History of Latin American Dermatology

Notes on the History of Dermatology in ParaguayFrom the thorough analysis carried out by researcher Luis T. González on the causesand consequences of Paraguay’s (Figure 1) lack of access to the sea — a situation derivedfrom many mistaken decisions by those in office and elements outside Spanish officialdom— we highlight the following:The gigantic province of the Indies begins its decadence withits first territorial mutilations. Paraguay suffered four seriousdismemberments. Due to this, not only did it lose vast territorialareas, but it also suffered the severance of parts thatwere vital for its existence. The segregation of the Amazonianand Cuyo area, for example, as important as they were fortheir vastness and wealth, did not affect the continuity of thenation. However, the cutting off from the Atlantic seaboardand the southern provinces were cases of true organic upheavalfor the province, with consequences that are still beingsuffered today 3 .The events we will mention below offer a reliable account of the causes that have ledParaguay to its geophysical confinement, if we can call it thus, a situation that has determinedthe fitting expression by the outstanding literary figure of Paraguay, AugustoRoa Bastos: “an island surrounded by land”; this is how he synthesizes the difficulties ofthe anguished course of its endless journey to the horizons of its definitive consecration,from an economic, political, and social point of view.In the extensive and judicious work of architect and historian Jorge Rubiani on thewar of the Triple Alliance we find the following statements:Figure 1. Colonial mapof the borders of theprimitive Province ofParaguayThe disproportionate extension of the Province did not generate any problems as longas its population concentrated within the borders marked by the solitary presence ofAsunción. But as soon as other cities began to emerge, out of the need to cover theterritory and to cut off the obstinate Portuguese presence on its borders, problemsbegan to arise. In 1562, the first dismemberment took place, that of Santa Cruz de laSierra. It was a sly undertaking by Ñuflo de Chávez, blessed with the historic ignoranceof the authorities about the peculiarities of the territories under their rule. Adetail which — to Paraguay’s detriment — would repeat itself a few more times.When King Phillip III signed the unfortunate Royal Certificate on December 16 in1616, the fate of Paraguay was left to the mercy of its southern neighbors. Throughdispositions, providences and rulings of those who haphazardly managed the destinyof the colonies, what was left of the ancient Gigantic Province of the Indies was dividedinto two provinces: that of the River Plate, which kept Buenos Aires, Santa Fe,Corrientes and Concepción del Bermejo for itself, and the new Province of the Guairá,made up of Villa Rica, Ciudad Real and Xerez, to which was annexed, almost surreptitiously,none other than the city of Asunción. Paraguay was thus left forever enshroudedin the suffocating mediterranean atmosphere. But while that certificate didnot specify geographic divisions, but rather administrative ones, it did not specifyprecise limits either, although it established that the division line between the twoprovinces were the “Bermejo River and the central Paraná.” This was not to be, however,the last blow to affect the territorial integrity of the Province. Through theTreaty of Madrid, signed in Portugal more than a century later, Spain abandoned theterritories which it had already lost in reality: the ones that had remained under theprotection of the demarcation established by the Treaty of Tordesillas in 1594. Thenew treaty concedes to Portugal not only large parts of Paraguay (…), but also seventowns of the Jesuit Missions 4 .287