Historical Atlas of Dermatology and Dermatologists

Abstract

Dermatology remains a mystery to many doctors, and will do so increasingly as its toehold in the medical curriculum is eroded (in some medical schools it no longer features at all in the undergraduate curriculum). The history of the specialty, which began to develop as a distinct entity in the nineteenth century, is a fascinating subject. Skin disorders that we now regard as trivial—impetigo, head lice, scabies—were common and untreatable. Syphilis, with its protean cutaneous manifestations, was rampant and incurable. Simple bacterial infections of the skin could lead to septicaemia and death. The early descriptive dermatologists were remarkable clinical observers. Jonathan Hutchinson, for example, was the first person to describe sarcoidosis, lentigo maligna melanoma, melanoma of the nail bed, Peutz-Jegher syndrome (and its association with intussusception of the bowel), arsenical keratosis, Hutchinson's teeth (in congenital syphilis); the list is far from complete. Few doctors confined their interests to the skin alone; Erasmus Wilson, regarded by many as the leading dermatologist of his era, found time to bring Cleopatra's needle to London and amass a fortune on the stock exchange. The illustrations and clinical descriptions produced put many of our present-day efforts to shame. The changes that have occurred in therapy are also remarkable: much of the early therapeutic use of X ray was in the treatment of benign dermatological disorders (it continued to be widely used for childhood ringworm until 1958). Dr Crissey and his coauthors, all distinguished dermatologists and collectors of ‘dermatological memorabilia’, have produced a book containing a remarkable collection of illustrations, of dermatologists, of their original papers, of their clinical cases, and related material. They have interlaced this with descriptions of their subjects, and the significance of their work. There is much to fascinate and enchant any dermatologist with any sense of history. The advertisement for do-it-yourself X-ray equipment and the illustration of the first picture of the scabies mite are just two examples among many. The text likewise has plenty to capture the imagination: Kaposi (of the eponymous vascular tumour) changed his name from Cohen, because he thought that it would help his career if he sounded less Jewish. This is not a history of dermatology, and should not be bought by anyone expecting it to be so. There is no theme of progression from one topic to the next, and much is omitted (for example, there is no mention of penicillin). The work might best be described as a scrapbook assembled by three enthusiasts for their subject, whose love of dermatology shines through the pages. As such it is enormous fun, and would make a perfect Christmas or birthday present for your favourite dermatologist.