The history of dermatology concerns the development of the practice of researching, defining and treating skin diseases, from ancient times to the present. The field has its origin in the earliest forms of medicine, later becoming a distinct field with its own specialised practitioners and researchers.
Readily visible alterations of the skin surface have been recognised since the dawn of history. Among the first to take an interest in skin diseases were the Mesopotamian peoples, who sought to understand the reasons for these problems, often resorting to explanations rooted in religion, astrology and divination, and were the first to observe and define various dermatopathies. Skin conditions were considered a sign of divine punishment, the actions of demons and spirits, or as the result of black magic. [1] [2]
One of the most influential sources of understanding views on skin conditions in Mesopotamia comes from the Babylonian chief scholar Esagil-kin-aplim, who wrote a diagnostic manual called Sakikkū . One passage describes a complex skin condition which is associated with a sexual encounter. Another work, Alandimmû , observes the human physical appearance, with a section dedicated to dermal marks, such as moles, and spots. [2]
While matching the descriptions of diseases in the few surviving cuneiform medical texts to specific ailments is challenging, it appears likely that Babylonians and Assyrians were the first to define and describe warts, pustules and scabies in writing. [3] It is also possible to draw some conclusions about their attitude to skin conditions. Doctors of the era clearly sought to define disease according to certain criteria, using observations such as such as heat, smell, breath and bodily fluids, to help draw a diagnostic conclusion. [1] [2]
Among the oldest preserved medical documents relevant to skin diseases are the ancient Egyptian Smith Papyrus and Ebers Papyrus dating to c. 1600 BCE and c. 1550 BCE respectively, though it is likely their contents were copied and passed down with their ultimate origins being much older folk remedies. [4] [5]
These scrolls describe various diseases, including skin complaints such as ulcers, burn wounds, rashes, and tumours, as well as medical techniques on how to recognise and treat the diseases. Many of the treatments involved magical incantations, the application of herbs, or formulations of ingredients for medicines or ointments, as well as surgical procedures, such as skin grafts. [6] [7]
Ancient Egyptians believed in a form of proto-humorism, that skin diseases were a symptom of health problems inside the body, caused by a blockage in the flow of bodily fluids. This turned the fluids into pain-making substances that could cause diseases anywhere in the body. [4]
While many of the procedures do not resemble those prescribed by modern medicine, the papyri are notable for their evidence of an early system of thorough inquiry into skin diseases, recommending a systematic examination, diagnosis and treatment, something that would later be more formalised by Greek schools of medicine. [4] [7] [8]
Ancient Greek physicians adopted many treatments of the Egyptians, with the likes of Homer and Diodorus attesting to their respect of Egyptian medicine, though they rejected the use of incantations as a method of treatment. [8] However, Greek and Roman medicine did not see the skin as an organ in itself, but rather a mere covering for the body. Similarly to the Egyptians, they viewed skin diseases as merely a representation of a humoral imbalance. [9]
Greek medicine, with its focus on the harmony between external beauty and internal goodness, laid the foundation for dermatological practices, emphasizing a healthy diet and physical activity. Empedocles of Agrigento made early inroads into understanding skin diseases and the concept of cutaneous respiration, suggesting the skin's role in gas exchange similar to the lungs. [10]
Hippocrates described skin diseases and proposed the first classification of skin diseases with two categories: diseases of the skin itself (idiopathic) and diseases due to an imbalance of humors that a merely manifested on the skin (exanthematic). [11] [12] Around a century later, his work would be compiled into the Corpus Hippocraticum , which described the anatomy and physiological processes of the skin, including sweating and glandular secretion. [12]
Rome, while indebted to Greek medical knowledge, also absorbed insights from Etruscan magical medicine, which revered water's regenerative powers and utilized plants for their antiseptic properties. Key Roman figures in dermatology include Aulus Cornelius Celsus and Claudius Galen. Celsus, in his De Medicina , detailed various skin conditions with precise terminology, covering diseases like ulcers and leprosy. Galen expanded on dermatological diseases, especially those affecting the genitals, and explored the causes of hair color and the notion of sexually transmitted diseases.
The major development in the formalisation of the study of skin came from Andreas Vesalius, who first analysed and described the skin's substance, its layers, pores, fat and nerves. [9] During his first public anatomical dissection in 1540, Vesalius showed and explained to the witnesses the difference between the 'inner skin' (dermis and/or hypodermis) and the 'outer skin' (epidermis) and their respective properties. [13]
In 1572, Geronimo Mercuriali of Forlì, Italy, completed De morbis cutaneis (translated "On the diseases of the skin"), and is known as the first scientific work to be dedicated to dermatology. One source lists Jean Astruc (1684–1766) as the founder of modern dermatology. [14] In 1799, Francesco Bianchi wrote the book Dermatologia which is the first comprehensive textbook of modern dermatology written for the students of medicine. [15]
In 1801 the first great school of dermatology became a reality at the famous Hôpital Saint-Louis in Paris, while the first textbooks (Willan's, 1798–1808) and atlases (Alibert's, 1806–1814) appeared in print during the same period of time. [16]
By the mid-19th century, dermatology had become a widely-recognised field. [17] Publications such as Gustav Simon's Die Hautkrankheiten durch anatomische Untersuchungen erläutert (Skin Diseases Illustrated by Anatomical Investigations) [18] and Ferdinand von Hebra's Atlas der Hautkrankheiten (Atlas of Skin Diseases) [19] sought to illustrate a wide range of dermatological conditions and allow physicians to recognise symptoms in their patients. Hospitals such as Berlin's Charité had established dedicated dermatological departments, which led to significant advances in the description of conditions and their potential treatments.
Aelius Galenus or Claudius Galenus, often anglicized as Galen or Galen of Pergamon, was a Roman and Greek physician, surgeon, and philosopher. Considered to be one of the most accomplished of all medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology, as well as philosophy and logic.
The history of medicine is both a study of medicine throughout history as well as a multidisciplinary field of study that seeks to explore and understand medical practices, both past and present, throughout human societies.
The history of anatomy extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern anatomists and scientists. Written descriptions of human organs and parts can be traced back thousands of years to ancient Egyptian papyri, where attention to the body was necessitated by their highly elaborate burial practices.
Dermatology is the branch of medicine dealing with the skin. It is a speciality with both medical and surgical aspects. A dermatologist is a specialist medical doctor who manages diseases related to skin, hair, nails, and some cosmetic problems.
Neurophysiology is a branch of physiology and neuroscience that studies nervous system function rather than nervous system architecture. This area aids in the diagnosis and monitoring of neurological diseases. Historically, it has been dominated by electrophysiology—the electrical recording of neural activity ranging from the molar to the cellular, such as patch clamp, voltage clamp, extracellular single-unit recording and recording of local field potentials. However, since the neuron is an electrochemical machine, it is difficult to isolate electrical events from the metabolic and molecular processes that cause them. Thus, neurophysiologists currently utilise tools from chemistry, physics, and molecular biology to examine brain activity.
Humorism, the humoral theory, or humoralism, is a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
Moulage is the art of applying mock injuries for the purpose of training emergency response teams and other medical and military personnel. Moulage may be as simple as applying pre-made rubber or latex "wounds" to a healthy "patient's" limbs, chest, head, etc., or as complex as using makeup and theatre techniques to provide elements of realism to the training simulation. The practice dates to at least the Renaissance, when wax figures were used for this purpose.
The Hippocratic Corpus, or Hippocratic Collection, is a collection of around 60 early Ancient Greek medical works strongly associated with the physician Hippocrates and his teachings. The Hippocratic Corpus covers many diverse aspects of medicine, from Hippocrates' medical theories to what he devised to be ethical means of medical practice, to addressing various illnesses. Even though it is considered a singular corpus that represents Hippocratic medicine, they vary in content, age, style, methods, and views practiced; therefore, authorship is largely unknown. Hippocrates began Western society's development of medicine, through a delicate blending of the art of healing and scientific observations. What Hippocrates was sharing from within his collection of works was not only how to identify symptoms of disease and proper diagnostic practices, but more essentially, he was alluding to his personable form of art, "The art of true living and the art of fine medicine combined." The Hippocratic Corpus became the foundation upon which Western medical practice was built.
The pulmonary circulation is a division of the circulatory system in all vertebrates. The circuit begins with deoxygenated blood returned from the body to the right atrium of the heart where it is pumped out from the right ventricle to the lungs. In the lungs the blood is oxygenated and returned to the left atrium to complete the circuit.
Moritz Kaposi was a physician and dermatologist from the Austro-Hungarian Empire who discovered the skin tumor that received his name.
Ferdinand Karl Franz Schwarzmann, Ritter von Hebra was an Austrian Empire physician and dermatologist known as the founder of the New Vienna School of Dermatology, an important group of physicians who established the foundations of modern dermatology.
The history of wound care spans from prehistory to modern medicine. Wounds naturally heal by themselves, but hunter-gatherers would have noticed several factors and certain herbal remedies would speed up or assist the process, especially if it was grievous. In ancient history, this was followed by the realisation of the necessity of hygiene and the halting of bleeding, where wound dressing techniques and surgery developed. Eventually the germ theory of disease also assisted in improving wound care.
Ancient Greek medicine was a compilation of theories and practices that were constantly expanding through new ideologies and trials. The Greek term for medicine was iatrikē. Many components were considered in ancient Greek medicine, intertwining the spiritual with the physical. Specifically, the ancient Greeks believed health was affected by the humors, geographic location, social class, diet, trauma, beliefs, and mindset. Early on the ancient Greeks believed that illnesses were "divine punishments" and that healing was a "gift from the Gods". As trials continued wherein theories were tested against symptoms and results, the pure spiritual beliefs regarding "punishments" and "gifts" were replaced with a foundation based in the physical, i.e., cause and effect.
Egyptian medical papyri are ancient Egyptian texts written on papyrus which permit a glimpse at medical procedures and practices in ancient Egypt. These papyri give details on disease, diagnosis, and remedies of disease, which include herbal remedies, surgery, and magical incantations. Many of these papyri have been lost due to grave robbery. The largest study of the medical papyri to date has been undertaken by Humboldt University of Berlin and was titled Medizin der alten Ägypter.
The use of medicinal clay in folk medicine goes back to prehistoric times. Indigenous peoples around the world still use clay widely, which is related to geophagy. The first recorded use of medicinal clay goes back to ancient Mesopotamia.
The history of medical diagnosis began in earnest from the days of Imhotep in ancient Egypt and Hippocrates in ancient Greece but is far from perfect despite the enormous bounty of information made available by medical research including the sequencing of the human genome. The practice of diagnosis continues to be dominated by theories set down in the early 20th century.
Karl Gustav Theodor Simon was a German physician, pathologist, and dermatologist and the founder of dermatopathology.
Modern understanding of disease is very different from the way it was understood in ancient Greece and Rome. The way modern physicians approach healing of the sick differs greatly from the methods used by early general healers or elite physicians like Hippocrates or Galen. In modern medicine, the understanding of disease stems from the "germ theory of disease", a concept that emerged in the second half of the 19th century, such that a disease is the result of an invasion of a micro-organism into a living host. Therefore, when a person becomes ill, modern treatments "target" the specific pathogen or bacterium in order to "beat" or "kill" the disease.
Gustav Riehl was an Austrian dermatologist.
The Atlas der Hautkrankheiten was an influential work in the field of dermatology, published in ten editions between 1856 and 1876.