History of Latin American Dermatology

ADAME, ARIAS, ARENAS, CAMPOS, NEUMANN, ORTIZ, RUIZ MALDONADO, SAÚLFigure 2.Application ofmedicinal plantswith enemasFigure 3.MagliabechianCodex.Consumption ofentheogenousmushrooms.Behind the Indianingesting them isthe godMictlantecuhtliDermatologyas large, as rich and as irreplaceable as that which wasmade by the flora of the Americas to the Europeanmedicine of the sixteenth century. It would be necessary fora new world to be discovered for it to be possible for thecurrent one to receive so great an input of unknown elementsas on that occasion” 1 .Within medical practice, some characters specialized inperforming bloodletting, others in carrying out surgicalprocedures (such as suturing wounds, draining abscesses,reducing dislocations, setting broken bones, applyingsplints and bandages, and making burr holes in skulls),procedures which were frequently carried out under theinfluence of hallucinogenic drugs (Figure 3), well identifiedby the Indians, to mitigate the pain. In the area of obstetricsthere was an adequate care of pregnancy, external versionsbeing carried out and, when necessary, termination 1, 2 .For the diverse Meso-American cultures, disease wasthe consequence of the punishment or revenge of the gods,or else of some natural phenomena (comets, eclipses). Forthat reason, the treatment of patients involved offerings tothe gods, human sacrifices, and invocations to the stars 3 .In that period, skin diseases were already known and treated. Among the Mexica orAztec gods was Xipe-Totec, “Our skinned lord,” the deity of medicine, the issue of Tzapotlán,god of spring, of flowers and of skin ailments, whose vengeance was to send mendiseases such as the “evil eye,” scabies and gumboils 4 .In the Nahuatl language the skin was called Euatl or Ehuatl, from the root yotl whichmeans “life” (Cruz-Badiano codex). In Mayan the name given to skin was box, kukultik,k’ewel and sol. Box was the bark or hard shell of some fruit such as the calabash. Kukultikwas human skin, k´ewel was animal skin or leather, tanned or for tanning, sol was thescab or crust of an ulceration or scabies, the skin of a skin or lizard, fish scales and treebark 5 .In the Matritensis and Florentine codices, the scholar Alfredo López Austin finds thenames given in Nahuatl to the diverse parts of the skin (Table 1).Table 1. Names in Nahuatl for the various areas of the skin according to the Matritensis and Florentine codicesTehuayoTopanehuayoItic paniehuayoCuaehuatlIxehuatlQuechehuayoMaehuatlCemixtli MapilliOur skinOur surface skinSubcutaneous tissue nextto the skinSkin with hairSkin of the faceSkin of the neckSkin of the arm and handSkin on the palm side ofthe fingersCuitlapanehuayoItiehuatlQuezehuatlTzintamalehuayoTepulehuayotlXipinehuatlTlancuaehuatlMetzehuatlCotzehuatlXocpalehuatlSkin of the backSkin of the abdomenSkin of the hipsSkin of the buttocksSkin of the penisCuticle of the foreskinSkin of the kneeSkin of the legSkin of the calfSkin of the footTezcatlipoca, the god that created the sky and the Earth, the adversary of Quetzalcóatl,the deity of medicine, who was venerated in Texcoco, punished the lascivious bysending them venereal diseases. Among the minor deities related to the skin wasNanahuatl, the god of lepers. The Aztec, with their overriding need to care for their war258