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Pantheon der Dermatologie. Herausragende historische Personlichkeiten

2010; Elsevier BV; Volume: 62; Issue: 4 Linguagem: Inglês

10.1016/j.jaad.2009.07.035

1097-6787

Robert W. Goltz,

Historical Medical Research and Treatments

The Pantheon in Rome survives today as one of the triumphs of Western architecture. It was erected between 120 and 124 AD by the Emperor Hadrian as a temple dedicated to the multiple gods of Rome. An eighteenth century depiction of it, in masterful perspective, by Giovanni Paolo Panini, now in the National Gallery of Art in Washington, DC graces the cover of this unique tribute to the “deities” of dermatology. It is fittingly entitled Pantheon der Dermatologie.Here, in alphabetical order, are biographies and commentaries on more than 200 now-deceased outstanding personalities of dermatology. Covering more than 600 years, entries range from that about Girolamo Fracastro (1483-1553)—who applied to the Great Pox that was then ravaging Europe and New Word the name syphilis (taken from a poem by Ovid about a shepherd named Syphilus)—to Sister Mary Joseph (1856-1939) and the only recently deceased physician-scientist Aaron Bunsen Lerner (1920-2007). Each of the essays has been composed by selected authors or coauthors who cover in detail the salient features of the life and work of each pioneer. Most entries are accompanied by portraits of the subject. Notable are the numerous reproductions in color of original depictions of other skin disorders. There are more than 1800 illustrations, many of them gathered from international libraries and private collections. Rare and original documents are displayed.No review can hope to comment on each and every one of the splendid entries. A sampling of just a few of special interest—at least to me—will have to suffice.Who of us in this age of digital photography, advanced light and electron microscopy, and computer-enhanced imaging appreciates the essential contribution of art to the original depiction and dissemination of knowledge about skin disorders? Not surprisingly, many of our forbearers were accomplished artists in their own right.An example was Anton Elfinger (1821-1862). Elfinger was born in Vienna. At the age of 15, he enrolled in the Academy of Fine Arts where he became an accomplished watercolorist. He began medical studies in 1839. Perhaps partly because of his artistic skills, he was appointed Assistant Physician in Von Hebra's department at the University of Vienna and the Allgemeines Krankenhaus. Stella Fatovic-Ferencic, author of this biography, states that: “Without the great artistic contributions of Hebra's coworkers, Elfinger and Heitzmann, Hebra's epoch-making Pictorial Atlas of Dermatology would not have come to be.”Elfinger was a skilled moulageur under the pseudonyms of Cajetan or Cjt, and he also became a well-known caricaturist of his era. The bloody revolution of 1848 ended that! Thereafter, he confined himself to medical and scientific works of art.A notable successor to Elfinger at Vienna was Carl Heitzmann (1836-1896). Born in what is now Croatia, Heitzmann studied medicine at the University of Vienna. He was as renowned a medical artist as a physician. He contributed watercolors not only to Hebra's Atlas der Hautkrankeiten but also that of Von Baerensprung and an atlas of dental pathology. His English language Microscopical Morphology of the Animal Body in Health and Disease was published in New York in 1883.Heitzmann is also recognized as a father of hematology. He outlined and illustrated the stages of development of red blood cells down to the hematoblast. Thus, he was a pioneer in information leading to the increasing therapeutic use of stem cells of the bone marrow.In 1974, Heitzmann immigrated to New York where, with fifteen colleagues, he became one of the founders of the American Dermatological Association.All dermatologists are familiar with the lines of Blaschko, but how many are aware of Alfred Blaschko's (1858-1922) pioneering contributions to the field of public health? His multiple achievements are reviewed by Rudolf Happle, who himself has contributed to the recent reemergence of the importance of the lines and of mosaicism in the causation and localization of congenital skin and bone disorders.Blaschko was the first to recognize that the localization of a number of nevoid skin lesions did not follow nerve distribution but on other influences operative during embryonic development. Later he, with Fischel, reported the case of a 47-year-old patient who developed an inflammatory skin disorder that disappeared after 8 weeks. It too followed the same embryonic lines. Lichen striatus is sometimes referred to as Blashkitis.In the early 1890s, Blaschko instigated an organized boycott at the Charite hospital in Berlin to protest the then barbaric treatment of patients with sexually transmitted diseases. They were treated as morally delinquent, were strictly isolated, and were made to wear special identifying clothing and forbidden to have all visitors, even immediate family members. The breadwinner of a family was often removed from employment and his family driven to deprivation. By this protest, Blaschko established the principle that a hospital's primary duty is to help the sick, not to act as a reformatory, and that it was in the best interests of society that all sick be restored to health and returned to the workforce as expeditiously as possible. Blaschko forcibly brought to the attention of the Prussian authorities, and of the public, the economic consequences and general societal benefits of sensible public health policies.Blaschko was later instrumental in founding the German Society for Combating Venereal Diseases and the establishment of departments of venereology and syphilology in academic centers in Germany and throughout the world.During the 1930s, dermatology in the United Kingdom and America was enormously enriched by the arrival of leading academic dermatologists from Germany, Austria, Hungary, and rest of Eastern Europe. They brought with them renewed emphasis on the vital importance of scientific research for the future progress of the specialty. To the United States came Helen Ohlendorff Curth, Stephen Epstein, Alfred Hollander, Max Jessner, and the great Stephen Rothman.Another was the elderly Felix Pinkus (1868-1947). He had been author of Volume I of Joseph Jadassohn's 1927 monumental 27-volume Handbuch der Haut und Geschlectskrankheiten. The introductory volume consists of a scholarly review of the anatomy and function of the skin as known at the time. It has 336 illustrations, mostly Pinkus' own drawings. An innovation was the inclusion of “serial sections” demonstrating both histologic and histopathologic changes that Pinkus had observed during his lifelong devotion to the meticulous study of the skin of man and other animals.Of special interest was Pinkus' description of the “Haarscheibe,” a protrusion or disc on the side of hair follicles. Here reside pluripotential cells capable of regenerating the follicle and epidermis. The Haarscheibe was later reemphasized in the writings of Felix's son, Hermann (1905-1985). Today, cells of the “bulge” are attracting increasing interest as a convenient source of adult stem cells.In 1970, Felix Pinkus also described a new skin disorder he named lichen nitidus, or “shining lichen.”Because of his Jewish ancestry, Professor Pinkus was forced to leave the Germany of the Nazi era. He fled first to Norway, thence by way of the Trans Siberian Railway to Shanghai and Japan, where he spent the early years of WWII. In 1941, Hermann, now established in Michigan, brought his father to America. He arrived with little more than the clothes on his back, but with a footlocker full of his precious anatomic and histopathologic drawings. Henry Michelson, Chair at the University of Minnesota, arranged for him to come to Minneapolis to spend 6 months teaching dermatopathology to faculty and residents. My close relationship to this kindly, gentlemanly scholar in my formative years was a priceless educational experience. As a neophyte dermatopathologist, I was privileged to have him as my mentor.A valuable inclusion in the appendix to the compendium is a listing of earlier works in several languages on the history of dermatology and dermatologists. Included are those published in America, by Walter Shelley, John Crissey, Lawrence Parrish, Karl Holubar, Peter and Greta Beighton, and William Allen Pusey. Many of these are now out of print, and information about their dates and places of publication will be helpful in finding them again.I enthusiastically recommend this veritable treasure trove (it weighs 2.5 kg) of information about the roots and tendrils of dermatology. It belongs in the collection of any dermatologist who is interested in the origins of our specialty and in libraries of medical centers and all dermatology training programs. At approximately $143, a work of this magnitude so lavishly and beautifully illustrated is surprisingly inexpensive. The text is in German, but for those of us with only limited or no familiarity with that language, a concise biographical summary for each entrant is easily understood. And the marvelous illustrations alone are worth the price of the book.The Pantheon der Dermatologie is a monumental work, not soon—if ever—to be matched! The Pantheon in Rome survives today as one of the triumphs of Western architecture. It was erected between 120 and 124 AD by the Emperor Hadrian as a temple dedicated to the multiple gods of Rome. An eighteenth century depiction of it, in masterful perspective, by Giovanni Paolo Panini, now in the National Gallery of Art in Washington, DC graces the cover of this unique tribute to the “deities” of dermatology. It is fittingly entitled Pantheon der Dermatologie. Here, in alphabetical order, are biographies and commentaries on more than 200 now-deceased outstanding personalities of dermatology. Covering more than 600 years, entries range from that about Girolamo Fracastro (1483-1553)—who applied to the Great Pox that was then ravaging Europe and New Word the name syphilis (taken from a poem by Ovid about a shepherd named Syphilus)—to Sister Mary Joseph (1856-1939) and the only recently deceased physician-scientist Aaron Bunsen Lerner (1920-2007). Each of the essays has been composed by selected authors or coauthors who cover in detail the salient features of the life and work of each pioneer. Most entries are accompanied by portraits of the subject. Notable are the numerous reproductions in color of original depictions of other skin disorders. There are more than 1800 illustrations, many of them gathered from international libraries and private collections. Rare and original documents are displayed. No review can hope to comment on each and every one of the splendid entries. A sampling of just a few of special interest—at least to me—will have to suffice. Who of us in this age of digital photography, advanced light and electron microscopy, and computer-enhanced imaging appreciates the essential contribution of art to the original depiction and dissemination of knowledge about skin disorders? Not surprisingly, many of our forbearers were accomplished artists in their own right. An example was Anton Elfinger (1821-1862). Elfinger was born in Vienna. At the age of 15, he enrolled in the Academy of Fine Arts where he became an accomplished watercolorist. He began medical studies in 1839. Perhaps partly because of his artistic skills, he was appointed Assistant Physician in Von Hebra's department at the University of Vienna and the Allgemeines Krankenhaus. Stella Fatovic-Ferencic, author of this biography, states that: “Without the great artistic contributions of Hebra's coworkers, Elfinger and Heitzmann, Hebra's epoch-making Pictorial Atlas of Dermatology would not have come to be.” Elfinger was a skilled moulageur under the pseudonyms of Cajetan or Cjt, and he also became a well-known caricaturist of his era. The bloody revolution of 1848 ended that! Thereafter, he confined himself to medical and scientific works of art. A notable successor to Elfinger at Vienna was Carl Heitzmann (1836-1896). Born in what is now Croatia, Heitzmann studied medicine at the University of Vienna. He was as renowned a medical artist as a physician. He contributed watercolors not only to Hebra's Atlas der Hautkrankeiten but also that of Von Baerensprung and an atlas of dental pathology. His English language Microscopical Morphology of the Animal Body in Health and Disease was published in New York in 1883. Heitzmann is also recognized as a father of hematology. He outlined and illustrated the stages of development of red blood cells down to the hematoblast. Thus, he was a pioneer in information leading to the increasing therapeutic use of stem cells of the bone marrow. In 1974, Heitzmann immigrated to New York where, with fifteen colleagues, he became one of the founders of the American Dermatological Association. All dermatologists are familiar with the lines of Blaschko, but how many are aware of Alfred Blaschko's (1858-1922) pioneering contributions to the field of public health? His multiple achievements are reviewed by Rudolf Happle, who himself has contributed to the recent reemergence of the importance of the lines and of mosaicism in the causation and localization of congenital skin and bone disorders. Blaschko was the first to recognize that the localization of a number of nevoid skin lesions did not follow nerve distribution but on other influences operative during embryonic development. Later he, with Fischel, reported the case of a 47-year-old patient who developed an inflammatory skin disorder that disappeared after 8 weeks. It too followed the same embryonic lines. Lichen striatus is sometimes referred to as Blashkitis. In the early 1890s, Blaschko instigated an organized boycott at the Charite hospital in Berlin to protest the then barbaric treatment of patients with sexually transmitted diseases. They were treated as morally delinquent, were strictly isolated, and were made to wear special identifying clothing and forbidden to have all visitors, even immediate family members. The breadwinner of a family was often removed from employment and his family driven to deprivation. By this protest, Blaschko established the principle that a hospital's primary duty is to help the sick, not to act as a reformatory, and that it was in the best interests of society that all sick be restored to health and returned to the workforce as expeditiously as possible. Blaschko forcibly brought to the attention of the Prussian authorities, and of the public, the economic consequences and general societal benefits of sensible public health policies. Blaschko was later instrumental in founding the German Society for Combating Venereal Diseases and the establishment of departments of venereology and syphilology in academic centers in Germany and throughout the world. During the 1930s, dermatology in the United Kingdom and America was enormously enriched by the arrival of leading academic dermatologists from Germany, Austria, Hungary, and rest of Eastern Europe. They brought with them renewed emphasis on the vital importance of scientific research for the future progress of the specialty. To the United States came Helen Ohlendorff Curth, Stephen Epstein, Alfred Hollander, Max Jessner, and the great Stephen Rothman. Another was the elderly Felix Pinkus (1868-1947). He had been author of Volume I of Joseph Jadassohn's 1927 monumental 27-volume Handbuch der Haut und Geschlectskrankheiten. The introductory volume consists of a scholarly review of the anatomy and function of the skin as known at the time. It has 336 illustrations, mostly Pinkus' own drawings. An innovation was the inclusion of “serial sections” demonstrating both histologic and histopathologic changes that Pinkus had observed during his lifelong devotion to the meticulous study of the skin of man and other animals. Of special interest was Pinkus' description of the “Haarscheibe,” a protrusion or disc on the side of hair follicles. Here reside pluripotential cells capable of regenerating the follicle and epidermis. The Haarscheibe was later reemphasized in the writings of Felix's son, Hermann (1905-1985). Today, cells of the “bulge” are attracting increasing interest as a convenient source of adult stem cells. In 1970, Felix Pinkus also described a new skin disorder he named lichen nitidus, or “shining lichen.” Because of his Jewish ancestry, Professor Pinkus was forced to leave the Germany of the Nazi era. He fled first to Norway, thence by way of the Trans Siberian Railway to Shanghai and Japan, where he spent the early years of WWII. In 1941, Hermann, now established in Michigan, brought his father to America. He arrived with little more than the clothes on his back, but with a footlocker full of his precious anatomic and histopathologic drawings. Henry Michelson, Chair at the University of Minnesota, arranged for him to come to Minneapolis to spend 6 months teaching dermatopathology to faculty and residents. My close relationship to this kindly, gentlemanly scholar in my formative years was a priceless educational experience. As a neophyte dermatopathologist, I was privileged to have him as my mentor. A valuable inclusion in the appendix to the compendium is a listing of earlier works in several languages on the history of dermatology and dermatologists. Included are those published in America, by Walter Shelley, John Crissey, Lawrence Parrish, Karl Holubar, Peter and Greta Beighton, and William Allen Pusey. Many of these are now out of print, and information about their dates and places of publication will be helpful in finding them again. I enthusiastically recommend this veritable treasure trove (it weighs 2.5 kg) of information about the roots and tendrils of dermatology. It belongs in the collection of any dermatologist who is interested in the origins of our specialty and in libraries of medical centers and all dermatology training programs. At approximately $143, a work of this magnitude so lavishly and beautifully illustrated is surprisingly inexpensive. The text is in German, but for those of us with only limited or no familiarity with that language, a concise biographical summary for each entrant is easily understood. And the marvelous illustrations alone are worth the price of the book. The Pantheon der Dermatologie is a monumental work, not soon—if ever—to be matched!