History of Latin American Dermatology

MARTHA MINIÑO, RAFAEL ISA ISAFigure 1. Primatecathedral of theAmericas andMonument toChristopherColumbus.First cathedral builtin the New World,where the remainsof AdmiralColumbus restFigure 2. Ruins ofSt. Nicholas of BariHospital.It was the firsthospital of the NewWorld, built in1509Indigenous medicine was empirical and transmitted orally; it was also traditional andsecret. Since no written records of this civilization exist, except those drawn up by Europeans,many facts are unknown.A very scarce flora existed on the island, but its inhabitants knew how to make the mostof it. In the Cohoba ceremony (in which they employed D. stramonium) the bohutí, or sorcerer,could induce a state of lethargic sleep in his patient. Another practice utilized smokeor aspiration of tobacco, also occasionally used by the Spaniards for the effect of stuporthat it provoked and which permitted them to alleviate the pain caused by ulcers 5-8 .Among the first recorded cutaneous pathologies, apart from buboe — painful ulcerativelesions — lesions known as caracaracol were found, which according to the narrations,could well correspond to ringworm or dermatophytosis of the body 5 . Buboe weretreated with an infusion of guayacán or holy wood; legs with circulatory disorders weresubmerged in an infusion of the jobo fruit that refreshed them and increased tension; thefruit of the little manzanillo tree were used for acute gout attacks, as even Columbushimself got to experience 7 .Yagrumo or yoruba in the form of poultices was applied on wounds, or otherwise nodules,excrescences and humors were sucked; other substances used were the bija (ajiacoor saffron) applied in the form of an oily ointment, with which they painted the body andwhich served them as part of their clothing and to drive mosquitoes away; guao leaves,besides being a powerful poison, were also used as whiteners of the facial skin, and thebalsam was applied as an homeostatic for wounds and ulcers. To combat malaria, theywere not unaware of the use of a plant with byproducts of quinia, which is still employedin certain regions of the mountains of our Central Cordillera 8, 9 .■ Dermatology in colonial in colonial times timesDue to the plagues and the vicissitudes of slavery, the Indian populationrapidly diminished in number; this was also the case, but to alesser degree, with the Spaniards, attacked by ailments unknown tothem, such as the first malaria epidemic which did not spare AdmiralColumbus, who suffered three attacks of the disease 2-4 .In 1493, the settlement of La Isabela was built in the north of theisland, in the current province of Puerto Plata, boasting the first colonialconstruction in the New World: fortress, church, roads, town hall,and hospital. The latter was staffed by Master Juan, a surgeon but notphysician. It was there that the first doctor sent and paid by theCatholic Kings began his practice: Dr. Diego Alvarez Chanca 10 who,arriving on Columbus’ second voyage, treated the first malaria epidemic,and also diagnosed some supposed ulcers of the Indian chiefGuacanagarix, equivalent to what we would call a factitial dermatosis2, 4 .In 1495, the first yellow fever epidemic was recorded 11 ; smallpoxepidemics struck the indigenous population as far back as 1494, sothat by 1518 only fifteen thousand Indians remained on the island,according to historian Ulloa Cisneros 2 .In 1502 the city of Santo Domingo was founded, and along with itthe first cathedral (Figure 1) and the first hospital, St. Nicholas ofBari, which possessed some twenty beds and a leprosarium andfound itself “infected with buboe” 2, 3 (Figure 2). Later, in 1511, theSt. Lazarus Hospital was opened, the first leprosarium in the NewWorld (Figures 3 and 4).378