History of Latin American Dermatology

Dermatology — art and cultureMany natural peoples have disappeared owing to epidemics triggered by the clashwith another civilization, famines, emigration and transculturation*.In our country, the Mataco inhabited the territory of the Chaco, where some groups stillsurvive. Their witch-doctors employed suction of the diseased area and pretended to vomitout stones, thorns, insects, arrowheads hidden in their mouths. They meanwhile engagedin song and dance. Among herbs they employed the Yetabay or Jalapa (bindweed); thejuice obtained from its flowers was prescribed for herpetic ailments and other dermatoses.The Guaraní, part of the Tupi Guaraní group, inhabited the islands on the ParanáRiver and their habitat extended as far as the Amazon. They employed the Ita oyster, abivalve shell which, in powdered or ground form, was sprinkled on wounds or abscessesto speed up healing.The skin of the raven (urubu) was applied to wounds. For venereal ailments they hadthe resin of the copaiba (Copaifera officinalis or Jesuit’s balsam); zarzaparrilla (Zarzaparrillasmilaxsifilitica), as a concoction or macerated in wine, which has the propertyof stimulating perspiration, was also used against scabies.For the same purpose they also employed zarza blanca (Byttneria or Punttneria cartagenesis)while sage (Salvia officinalis) was indicated for the re-epitalization of ulcers. Theemployment of annatto or urucú (Bixia orellana) was very interesting; the seeds of thistree contain two coloring matters: one of them yellow, called orellina, the other cinnabarred, called bixina. The latter, which is insoluble in water, was applied by the Indians onthe skin in combination with fats, resins and waxes to repel insects and temper the effectof ultraviolet rays. Urucuization was resistant to baths and perspiration.In the pre-Columbian period, tobacco (Nicotiana tabacum) was employed againstscabiosis, erysipelas and bites.The Mocoví lived from the Bermejo River and the borders of Tucumán down to SantaFe. They used cebil – belonging to the Mimosa family – as a paste for the mutilating lesionsof leprosy.Inhabiting the area between southern Mendoza, Santa Fe, San Luis, Córdoba andnorthwestern Buenos Aires were the Pampa, who employed the yang to treat aphthas inthe mouth 13 .The pre-technical forms of medicine have bequeathed us some practices which wereincorporated into folk medicine.Empiricism (that is to say, resorting to a medicine or practice because it has been beneficialin similar cases) and magic came together in the employment of some drugs whichhave passed from the primitive or natural world to the “civilized” one. Examples of thisare quinia, opium and belladonna, among others 11 .The method employed by the medicine men to promote healing is suggestion 14 . Theshaman occupies an outstanding position in the social sphere; he is respected by his ethnicgroup, which believes him to know the mystery of life and death and to possess thecapacity to heal and, at will, to cause an illness.Medicine is art (tekne) when the person exercising it knows rationally what the diseaseis and what is the remedy that is employed in each case. This double knowledgerefers to the likewise rational knowledge of the “nature” of the disease and of the cure.The change in paradigm is due to the genius of Greek physicians, expressed in a textby Alcmaeon of Croton towards the year 500 B.C. 11 .Following the discovery of America there arrived European physicians who took upresidence in the major population centers and proved insufficient to meet the needs ofthe inhabitants, who often turned to medicine men.* Transculturation: process of dissemination or influence of cultural features of a society, when it comes into contactwith another that is considerably less developed.51