Ramón Luis Miranda Torres

He stands out as Martí's physician, due to his excellent medical work during the final years of life of our National Hero.

The doctor distinguished himself in other little-publicized aspects, which is why we believe he has not been given his true dimension, as he was an ophthalmologist. In Cuba he worked in the Military Health Corps of La Habana and in the Military Hospital of San Ambrosio. He also provided medical services at the Royal House of Charity and Maternity of La Habana.

He was born in Matanzas, his parents were Don Bernardino de Miranda and Doña Gumersinda Torres. At eight years old they moved to La Habana and Ramón enrolled as a student at the "El Salvador" Academy; which already constituted a true institution of education, directed by the illustrious patriot José de la Luz y Caballero. After completing the different levels of schooling with excellent results, in 1853 he enrolled in the Medicine program and passed with outstanding grades in the first two courses.

As was common among young people of the time, he moved to Paris and enrolled in the Faculty of Medicine. From his years as a student in France he began to show interest in ophthalmology. The journal "Eco de París", which he had founded together with other Cubans studying in the French capital, evidences his interest in these topics. In June of 1857, he marked his prominence as a student when he published in that month's issue his first article titled "Foreign Review", where he offers a summary of some facts publicized by the press.

There he describes the treatment of various diseases and their results. Among them he refers to a vascular tumor of the orbit and its treatment, the excision of the superior maxillary nerve in three cases of facial neuralgia and others. In August of that same year he alludes to vertigo, in the Medical Clinic section. Thus he presents cases, where he refers to the way to diagnose them, the treatments and results, and insists that it can appear together with diseases of the visual system.

He also addressed blood tumors of the cranial vault, in communication with intracranial venous circulation, where he noted that some can extend to the eyelids and grow excessively. Of these lesions he highlights "these tumors that in the Surgical Society have been compared with venous aneurysms observed frequently in some regions of the body, but never in the skull, are not described or even mentioned in surgical treatises both ancient and modern: today thanks to investigations… it has been possible to trace quite well the general history of those tumors…".

On May 10, 1861 he performed brilliant exams and graduated as a physician. From his exam, Dr. Gustavo López distinguished him, cited by Rodríguez Expósito: "There before the competent tribunal that graduated him, he knew how to defend his thesis titled 'Paralysis of the Common Ocular Motor'. His arguments were very well received, justifying the congratulations he received from Professor Martín Malgron, who counted Doctor Miranda among his favorite students".

Once again we see his relationship with Ophthalmology, as he chose to defend his thesis on the paralysis of the third cranial nerve. In the text he explains in detail the afflictions that both the intrinsic and extrinsic musculature suffer. Being proposed by the tribunal for publication, the thesis was edited in Paris with the dedication: "To the best of fathers, how fortunate I consider myself today to be able to offer you this simple fruit of my labors, and may it be found that your tender solicitude and your paternal sacrifices are rewarded in some way. To my good mother: eternal love. To my dear brother: affection and unity".

His thesis was the result of work and experience acquired during the time he spent in the Physiology laboratories of Professor Malgron and merited warm praise from Professor Paul Broca, an eminent French scientist, who located the center of articulate language in the foot of the third left frontal convolution.

From France he moved to Spain, where given his French background, he was obliged to take exams in all subjects. The young doctor responded fully to the interrogations. His degree exam at the Faculty of Medicine at the University of Madrid was very notable. He performed a cleft lip operation, which earned him not only the degree but also the congratulations of the Professor of Operative Medicine, who expressed satisfied: "Here is an aesthetic surgeon".

Upon returning from Spain he was 25 years old. In Cuba he set up his office in La Habana and gradually won the admiration of his numerous patients. A large portion of them lived in poor neighborhoods, tenement houses and compounds, where Miranda attended punctually, bringing them his love and his medical knowledge. It is known that not only did he not collect fees but he often left money alongside prescriptions for the purchase of medicines. There were many nights when he interrupted his sleep and mounted his carriage or volante, to attend to the home of a poor person in need of his services. He performed this function as a duty and with tremendous pleasure.

To aspire to Supernumerary Academician of the Medicine Section in the Academy of Medical, Physical and Natural Sciences of La Habana, he presented a work titled "On Local Anesthesia", an interesting study that was very well received. On October 28, 1866, Dr. Luis M. Cowley, an illustrious medical figure of the time, reported at the plenary of the academy his opinions regarding the paper presented by Dr. Miranda. Cowley ended by asking those present to gladly grant the author's aspiration by giving him the title of Regular Member and to publish the text that contains important facts and extremely detailed observations. Dr. Cowley's proposal was approved unanimously and Miranda Torres' request was accepted.

At the session of November 11, 1866, Dr. Miranda attended to take possession of his position as Academician. Thus began an intense academic activity that he developed with professionalism, dedication and true enthusiasm. Activity that he continued abroad, when in May of 1874 he established his residence in Nueva York. He continues with his collaborations and on January 11, 1885 he sends a report to the academy regarding local anesthesia produced from cocaine hydrochloride.

He emphasizes the procedure and explains that the experiments conducted by different ophthalmologists, many of which operations he has witnessed, demonstrate that the solution dilates the pupil through an effect on the sympathetic nervous system, and produces anesthesia not only in the ocular mucosa, but in the mouth, larynx etc., which he relates to the innervation of the zone.

His interest in ophthalmology led him, as he explains, to witness various operations, although—as far as our research has advanced—we have not found that he practiced ophthalmology directly. In 1887 he publishes a work on saccharine diabetes and returns to refer to the subject we are analyzing. There he narrates the history of one of his diabetic patients who upon examination presented "vague gaze, difficulty in distinguishing objects, contracted pupils".

Between October 2 and 9 of the year 1900, the International Exhibition and XIII International Medical Congress were held in Paris. There he attended in representation of Cuba—according to Dr. Miranda—the distinguished Cuban ophthalmologist Dr. Juan Santos Fernández Hernández. Together they attended the different sessions of the event, toured the Exhibition and exchanged ideas about the development of Ophthalmology in Cuba. In the session of October 28 the academy discussed a report written by Dr. Miranda, later published, where he explains what happened in the French capital. He emphasizes the acceptance that "eye instruments and the magnificent artificial eyes" have had.

Possibly in the first days of December of 1909, in Nueva York, he suffered a stroke due to cerebral hemorrhage that left him bedridden, grave and with right hemiplegia. We say in the first days of December because Gonzalo de Quesada—Cuban patriot and Miranda's son-in-law—sends with date of December 13 a telegram to the academy, in response to this institution's request, where he highlighted the gravity of the doctor. On December 30 the Secretary of the Academy sends the following letter to Dr. Gonzalo de Quesada: "Convened this Academy last night for the first time after the attack suffered by our much-beloved Academician of Merit Dr. Ramón Luis Miranda, notice was taken of his serious illness and the corporation agreed to make known the sincere feelings that animate it and its wishes for the speedy recovery of the beloved patient...".

Despite all the effort made by the physicians who attended to him, at three o'clock in the morning on January 27, 1910 Dr. Miranda passed away. This is confirmed by the telegram sent by Gonzalo de Quesada to his beloved academy, where the pain was very deep upon learning the unfortunate news. The next day, January 28, the recognized institution sends a communication to Nueva York. The message expressed: "Informed the Academy, by yesterday's telegram of the regrettable death of our beloved academician of merit, Dr. Ramón Luis Miranda, it agreed, in its session last night, to suspend it as a manifestation of mourning…". An irreparable loss that had wide repercussions among the academicians who admired and respected him.

Source: Cuban Journal of Ophthalmology