History of Latin American Dermatology

ELBIO FLORES-CEVALLOS, LUIS FLORES-CEVALLOS, ZUÑO BURSTEINthe end of the Protomedicato, which yielded its rights to the new Medical School, createdon September 9, 1856. Merit-based competitions were held in order to fill the posts inthe various chairs and to obtain the best doctors to undertake the reform of Peruvianmedical education. Thereafter, many of the young students who would later fill the chairswere sent to Europe, especially to France. The Dean of the Medical School, CayetanoHeredia, established the new rules, with a modern teaching program, creating newchairs and giving more importance to hospital internships. He founded the Natural HistoryMuseum and a Herbarium with 1,820 plants, as well as a beautiful collection of mineralsand geological species. Heredia surrounded himself with prestigious collaborators,such as José Elboli (Italian), who launched Chemistry studies; Antonio Raimondi (Italian),a great explorer who described Peru physically, and Rafael Benavides, lecturer on MedicalPhysics and Hygiene.In 1851, a new epidemic appeared in Lima: yellow fever. This motivated the creationof a new Hospital to replace the old St. Andrew’s Hospital — a modern health center intune with urban and scientific progress. The new Dos de Mayo Hospital was inauguratedon February 28, 1875, as one of the best in South America, equipped with the latest technologicaladvances of the time.In 1870, during the construction of the railroad of the Central Sierra, there was agreat epidemic of Peruvian wart among the workers, primarily affecting those who camefrom other regions of Peru and from abroad. The sad epilogue of this great work of engineeringwas that each crosstie meant a life lost.In 1879, the war with Chile caused a complete economic, cultural and social halt inPeru. Libraries were ransacked by the invading army, the Dos de Mayo Hospital was occupied,and the Medical School and other institutions stopped operating.Once this war was over, the Dos de Mayo Hospital reopened; here, conferences wereheld and the Oroya fever and the wart were classified as separate issues. In this contextthere appeared Daniel Alcides Carrión, fourth-year medical student, who, imbued in thenew medical and philosophical knowledge of his time, decided to sacrifice himself voluntarily.On 27 August, 1885, he underwent four inoculations — two in each arm — ofthe warty button of an already convalescent patient who was hospitalized in a Dos deMayo ward. Some days later, he developed the symptoms of the disease: violent chills,high fever, cephalalgia gravativa, muscular pain, cramps, insomnia, presenting alterationsof the senses, unrest and delirium. On the first few days, he was lucid, and describedthe symptoms of the disease. He stated in the clinical history: “But now I amfirmly convinced that I am affected by the fever that killed my friend Orihuela. This is thepalpable proof that the Oroya fever and that of the eruptive wart are of the same origin,as I once heard Dr. Alarco assert”. With his sacrifice, Carrión definitively solved the classificationproblem of the Peruvian wart. Before losing consciousness, he left us his eternalmessage: “I have not died yet, dear friends; now it is your turn to finish the workundertaken, following the path I have outlined” 3 .After Carrion’s death, an incessant search by our researchers began, a standoutamong them being Alberto Barton, who in 1905 discovered the germ that caused the Peruvianwart.At the St. Ferdinand Medical School, a new Study Plan was approved in 1887, and, insubsequent years, new chairs were created. In 1903, the current venue of the MedicalSchool was created.Medical literature continued to be very poor during the first years of the Republic. In1884, Pablo Patrón published in the Lima Medical Gazette an essay entitled “Brief Treatiseon Venereal Disease or Gallic Morbidity,” dedicated to the French doctor of the Parisschool, Pablo Petit, the first to introduce to Peru the use of mercurials for the treatmentof this dreadful disease. This French doctor living in Lima severely criticized his colleagues,who still applied treatments based on purges, bloodlettings, enemas, herbs such310