History of Latin American Dermatology

M. MADERO, F. MADERO, G. MONTENEGRO, M. COELLO, C. ARIASBasil Hall, in his book Extracts from a Journal: Written on the Coasts of Chili, Peruand Mexico in 1820, 1821 and 1822, refers to Guayaquil women in the following manner:“Oftentimes we had heard praises of the light skin of Guayaquil women, but we hadimagined that it was an exaggeration. That is why we were surprised to find these ladies,white and blonde like any European. Their eyes, different from the Spaniards’, wereblue, and their hair, fair. This is even more extraordinary given that Guayaquil is locateda little more than two degrees south of the Equator, and, located at sea level, is excesivelyhot all year round.”In their Travel to South America Jorge Juan and Antonio de Ulloa also pointed out thefact that despite “that country being so warm, its natives are not dark-skinned and thatthe Spaniards not having the skin so naturally white, like the nations of the north, theirchildren there are blond.”The reasons that Dr. Abel Brandín gave in 1826 for this characteristic were “the influenceof the humidity of the weather, the lifestyle of the women, their perfect inactivityand avoidance of light; just like plants devoid of any exposure to the sun and to any light,and that they wither, lose their colors […] The lack of exercise, of movement, with theheat and the humidity, favor the development of cell tissue, satiate it, impregnate it withhumidity, and favor the whiteness of the epidermis.”The most common diseases among the Guayaquil population then were malaria,dysentery, smallpox, tuberculosis, measles and syphilis.Republican period (1830-1900)From the beginning of this era, the hitherto free province of Guayaquil and now partof the Republic of Ecuador exhibited sustained progress in all aspects; and medicine,with the arrival of some doctors who decided to settle at this location, also showed remarkableand constant development.During the first decades of the republican era, medical studies had to be carried outin the city of Quito, the only one in Ecuador to have a Medical School at that time; this iswhy doctors from our coastal region were natives who had to travel to other places inorder to study, or foreigners who stayed mainly in Guayaquil. None of this kept Guayaquildoctors, willing to achieve scientific improvement, from, in 1835, constituting the DepartmentalMedical Board, and, very shortly afterwards, the Guayas Medical Society.The emergence of the Guayas Medical Society marked a stage of advancement andprogress in Guayaquil medicine, since during its long and fruitful existence, it was incharge of issuing rulings to combat epidemics, defend physicians, appoint the city’s medicalauthorities and participate in the founding of hospitals.The activity of Dr. Mariano Arcia is worth recalling: possibly influenced by accountsof Alibert healings in the sulfurous waters of the Tivoli, Dr. Arcia thought that our leperswould be able to heal with the sulfurous waters of the Santa Elena peninsula. To this end,he obtained the means for the construction of a leprosarium at the very sites where theSanta Elena thermal waters emerge, which began treating patients in late 1837.Between 1842 and 1867, the Ecuadorian coastal area, and especially the city ofGuayaquil, suffered three yellow fever epidemics that caused high mortality among itsinhabitants.In December 1867, the University Board began to operate in Guayaquil — an organizationwhose role was to receive the admission exams of those who wanted to practicein Guayaquil or in the province. Ten years later, in 1877, the Guayaquil Medical Schoolopened its doors, launching a new and more successful period for local medicine.Guayaquil was attacked by a new yellow fever epidemic in 1880. This disease anddengue, smallpox, measles, cholera and dysenteries were the most frequent ailments ofthe region in the last quarter of the nineteenth century.190