The acclaimed pioneer of the History of Medicine in Portugal, Maximiano de Lemos, was son his father of the same name, Maximiano Augusto de Oliveira Lemos and his wife D. Guilhermina de Matos e Oliveira, a middle-class couple who lived in Rua de Medreiros in Peso da Régua, where their son was born on 8 August 1860. Little is known of his early life on the banks of the Douro, but by the age of fifteen he was already settled in Porto studying for entry into medical school at the Academia Politécnica do Porto, matriculating after a year to the Escola Médico-Cirúrgica do Porto, in late September 1876. Throughout his five years of studies Maximiano de Lemos showed himself to be a gifted and hard-working student, while sharing his interests with the literary and bohemian world as an amateur poet and a restless and effusive young man, according to the memoirs of his friend Ricardo Jorge.

In July 1881, he defended his inaugural thesis called A Medicina em Portugal até aos fins do século XVIII (tentiva histórica) [Medicine in Portugal to the end of the eighteenth century (historical essay)], which gained the approval of the jury, who awarded him the diploma in medicine and surgery, just short of twenty-one years of age. His choice of topic already revealed what would be his overriding intellectual interest and the centre of his researches: the History of Medicine, until then left neglected in sporadic and minor studies. He illustrated his thesis with an accumulation of material and a historical exposition of the progress of medicine in Portugal from the foundation of the kingdom to the eighteenth century, from various angles: scientific areas of knowledge, educational and medical institutions, leading personalities, and a bibliography. This first work of a historical nature already demonstrated some of the characteristics of his later works, while also showing clear influences of the historical approach adopted by Alexandre Herculano, such as the selection of facts from historical sources, a critique of the same in search of truth from original documents, or the construction of knowledge in a way that is erudite, all-embracing, and of a nationalist character. He justified this in his introductory remarks: ‘prompted by the enthusiasm that he has for the glories of his fatherland to assay the merit of those became notable in his country in the branch of knowledge to which he has dedicated himself’ (A Medicina em Portugal, 1881, pp. 13–14).

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