History of Latin American Dermatology

M. MADERO, F. MADERO, G. MONTENEGRO, M. COELLO, C. ARIASmedicine men; while the latter belong to the medical terrain. Some fundamentalist criteriainsist that a street disease is not cured by the physician; likewise, if the healer doesnot relieve it, it falls into the scope of the doctor.The sum of more or less experimented herbal knowledge and the conception that diseasewas linked to cosmic phenomena and magical-religious convictions gave rise totherapeutics based on such determinations; the use of certain vegetables such as rue(Ruta graveolens), feverfew (Pyrethrum parthenium), figs (Ficus carica) and garlic, usedin “cleansings” and other maneuvers, leave certain dermatitis on the forehead and navel,as well as on the rest of the body, following the path of sensitizing herbs. This happensin treatment processes for the Evil Eye, the Evil Air and the Fright which are part of thecosmic and supernatural pathology with clinical statuses defined by experience.Strong interpretations of “damages” (caused by man) fell on vitiligo; here, the iguanahad a starring role in the fantasy and in the belief in punishment and stigma for seedingthieves. Vega G. 6 states: “The evil eye occurs when the spell-caster becomes fond ofsomeone; sometimes the hair of the person given the evil eye drops...” In the terrain ofthis pathology, the enigmatic alopecia areata and vitiligo are in tune with certain interpretativearguments.In 1526, during the rule of Charles V (1520-1556), twenty-four years after the discoveryof America and thirteen years after the discovery of the Pacific Ocean, theSpaniards arrived on the Ecuadorian coast under the leadership of pilot Bartolomé Ruizat Esmeraldas 2 . Between 1531 and 1532, the Spanish troops commanded by FranciscoPizarro made their incursion into the territory of present-day Ecuador, coming fromPanama; they arrived along the coasts of Manabí, in the Coaque area. There, they sufferedtheir first encounter with the regional pathology: an outbreak of Peruvian wart thatthe first chroniclers called buboe, confusing it with syphilis; some authors believe that itwas probably a frambesia outbreak that affected many Spanish soldiers 5 .Among the most significant historical data, we can mention the following: in 1534, theSpanish founding of Quito took place. In 1535, the foundings of Guayaquil, Portoviejo andLima were recorded, as well as a new smallpox epidemic in Ecuador. In 1537, a newfounding of Guayaquil took place with 150 inhabitants; that same year, Paul III’s papalbill was issued, condemning the slavery of Indians and declaring that they, as well asblacks, “are really men.” At this time, the Royal Order to found hospitals was issued. In1547, the city of Loja was founded and Royal Decrees were issued to protect the healthof the Indians. In 1555, Lima’s St. Mark University was founded. During Philip II’s rule,Andrés Hurtado de Mendoza, Viceroy of Peru and Marquis of Cañete, on May 15, 1550,in Lima, issued a Provision for the founding of Cuenca. Gil Ramírez Dávalos chose thesite of “Paucarbamba” (Tomebamba) for the new city; therefore, on a Monday of HolyWeek, April 12, 1557, Cuenca was born into history with an indication of the territoryunder its jurisdiction: to the North up to the native town of Tiquizambi, to the South downto the cities of Loja and Zamora; to the East up to Macas, Cuyena and Zuña, and to theWest up to the boundary of la Puná Island. The lots were distributed and the street thatgoes along the Parade Ground was called Santa Ana 9, 10 (Figures 11 and 12). In thatsame period, Royal Decrees were issued to the effect that in all the cities there had to beseparate hospitals for ordinary and contagious diseases 2 .In 1558, a new general epidemic of smallpox was described in Ecuador, which wascombated with sarsaparilla and guaiacum stalk. In 1564, the Royal Audience and Presidencyof Quito (Hernando of Santillán) was inaugurated, and the organized colonial systembegan 2 . In 1565, the founding of the first Hospital, the Holy Charity and Mercy ofOur Lord Jesus Christ, took place in Quito.In 1580, 1581, 1587, 1589 and 1590, new smallpox and measles epidemics were describedin Ecuador; the latter was the most aggressive one, since it caused around30,000 deaths. In 1660, the first Hospital was founded in Guayaquil, headed by Brother204