Commentary

THE STATUS OF THE HISTORY OF DERMATOLOGY: AN AMERICAN APPRAISAL •

LAWRENCE CHARLES PARISH, M.D.

The history of specialized fields of medicine has achieved new prominence in the last decade. With the increasing fractionation of medicine into numerous divisions, many groups have begun to take stock of their heritage, possibly in part due to the reawakening of historical interest for the nation's Bicentennial. Recent publications of books on the development of ophthalmology,^ psychiatry,2 and anesthesia^ attest to this upsurge in interest. Dermatology has not been neglected. At the 1975 American Association for the History of Medicine Meeting, the first seminar devoted to a specialty was developed around dermatology.^ Although the concensus was that surgically oriented physicians were far more historically minded, dermatologists were not far behind in their interest in developing their own historical records. Background

Since the earliest days of dermatology and the second half of the 19th century, dermatologists have been aware of their heritage. Our founders, Louis A. Duhring5 and James C. White,'^ prepared lengthy accounts of the development of our knowledge of cutaneous medicine before the 187O's. A half century later. Address for reprints: Lawrence Cbarles Parisb, M.D., Department of Dermatology, University of Pennsylvania School of Medicine, Pbiladelpbia, PA 19104.

From the Department oi Dermatology, University of Pennsylvania School of Medicine, and the Committee on the Fiistory of Dermatology of the American Academy of Dermatology '- ' National Program for Dermatology • -: Philadelphia, Pennsylvania

such distinguished practitioners as William Allen Pusey' and B. Barker Beeson* again called attention to the extensive heritage of dermatologists. Later, Paul Bechet collected an extensive library of books, letters, and mementos relating to dermatology, as did Herman Goodman.' Walter B. Shelley and John Crissey researched the first dermatologic descriptions of various diseases for their book that has become a classic. Classics in Clinical Dermatology.^^ By the early 195O's, Samuel J. Zakon, the first historian to the American Academy of Dermatology, had begun conducting annual symposia on the history of the specialty. Samuel X. Radbill, a Philadelphia pediatrician, had the distinction of giving the first lectures on the history of dermatology at the Graduate School of the University of Pennsylvania,'^ just as Paul Bechet had done in the early 194O's at the New York Skin and Cancer Unit. American Academy of Dermatology When I became historian to the American Academy of Dermatology in the present decade, I began to assess our

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Table 1, Questionnaire on the History of Dermatology Questions submitted to 93 cbiefs of dermatology departments*

1, Interested in Syllabus? 2, Interested in departmental presentation of tbe history of dermatology? 3, Resident interest in prize essay?

Yes No Maybe 73 4 0

62 13

2

26 32

19

* 77 replied.

current status. If we were to move forward with the historiography of dermatology, we needed to know what had been accomplished. As the first major thrust for this program in the history of dermatology, a bilaliography of the history of our specialty was instituted. Thus far, the Bibliography of Secondary Sources on the History of Dermatology is completed through Part III: Part I being the journal articles through 1972,^2 Part II being biographical information,i'1-* and Part lips being books and chapters all through the same period. Only ophthalmology is known to have had a similar program.1'' The usefulness of this bibliography has become increasingly apparent, and such a project is recommended for each specialty. The next approach was the formation of a Task Force on the History of Dermatology, under the auspices of the National Program for Dermatology. Since 1973, this group, now known as the Committee on the History of Dermatology of the American Academy of Dermatology's National Program for Dermatology has achieved several goals. The Committee began by surveying the various departments of dermatology of medical schools to ascertain their interests in history. As shown in Table 1,

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93 department chiefs were queried in 1974 as to: (1) their interest in a proposed syllabus on the history of dermatology, (2) departmental presentations on the history of dermatology, and (3) resident interest in a history of dermatology prize. Of these, 77 responded, most in a positive manner. Therefore, the Committe has moved ahead under the direction of John Crissey to prepare a syllabus. The purpose of this short manual will be to provide basic information to practitioners and residents of dermatology concerning the development of our specialty. When this syllabus becomes available, the Committee plans to approach the American Board of Dermatology about the possibility of including history in the examination. As shown in Table 2, we have surveyed the 20 American specialty boards. Presently, only the examinations for neurological surgery and plastic surgery include questions on the history of the specialties. Although we recognize crowding of subjects in the undergraduate medical school and in the postgraduate training programs, we also beTable 2, Questionnaire and Results on the History of Medicine Submitted to Medical Specialty Boards Questions submitted to 20 specialty boards 1, Are tbere any questions on the history of your specialty included in your exam? 2, Are there any requirements for the study of the history of your specialty? 3, If so, is tbere a course given or a syllabus available? 4, Is there interest in tbe developing such a course or syllabus?*

Yes

No

3

17

20 20 20

* Tbe three specialties interested in history are Neurological Surgery, Surgery, and Plastic Surgery.

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DERMATOLOCY HISTORY • Parish

lieve that the American Board of Dermatology candidate should have a basic understanding of the background of dermatology. The Committee has also undertaken the organization of the History of Dermatology Club. This group of approximately 60 people meets at the time of the American Academy of Dermatology sessions. The program offers an informal forum for an exchange of ideas on the development of the specialty. Following an annual address by a dermatologist of note, the members have an opportunity to relate anecdotes on our specialty, thus providing an added dimension to the history of dermatology (Table 3). The Committee has been instrumental in the enlargement of the American Academy of Dermatology Collection at the College of Physicians of Philadelphia. We have a collection of portraits of over 2500 dermatologists; this represents the largest group of Bachrach portrait in the world and was donated to the Collection by Miles Laboratories in 1973. The Collection itself has already begun to grow and contains, for example (1) an extensive reprint collection which formed the basis of a major textbook on dermatology, (2) memorabilia and letters collected by Paul Bechet, and (3) department files. In the Mutter Museum, the American Academy of Dermatology Collection contains projection slides, instruments, and patch testing equipment of the earlier years of our specialty. Larger collections may exist at Hopital St. Louis in Paris and older ones at the Royal College of Physicians in London; their respective dermatology societies have been collecting historical items for a lengthy period of time, but we believe we are developing a working panorama of dermatology, in depth.'^

Table 3.

353 History of Dermatology Club

Annual Meetings Marion B. Sulzberger, M.D., presented "My Dermatologic Training in Switzerland in the 192O's and 193O's" on December 4, 1973, at the Wrigley Building Restaurant, Chicago. Samuel J. Zakon, M.D., presented "Reminiscences of the Viennese School of Dermatology" on December 10, 1974 at the Wrigley Building Restaurant, Chicago. Donald M. Pillsbury, M.D., presented "Reflections" on December 6, 1975, at the Blue Fox Restaurant, San Francisco.

Recommendations

In conclusion, the Committee on the History of Dermatology has recommended that subsequent to the development of a syllabus on the history of dermatology, we begin work on a textbook. Currently, the only major English source is the Pusey book of 1933.^ We recommend the continuation of symposia in the history of dermatology both at the American Academy of Dermatology meetings and at regional meetings. We also believe that it is important for the various publications in dermatology to include historical material, both overtly and covertly. References 1. Albert, D. M., and Scheie, H. G., A History of Ophthalmology at the University of Pennsylvania. Springfield, Charles C Thomas, 1965. 2. Ackerknecht, E. H., A Short History of Psychiatry. London, Hafner, 1968. 3. Faulconer, A., and Keys, E., Foundation of Anesthesiology. Springfield, Charles C Thomas, 1965. 4. Parish, L. C, History of Dermatology Seminar. Presented at the American Association for the History of Medicine meeting, Philadelphia, May, 1975. 5. Duhring, L. A., The rise of American dermatology. Trans. Am. Dermatol. Assn. 1881, pp 3-39. 6. White, J. C, Modern dermatology. Am. J. Med. Sci. new series 61:466, 1871.

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7. Pusey, W. A., Tbe History of Dermatology. Springfield, Charles C Thomas, 1933. 8. Beeson, B. B., Acarus scabiei: A study of its history. Arch. Dermatol. Syphilol. 16:294, 1927. 9. Coodman, H., Notable Contributors to the Knowledge of Dermatology. Nevi' York, Medical Lay Press, 1953. 10. Shelley, W. B., and Crissey, J. T., Classics in Dermatology. Springfield, Charles C Thomas, 1953. 11. Radbill, S. X., Letter to tbe Editor. Bull. Hist. Med. 28:276, 1954. 12. Parish,L. C, et al.. Bibliography of secondary sources on the history of dermatology. Part I. Journal articles in English. Arch. Dermatol. 108:351, 1973. 13. Parisb, L. C, et al.. Bibliography of secondary sources on the history of dermatology. Part II. Obituaries and biographies in English

14.

15.

16.

17.

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journals before 1973. A through L. Arch. Dermatol. 111:1036, 1975. Parish, L. C, et al.. Bibliography of secondary sources on the history of dermatology. Part II. Obituaries and biographies in English journals before 1973. M through Z. Arch. Dermatol. 111:1188, 1975. Parish, L. C, et al.. Bibliography of secondary sources on the history of dermatology. Part III. Books, monographs, and chapters in English prior to 1975. Int. J. Dermatol. 15: 206, 1975. Snyder, C, A bibliography of the history of ophthalmology. Arch. Ophthalmol. 63:330, 1960. 66:744, 1961. 71:267, 1964. 74:579, 1965. Parish, L. C, and Holloway, L. M., Dermatology collection at the American Academy of Dermatology. Arch. Dermatol. 106:473, 1972.

Dermatophytosis The first pithead baths in Wales were installed at North Celynen Colliery in 1932. Where pithead baths are used, tinea pedis (athletes foot) can be accepted as an industrial accident since the commissioner in 1949 (Commissioners decision 1949) upheld the decision of a local appeal tribunal in favour of a claimant. He said, "there is a strong inference that the disease was caused by the 'bacilli' (sic) of epidermophytosis which are present at the pithead baths." In fact the fungi Trichopbyton interdigitale and T. rubrum are more commonly found (English 1957). The commission's decision has been supported in practice by Gentles and Holmes (1957) in Britain, who found 31% of miners using the baths to be infected with tinea pedis compared with 8% of those who did not.—Hodgson, G. A.: "Tbe History of Coal Miners' Skin Diseases." In Wales and Medicine. Edited by Cule, J., Llandysul, Wales, Tbe British Society for tbe History of Medicine, 1975.

The status of the history of dermatology: an American appraisal.

Commentary THE STATUS OF THE HISTORY OF DERMATOLOGY: AN AMERICAN APPRAISAL • LAWRENCE CHARLES PARISH, M.D. The history of specialized fields of med...
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