History of Latin American Dermatology

History of Ecuadorian Dermatologyprolonged incursion that started in 1450, subjugated the whole inter-Andean region afterbloody battles, which ended in the strategic submission of the Cañari and the impositionof certain previous conditions on the occupation of the plain that they called Tomebamba,which they made into the second capital of the empire 4 ; in this way they imposed theirCuzco culture, contributing Quechua elements to native life.The Inca Túpac-Yupanqui brought his main wife Mama Ocllo from Cuzco (1450), andthe heir of the “Sons of the Sun” was born here: Huayna-Cápac (1452). “Tomebamba becamethe site and sanctuary of the highest category, after the mythical capital of the messianicempire”; it was then the second capital that sought to emulate, at length, thesplendor of Cuzco. The highest military, administrative and religious functions were concentratedhere; and here the greatest of Inca rulers, Huayna-Cápac, lived for many years 4 .The medicine of sorcerers and amautas in those pre-Columbian times was mainlytheotherapeutic (spells and amulets), phytotherapeutic (antitoxic, cathartic, narcotic,anti-fever), magical and religious (use of herbs and vegetable products, which in all likelihoodoriginated many cases of what we know today as phytodermatosis), but also surgical(curing ulcers, mummification, trepaning, dental drilling, cranial reduction —tzantzas), and not lacking in some anatomical knowledge and a certain discernment regardingdiseases, epidemics and endemic ailments 2 .Of epidemics, smallpox decimated the indigenous population and later also the Spanishcolonizers 1, 2 . According to Cieza de León, in 1526 the very emperor of theTahuantinsuyo, Huayna-Cápac, fell ill with smallpox and ultimately died because of thisdisease 5 . But not only smallpox was known; there were also representations of Chagasdisease, leishmaniasis, tuberculosis and syphilis, which attacked the Indian population 1 .Upon the death of Huayna-Cápac, his testament divided the kingdom between his twosons: Huáscar in the South (Cuzco) and Atahuallpa (son of a Quito princess) in the North;in this way, the unity of the empire was dissolved.Around 1530–1531, due to the defeat of Huáscar by Atahuallpa at Huamachuco, a typhusepidemic was described for the first time in the territory of present-day Ecuador.Years later, in 1536, Atahuallpa was clubbed to death in Cajamarca 5 . Despite the above,history recorded the first smallpox epidemic in Ecuador only in 1533 2 .Dermatology during the Hispanic and Pre-Republican eraWhen we talk about the Hispanic and Pre-Republican era, it is worth reviewing someaspects of Dermatology in traditional medicine. Following the conquest of the NewWorld, Spain marveled at references of healing plants that enthused sixteenth-centurydoctors and society. Philip II himself ordered Mexico’s most famous species to be collectedand taken to the Peninsula.De historia plantarum novae hispanie is a revolutionary work by the physician FranciscoHernández 6 , which lists all the plants known by the Indians that served to curehopeless patients abandoned by doctors. Explorers and adventurers with greater orlesser fortune traveled along Columbus’s route with loads of marvelous herbs.We thus come face to face with the “other medicine,” relegated to marginal fringeswith a certain disdain for being considered a matter of “medicine men.” The existence ofthis medicine, which was born at the dawn of cultures, has been recognized by WHO 7 ;its popular stock, considered empirical, based on a certain experience or knowledge, explainableor not, has not prevented it from breaking the limits of conventional medicineand lingering as an oftentimes complementary activity, in response to convictions deeplyrooted in people who are a product of cultural crossbreeding. The scope of these two“schools” is marked by the aboriginal conception of the nosology of diseases.Indeed, there is talk of countryside or street diseases and of “diseases of God” 8 . Theformer have a supernatural origin; their magical-religious roots make them a matter for203