The experience of madness according to spiritism an analysis of the medical records of the

Sanatório Espírita de Uberaba

This paper aims to present, from the analysis of the medical records of an institution for the
treatment of the alienated, managed by followers of spiritism, the particular conceptions about
health, disease and madness produced by this doctrine and how they were transposed to the interior
of an asylum institution, the Sanatório Espírita de Uberaba, in Brazil in the first half of the twentieth
century.

Keywords: History of psychiatry, history of spiritism, madness, medical records

Headnote

Keywords: History of psychiatry, history of spiritism, madness, medical records

Mots clés: Histoire de la psychiatrie, l'histoire du spiritisme, folie, dossiers médicaux

Palabras clave: Historia de la psiquiatría, la historia del espiritismo, locura, medical records

In recent national academic works, researchers have sought to demonstrate that the therapeutic
activities developed by Kardecist-oriented spiritist groups was one of the main competing practices
of academic medicine and its project to become the hegemonic knowledge in the field of healing
arts in Brazil in the first half of the 20th century (Jabert, 2008; Almeida, 2007; Scoton, 2007).

Regarding madness specifically, at the same time that Brazilian psychiatry was being
institutionalized (Engel, 2001), spiritist institutions were developing therapies based on the belief
that spiritual entities had the ability to intervene in the natural course of development of a disease
(Giumbelli, 1997). Among these practices we can highlight the work of spiritual disobsession, which
sought to treat individuals suffering from fits of madness through spiritual indoctrination of
obsessing spirits.

For some decades now, researchers have resorted to the use of clinical documents in investigations
about the history of psychiatry and madness in Brazil (Cunha, 1986; Engel, 2001; Facchinetti, Ribeiro,
Muñoz, 2008; Facchinetti, 2010; Jabert, 2008; Jabert, 2011; Muñoz, 2010; Santos 2008; Wadi, 2002).

We consider medical records a privileged instrument for the analysis of the activities of institutions
and their therapeutic agents. In addition to the visibility, they offer about the collective and individual
experiences related to madness, the analysis of this type of document also helps to identify how the
phenomenon of madness was understood by the social group to which the crazy person belonged,
demonstrating which collective interpretations were produced about the experience of madness. It
also allows us to detect which attitudes and behaviors exhibited by a particular subject were
identified as unequivocal signs and symptoms of his or her madness.

In the medical records of asylum institutions for the treatment of the insane, the discourse on
madness, be it psychiatric or spiritualist, is presented in a different way from what can be found in
texts that deal with the theme from a strictly theoretical point of view and that aim to produce an
interpretative system that offers intelligibility to the phenomenon of madness. In this specific type of
documentation, this discourse appears operationalized by the medical-administrative body of the

1
institution in its practical form of analysis, interpretation, and control of madness, besides being tied
to individual and singular cases that exemplify the daily experience of madness through the
application of this discourse to specific situations (Jabert, 2011).

Finally, the choice for the analysis of psychiatric records allows us to give visibility to the most
marginalized speech among all those that deal with the experience of madness: the speech of the
crazy person himself. However, it is important to emphasize, as Cunha (1986) points out, that the
discourse of the insane is muffled and filtered by the medical-psychiatric knowledge, being possible
to rescue only partially his voice and his experiences.

Spiritism and its interpretations of the body, health, and illness

What has been defined as Kardecist spiritism was created by the French educator Allan Kardec,
baptized Hippolyte Léon Denizard Rivail, in 1857. In that year The Spirits' Book was published, the
inaugural work of Kardecist spiritism, which exposes spiritual communications, organized, and
systematized in the form of questions and answers. From this work Kardec produced a doctrine that
sought to be based on scientific precepts and established a moral philosophy with the following
assumptions: the existence of God, the immortality of the soul, the belief in reincarnation, in the
plurality of inhabited worlds, and in the capacity of physical manifestation of spiritual entities. The
idea of evolution is also fundamental. Extrapolated to the spiritual world, the evolutionist theory is
reflected in the precept that individuals should go through various evolutionary stages until they
reach spiritual perfection (Kardec, 2003; Giumbelli, 1997; Silva, 2005).

Kardecist-oriented spiritualism postulates the existence of a dualistic universe. In its conception,

God created not only the material world, where we live our daily lives, but two worlds or planes of
existence. A material or visible world, which is familiar to us, and the spiritual or invisible world.
According to the doctrine, this invisible world, populated by the spirits that inhabit it, represents a
dynamic dimension that is responsible for our experiences in the visible world, giving them form,
meaning, and substance.

Kardecism defends the idea that each spirit, when created, begins a long path of development, both
moral and intellectual, that should lead him to perfection. This notion of the progression of spirits
toward perfection is the central point of the spiritist belief system. In order to evolve, however, spirits
of the invisible world need to participate in the visible world. The material world is seen as a
classroom, attended by spirits in order to face challenges and go through the trials and suffering of
the material world.

The experiences of misfortune and suffering are of particular importance for the Spiritist doctrine;
after all, every difficulty that a subject goes through during his or her life is understood as a trial to be
faced with resignation and humility, so that he or she can evolve spiritually, besides being seen as an
opportunity to redeem, in the current existence, from faults and sins committed in previous
incarnations. In this sense, the sickness experience is usually understood as having the objective of
making the individual pay off a spiritual debt contracted through a fault committed in a previous life.

For this doctrine it would be the individual himself who would choose, before his incarnation, what
kind of existence he will lead, determining also all the trials and sufferings through which he will

2
have to pass so that he can atone for his past faults and learn the necessary lessons for the
continuation of his spiritual evolution. In this way, for Kardecism, the subject would always be
responsible for any kind of misfortune or difficulty he may face during life. As Kardec himself points
out (2003) in The Spirits' Book

He [the disincarnate spirit] himself chooses the kind of trials through which he is to pass, and in this
consists his free will ... By giving the spirit the freedom to choose, God leaves it fully responsible for
its actions and the consequences they have. (p. 171)

When it returns to the invisible plane after each incarnation, the spirit no longer needs the body it
used during its life. When it disincarnates, it discards this body, and the spirit will assume another
body the next time it returns to the material world. The material body, being temporary, has a
secondary and inferior character when compared to the spirit, which is eternal, and can be seen as a
shell, which can be used and discarded when the spirit no longer needs it. Furthermore, it is the
spiritual body that would have the ability to animate and control the material body.

To allow for their periodic incarnations on the material plane, spirits would have been created with a
semi-material and fluidic extension called the perispirit. When it incarnates, the spirit attaches itself
to the body through this substance. For spiritism, the creation of material bodies is a natural
biological process in the material world, which is, however, influenced by the spirit on the immaterial
plane. Since the body is conceived biologically

For spiritism, the creation of material bodies is a natural biological process in the material world,
which is, however, influenced by the spirit on the immaterial plane. Once the body is conceived
biologically, the spirit couples with the newly formed fetus. This coupling process is accomplished
through a mediation, performed by the perispirit, between the physical body and the spiritual body
(Kardec, 2003, p. 85).

Once this has occurred, a symbiotic relationship is established between the spirit and the body it will
use for the rest of its incarnation. A subject's state of health would be reached when the spirit is
harmonically coupled with the physical body through the perispirit. Consequently, diseases would be
the result of some factor that disturbed this relationship. In this sense, the Rio de Janeiro physician
Guedes (1955) stated in his book Ciência Espiritrita: origem da medicina (Spiritist Science: origin of
medicine), published in 1901

Spiritism is a profound, vast, eclectic science, whose study provides knowledge, not only about the
spiritual man, but also about the corporeal man ... It enables us to better understand the mechanism
of the functions, not only of the psychic or mental ones, but also of the organic or vital ones; and the
relations of the soul with the body, whose disturbances are predisposing and even determining
causes of morbid states. (p. 27)

These disturbances in the relationship between the spiritual body and the material body could be
caused by a decrease in vital energy. The energy or vital fluid would be a substance produced by the
spirit and used by the perispirit to animate the material body. Because this energy is not
homogeneous among all human beings, and can also vary during a person's life, it could be found in

3
more or less abundance in different subjects, and its scarcity is considered the determining factor of
death.

Spiritism and Madness

Although its original concern was not related to the search for an explanation for the phenomenon of
madness, Kardecism eventually produced its own explanatory conception about the nature of
mental phenomena. According to this doctrine, mental functions such as will, intelligence,
consciousness, feelings, and thought were attributes of a spiritual body that was temporarily
inhabiting a material body.

As the material body was understood as an instrument for the manifestation of the spiritual body,
any kind of deficiency in the physical part could influence the ability of the spiritual part to perceive
the world and act upon it in an appropriate way, even if the spiritual body itself did not present any
imperfection. Thus, a brain lesion would only impair the spirit's ability to express its thoughts
properly, and the spirit's own ability to reason would not be impaired. In this case, what spiritists call
"madness by brain lesion" would occur. On the other hand, there would also be cases in which
mental disorders could occur without the presence of detectable brain lesions. When this situation
occurred, these cases were evaluated as resulting from the action of disembodied spirits, who were
acting over the spiritual body of an individual:

Matter and the imperfection of the organs may hinder the manifestation of the spirit. Idiocy and
madness are often the result of dismantled or undeveloped organs. We say many times because
madness may be produced by an obsessor from space, who, in this case, may be removed and the
sick person cured. (Freitas, 1948, p. 21 and 22)

In his book Madness under a New Perspective, the physician Bezerra de Menezes (2002) presents
some of the spiritist conceptions about the functioning of the human mind. According to this author,
the brain, for example, should not be seen as the organ that produces thought, but only as its
transmitting organ. In the introduction of this book, for instance, Bezerra de Menezes states: "...
thought is purely a function of the soul or spirit, and, therefore, its disturbances, in theory, do not
depend on brain lesions" (p. 7). For Kardecism, the spiritual body would be responsible for
controlling all the behaviors and activities of the physical body. Thus, when something affected the
natural origin of thought - the spirit - it would present itself in an incomprehensible and delirious
manner. In this case, as the spirit is understood as immaterial, the source of the disturbance could
only be of immaterial nature, which led Bezerra de Menezes to state that madness "... can also be
the result of the fluidic action of enemy spirits on the soul or spirit incarnated in the body" (p. 9).

From this conceptual model presented, we can say that, for Kardecism, all mental disturbances in
which an organic cause could not be detected were understood as deviations from reason or morals
and were explained as resulting from the persecutory action of disincarnate spirits who had the
ability to influence the mental functions of the incarnate. In this sense, when a spiritual obsession
was detected, the best treatment strategy to be employed would consist in the use of a specialized
group of mediums who would act to indoctrinate the obsessing spirit, trying to convince it to

4
abandon the persecution of the patient, in an exercise of thematization of the Christian precept of
forgiveness and charity (Jabert, 2011).

By establishing its own explanation of the nature of mental phenomena, of the human mind as a
manifestation of a spiritual body temporarily inhabiting a material body, and of madness as a
possible result of the influence of disembodied spiritual entities, spiritism developed its own
therapeutic method for the treatment of madness, understood as a process of spiritual obsession.
As a result of these precepts, the followers of Kardecism ended up sponsoring the creation of
several asylum institutions for the treatment of the insane in Brazil in the first half of the 20th
century. To have an idea, only in the interior of the state of São Paulo (apud Puttini, 2004), seven
institutions with these characteristics were created between 1930 and 1950.

For an accurate analysis of this conception about mental disorders, as well as to understand the
transposition of this conception to the daily practices of spiritist treatment, analysis, and control of
the insane and the madness phenomenon, we will present clinical cases from the Sanatório Espírita
de Uberaba (SEU).

Spiritist healing practices in an asylums space: the SEU records

The construction of the Uberaba Spiritist Sanatorium was the result of the mobilization of the
Uberaba spiritist movement around a project that aimed to offer the city's population an institution
to receive and treat the mentally ill. Inaugurated in December 1933, this institution was directed by
medium Maria Modesto and its clinical director was physician Inácio Ferreira. It is important to note
that, even though he graduated from the Medical School of Rio de Janeiro in 1929, Dr. Inácio Ferreira
was a practitioner of spiritism and also acted as a medium at the Sanatório Espírita de Uberaba
(Spiritist Sanatorium of Uberaba) (Jabert, 2011). Moreover, in the years following his appointment as
clinical director of this institution, Dr. Inácio Ferreira published a series of books in which he
advocated the use of spiritist therapy as a viable form of treatment for madness (Ferreira, 1941;
1945; 1946; 1946; 1949; 1951).

When we observe the structure of the medical records used in Sanatório1 , we have the impression
that we are facing a psychiatric institution similar to any other found in Brazil in the period. At first
sight, the institution would be run by physicians who used exclusively the psychiatric knowledge and
theories of the time to perform their work of diagnosis, treatment and, if possible, cure of the patient.
The personal information about the patients, the anamnesis, the questionnaires and the physical
examinations, all the constituent elements of the structure of the medical records are apparently in
accordance with the teachings and formulations of the academic psychiatry of the period (Jabert,
2008).

However, although the questions in the medical record and its very structure are based on an
organicist, psychiatric model of interpreting madness, the primacy of a strictly organicist theoretical
conception for the etiology of madness is only apparent. In the space between the questions, in the
gaps in the questionnaire that should be filled in by the writing of the physician responsible for the

5
admission of the patient, it is possible to note that psychiatry was only one of the conceptual trends
that informed the ways of understanding and treating mental alienation employed at the Sanatório
Espírita de Uberaba. From the analysis of these documents, we can observe more thoroughly and
objectively how concepts originating from fields of knowledge often considered antagonistic -
spiritism and psychiatry - were used in a complementary way inside this institution.

In this sense, although cases in which physical characteristics were detected in patients' medical
records in a way that suggested the presence of an organic substrate as the main cause for their
state of mental disturbance, this association was not always established automatically and
immediately, since other interpretative resources could be used to define and elucidate the nature of
the patient's clinical picture. An illustration of this situation is the case of patient J.R.C., recorded in
the medical chart under no. 53. The patient's medical history tells us that after being diagnosed with
syphilis, J.C.R. had begun to isolate himself from family and friends, and to present a picture of
progressive physical decay, rapidly deteriorating because he stopped sleeping and eating properly.
In addition, in the four days prior to his hospitalization, he had started to run away from home,
wandering and running through the city streets, becoming a constant source of worry for his family.
At the time of his hospitalization, the usual physical examinations were performed, where the
presence of what were considered traces of organic degeneration was verified:

However, although syphilis was confirmed and visible and pronounced signs of physical
degeneration were described, the patient ended up receiving a differentiated diagnosis, in which a
category that could hardly be fit into the psychiatric nosography commonly used in the period was
employed: "Diagnosis: Obsession" (1937 register book, file number 53). Even more interesting is the
record of how this diagnosis was made. When making notes about the treatment that was being
offered to the patient, the physician in charge of his case commented that:

... a good psychic medium noticed beside the patient, in his own room, the obsessing spirit acting
with his evil fluids: - An individual, rather, a tall, thin spirit, long face and covered with leprous sores.
In fact, the patient is always impressed to have his body covered by leprosy, living with the
tremendous pain, moral pain, in feeling leprous. (1937 register book, file number 53)

First of all, one can notice in the excerpt above how the functions of treatment and diagnosis of
patients were shared between the medical staff and the group of mediums that voluntarily worked at
the Sanatório Espírita de Uberaba. The register seems to point to the fact that the group of mediums
directly intervened, through their mediumistic indications, in the process of diagnosis of the patients,
determining which were the cases in which the sick person was affected by a spiritual obsession
and, consequently, which was the most indicated type of treatment for that intern.

In this way, we can observe that the results of the physical exams performed on the patients, which
in certain Brazilian institutions of the period, would have been enough to point out the presence of
stigmata of a psychosis with a constitutional background, arising from organic degeneration, could
also be interpreted as the physical signs of a spiritual obsession, depending on the indications
offered by the group of mediums from the Sanatorium. Still regarding this specific case, after the
treatment of disobsession, the patient was considered cured, and was discharged from the
institution two months after his admission.

6
In addition to helping in the diagnosis of the patients, the mediums who worked at the Sanatorium
also had an active participation in the therapeutic process of the patients. A record of this type of
activity can be found in medical file n. 109, which refers to the case of the patient C.M.J. Admitted
free of charge to the Sanatorium at the request of the police chief of Uberaba, the patient had been
picked up by the police after being found wandering the streets of the city in a state of complete
disorientation and mental stupor. At the time of her admission, the doctor in charge of her
examinations recorded that the patient was in a state of total physical exhaustion. In addition to
being unable to speak and express herself adequately, the patient had no notion of space, time, and
place, no reasoning ability, and no memory of her past life.

In the diagnostic record, the doctor states that the patient was suffering from a strong moral trauma,
which was further accentuated by the presence of spiritual radiations. As a way to contain these
irradiations, which were contributing to the weakening of her state of health, the institution's
mediums were charged with the task of working together with the doctors to help in the treatment of
the patient, who, after receiving the recommended therapy, was considered cured and discharged.
The result of this joint work between doctors and mediums was recorded in the patient's medical
chart:

With the comfort she received, affection and medical care, her physical condition was gradually
reconstituted and the spiritual passes, with their powerful and beneficial fluids, were able to free her
from the strong evil irradiations of which she was a victim. Today, rediviviva, one can say, she tells
her story (1937 register book, file number 109).

Besides helping in the diagnosis of patients and their physical recovery, through the application of
spiritual passes, the main activity developed by the mediums who worked in the Sanatório Espírita
de Uberaba was the participation in the sessions of desobsession. The cases called madness by
spiritual obsession could result both from the action of unconscious spirits, who were unaware of
their state of obsession, and from persecuting spirits, who acted with the objective of getting
revenge for some event related to the obsessed one, which could have happened in some past
incarnation or in his current incarnation. In this sense, the performance of the mediums during the
disobsession aimed to indoctrinate the spirits and clarify them about the acts they were practicing,
as well as to dissuade them from their obsessive activities.

In the Sanatorium's admission records, there are numerous records of patients who were diagnosed
as suffering from some kind of spiritual obsession, and there are even a few cases in which records
of disobsession sessions were held. This is the case, for example, of the file number 165, referring to
the patient G.M.M. Interned after showing himself unable to work and aggressive towards his family
and friends, the patient showed himself furious and uncontrollable for several days, constantly
shouting and speaking disconnected sentences, without showing recognition of family members
and refusing to eat. As a result, he was kept in a state of confinement and tied up for several days,
having to be force-fed by Sanatorium staff. In addition, in the item of the medical record dedicated to
the examination of his nervous system, the doctor informs that the patient observed presented a
picture of uncontrollable dread for something that "presented itself invisible to other people".

7
Having been diagnosed as the carrier of a spiritual obsession, the next stage of his treatment
consisted in the execution of sessions of disobsession performed by the group of mediums that
worked in the Sanatorium, and the first of these sessions was registered by the doctor responsible
for the admission of the patient:

In the session of 06/04/38 - we managed to enter into conversation with one of his persecutors - he
recognized his condition and persecuted [the patient] out of hatred and revenge. An evil spirit with a
vengeful temperament, saying that he would rather walk with the devil than with God. He had been
looking for the obsessed one for a long time and now that he found him, he will only leave him after
avenging all the evil he suffered. He disincarnated, still angry, saying that he would continue with his
vengeful purposes. (1938 register book, file number 165)

The patient's medical chart does not provide further information on the occurrence of subsequent
sessions of disobsession, but there is a record that he was discharged from the institution, being
considered cured less than a month after the beginning of his hospitalization, a fact that leads us to
suppose that other sessions were held and that the mediums from Sanatorium considered that they
had obtained success in the process of disobsession, evaluating that the obsessing spirit had
abandoned its persecution of the patient.

From what was exposed above, we can glimpse how the therapeutic and diagnostic activities were
shared by doctors and mediums inside the Sanatorium. In this sense, while the medical-psychiatric
staff of the institution tried to perform a series of examinations and inquiries - anamnesis, physical
and nervous system examinations - which aimed to establish the possible organic causes of the
patient's state of mental alienation and to make a diagnosis

The group of mediums, on the other hand, tried to detect the presumable persecutory action of
disincarnate spirits that, through spiritual irradiations or the manipulation of the universal fluid, could
be producing a spiritual obsession in the patient, besides indicating the adequate spiritual treatment
in case the obsession was confirmed. In this sense, the internal organization of the Sanatorium, as
recorded in the admission records, seems to indicate the existence of a "medical-spiritual" division
of work, with each field of knowledge being used by specific groups of employees in charge of
different aspects of the attention to the intern.

However, it is important to note that, even though there was a sharing of responsibilities between
doctors and mediums in the exercise of therapeutic and diagnostic activities within the institution,
the roles exercised by both groups were not mutually exclusive since, for example, doctors could
participate in the desobsession sessions, as observed in the last case reported above. In this sense,
it is also relevant to note that, in the same way as the mediums, the Sanatorium medical staff also
shared the conception that a spiritual component could be responsible for the mental disorders
presented by the inmates. This characteristic can be more easily observed in the medical records of
patients diagnosed as being victims of a spiritual obsession.

8
Conclusion

Through the analysis of medical records of patients admitted to the Sanatorio Espírita de Uberaba,
we tried to demonstrate how the spiritist theory of madness treatment was used to inform the daily
healing practices employed in that establishment, influencing the mediums' and even the physicians'
strategies of acting with the patients admitted. In the Sanatorium, allopathic medicines were not
commonly used for the treatment of mental illness, and preference was given to the strategies of
spiritual indoctrination, fluidic water, mediumistic passes, and sessions of disobsession.

On the other hand, the medical records used in the institution had a similar structure to those used in
the Juquery Psychiatric Hospital, as described by Cunha (1986), and to those used to register
patients in the National Hospice of Psychopaths, as described by Facchinetti (2004).

The analysis of the medical records of the Sanatório Espírita de Uberaba allowed us to verify how
formulations from both the academic medical field and the Kardecist-oriented spiritism were
conjugated in this institution. In this sense, although nosographic models derived from the
psychiatric field were used for the classification of the illness affecting the patient, the cases in
which the patients were diagnosed by the mediums of the institution as being victims of a process
of spiritual obsession were also frequent.

In the more specific case of the techniques of disobsession, we saw earlier that, for the followers of
Kardecist spiritism, madness would normally be the result of a persecution carried out by spiritual
entities that sought revenge on the sick person due to faults committed by him in his current or
previous incarnations, and to this end produced spiritual irradiations that affected the perispirit of
the patient, disturbing his reasoning and disturbing his emotions. Thus, the practice of disobsession
was seen as of fundamental importance for the reaffirmation of the spiritist values by the search for
a life based on the Christian principles of forgiveness and charity, since the disobsession would only
be achieved if the obsessing spirit, through its spiritual indoctrination, would realize the importance
of forgiving its past-life adversary, ceasing its search for revenge. Within this logic, in order to
facilitate the process of disobsession, it was also important that the obsessed spirit showed
repentance of those same faults, promoting the exercise of forgiveness by the obsessor. Finally, for
the mediums, the practice of disobsession presented itself as an opportunity to exercise the
principle of charity, offering mediumistic assistance to tormented spirits that were in the material
world, as well as in the spiritual plane. It was through this search for feelings based on Christian
morality that the spiritists tried to guarantee the continuity of the process of spiritual evolution, be it
for the obsessed, for the obsessors or for the employees of the Spiritist Sanatorium of Uberaba.

First of all, one can notice in the excerpt above how the functions of treatment and diagnosis of
patients were shared between the medical staff and the group of mediums that voluntarily worked at
the Sanatório Espírita de Uberaba. The register seems to point to the fact that the group of mediums
directly intervened, through their mediumistic indications, in the process of diagnosis of the patients,
determining which were the cases in which the sick person was affected by a spiritual obsession
and, consequently, which was the most indicated type of treatment for that intern.

In this way, we can observe that the results of the physical exams performed on the patients, which
in certain Brazilian institutions of the period, would have been enough to point out the presence of

9
stigmata of a psychosis with a constitutional background, arising from organic degeneration, could
also be interpreted as the physical signs of a spiritual obsession, depending on the indications
offered by the group of mediums from the Sanatorium. Still regarding this specific case, after the
treatment of disobsession, the patient was considered cured, and was discharged from the
institution two months after his admission.

In addition to helping in the diagnosis of the patients, the mediums who worked at the Sanatorium
also had an active participation in the therapeutic process of the patients. A record of this type of
activity can be found in medical file n. 109, which refers to the case of the patient C.M.J. Admitted
free of charge to the Sanatorium at the request of the police chief of Uberaba, the patient had been
picked up by the police after being found wandering the streets of the city in a state of complete
disorientation and mental stupor. At the time of her admission, the doctor in charge of her
examinations recorded that the patient was in a state of total physical exhaustion. In addition to
being unable to speak and express herself adequately, the patient had no notion of space, time, and
place, no reasoning ability, and no memory of her past life.

In the diagnostic record, the doctor states that the patient was suffering from a strong moral trauma,
which was further accentuated by the presence of spiritual radiations. As a way to contain these
irradiations, which were contributing to the weakening of her state of health, the institution's
mediums were charged with the task of working together with the doctors to help in the treatment of
the patient, who, after receiving the recommended therapy, was considered cured and discharged.
The result of this joint work between doctors and mediums was recorded in the patient's medical
chart:

With the care she had, affection and medical care, her physique was gradually reconstituted and the
spiritual passes, with their powerful and beneficial fluids, succeeded in ridding her of the strong evil
radiations of which she was a victim. Today, rediviviva, one can say, she tells her story (1937 register
book, file number 109).

Besides helping in the diagnosis of patients and their physical recovery, through the application of
spiritual passes, the main activity developed by the mediums who worked in the Sanatório Espírita
de Uberaba was the participation in the sessions of desobsession. The cases called madness by
spiritual obsession could result both from the action of unconscious spirits, who were unaware of
their state of obsession, and from persecuting spirits, who acted with the objective of getting
revenge for some event related to the obsessed one, which could have happened in some past
incarnation or in his current incarnation. In this sense, the performance of the mediums during the
disobsession aimed to indoctrinate the spirits and clarify them about the acts they were practicing,
as well as to dissuade them from their obsessive activities.

10
In the Sanatorium's hospitalization records, there are numerous records of patients who were
diagnosed as suffering from some kind of spiritual obsession, and there are even a few cases in
which records of disobsession sessions were held. This is the case, for example, of the file number
165, referring to the patient G.M.M. Interned after showing himself unable to work and aggressive
towards his family and friends, the patient showed himself furious and uncontrollable for several
days, constantly shouting and speaking disconnected sentences, without showing recognition of
family members and refusing to eat. As a result, he was kept in a state of confinement and tied up
for several days, having to be force-fed by Sanatorium staff. In addition, in the item of the medical
record dedicated to the examination of his nervous system, the doctor informs that the patient
observed presented a picture of uncontrollable dread for something that "presented itself invisible to
other people".

Having been diagnosed as the carrier of a spiritual obsession, the next stage of his treatment
consisted in the execution of sessions of disobsession performed by the group of mediums that
worked in the Sanatorium, and the first of these sessions was registered by the doctor responsible
for the admission of the patient:

In the session of 06/04/38 - we managed to enter into conversation with one of his persecutors - he
recognized his condition and persecuted [the patient] out of hatred and revenge. An evil spirit with a
vengeful temperament, saying that he would rather walk with the devil than with God. He had been
looking for the obsessed one for a long time and now that he found him, he will only leave him after
avenging all the evil he suffered. He disincarnated, still angry, saying that he would continue with his
vengeful purposes. (1938 register book, file number 165)The patient's medical records do not
provide further information about the occurrence of subsequent sessions of disobsession, but it is
recorded that the patient was discharged from the institution, being considered cured less than a
month after the beginning of his hospitalization, a fact that leads us to suppose that other sessions
were held and that the mediums from Sanatorium considered that they had obtained success in the
process of disobsession, evaluating that the obsessing spirit had abandoned its persecution of the
patient.

From what was exposed above, we can glimpse how the therapeutic and diagnostic activities were
shared by doctors and mediums inside the Sanatorium. In this sense, while the institution's medical-
psychiatric body sought to perform a series of examinations and inquiries - anamnesis, physical and
nervous system examinations - which aimed to establish the possible organic causes of the
patient's state of mental alienation and to make a psychiatric diagnosis so that it would be possible
to prescribe the adequate treatment, the group of mediums, on the other hand, tried to detect the
presumable persecutory action of disincarnate spirits that, through spiritual irradiations or the
manipulation of the universal fluid, could be producing a spiritual obsession in the patient, besides
indicating the adequate spiritual treatment in case the obsession was confirmed. In this sense, the
internal organization of the Sanatorium, as recorded in the admission records, seems to indicate the
existence of a "medical-spiritual" division of work, with each field of knowledge being used by
specific groups of employees in charge of different aspects of the attention to the intern.

However, it is important to note that, even though there was a sharing of responsibilities between
doctors and mediums in the exercise of therapeutic and diagnostic activities within the institution,

11
the roles exercised by both groups were not mutually exclusive since, for example, doctors could
participate in the desobsession sessions, as observed in the last case reported above. In this sense,
it is also relevant to note that, in the same way as the mediums, the Sanatorium's medical staff also
shared the conception that a spiritual component could be responsible for the mental disorders
presented by the inmates. This characteristic can be more easily observed in the medical records of
the patients diagnosed as being victims of a spiritual obsession.

Conclusion

Through the analysis of medical records of patients admitted to the Sanatorio Espírita de Uberaba,
we tried to demonstrate how the spiritist theory of madness treatment was used to inform the daily
healing practices employed in that establishment, influencing the mediums' and even the physicians'
strategies of acting with the patients admitted. In the Sanatorium, allopathic medicines were not
commonly used for the treatment of mental illness, and preference was given to the strategies of
spiritual indoctrination, fluidic water, mediumistic passes, and sessions of disobsession.

On the other hand, the medical records used in the institution had a similar structure to those used in
the Juquery Psychiatric Hospital, as described by Cunha (1986), and to those used to register
patients in the National Hospice of Psychopaths, as described by Facchinetti (2004).

The analysis of the medical records of the Sanatório Espírita de Uberaba allowed us to verify how
formulations from both the academic medical field and the Kardecist-oriented spiritism were
conjugated in this institution. In this sense, although nosographic models derived from the
psychiatric field were used for the classification of the illness affecting the patient, the cases in
which the patients were diagnosed by the mediums of the institution as being victims of a process
of spiritual obsession were also frequent.

In the more specific case of the techniques of disobsession, we saw earlier that, for the followers of
Kardecist spiritism, madness would normally be the result of a persecution carried out by spiritual
entities that sought revenge on the sick person due to faults committed by him in his current or
previous incarnations, and to this end produced spiritual irradiations that affected the perispirit of
the patient, disturbing his reasoning and disturbing his emotions. Thus, the practice of disobsession
was seen as of fundamental importance for the reaffirmation of the spiritist values by the search for
a life based on the Christian principles of forgiveness and charity, since the disobsession would only
be achieved if the obsessing spirit, through its spiritual indoctrination, would realize the importance
of forgiving its past-life adversary, ceasing its search for revenge. Within this logic, in order to
facilitate the process of disobsession, it was also important that the obsessed spirit showed
repentance of those same faults, promoting the exercise of forgiveness by the obsessor. Finally, for
the mediums, the practice of disobsession presented itself as an opportunity to exercise the
principle of charity, offering mediumistic assistance to tormented spirits that were in the material
world, as well as in the spiritual plane. It was through this search for feelings based on Christian
morality that the spiritists tried to guarantee the continuity of the process of spiritual evolution, be it
for the obsessed, for the obsessors, or for the employees of the Spiritist Sanatorium of Uberaba.

12
Through the analysis of clinical records of patients admitted to the Sanatorio Espírita de Uberaba,
we sought to demonstrate how the spiritist theory of madness treatment was used to inform the
daily healing practices employed in that establishment, influencing the mediums' and even the
physicians' strategies of acting with the patients admitted. In the Sanatorium, allopathic medicines
were not commonly used for the treatment of mental illness, and preference was given to the
strategies of spiritual indoctrination, fluidic water, mediumistic passes, and sessions of
disobsession.

On the other hand, the medical records used in the institution had a similar structure to those used in
the Juquery Psychiatric Hospital, as described by Cunha (1986), and to those used to register
patients in the National Hospice of Psychopaths, as described by Facchinetti (2004).

The analysis of the medical records of the Sanatório Espírita de Uberaba allowed us to verify how
formulations from both the academic medical field and the Kardecist-oriented spiritism were
conjugated in this institution. In this sense, although nosographic models derived from the
psychiatric field were used for the classification of the illness affecting the patient, the cases in
which the patients were diagnosed by the mediums of the institution as being victims of a process
of spiritual obsession were also frequent.

In the more specific case of the techniques of disobsession, we saw earlier that, for the followers of
Kardecist spiritism, madness would normally be the result of a persecution carried out by spiritual
entities that sought revenge on the sick person due to faults committed by him in his current or
previous incarnations, and to this end produced spiritual irradiations that affected the perispirit of
the patient, disturbing his reasoning and disturbing his emotions. Thus, the practice of disobsession
was seen as of fundamental importance for the reaffirmation of the spiritist values by the search for
a life based on the Christian principles of forgiveness and charity, since the disobsession would only
be achieved if the obsessing spirit, through its spiritual indoctrination, would realize the importance
of forgiving its past-life adversary, ceasing its search for revenge. Within this logic, in order to
facilitate the process of disobsession, it was also important that the obsessed spirit showed
repentance of those same faults, promoting the exercise of forgiveness by the obsessor. Finally, for
the mediums, the practice of disobsession presented itself as an opportunity to exercise the
principle of charity, offering mediumistic assistance to tormented spirits that were in the material
world, as well as in the spiritual plane. It was through this search for feelings based on Christian
morality that the spiritists tried to guarantee the continuity of the process of spiritual evolution, be it
for the obsessed, for the obsessors or for the employees of the Spiritist Sanatorium of Uberaba.

Sidebar

Abstracts

(The experience of madness in accordance with spiritism: a review of medical records from the
Sanatório Espírita de Uberaba)

Based on the analysis of the medical records of an institution destined for the treatment of the
insane and managed by followers of spiritism, this paper has the purpose of presenting the specific

13
notions about health, disease and madness produced by this doctrine and the way in which they
were transferred to an institution with Sanatório Espírita de Uberaba.

Financing/Funding: The authors declare that they have no support or funding to report.

Conflito de interesses/Conflict of interest: The authors declare that there is no conflict of interest.

Footnote

* Article based on Alexander Jabert's thesis, De médicos e médiuns: medicina, espiritismo e loucura
no Brasil da primeira metade do século XX. House of Oswaldo Cruz. Fiocruz, 2008. Under the
supervision of Cristiana Facchinetti and Gilberto Hochman. Alexander Jabert's thesis was awarded
the 2009 Capes prize, in the area of History (Note by the associate editor).

1. For this research, a qualitative analysis of 1,841 medical records of patients admitted to the SEU
between the years 1933 and 1950 was carried out. The records were in good condition, legible and
bound in record books. During the period analyzed, the SEU used four different models of medical
records, with the second model, used between 1935 and 1941, offering more detailed information
about the patient, such as the case report, physical and psychological exams, diagnosis and notes
on the treatment of the illness. Due to these characteristics, this model of medical record was
preferred to illustrate the analyses performed in this article. For more information about the medical
records models used at SEU, see: Jabert, A. De médicos e médiuns: medicina, espiritismo e loucura
no Brasil da primeira metade do século XX. Thesis (Doctorate) - Casa de Oswaldo Cruz. Fiocruz,
2008.

2. In the medical records it is possible to identify how procedures from academic medicine were
also used by the Sanatorium staff, such as, for example, the use of drugs for the treatment of
patients and the nosography used for diagnosis. However, due to the space limitations
characteristic of scientific journal articles, we seek to emphasize in this paper how spiritualist
practices were transposed to the interior of an institution for the treatment of the alienated. For
more information about the use of academic medicine in the SEU see: Jabert, A. De médicos e
médiuns: medicina, espiritismo e loucura no Brasil da primeira metade do século XX. Thesis
(Doctoral), Casa de Oswaldo Cruz, Fiocruz, 2008.

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