{ "id": "epydrhdtxz", "slug": "manuel-de-abreu", "title": "Manuel de Abreu", "updated": "2026-10-21", "topic_path": [ { "id": "life", "label": "Life and health", "api_url": "https://www.edgepedia.org/api/v1/topics/life" }, { "id": "life.scientists", "label": "Life and health scientists", "api_url": "https://www.edgepedia.org/api/v1/topics/life.scientists" }, { "id": "life.scientists.medicine-health", "label": "Medical and health researchers", "api_url": "https://www.edgepedia.org/api/v1/topics/life.scientists.medicine-health" }, { "id": "life.scientists.medicine-health.med-diag", "label": "Researchers in molecular diagnostics, pathology, medical imaging, and precision medicine", "api_url": "https://www.edgepedia.org/api/v1/topics/life.scientists.medicine-health.med-diag" }, { "id": "life.scientists.medicine-health.med-diag.diagnostic-radiology-and-imaging", "label": "Diagnostic radiology and imaging", "api_url": "https://www.edgepedia.org/api/v1/topics/life.scientists.medicine-health.med-diag.diagnostic-radiology-and-imaging" } ], "geo": [ { "id": "geo.latam.t1800.life", "label": "Latin America and the Caribbean · 1800 to 1945: Life and health", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.latam.t1800.life", "path": [ { "id": "geo.latam", "label": "Latin America and the Caribbean", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.latam" }, { "id": "geo.latam.t1800", "label": "Latin America and the Caribbean · 1800 to 1945", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.latam.t1800" }, { "id": "geo.latam.t1800.life", "label": "Life and health", "api_url": "https://www.edgepedia.org/api/v1/geo/geo.latam.t1800.life" } ] } ], "excerpt": "Manuel de Abreu, also known as Manoel Dias de Abreu, was a Brazilian physician and inventor who created abreugraphy, cheap mass chest screening for tuberculosis, in 1936.", "snippet": "Manuel de Abreu, also known as Manoel Dias de Abreu, was a Brazilian physician and inventor who created abreugraphy, cheap mass chest screening for tuberculosis, in 1936.", "node": "life.scientists.medicine-health.med-diag.diagnostic-radiology-and-imaging", "markdown": "# Manuel de Abreu\n\n**Manoel Dias de Abreu** was a Brazilian physician and inventor best known for creating abreugraphy, a form of chest [photofluorography](https://www.edgepedia.org/photofluorography) that made mass screening for tuberculosis affordable, installed at the German (Alemão) Hospital of Rio de Janeiro in 1936. Even his basic dates are disputed: the Academia Nacional de Medicina records his birth as 4 January 1891 in São Paulo[1](https://www.anm.org.br/manoel-de-abreu/), the Arquivo Nacional as 4 January 1894[2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962), and other references give 1892; his death is dated 30 January 1962 by the ANM and Arquivo Nacional[1](https://www.anm.org.br/manoel-de-abreu/) • [2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962) but 30 April 1962 in other accounts. A 1937 identity confusion with a homonymous radiologist, Manoel de Abreu Campanario (1906–1994), was resolved by the Sociedade de Medicina e Cirurgia[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt).\n\n| Key fact | Detail |\n|---|---|\n| Invention | Abreugraphy (chest photofluorography), installed at the Hospital Alemão, Rio de Janeiro, June 1936; originally called \"roentgenfotografia\", renamed \"abreugrafia\" in 1939 at Ary Miranda's suggestion[4](https://doi.org/10.1148/33.3.363) • [3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt) |\n| Economy | Films of about 2.4×3.6 cm, smaller in sensitive surface than 30×40 cm radiography film and cheaper; film cost for 1,000 chests fell from about £100 to about £2 8s[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt) • [5](https://doi.org/10.1136/bmj.1.4143.879) |\n| Throughput | Up to five people per minute; average exposure 72 kV peak, 80 mA, 0.3 second; 40–45 exposures per 35-mm roll[6](https://ebooks.spr.org.br/o-mestre-das-sombras.pdf) • [5](https://doi.org/10.1136/bmj.1.4143.879) |\n| Yield | About 100 previously unsuspected tuberculosis cases per 10,000 examined, roughly ten with cavities; first series of 14,000 cases found 3.78% tuberculous[5](https://doi.org/10.1136/bmj.1.4143.879) |\n| Adoption | 25 installations in Brazil by 1939, plus Argentina, Chile, Uruguay, Germany, and France; over 500,000 German examinations by Holfelder by 1938[4](https://doi.org/10.1148/33.3.363) • [7](http://www.imaginologia.com.br/extra/upload%20historia/Manoel-de-Abreu-e-o-Dia-Nacional-da-Abreugrafia.pdf) |\n| Decline | WHO's 9th Expert Committee on Tuberculosis (1974) opposed mass abreugraphy as expensive, low-yield, and staff-intensive; mandatory use abolished in Brazil in the late 1970s[8](http://www.scielo.br/j/rsp/a/xgdV3Cyym5Vt9SQYPxBypVH/?lang=pt) • [9](https://bibliosus.saude.gov.br/04-01-dia-da-abreugrafia/) |\n| Honors | Three Nobel Prize nominations (1946, 1951, 1953); chevalier of the French Legion of Honour (1918); Dia Nacional da Abreugrafia, 4 January, instituted by Decreto nº 42.984 of 1958[1](https://www.anm.org.br/manoel-de-abreu/) • [2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962) • [9](https://bibliosus.saude.gov.br/04-01-dia-da-abreugrafia/) |\n\n## Life and career\n\nAbreu graduated in medicine in Rio de Janeiro in 1914; the ANM records his doctoral thesis as \"Natureza pobre\"[1](https://www.anm.org.br/manoel-de-abreu/) • [2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962). In his own retrospective account he dated the germ of the fluorography idea to 1918 at the Laennec Hospital, then directed by Dr E. Rist, where a \"double curiosity\" in physics and medicine led him to think about fixing the fluoroscopic image[10](https://journal.chestnet.org/article/S0096-0217(15)33942-X/abstract). In his 1939 *Radiology* article he wrote that he attacked the problem diligently in 1918 and again in 1924 without decisive or practical results[4](https://doi.org/10.1148/33.3.363).\n\nHis institutional career ran through Rio's radiology services: head of the Serviço de Radiologia do Hospital Jesus from 1935, professor catedrático of Radiologia from 1937, and head of the Serviço de Diagnóstico Pulmonar e Cadastro Torácico of Guanabara from 1944 to 1962[2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962). He was the first president of the Sociedade Brasileira de Radiologia e Eletrologia in 1930[1](https://www.anm.org.br/manoel-de-abreu/), president of the Sociedade Brasileira de Tuberculose in 1947–1948, and president of the Sociedade Brasileira de Abreugrafia, founded in 1957, in 1958[2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962) • [11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). He was elected a Titular Member of the Academia Nacional de Medicina on 13 September 1928, chair 90, patron Oswaldo Cruz[1](https://www.anm.org.br/manoel-de-abreu/).\n\n## Abreugraphy: how the technique worked\n\nThe apparatus emitted an X-ray beam onto an écran, a square plate of calcium tungstate, whose fluorescent image was captured by the lenses of a photographic camera onto 35 mm film[6](https://ebooks.spr.org.br/o-mestre-das-sombras.pdf). The documentation used standard 35 mm or 70 mm film; Abreu always recommended 35 mm, which required magnifying glasses for interpretation[12](https://radiopaedia.org/articles/manoel-de-abreu). The average exposure was 72 kV peak and 80 mA for 0.3 second, with a large-aperture lens focused on a 14-by-14-inch fluorescent screen and a 10-kW tube; the camera took 40 to 45 exposures per roll, and the miniature radiographs were projected and enlarged for reading[5](https://doi.org/10.1136/bmj.1.4143.879). In 1936 Abreu could radiograph the chest of up to five people per minute[6](https://ebooks.spr.org.br/o-mestre-das-sombras.pdf).\n\n**The economy rationale.** Abreu himself stated that the method's great and only advantage was economy: films of about 2.4×3.6 cm, whose sensitive surface is smaller than that of a 30×40 cm radiography film, costing much less[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt). A contemporary review put the film cost of radiographing 1,000 chests at about £100 by ordinary radiography against about £2 8s with 35-mm screen photography, with a satisfactory installation costing about £650[5](https://doi.org/10.1136/bmj.1.4143.879).\n\nThe method was first presented to the Sociedade de Medicina e Cirurgia do Rio de Janeiro in 1934 as \"radiografia indireta do tórax\"[1](https://www.anm.org.br/manoel-de-abreu/), and in July 1936 to the Brazilian Society of Tuberculosis[12](https://radiopaedia.org/articles/manoel-de-abreu). First called \"roentgenfotografia\", it was renamed \"abreugrafia\" in 1939 at the suggestion of Ary Miranda, president of the first Congresso Nacional de Tuberculose; the Congresso Brasileiro de Tuberculose made the name official in 1939 and the União Internacional contra a Tuberculose later approved it[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt) • [1](https://www.anm.org.br/manoel-de-abreu/).\n\n## By the numbers\n\nThe first apparatus, built by engineers of Casa Lohner, a Siemens subsidiary in Rio de Janeiro, from Abreu's drawings, was installed at Centro de Saúde nº 3, rua do Rezende 128; from 8 to 21 July 1937 it examined 758 apparently healthy individuals and detected pulmonary lesions in 44[13](https://revistapesquisa.fapesp.br/en/portraits-of-our-lungs/) • [11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). Mass thoracic registration began in March 1937 under the public health leaders J. Barros Barreto and J. P. Fontenelle, after the Brazilian Society of Tuberculosis endorsed the method on 2 December 1936[8](http://www.scielo.br/j/rsp/a/xgdV3Cyym5Vt9SQYPxBypVH/?lang=pt).\n\nBy 1939 there were 25 installations in Brazil, with others in Argentina, Chile, Uruguay, Germany, and France[4](https://doi.org/10.1148/33.3.363). In 1938 three thoracic-census services were created in São Paulo, and the technique spread to other Brazilian cities, South America, the United States, and Europe[11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). In Germany alone, the number of examinations performed by Professor Holfelder had exceeded 500,000 by 1938[7](http://www.imaginologia.com.br/extra/upload%20historia/Manoel-de-Abreu-e-o-Dia-Nacional-da-Abreugrafia.pdf). Abreu's first published series covered 14,000 cases with 3.78% found tuberculous, and a further series of over 10,000 food-trade workers revealed 3.4% tuberculosis cases[5](https://doi.org/10.1136/bmj.1.4143.879). Under prevention laws in Brazil and Japan, up to 60% of populations were screened[14](https://www.terra.com.br/noticias/brasil/o-brasileiro-que-criou-a-abreugrafia-exame-que-salvou-milhares-de-vidas-da-tuberculose,c9a861b892cee72abb8296de7f4e54be413kat3i.html).\n\n## Comparisons and the priority question\n\nAgainst its alternatives, abreugraphy's case rested on cost and throughput. Fluoroscopy-based surveys would have required about 150 skilled specialists per million examinations per annum, whereas fluorography permitted low-cost mass chest surveys[4](https://doi.org/10.1148/33.3.363). A mass screen-photography program could pick out approximately 100 previously unsuspected tuberculosis cases, about ten of them with actual cavities, from every 10,000 persons examined[5](https://doi.org/10.1136/bmj.1.4143.879). Later critics noted that sputum smear examination for Koch's bacillus was epidemiologically cheaper and safer than abreugraphy[8](http://www.scielo.br/j/rsp/a/xgdV3Cyym5Vt9SQYPxBypVH/?lang=pt).\n\n**Priority.** Abreu claimed uncontested priority for the first installation of fluorographic apparatus for collective thoracic survey, at the German Hospital of Rio de Janeiro in 1936[4](https://doi.org/10.1148/33.3.363). Earlier experimenters with fluorography included Blyer (1896), MacIntyre, Porcher, Köhler, Lomon, Comandon, and Cole[4](https://doi.org/10.1148/33.3.363). His priority was contested by a publication of Dr Friedrich Berner crediting Professor Holfelder's Siemens roentgenreihenbildner; a letter from the Siemens director Th. Sehmer confirmed the device was officially named \"Schirmbildgerät Siemens ... segundo ABREU\"[11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). Holfelder made technical modifications that produced the Abreu-Holfelder mass radiography unit[15](https://www.medmuseum.siemens-healthineers.com/en/stories-from-the-museum/lung-screening). Abroad the same technique was called roentgenfluorography in Germany, radiophotography in France, schermography in Italy, photofluorography in Sweden, and mass miniature radiography in the UK and US[12](https://radiopaedia.org/articles/manoel-de-abreu).\n\n## Other scientific contributions\n\nAbreu published *Radiodiagnostic dans la tuberculose pleuro-pulmonaire* (Masson, Paris, 1921), developed a theory of radiogeometry, and devised simultaneous tomography, in which multiple superposed films are exposed at once[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt) • [11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). On 17 August 1944 he performed the first tracheobronchial washout for detection of the Koch bacillus, at Hospital São Sebastião[11](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf). The use of abreugraphy itself generalized beyond tuberculosis to the investigation of cardiac lesions, tumors, mycoses, and cancer[16](https://enciclopedia.med.br/termos/abreu-manuel-dias-de/).\n\n## Honors and legacy\n\nAbreu was nominated three times for the [Nobel Prize in Physiology or Medicine](https://www.edgepedia.org/nobel-prize-in-physiology-or-medicine), in 1946, 1951, and 1953, though never laureated[1](https://www.anm.org.br/manoel-de-abreu/). He was made a chevalier of the French Legion of Honour in 1918, with the medal of Devotement of the French Red Cross and the Reconnaissance Française medal[2](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962). He received honorary membership of the German Society of Radiology (1940) and the [American College of Radiology](https://www.edgepedia.org/american-college-of-radiology) (1945), the medical medal of the year from the American College of Chest Physicians (1950), and the gold medal of the Colegio Interamericano de Radiologia (1958)[12](https://radiopaedia.org/articles/manoel-de-abreu). In Brazil, the Dia Nacional da Abreugrafia, 4 January, his birthday, was instituted by Decreto nº 42.984 of 3 January 1958 under President Juscelino Kubitschek[9](https://bibliosus.saude.gov.br/04-01-dia-da-abreugrafia/) • [3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt). He died of lung cancer in 1962[3](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt).\n\n## References\n\n1. [Manoel Dias de Abreu — Academia Nacional de Medicina](https://www.anm.org.br/manoel-de-abreu/)\n2. [Abreu, Manuel Dias de — Dibrarq, Arquivo Nacional (Brasil)](https://dibrarq.arquivonacional.gov.br/index.php/abreu-manuel-dias-de-1894-1962)\n3. [Esclarecendo o caso dos homônimos Manoel de Abreu — História, Ciências, Saúde – Manguinhos (2015)](http://www.scielo.br/j/hcsm/a/HmsvjFf4thFTZKVpDmcSb6c/?format=pdf&lang=pt)\n4. [Collective Fluorography — M. de Abreu, Radiology (1939)](https://doi.org/10.1148/33.3.363)\n5. [Mass Radiography. With Special Reference to Screen Photography and Pulmonary Tuberculosis](https://doi.org/10.1136/bmj.1.4143.879)\n6. [O Mestre das Sombras — Um Raio X Histórico de Manoel de Abreu (Sociedade Paulista de Radiologia, 2012)](https://ebooks.spr.org.br/o-mestre-das-sombras.pdf)\n7. [Manoel de Abreu e o Dia Nacional da Abreugrafia — Dr. Sandro Fenelon](http://www.imaginologia.com.br/extra/upload%20historia/Manoel-de-Abreu-e-o-Dia-Nacional-da-Abreugrafia.pdf)\n8. [Abreugrafia sistemática em massa: inviabilidade econômica e eventuais perigos da exposição a radiações — Gikovate & Nogueira, Revista de Saúde Pública (1976)](http://www.scielo.br/j/rsp/a/xgdV3Cyym5Vt9SQYPxBypVH/?lang=pt)\n9. [04/01 – Dia da Abreugrafia — Biblioteca Virtual em Saúde](https://bibliosus.saude.gov.br/04-01-dia-da-abreugrafia/)\n10. [The Bearers of Shadows — Diseases of the Chest](https://journal.chestnet.org/article/S0096-0217(15)33942-X/abstract)\n11. [Manoel de Abreu — historical memoir (Imaginologia, based on Itazil Benício dos Santos, 1963)](http://www.imaginologia.com.br/extra/upload%20historia/Manuel-de-Abreu.pdf)\n12. [Manoel de Abreu — Radiopaedia.org](https://radiopaedia.org/articles/manoel-de-abreu)\n13. [Portraits of our lungs — Revista Pesquisa FAPESP (2015)](https://revistapesquisa.fapesp.br/en/portraits-of-our-lungs/)\n14. [O brasileiro que criou a abreugrafia — Terra](https://www.terra.com.br/noticias/brasil/o-brasileiro-que-criou-a-abreugrafia-exame-que-salvou-milhares-de-vidas-da-tuberculose,c9a861b892cee72abb8296de7f4e54be413kat3i.html)\n15. [Lungs in focus: Lung screening then and now — Siemens Healthineers MedMuseum](https://www.medmuseum.siemens-healthineers.com/en/stories-from-the-museum/lung-screening)\n16. [Abreu, Manuel Dias de — Enciclopédia Médica](https://enciclopedia.med.br/termos/abreu-manuel-dias-de/)\n\n---\n*Topic: Encyclopedia › Life and health › Life and health scientists › Medical and health researchers › Researchers in molecular diagnostics, pathology, medical imaging, and precision medicine › Diagnostic radiology and imaging*\n\n*Initially written Oct 10, 2026 · Edited: Oct 11, 2026; Oct 15, 2026; Oct 21, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n", "same_as": [], "url": "https://www.edgepedia.org/manuel-de-abreu", "markdown_url": "https://www.edgepedia.org/manuel-de-abreu.md", "license": { "name": "Edgepedia Community License 1.0", "url": "https://www.edgepedia.org/edgepedia/license", "summary": "Free with credit, commercial use included. AI training is open to everyone. 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