Abstracts on historical topics at the
European Academy of Dermatology and Venereology

6th EADV Congress, Dublin, September 11th - 15th, 1997

These abstracts appeared in J Eur Acad Dermatol Venereol 1997; 9, supp.1.
Workshop on History of Dermatology and Venereology
EADV 97 WS 014 History of dermatology symposium - An introduction (K. Holubar)
EADV 97 WS 015 The dermatological/medical and human experiences of Diaz d'Ysla on syphilis (Amelia Ricon-Ferraz)
EADV 97 WS 016 Syphilization - "Vaccination" against syphilis in the 19th century in Norway (Ole Fyrand)
EADV 97 WS 017 Skin diseases mentioned by Shakespeare (J. Goens)
EADV 97 WS 018 History of erythema nodosum (C. Durand)
EADV 97 WS 019 The destiny of the Jewish dermatologists in Germany in the time of Nationalsocialism (S. Eppinger, A. Scholz)
Other Communications
EADV 97 - Oral comm. O80 75-TH anniversary of the polish association of dermatology (A. Górkiewicz-Petkow, W. Glinski)
EADV 97 - Oral comm. 084 Armauer Hansen (1841-1912) : The life of the discoverer of the aetiology of leprosy (A. Nyfors)
EADV 97 - Poster 227 The history of Irish dermatology (F.C. Powell, D. Burrows)
EADV 97 - Poster 261 Jacob's ulcer : "An ulcer of peculiar character" (L. Barnes)

Workshop on History of Dermatology and Venereology

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EADV - 97 - WS 014
History of dermatology symposium - An introduction
K. Holubar Institute for the History of Medicine, University of Vienna, Vienna, Austria

The introduction will outline the selection of topics of meetings in the immediate past and those planned in the future and will also comment on the choice of speakers. Dermatologists will reminisce about an important bicentennial, the publication of Robert Willan'S (1757-1812) book, the preface of which was dated November 20 1797 and published in London in 1798. The speakers of the EADV symposium will be shortly introduced and at the end of the session, a conclusion of the presentations will be made.

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EADV 97 - WS 015
The dermatological/medical and human experiences of Diaz d'Ysla on syphilis
Amelia Ricon-Ferraz Portugal

In 1492 the King D. Joăo II of Portugal founded the All Saints Royal Hospital as a result of the unification of Lisbon's Hospitals.
Ruy Diaz d'Ysla, a Spanish surgeon, who became an expert on the diagnosis and treatment of syphilis, was hired as a "specialist" for the care of this kind of patients at this Hospital.
The "Treatise Against the Serpentine Disease", written by Diaz d'Ysla, printed in 1539 is based on his experience, acquired in the All Saints Royal Hospital. Important knowledge (related with the origin of the disease, its evolutive stages, contagion and treatment) was pointed with methodology and accuracy. The efforts developed by the "Misericórdia" (a charitable institution), and by the physicians and surgeons of the Hospital were precursors and are a remarkable historical event.

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EADV 97 - WS 016
Syphilization - "Vaccination" against syphilis in the 19th century in Norway
Ole Fyrand Department of Dermatology, The National Hospital, Rikshospitalet, University of Oslo, Norway

Norwegian dermatology can be dated back to 1817, when lectures in skin- and sexually transmitted diseases were started at the University of Oslo. Carl Wilhelm Boeck (1808-1875), worked as a lecturer from 1846 at the University of Oslo, from 1851 as the first professor of dermato-venereology. Boeck is reknown in the history of medicine for his treatment of syphilitic patients with "syphilization". This was a kind of "vaccination" against syphilis, at a time when vaccinations according to the method of Jenner was modern. Syphilization was first developed and used by Joseph Auzias-Turenne (1813-1870) from France. He postulated that if a syphilitic patient was inocculated through the skin with a "syphilitic matter" the organism would obtain a therapeutic effect through "syphilitic saturation". CW Boeck became the "most famous syphilisator in the world", until the method was abandoned with his death in 1875.

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EADV 97 - WS 017
Skin diseases mentioned by Shakespeare
J. Goens Brussels, Belgium

Shakespeare's works are astonishingly rich in medical references, especially dermatological, ranking from realistic descriptions to metaphoric allusions. Some points are especially outstanding:

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EADV 97 - WS 018
History of erythema nodosum
C. Durand Service of Dermatology Pr. J. Meynadier, Montpellier, France

In his book "on cutaneous diseases", in 1798, R. Willan described and named the EN. At first, EN was considered a simple skin inflammation (Willan, Biett, Cazenave...). But this conception was not enough to explain EN's premonitory symptoms.
In the same time EN was considered a sign of rheumatic infection. (Schöenlein, Bouillaud, Begbie...). The principal arguments of this rheumatic theory are: young people, rheumatic fever in past medical history, sore throat and joint pain, dysfunction of menstruation, effectiveness of quinine sulfata treatment. But how to explain EN without joint pain?
A third theory was evoked: EN was a specific infective disease. Trousseau in France, Hebra in Vienna were the leaders of this opinion. But still nobody was finding the specific etiologic germ when many different cases of EN were occurring.
In 1893, the discovery of b-hemolitic streptococci will show that EN is the sign of a streptococci infection instead of rheumatic infection. The rheumatic theory will be abandoned.
But the more frequently observed association was EN and tuberculosis (Koch bacilli was discovered in 1882). During 50 years, Dermatologists who assert EN as a secondary sydrom will be opposed by the Pediatricians who believe EN as a sign of primary tuberculosis. The great advances in medical technology will offer to the opposing teams different sorts of arguments. In 1938, in Strasbourg congress, they found a consensus:

Since 1940, several cases of EN following sulfathiazole treatment were described, no matter what original infection: EN might have a toxic genesis too. But the last revolution came from Scandinavia. Löfgren, among 178 EN cases, displayed a new association: EN with Bilateral Hilar Lymphoma Syndrom, which questioned the tuberculosis etiology. He also admitted the possibility of many uncharacteristic EN cases...a real revolution!
The etiologic list has increased during the XXth century with many different causes. Actually, we notice the more frequently, uncharacteristic EN cases then BHL syndrom and after EN as the sign of concurrent infections of complex etiology.
At the beginning of the XIXth century, EN interested Physicians who were recently clinicians. But they were investigators too and the danger was to explain all the facts they observed by the science they have just discovered. We think, now, that the EN is the result of two types of immunologic reaction according to different allergens. Two questions subsist: the predisposition of a person and the pathogenesis of EN. In the near future, we will maybe have the answer with our most recent science: Genetics.

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EADV 97 - WS 019
The destiny of the Jewish dermatologists in Germany in the time of Nationalsocialism
S. Eppinger, A. Scholz Institut for history of medicine, TU Dresden, Germany

16% of the physicians in Germany in 1933 were Jews. The share of Jews of the whole population amounted few than 1% in this time. Jewish physicians had to suffered under the antijewish laws of the Nationalsocialists. In this connection they were removed from the universities and the public hospitals after 1933. By the law "4. Verordnung zum Reichsbürgergesetz" they were strucked off the Medical Register on September 30th, 1938.
The share of Jews under the dermatologists were amounted about 27%. 566 Jewish dermatologists could be documented. It was possible to detect the destinyof 70% of the Jewish dermatologists. It could be shown, that 16% were murdered in concentration camps, 16% died in Germany in a natural death, 5% survived in Germany, 3% committed suicide and 60% of the Jewish dermatologists emigrated. The USA were the main emigration destination. 40% found a new home there.

Other Communications

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EADV 97 - Oral communication O80
75-TH anniversary of the polish association of dermatology
A. Górkiewicz-Petkow, W. Glinski Department of Dermatology, Warsaw School of Medicine, Warsaw, Poland

The Polish Association of Dermatology (PTD) was established in 1921 in Warsaw after Poland had regained independence ein 1918 lost for 123 years. However, the society had it roots in 19th century in Cracow, Wilno Lwów, Warsaw. In 1864 the first dermatological ward was organized in Cracow by Prof. A. Rosner who was a pupil of Hebra, and first Polish professor in dermatology. At the beginning of 20th century when territory of Poland was still divided among Russia, Austria and Germany, official sections of dermatology of local Medical Associations in Warsaw and Cracow were founded. The first congress of PTD was held in Warsaw in 1922. In the period 1922-1939 the society had 4 branches in Cracow, Lwów Poznan and Warsaw and it edited scientific and clinical periodical entitled "Przeglad Dermatologiczny" since 1921. The cooperation of PTD with other European countries i.e. Czech, Bulgaria, France and Germany was started, the Polish dermatologists were active organizers of Slovian Group of Dermatologists. The well known dermatologists such as Prof. Krzysztalowicz, Bernhardt and Grzybowski maintained close cooperation and contact with other dermatological societies and European centers. After 2nd World war the 12 Congress of PTD was organized in 1948 in Warsaw after PTD had started again its activity in 1947. New branches of PTD in all 11 University Centers in Poland were organize as well as sections of micology, allergology, immunology, pharmacology, venereology, pediatric dermatology, surgery and oncology. PTD is a member of ILDS, recently over 1300 dermatologist are members of the society and many of them are active in various international organizations. The next 26th Congress of PTD will be held in September 1998 in Warsaw.

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EADV 97 - Oral communication 084
Armauer Hansen (1841-1912): The life of the discoverer of the aetiology of leprosy
A. Nyfors Haukeland Sykehus, N-5021 Bergen, Norway

Gerhard Armauer Henrik Hansen was born in Bergen July 29, 1841. He was the eight in a family of 15 children. In 1859 he moved to Christiania (Oslo) to study medicine. He was a diligent student who developed a special interest in pathological anatomy. In the autumn of 1866 he passed his medical examinations with honours. In 1867 he served as a registrar in the northern part of Norway in a fishing community.
In the spring of 1868 Armauer Hansen (AH) returned to Bergen to work under the world-known leprologist dr. Danielssen at Pleiestiftelsen no. I (leprosarium no. I) as a clinician and researcher. AH studied sections from lymph nodes and organs from lepers in his microscope. On a rainy evening the 28. of February 1873 he noticed some small rods moving in the field he studied. Later he was able to stain such rods (mycobacterium leprae).
AH's life will be reviewed with photos from Pleiestiftelsen no. I as well as from the Lepramuseum in Bergen.

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EADV 97 - Poster 227
The history of Irish dermatology
F.C. Powell, D. Burrows
Mater Misericordiae Hospital, Dublin, Ireland
Royal Victoria Hospital, Belfast, UK

One hundred and fifty years ago Drs William Stokes (Stokes - Adams Syndrome), John Cheyne (Cheyne-Stokes Breathing) Dominick Corrigan (Corrigan's Pulse), Robert Graves (Graves Disease) and Abraham Colles (Colles Fracture) practised in Dublin. Dermatology flourished during this period in Dublin and Belfast where hospitals for treatment of skin diseases were founded. Dr. Arthur Jacob described "Jacobs Ulcer", the first accurate delineation of Basal Cell Carcinoma while Dr. Walter Smith defined the condition Monilethrix. In 1965 The Irish Association of Dermatologists was founded and has grown from strength to strength since. The I.A.D. welcomes delegates to the Congress and places Irish Dermatology of today in the context of its evolution from the past.

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EADV 97 - Poster 261
Jacob's ulcer: "An ulcer of peculiar character"
L. Barnes City of Dublin Skin and Cancer Hospital and St. James's Hospital, Dublin, Ireland

As Celtic ancestry is considered to be the strongest indicator of susceptibility to non-melanoma skin cancer, it is appropriate that the first description of a basal cell carcinoma is credited to an Irish physician.1 Arthur Jacob trained in the College of Surgeons, Dublin where he was a pupil of Abraham Colles. He also studied in Edinburgh and London, returning to Dublin in 1814 to work as an ophthalmic surgeon and anatomist.
Better known for his research into anatomy of the eye, he described one layer as "the most beautiful specimen of a delicate tissue which the human body affords". This became known as membrana Jacobi and ultimately, the retina.
In 1827 he described "an ulcer of peculiar character which attacks the eye lids and other parts of the face" now known as a basal cell carcinoma but referred to as Jacob's ulcer in the 1800s. Proud of his description, Jacob drew it to the attention of writers who failed to mention his work.
His original description still holds true "the extraordinary slowness of its progress, the peculiar condition of the edges", "smooth and glossy" having "veins ramifying over it". He distinguished it clearly from a squamous cell carcinoma "the ulcer with cauliflower-like fungus growth, which occasionally attacks old cicatrices", noted its locally destructive nature and its tendency to "spare contaminating the neighbouring lymphatic glands". He considered the only cure was "by the knife" and emphasised that the tumour "bids defiance to all remedies short of extirpation".

Reference: Jacob A. Observations respecting an ulcer of peculiar character which attacks the eyelids and other parts of the face. Dublin Hospital Reports 1827; 4: 232-9

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