History of Latin American Dermatology

History of Ecuadorian Dermatologythe Indians’ health. The health of the inhabitants of the Ecuadorian coastal area was inthe hands of medicine men, and the presence of a certified doctor in these lands was consideredby many as a work of Divine Providence. At the Guayaquil Hospital, the treatmentof patients was usually provided by a Catholic priest with practical knowledge.Little is known about the diseases that were present in the seventeenth century. In thechronicles, measles and smallpox epidemics, like those that caused major damage in ourpopulation, are mentioned.In the early eighteenth century, Guayaquil suffered another smallpox epidemic thatcaused great mortality among its population, which in 1708 was around 4,000. Towardsthe second half of the century, Guayaquil ceased to be a city abandoned by medicine, anda larger number of doctors appeared who devoted themselves to the treatment of patientsat the hospital or privately.With the presence of doctors, more technical descriptions of diseases were achievedin that period, and more detailed reports on certain skin ailments and on their differentforms of treatment began to appear. An example of this was, in 1776, the use of “a wonderfulmedicine” used to extirpate a parasite from the skin that was a true plague bothfor the Spaniards and for Indians and people of mixed race: chiggers. The wonderfulremedy consisted in “smearing the parts where the chiggers reside with unheated oliveoil, and after they die the small sacks that contain them come off easily.”Chiggers and lice are parasites that have been present since the times of the natives,and which, right through the conquest and the colonial period, have made it to our days.Chiggers cause the well-known local complaint, and lice even produce exanthematic typhusmentioned many times in chronicles of the colonies.As had happened in previous centuries, smallpox and measles also were common andserious problems in the eighteenth century. It is necessary to point out that during theentire colonial period these two diseases were endemic in our coastal area and particularlyin the city of Guayaquil, but from time to time, acquired the character of an epidemic.Such was the case of the new smallpox epidemic of 1785.In the archives of the conquest, there are no indications that leprosy might have existedin our environment at that time. It is likely, as is believed in other American countries,that our natives did not suffer it, and that it was imported from Europe and possiblyalso from Africa through black individuals brought for certain tasks.Only in the eighteenth century can we find a ruling that lepers had to be sent to theCartagena of Indias Leprosarium, which was difficult to comply with, given the distancesand the bad roads; this is why the sick moved about freely on the streets of Guayaquil.Then arose the idea of identifying all lepers in the city and planning the construction ofa special site where they would be secluded and isolated.In 1795, a census of people affected by leprosy established that there were 24 lepersin Guayaquil, and it was determined that some of them were to be sent to the Cartagenaof Indias Leprosarium and others to the recently-created Quito Leprosarium.Due to the emergence of new cases of leprosy, the need for a site of contention becameevident; in 1818 the first lazaretto in the Ecuadorian coastal area, set up in the cityof Guayaquil, began its activities.Independence (1820-1830)During this period, medical practice maintained the routine practices established duringcolonial times, and scientific contributions were scarce; these contributions were attainedby the few people who, after studying medicine in more advanced centers abroad,returned to these lands.A curious fact which worth mentioning is brought up by various authors of this timeregarding the color of the skin of Guayaquil inhabitants, in particular of its women.189