History of Latin American Dermatology

CÉSAR IVÁN VARELA HERNÁNDEZand especially leprosy; thus, the slave market and trade were also determining factorsfor the spread of infection and of many other diseases.Yellow fever, according to Soriano Lleras, found in the Aedes aegyptii mosquito thevector for reaching urban centers. The Aedes came on board the ships bringing Africanslaves, reached the Atlantic coasts and traveled up the Magdalena River, causing multipleepidemics as of 1509 8 . Tabardillo (exanthematic typhus) caused many epidemicsduring the seventeenth century; this Rickettsiosis that caused great mortality led theSpaniards to forbid the Indians from bathing every day 6 . According to Pedro de Aguado,the first of the many smallpox epidemics took place in 1558; the virus reached theCaribbean coast through Hispaniola and traveled inland along the Magdalena River:“Thus a black woman who had contracted this contagious disease of the seaside,... hasaccording to popular saying been the cause of this calamity and misfortune” 16 . Thesmallpox epidemics that took place later, as well as those of measles, caused great mortalityamong Indians, black slaves and the Spaniards themselves. Other dermatologicalor related diseases the arrived were brucellosis, gonorrhea, mycobacterioses, cholera,diphtheria, black or bubonic plague and trepanomatoses; rubella, flu and dengue,malaria, schistosomiasis, “Arab elephantiasis” caused by the Wuchereria bancrofti filariaand “river blindness” by Onchocerca volvulos 6 . There also arrived lice, new vectors likethe mosquito (Aedes aegypti), the flea (Xenophylla cheopis) and hosts for zoonoses, likehorses, goats, cattle, hogs, the domestic cat and mice 2, 6 .■ Dermatology from from the Colony the to the Colony present time to the present timeCésar Iván Varela HernándezMedicine during the Colony was framed by the combination of European knowledgewith the wisdom and the magic of the Indians, the mixture of therapeutic substances andpractices with psycho-religious doctrines and ingredients. An important role was playedby “spiritual medicine” characterized by the construction of cathedrals and hermitagesand by the arrival of the images of Virgins such as that of Chiquinquirá in 1598, viewedas mediators with the supreme physician, added to the spiritual assistance offered to Indiansand slaves by merciful clergymen like the apostle of the Africans, St. Peter Claver,who died of yellow fever in 1650 2, 3 .The diseases that characterized the Colonial era were smallpox, tabardillo or murinetyphus (exanthematic typhus), measles, leprosy, buboe and scurvy. Many epidemicsstruck the territory: those of smallpox were the most serious, affecting a number of cities.In Tunja, in 1587, “citizens and Spaniards died like rats harassed by the flute ofHamelin.” There were neither apothecaries nor civil cemeteries; between 400 and 1,000of the 3,000 inhabitants are believed to have died. The Hospital Convent of St. John ofGod had only two beds for the wealthy and two for the poor; the empirical physicianPedro Juan Ruiz Delgado had worked there since 1586. Two decades later the epidemicspread to the entire Kingdom of New Granada; “the Indians, frightened by the high mortality,fled to the forests and mountains, leaving the settlements abandoned.”Syphilis was also very much present in this region, owing to the promiscuity of thecolonizers; this can be deduced from what was written by Juan Rodríguez Freyle in hiswork “The Ram” regarding the judge (oidor) Don Luis Tello de Erazo, a resident of SantaFe and an official of the president of the New Kingdom, Diego Gómez de Mena. The judgewould appear to have gone to die in Seville of the “French disease,” after “trading thegown for adventures with promiscuous damsels.” In 1630 a murine typhus epidemicbroke out in Santa Fe, spreading in four years over the entire country; excepting thesmallpox epidemics, none other extended so widely or was so devastating; according to116