History of Latin American Dermatology
History of Latin American Dermatology History of Latin American Dermatology
CÉSAR IVÁN VARELA HERNÁNDEZDown my cheek and madeMy longing evident...(Carlos Aníbal Niño Calero, en “To Tania”).. . . And I also tell themWith tearful eyes,And a heavy heart,That nothing is happening hereThat they should carry onSeeking little birdsSinging among the branches...(Jaime Betancourt Osorio, in “Illusions”).. . . Violins of the twilights in your enrapturing speechBright twinkling stars of blue like the sea’sThe mother-of-pearl of your skin sculpted in the cloudsInspire, unmatched, my being, my light, my love.The trill in your lips preludes the laurelTaking our trip to the swaying of lilac cámbulosMy romance is paternal, an offering to the great creator.(César Iván Varela H., in “Camila”).. . . When your worries overwhelm youThink of the good things,Of the beautiful momentsAnd of the people you love.Search in the bottom of your heartAnd you will find the road to the stars.Dream, have hope and patience,They are the three moons that will lightenThe night of impossible things...(Martha Cecilia Valbuena Mesa, in “When”)“Each people has, as is obvious, had a different type of skin as its ideal of beauty; asnowy color, ivory-like, moonlike silver, among Europeans; golden, corn, for AmericanIndians; black akin to “diamond-like night,” or ebony, for Africans...” (Jaime GilJaramillo, in “Skin,” non-fiction book).“The amazement of looking at you even if I cannot see you. In comparison to you thesmallness of my own matter amazes me. I would like to get to know you, to discoverall your secrets. But I believe that at that instant my charmed dream would shatterinto a thousand pieces and would lose all its magic...” (Luis Arturo Gamboa Suárez,in “To the Universe”).Like a resplendent star at the height of the zenith,You arrived with your brilliance, setting my feeling alight,Your great eyes like the prairie in spring,Your mouth painted by a brush, your skin like cinnamon,Your grace is a charm, your speech a poem.(César Iván Varela H., in “Natalia”).144
History of Dermatology in ColombiaPopular medicine. Medicine men. MagicCOLLABORATOR: Juan Pedro Velásquez Berruecos (Figure 64)Our medical history is based on the cultural development of the native societies,among which the myths and beliefs were transmitted as ancestral information fromgeneration to generation. Among primitive cultures, religion, magic and medicaltreatment necessarily were utterly inseparable. The primitive patient and his healersought supernatural origins for many events, including illnesses, and were psychologicallypredisposed to accept the efficacy of magic 47 .Shamans had to be privileged and respected doctor-priests who followed the lineof conduct of Chibcha medicine. The term tegua (healer) appeared with the arrival ofthe Spaniards, although it is a Muisca Indian word. In the lands of the chieftancy ofQuemuenchatocha, in the Boyacá township of Campohermoso, there existed and existsthe Teguas community, in which the Indians maintained a center for the education, fromadolescence onwards, of the future zaques and other chiefs, of the priests and shamans.With the varied flora available there, the elect practiced and learned the therapeuticproperties of plants. When the Spaniards learned about these practices, they began togive the name of teguas to the healers, herb doctors, witch doctors and natives with theability to cure illnesses 2 .Healers, shamans, teguas and medicine men have been regarded with distinctionamong primitive peoples, although each of them probably had different peculiarities.Shamans, possessing millennial knowledge, employed diverse psychotropic plans, someof them stimulants like coca or tobacco, others hallucinogenic like yagué, Banisteropsiscaapi, or yopo, Virola sp; these plants serve to produce or accelerate alternate states ofconsciousness, by means of which it was possible to effect cures and establish contactwith the supernatural world. Within their religious tradition, some groups of mixedbloodcolonists admitted the use of psychotropic plants and Indian shamanism as a healingalternative. “Shamans, interpreters of natural events, fulfill a primordial political,social and religious role within the cultural contexts to which they belong, insofar as theyprovide protection for their group in the face of the aggression of beings and forces, andeven in the face of the ritual and shamanistic attacks originating in other groups” 3 . Theknowledge, handling and use of plants and of other elements of an animal or mineral originconstitute a fundamental part of the shaman’s power and, of course, of the efficacyof his practice in the search for the causes of diseases.During the Discovery and at the outset of the Colony, the appearance of medicine menwho performed the role of physicians, and of barbers who acted as surgeons, was the productof the urgent need for medical care among the population in the face of the scarcity ofphysicians holding degrees. The first medicine man that we know about was Diego deMontes in 1535 9 . Healers were harshly criticized for their lack of knowledge; nevertheless,in specific circumstances they played an honorable and/or necessary role in history.From the book Dermatology in France, which was given as a gift to those of us whoparticipated in the last World Congress in Paris (2002), I have culled the following paragraphthat appropriately reflects my way of thinking about the subject under discussion:“Within a few years, Dermatology has undergone an extraordinary evolution not to remainin the shadows. Centuries of beliefs in which medical practice did not stray far fromthe empirical practices of a popular medicine that could only resort to natural remediesor to untested conceptions. The development of rigorous scientific and clinical researchand the generation of fortuitous therapeutic trials have revolutionized the progress ofcures, efficiency being the winner. Nevertheless, the history of France teaches us that thespirit doesn’t always accept falling ill within the realm of reason; everyone has the rightto believe in the irrational. In the face of what we today call the “placebo effect” andFigure 64. J. PedroVelásquezBerruecos145
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CÉSAR IVÁN VARELA HERNÁNDEZDown my cheek and madeMy longing evident...(Carlos Aníbal Niño Calero, en “To Tania”).. . . And I also tell themWith tearful eyes,And a heavy heart,That nothing is happening hereThat they should carry onSeeking little birdsSinging among the branches...(Jaime Betancourt Osorio, in “Illusions”).. . . Violins <strong>of</strong> the twilights in your enrapturing speechBright twinkling stars <strong>of</strong> blue like the sea’sThe mother-<strong>of</strong>-pearl <strong>of</strong> your skin sculpted in the cloudsInspire, unmatched, my being, my light, my love.The trill in your lips preludes the laurelTaking our trip to the swaying <strong>of</strong> lilac cámbulosMy romance is paternal, an <strong>of</strong>fering to the great creator.(César Iván Varela H., in “Camila”).. . . When your worries overwhelm youThink <strong>of</strong> the good things,Of the beautiful momentsAnd <strong>of</strong> the people you love.Search in the bottom <strong>of</strong> your heartAnd you will find the road to the stars.Dream, have hope and patience,They are the three moons that will lightenThe night <strong>of</strong> impossible things...(Martha Cecilia Valbuena Mesa, in “When”)“Each people has, as is obvious, had a different type <strong>of</strong> skin as its ideal <strong>of</strong> beauty; asnowy color, ivory-like, moonlike silver, among Europeans; golden, corn, for <strong>American</strong>Indians; black akin to “diamond-like night,” or ebony, for Africans...” (Jaime GilJaramillo, in “Skin,” non-fiction book).“The amazement <strong>of</strong> looking at you even if I cannot see you. In comparison to you thesmallness <strong>of</strong> my own matter amazes me. I would like to get to know you, to discoverall your secrets. But I believe that at that instant my charmed dream would shatterinto a thousand pieces and would lose all its magic...” (Luis Arturo Gamboa Suárez,in “To the Universe”).Like a resplendent star at the height <strong>of</strong> the zenith,You arrived with your brilliance, setting my feeling alight,Your great eyes like the prairie in spring,Your mouth painted by a brush, your skin like cinnamon,Your grace is a charm, your speech a poem.(César Iván Varela H., in “Natalia”).144