electronically by means of an image sensor or chemically by means of a light-sensitive material such as photographic film...
studies of the lungs in 1918, now at the Laennec Hospital (also in France).
Abreu's first landmark contribution to the radiography of soft tissues (until then not much utilized as a diagnostic radiographical method, due to the low definition of images) was to develop a x-ray densitometry
Densitometry
Densitometry is the quantitative measurement of optical density in light-sensitive materials, such as photographic paper or film, due to exposure to light...
method, by comparing the degree of white density of biological tissues to water's and to other highly dense references, such as bones, and to point out its value for radiodiagnosis. In 1921 he first published his pioneering work on the radiological interpretation of pulmonary injuries in pleuropulmonary tuberculosis, titled "Le Radiodiagnostic dans la Tuberculose Pleuro-Pulmonaire". This and his method of pulmonary densitometry gave him an invitation to join the prestigious Académie de Médicine de Paris.
In 1922 Abreu returned to Brazil and accepted a post as the head of the X-Ray Department at the Federal public health service for the prophylaxis of tuberculosis in Rio de Janeiro. The city was at that time going through a devastating epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
of tuberculosis. He intensified research on thoracic radiography for the purpose of early diagnosis of tubercular lesions, but the results were initially discouraging, due to the low quality of fluroscopic images at the time.
Mid career
As a result of the improvements of fluoroscopic and photographic devices and techniques, in 1935 he took again his experiences in the old German Hospital of Rio de Janeiro, and was then able to conceive a cheap and fast method to take small (50 or 100 mm) photographic plates of lungs in a single roll of film, which became a standard tool for an easier diagnosis of tuberculosis for many decades to come, with a corresponding impact on its prophylaxis and cure.Abreu's ideas for a new mass screening radiography apparatus was made true by the construction of a first device by the Lohner House, a representative of Siemens
Siemens AG
Siemens AG is a German multinational conglomerate company headquartered in Munich, Germany. It is the largest Europe-based electronics and electrical engineering company....
in Rio de Janeiro. The first service of Thoracic Census was established in 1937. The first results indicated the usefulness of abreugraphy: the screening of 758 asymptomatic and apparently sane individuals in July 1937 revealed that 44 of them had already tuberculosis lung lesions, which allowed for early treatment and a better survival. Mobile units were also employed, and soon abreugraphy became a mandatory examination for anyone applying to a public job or school in Brazil. By the end of the 40s, Dr. Manuel de Abreu could present the first positive impact of mass screening on tuberculosis mortality.
Abreugraphy
The invention was named abreugrafia in his honor by the Society of Medicine and Surgery of Rio de Janeiro in 1936. Abreugraphy was largely discontinued as a mandatory screening tool in Brazil in the 1970s, after antibioticAntibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
treatment and public health programs greatly decreased the incidence of the disease, and also out of fear of unnecessary exposure to x-rays, particularly in children and pregnant woman. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
recommended its discontinuance and the Brazilian health service stopped to pay for it in 1999.
Abreugraphy was not used in other countries so intensively as in Brazil and a few other Latin America countries. It received several different names, according to the country where it was adopted: mass radiography, miniature chest radiograph (United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and USA), roentgenfluorography (Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
), radiophotography (France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
), schermografia (Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
), photoradioscopy (Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...
) and photofluorography (Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
). The importance of abreugraphy was outlined by the creation of the Brazilian Society of Abreugraphy, in 1957, and the publication of the Revista Brasileira de Abreugrafia.
Further accomplishments
Abreu was also one of the first radiographists to develop quantitative methods to evaluate the area of internal anatomical structures and to use it in medical diagnosisDiagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, an approach which he used to quantitate images of the mediastinum
Mediastinum
The mediastinum is a non-delineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thoracic cavity...
, and which he named radiogeometry. His ideas where collected and published in 1928 in his book "Essai sur une nouvelle Radiologie Vasculaire". Furthermore, Abreu was instrumental in developing new techniques for x-ray planar tomography
Tomography
Tomography refers to imaging by sections or sectioning, through the use of any kind of penetrating wave. A device used in tomography is called a tomograph, while the image produced is a tomogram. The method is used in radiology, archaeology, biology, geophysics, oceanography, materials science,...
of the thorax using the simultaneous exposure of several films, as well as the use of tracheobronchic washout as technique for precise detection of Koch bacilli in infected individuals.
Manuel Dias de Abreu lectured in the field of medical radiology in innumerable Brazilian and foreign scientific institutions, and was a member of the most important medical organizations of the world. He was awarded the French Légion d'Honneur
Légion d'honneur
The Legion of Honour, or in full the National Order of the Legion of Honour is a French order established by Napoleon Bonaparte, First Consul of the Consulat which succeeded to the First Republic, on 19 May 1802...
and several other scientific prizes, among them the Gold Medal of the American College of Chest Physicians
American College of Chest Physicians
The American College of Chest Physicians is a medical organization in the United States consisting of physicians and non-physician specialists in the field of chest medicine, which includes pulmonology, thoracic surgery, and critical care medicine....
, in 1950 and the Gold Medal of the Argentinian Radiological Society, in 1953.
Besides several books on medicine, Abreu published also two poetical works: Substâncias, which was illustrated by famous Brazilian painter Emiliano Di Cavalcanti
Emiliano Di Cavalcanti
Emiliano Augusto Cavalcanti de Albuquerque Melo , known as Di Cavalcanti, was a Brazilian painter who sought to produce a form of Brazilian art free of any noticeable European influences...
and Poemas sem Realidade, illustrated by himself.
Tragically (and ironically, for a pneumologist), Dr Abreu died in 1962 from lung cancer
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...
, probably caused by his long habit of smoking
Tobacco smoking
Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...
.
Quotation
External links
- Abreugrafia. Brazilian Inventors Network. In Portuguese.