History of Latin American Dermatology

JULIO CORREAand tugwihka; in the first, blood flows enough to wet all of the affected area; with the second,blood runs abundantly or gushes out. The first way is usually enough to remedy fatigueand can be repeated often. The second leaves the person ill for one or two weeks,and sometimes the patient must remain bedridden for many days, face down. The partthat is generally affected is the rear, from the back to the buttocks and in some cases, thecalves. Only in case of sickness is it applied where the ailment is, as was done with leechesand scarification suction cups. With scarification a local decongestion is obviously carriedout. With regard to knowing how decongestion can eliminate fatigue, there does not seemto be any explanation other than that with the blood and the lymph, toxins and certainresidues that settle in the muscles subjected to excessive work are also expelled.When admitted into adulthood, the male had to previously subject himself to one ofthe most rigorous treatments, which had to show his resistance to suffering; for this purposehe would be cured quickly but painfully. With each male son’s birth, the fatherwould have another scarification done, more rigorously when it was the first-born. Insome communities — perhaps in all — blood had to be gathered to mark the newbornwith it and in this manner communicate a part of the father’s spirit, since it was consideredthat essentially in the blood lies life and in the heart, the soul. Expiatory scarificationcovered different methods and was of different intensity, depending on the fault toexpiate, the error to purify, the metapsychic danger to avoid or other motives of thisorder. It is worth noting that the scarifications constituted at the same time extensivelyrevulsive and, by being frequent enough, had to influence the conservation of the body’soverall health, even when they were not curative. When scarring is not activated throughartificial means, the revulsive effect becomes more powerful, since in this case thewounds heal more slowly and always with some suppuration. In some regions this seemsto be the most common case, judging by the numerous permanent signs that the inhabitantspresented. But it was known, and still is, how to cure such wounds in a mannerthat leaves almost no scar. Certain substances were applied as disinfectants. For instance,the juice of the fruit of the ñandihpa-guazú or genipapo (Genipa americana) wasfrequently applied as a skin disinfectant with certain illnesses, sometimes to the point ofpainting the whole body with it, a custom that has been preserved. The decoction ofParaih, also known as bitter stick (Picrasma palo-amargo) as well as of othersimarubaceae species (Simaruba, Quassia, Simaba), was often used to disinfect the skinand to protect against the sting of insects and mosquitoes, the first species still being ingeneral use, seemingly being the most active and one that extends as far as southeasternParaguay. Boiled water was also correctly considered as a means to conserve asepsisand was used to disinfect diseased areas; Baron Nordenskiold highly praised itsemployment by the Guaraní.It is worth noting that among the Guaraní the art of healing was practiced by thepayé, an Indian acknowledged by the community, observant, intelligent, who had a therapeuticarsenal at his disposal made up of innumerable jungle plants, of which they knewtheir virtues.According to Moisés Bertoni, the term payé has given place to certain confusion. Itsmeaning is not identical in all countries and doesn’t seem to have been so in antiquity either.It cannot be taken as a synonym for “sorcerer”, because no Guaraní people werefetishistic or used fetishes. The payé is always a physician, but not essentially so; and heemploys, above all, suggestion and magnetism (which is not “healing with words” assome believe, and which is a superstitious custom of European origin): “The tuvichava,erroneously called cacique (Indian chief), is also usually a physician; the kurupaihvoñangaas well, but more so a spiritualist or an evoker of spirits” 6 .Regarding illnesses, certain abscesses deserve our attention. One specially, the boil ormiã, sometimes acquires an epidemic nature and attacks everyone, while the commonnacidos are more frequently experienced by people of the white race and who are not290