History of Latin American Dermatology

History of Dermatology in Guatemalasurgical techniques, much less of the people saved by his scalpel, buthis energetic struggles against empiricism are perfectly well known,and his activities in this regard enshrine him as the first defender ofthe Guatemalan physician, as the first surgeon who, grasping hismajor social mission, defended the treasure of health and opened theeyes of rulers unaware of those vital problems. He asked the Mayor,Don Diego de Paz Quiñónez, to demand that barbers who acted assurgeons immediately exhibit their licenses; if they should not do so,they should receive a serious punishment, because the neighborhoodwas in danger in their hands; and not only did the barbers carry outcures, but so tool did their offspring and servants.The Record of Tecpán Atitlán provides us with the best descriptionof the plagues that scourged the population during the sixteenthcentury:In truth it was terrible when the Great Lord God sent us this death. Many familiesbent their head before it. People were overcome by cold, immediately followed byfever; blood flowed from the nose, there was coughing and the throat becameswollen, both in the major and in the minor plague. Everyone came under attack.Seven days after Easter the plague increased, there being an incredible number ofvictims, among men, women and children.This epidemic was called chaac in the Cakchiquel language; it means disease orplague with skin eruption, exanthemata or sores. Other words are derived from this oneand they all refer to manifestations of scabies, burns, festering sores, etc. (in the Mayanlanguage there is the word chac, which means “red”); this plague with exanthemata orsores could correspond to measles and exanthematic typhus.In the seventeenth century numerous doctors and surgeons arrived in the city fromNew Spain and from faraway cities of the Hispanic peninsula. The flourishing of the colonialmetropolis of Central America awoke ambitions and for this reasonmany physicians undertook the voyage hoping for a securefuture. Chronologically by order of arrival in Guatemala they wereJuan de León (1600), Joseph Adalid Bohórquez (?), Cristóbal Tartajo(1624), Pedro Ramírez Delgado (1627), Enrique de Sosa (1630),Alonso Aragón (1633), Mauricio López de Lozada (1640), Juan deCabrera (1640), Andrés Sánchez de Miranda (1648) and BartoloméSánchez Parejo (1649).In April 1769, the city was hit by an epidemic of malignantmeasles, which caused ravages mainly among the Indians. The headlecturer in Medicine, Dr. Ávalos y Porres, and the French physicianDesplanquez had the task of issuing healing prescriptions, the dietand other measures against this epidemic. In the month of June 1773,a violent earthquake destroyed the city of Santiago de los Caballeros de Goathemala.The damage wasn’t total, but the commander Don Martín Mayorga and some fearfuland bereaved dwellers abandoned the city in an overly hasty and imprudent manner.The ruined city was in chaos and as a last straw a plague of murine or exanthematictyphus, which lasted somewhat less than a year, killed four thousand people, causingmuch more harm than the tremors. It began in late 1773, became exacerbatedin March 1774, and ended in the month of June of that same year. The epidemic wasoriginated by the exodus of the Indians and workers to the higher-lying towns, placeswhere typhus was endemic. Their precipitate flight soon forced them to return to the ravagedcity, where they arrived half-naked and hungry, carrying the germs of the disease.Figure 18. Hospital ofSt. Alejo or of theIndiansFigures 19 and 20.Santiago Hospital233