History of Latin American Dermatology

History of Dermatology in Perutrue ideograms, the portrait-jar anthropomorphic pottery pieces of pre-Incaic culturesprovide us very fine and realistic portrayals not only of the external manifestations of thevarious dermatological pathologies, but also of other specialized medical fields such asobstetrics, traumatology, surgery, oncology and teratology; and they also present representationsof sexual activity as well as their knowledge of architecture and music, theirmagical and religious beliefs, their expressions of happiness, pain, and concern.DERMATOLOGICAL DISEASES IN THE INCA ERAThe Inca (or Tahuantinsuyo) Empire developed from the beginning of the twelfth centuryto the arrival of the Spaniards in 1532. The ancient pre-Incaic cultures had flourishedthrough the years along the coast and the Andean and inter-Andean valleys;according to legend, they were conquered by the Quechua who came from the Collaoplateau near Titicaca Lake.At the time of the Conquest, the Tahuantinsuyo occupied the northern part of presentdayColombia and Ecuador, all of Peru and Bolivia and down to the Bío Bío River in thesouth, in the center of Chile, and the Argentine Tucumán region (Santiago del Estero,Salta, Jujuy and La Rioja provinces). The western boundary was the Pacific Ocean, andthe eastern boundary was the Amazon jungle, inhabited by wild tribes.When the Spanish conquest took place, less than 100 years had elapsed since the IncaEmpire had reached its maximum height. In the mid-fifteenth century, the Inca Tupac Yupanquihad extended the Empire southwards down to the Bío Bío, and in the early sixteenthcentury his successor Huayna Capac had extended it to the kingdom of Quito inpresent-day Ecuador. When the latter Inca died, the Empire was divided between his twosons: the kingdom of Quito was given to Atahuallpa and the kingdom of Cuzco, to Huáscar.This division proved fatal: very soon the brothers engaged in a fierce fratricidal war,in which all the tribes of the Empire participated on one or the other side. A few monthsbefore Huáscar’s defeat, Francisco Pizarro had started the conquest of the Inca Empire;easily and with no major battles, he took Inca Atahuallpa prisoner by surprise in Cajamarca,on November 15, 1532. Pizarro later executed Atahuallpa, and in a few months,with the help of numerous Indian tribes who fought alongside his troops, he conqueredthe city of Cuzco, capital of the Empire.The sacred city of Cuzco, “Center of the World,” was, according to chroniclers, a heavilypopulated and impressive city, a wonder of the world, built with stones assembled ina marvelous way, and connected by many roads to the diverse other cities of the Empire,as far as Quito in the North and Chile in the South. 2The Inca government was despotic but benevolent, with well-defined social classes. TheInca was considered a God, son of the Sun, his relatives ranked below him. He had manyconcubines, and had between 100 and 200 sons, who constituted the nobility. This nobilitymade up the officer corps of the army, occupied high ranks of the religious hierarchy,and included the noble orejones (big-eared ones) and the amautas or sages. The rest of thepopulation, who were the ones who really did all the work, ranked far below them.In the Inca Empire there was no poverty, no beggars, no money, and no starvation.Everyone had work; there was no private property.The medical system of the Inca Empire was well organized. There were differenttypes of doctors for each social class. The Ambicamayo took care exclusively of the Inca’shealth and that of his family and the nobility. The Ccamascas or Soncoyoc had the capabilityto exercise medicine on the average man or runa; the Hampi-camayoc was thephysician in the strict sense of the word. There were also magicians, sorcerers, witchdoctors,and fortune-tellers.The Hacarícuc or Cuyricuc were fortune-tellers who analyzed the entrails of cavies(which they opened up with a fingernail) in order to diagnose the disease. The Calparicuquisaw the future and fate through the examination of llama corpses; they blew into303