History of Latin American Dermatology

History of Dermatology in PeruDermatology during the Conquest and the ViceroyaltyThe medicine that the Spaniards introduced to the New World was the medicine dominatedby the Scholastic Theology of the Middle Ages and the philosophical concepts ofAristotle, says Unanue 4 . Sixteenth-century Spanish universities were subjected to the religiousintolerance of the Inquisition. Renaissance ideas in general, such as those ofVesalius, who revolutionized Anatomy with the dissection of corpses, met with much resistance.The conquest of the Inca Empire can be dated to the year 1526 with the signature ofa document by Francisco Pizarro, Diego de Almagro and the priest Hernando de Luqueto conquer a fabulous land, beyond the coasts of the Southern Sea, which they called“Biru.” In 1531, on their third and last trip to the South, the conquistadors had to halt atthe peaceful Las Esmeraldas bay, in Coaque (Ecuador). “An unknown and dreadful diseasecalled berrugas” attacked a large number of them, causing consternation and discouragement.The “Inca” Garcilaso narrates that a “strange, abominable” diseasesuddenly appeared, which consisted of a multitude of warts that sprouted on the skin ofthe entire body; many of them grew disproportionately and looked like “figs,” and bled alot, affecting the face, since many “hung from the forehead, others from the eyebrows,others from the tip of the nose, from the beards and ears.” Many men were affected bythe epidemic, with large bleeding warts like “eggs,” and others with symptoms of intoxication,delirium and paralysis. Since this disease was new to the Spaniards, accordingto Gómara, “they knew not what to do” 3-6 .This torture of the Spanish lasted seven months. Many succumbed under the effects ofthis strange ailment, which started off suddenly, since they “went to bed healthy and wokeup very sick.” This was one of the first systemic dermatological diseases, which was masterfullydescribed in its eruptive phase by the Spanish chronicler Miguel de Estete. Thiswriter states that “the village of Coaque is the most diseased coast under the heavens” 3 .The Spaniards attached no importance to the medical knowledge of the Inca. Garcilasode la Vega, in his General History of Peru, relates that the Inca Atahualpa becameill while being held prisoner; according to Father Blas Valera “in prison, the Inca felt noremaining hope in life, with a great melancholy due to his being in chains and alone; thatthey did not let any Indians into where he was, but for a nephew of his, a young boy whoserved him. The Spaniards then took him out of prison and called up the more importantIndians, who brought in large collections of herbs that cured him, and who, in order tocertify his high temperature, took his pulse from the nose, between his eyebrows, thatthey gave him a herbal drink of great virtue. He calls one of them payco, and names noother. He says the drink made him sweat profusely and fall asleep deeply for a long time,so that when he woke up the high temperature was gone; and that they concocted anothermedicament, and that in a few days he came to, and that he was subsequentlytaken back to prison” 3-6 .As soon as Lima was founded, in 1535, the need was felt to have hospital centers forthe numerous Spanish and Indian patients. On March 16, 1538, the first hospital wasbuilt at the Rinconada of Santo Domingo and the Camilas house of lay sisters opened forwomen who had the “chancre” ailment. Toward 1549, the construction of the St. AnaHospital began, according to Córdova and Urrutia a hospital for the “healing of the miserableIndians who died like beasts on the fields and on the streets”; they died mainly ofinfectious diseases. In 1556, St. Andrew’s Hospital was founded for Spanish patients 3 .By Royal Order dated 1501, African slaves were introduced in the Americas. Thosewho traveled through Panama brought many diseases, such as smallpox, leprosy,measles and tabardillo; they lived among corruption and diseases 3 .Leprosy infected the American soil, and it was therefore deemed necessary in 1546,following the initiative of Antón Sánchez, to found a hospital. This hospital was called St.307