History of Latin American Dermatology

Notes on the History of Dermatology in Paraguayof the Crown, the treaties between the Spanish and Portuguese Courts over territorialdefinitions, the presence of the Jesuits in the reservations (reducciones) of Paraguay, Argentinaand Brazil, which lasted two hundred years, until their expulsion by King CharlesIII, toward the middle of the eighteenth century.All these events, constituted a social framework where institutions dedicated to healthwere gradually set up, improvised and rudimentary at first, with occasional practitionerswho performed the roles of doctors and the like, without academic training but constitutinga last refuge for some mitigation of illnesses, light or severe.Of the work by Dr. Guillermo Vidal found in the Annals of the University of MedicalSciences, we extract the following:With the conquistadors, the first European physicians arrived in Paraguay. This happenedin the sixteenth century. In the deeds (capitulaciones) that the Governors (Adelantados)established with the King there was usually a clause by which theycommitted themselves to take along doctors and surgeons, apothecaries andmedicine, with which they would take care of the sick free of charge during the seavoyage or in the conquered lands. At first it was the surgeons who went. And not certifiedones, but simple barbers for whom bloodletting was as customary a task asshaving, pulling teeth or applying suction cups. Later, in the last stages of the sixteenthcentury, graduate medical surgeons began to practice, but these were a minority.The River Plate, which in spite of its name (meaning River of Silver) had nosilver or anything of the like, offered little attraction to doctors in Medicine andSurgery. What we now call dysentery, smallpox, malaria and avitaminosis, whichwere probably the most common medical ailments of the time, were mostly treatedwith purgatives, bloodlettings and cupping glasses. Their habitual work consisted inputting splints on broken bones, reducing dislocations, draining abscesses, cauterizingwounds and amputating gangrenous members. Their preferred remedies werethe purge and bloodletting, true universal catholicons. They also recurred on occasionto unicorn dust, to the miraculous bezoar or to the thousand and one potions,never lacking in wine and oil, put into vogue in the medicine of the Renaissance.[...]Together with these artisans, many diseases also came to the Americas. In the sixteenth,seventeenth and eighteenth centuries, Paraguay suffered devastating epidemicsof smallpox, measles and other imported infections that destroyed entirepopulations. The Indians, less immunized than the Europeans, died by the thousands.After the creative drive of the conquest, Paraguay fell into a centuries-long lethargy.Bad governments, successive and uninterrupted colonizing migrations, and geographicfate brought the promising upswing of its first years to nought.The presence of healers who handled vegetable products must be pointed out. Thereligious exaltation that reigned during the Colony also caused Medicine to be somewhatdespised 8 .González Torres and Guillermo Vidal agree on placing the creation of the Hospital forSpaniards and Natives in the year 1541, since on that date Asunción was constituted asa city. A Royal Certificate ordered the Viceroys, Assemblies and Governors, to set up hospitalsin the settlements of Spaniards and natives. During the colonial period two hospitalswere built in Asunción. The first, Saint Bartholomew’s Hospital, was erected in 1603by the Franciscan bishop Friar Martín Ignacio de Loyola. The second was founded andorganized by the Paraguayan physician Dr. José Dávalos y Peralta, who had studiedmedicine in the University of St. Mark, in Lima. Around 1695 he founded the hospital,where he worked until his death in 1731 9 .Around the year 1760, another hospital was built on the land later called Potrero, onthe banks of the Garden Brook, by decision of the Court, which was tenaciously opposed295