History of Latin American Dermatology

ADAME, ARIAS, ARENAS, CAMPOS, NEUMANN, ORTIZ, RUIZ MALDONADO, SAÚLFigure 5. Façade ofthe church next tothe second Hospital ofSt. LazarusFigure 6. Conditionleprosy patients foundthemselves in at theHospital of St. Lazarusnative population. Of course, Dermatology did not exist as such, because, as is wellknown, the latter was born in Britain and France in the late eighteenth century 15 .Two protomédicos arrived with Cortés — Pedro López (1527-1597) “the Elder” andCristóbal de Ojeda — who tended to the numerous victims of the smallpox and typhusepidemics. The former had been born in Duelas, Castille, and at the age of 30 arrived inthe very Noble and Loyal City of Mexico. He was one of the first physicians given the degreeof doctor by the Royal and Pontifical University of Mexico; he was a great benefactorand founded two hospitals, that of the Destitute — which in time was to become theWomen’s Hospital — and the second St. Lazarus Hospital for leprosy patients. Lópezmaintained these hospitals out of his own pocket and after his death, in 1597, his descendantscontinued his work.This second hospital of St. Lazarus lasted three centuries (1572-1862). It was built onthe shores of the Lake of Texcoco, in a locality known as Las Atarazanas, the arsenalwhere Cortés kept his thirteen brigs after the conquest of the city. It isn’t clear if this sitewas on the street of Ixtapalapa — today Pino Suárez — or along the path of LaMerced, in the city’s east, in the neighborhoodthat for that reason received thename of San Lázaro. This hospital had alengthy life and was demolished when ithad regrettably fallen into ruin, only theconnected church, devoted to St. Roque,remaining standing, but later also torn15, 16down on the altar of modernity(Figure 5). The patients were transferredto the St. Paul Hospital, called Juárez Hospitalas of 1872. This institution underwenta troubled existence; run by the order of St. John, it always suffered from alack of medicines and healing materials, and patients sent there vegetated underdeplorable conditions (Figure 6). The authorities never showed an interest in thishospital, which died gradually, like the patients living there. It was headed by majorphysicians, like Dr. Ladislao de la Pascua (Figure 7) (1833 to 1842), during whose tenure205 patients were admitted. De la Pascua was the first to draw attention to the diseasegiven the name of “spotted” form, now known as Lucio-Latapi diffuse lepromatous leprosy;he also published the first article on leprosy in the journal of the Philoiatric Society.From 1843 and until its demolition in 1862, the hospital was headed by Dr. RafaelLucio, who completed Dr. De la Pascua’s observations on the spotted form of leprosy.The first hospitalsFigure 7. Dr. Ladislaode la Pascua(1815-1891)The Spain that conquered America was still imbued with a medieval spirit, with a socialproject grounded in the spirit of the Crusades and meager development in the areaof health. The major epidemics that ravaged the Old World necessitated the constructionof hospital centers, the operation of which hewed more closely to that of shelters for thepoor and destitute than to that of medical clinics; the hospital was an act of charity, orientedmore closely to accompanying the patient spiritually than to attempting to mitigatehis ailments 11 .Evangelization ran in tandem with military conquest and monasteries were builtwhich, following the medieval practice, also operated as dispensaries and infirmaries; forthis reason, it may be stated that the number of these centers was large toward the endof the sixteenth century, a period in which major epidemics spread throughout Meso-America, with a high degree of mortality among the Indian peoples.This is the medicine that reached the “New World” from the “Old” and this was the262