History of Latin American Dermatology

ADAME, ARIAS, ARENAS, CAMPOS, NEUMANN, ORTIZ, RUIZ MALDONADO, SAÚL■ Colonial periodMedicineNew Spain was launched in 1521 with the conquest of Tenochtitlán, capital of theAztec Empire, and ended officially in 1821 when Don Agustín de Iturbide declared thecountry independent of the Spanish crown 10 . Before the arrival of the Spaniards the conceptof “country” did not exist; what is today Mexico was inhabited by diverse ethnicgroups distributed over a vast territory from the United States to South America, whohad different cultures and languages and carried out continuous wars for supremacy. OnAugust 13, 1521, Hernán Cortés and a group of his soldiers, with the support of thirteenbrigs, seized the lake city of Tenochtitlán, destroying it stone by stone and filling thecanals with hundreds of bodies that rendered it uninhabitable for a lengthy period. Thisforced the Spaniards to take refuge in nearby Coyoacán. Twenty years later the new citybegan to be erected following the layout of European cities and employing the stones ofthe Aztec temples. The city was to become the capital of the Kingdom of New Spain, whilethe Spaniards extended their adventure northwards to California and Texas. Theybrought their culture, their language and their religion, but also brought diseases suchas smallpox and measles and took others with them, like syphilis 10 . Thus, less than 50years after the arrival of the conquerors, the Indian population had shrunk from 25 to 3million, due both to those epidemics and to the wars and the mistreatment suffered.A large part of the Spaniards, when observing the strange rituals which accompaniedmedical treatment, only saw magic and superstition in them, the medicine of primitivepeoples and the absence of any positive knowledge. They were incapable of appreciatingthe value of their experience, the wealth of their pharmacology and of their attempts atclassification, the marvelous intuition of peoples who did not receive influences fromother races or civilizations and that had to create their own, slowly and in isolation,trusting only in centuries of testing and the confirmation of their ideas. In order to imposethe Christian religion and root out the natives’ heresy, the conqueror destroyedtheir temples, tore down their idols and even reached the point of burning their codices,with which he mutilated their history. A major part of what the Indian race had patientlyaccumulated over the centuries was thus lost 1 .No sooner were they established in New Spain than the Spaniards instituted the Protomedicatoinspection system, an institution in charge of controlling proper medicalpractice and the appropriate operation of apothecaries. The need to create educationalcenters for the training of the inhabitants of the conquered lands caused the creation byRoyal Act, on September 21, 1551, of the Royal and Pontifical University of Mexico, whichbegan operating two years later. That same year (1553) the first physicians to arrive inthe country began to be admitted, among them Dr. Pedro López. Simultaneously, the lackof doctors led to the inclusion of medical studies in academic syllabuses. Medical programs,similarly to those employed in European universities, were constituted by foursubjects: “Medical matins,” “Medical vespers,” “Anatomy and surgery” and “Method andpractice of medicine,” using as basic principles the concepts set forth by Hippocrates andGalen. It must be admitted that, as Ignacio Chávez states, it was in the fifteenth and sixteenthcenturies — the golden centuries of Spanish medicine — that the world’s sevenoldest and best universities were created, under the Arab influence of Avicenna, and itis in this same period that the university was also born in New Spain.In 1535, in Tlatelolco, the Franciscans founded the convent of the Apostle James andthe School of Santa Cruz de Tlatelolco; the De la Cruz-Badiano Codex, the oldest medicalcode in the Americas, which reaffirms the main therapeutic systems of Indian herbalmedicine, was written there around 1552 (Figure 4). The Indian savant Martín de laCruz, a native of Xochimilco, wrote the Libellus de Medicinalibus Indorum Herbis, a very260