Norris, David A.

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The Tradition of Excellence: Dermatology at the University of Pennsylvania, 1870–1985 (Book) 

The Tradition of Excellence: Dermatology at the Univer-
sity of Pennsylvania , 1870-1985. By Herman Beerman , A.B ., 
M .D ., ScD.(Med), F.A.C. P , and Gerald Sylvan Lazarus, B .S. , 
M .D ., M .A.(H on) , F.A.C. P. Beerm an and Laza rus, Inc., Phil-
a delphi a, 1986 (280 pp , $49.00) 
In February of 1988, we celebrate the 50th anniversa ry of the 
fo unding of The Society fo r In ves tigative D ermatology, Inc., and 
of The Journ al o f Inves tiga tive D ermatology. On the threshold 
of our 50th anniversa ry celebration, we are truly fo rtunate in th e 
publication of a book that documents the development of Amer-
i can derm atology th rough the history and exa mple of the de-
p artment(s) o f dermatology at the University o f Pennsylvania. 
T he T radition of Excellence by Beerman and Lazarus provides an 
e ntertainin g and info rm ative perspective on the grow th of Amer-
ican dermatology fro m the descriptive, unorga nized and confused 
practice of the mid-nineteenth century to the science-based spe-
c ialty practi ce o f the late twentieth centu ry, as seen through the 
microcosm of dermato logy at the Uni versity of Pennsylvania. 
This book is divided into chapters on the history of derma-
t o logy in America , on ' the maj o r fi gures in the department o f 
d ermatology in the school o f medicine and in the graduate school 
a t Penn, on research and teaching at Penn , on the societies founded 
o r influenced by Penn , and on the ph ysical plant. There is a chapter 
on the Duhring associates that provides anecdo tal information on 
the departm ent, especially during the past fift y years. 
The Uni versity of Pennsylvania occupies a unique position in 
American medicine and dermatology . Penn can be cited as the 
"grand old father of medical institutions" in the United States . 
Into that dynamic environment in the las t quarter o f the nine-
t eenth century ca me Lo uis A. Duhring to es tablish th e first great 
American department of dermatology, based on the lessons that 
h e had lea rned while studying in Eu rope. Duhring's influence was 
s o great that most hi s to ri an~ simpl y di vide the time line of der-
m atology at Penn into before, during, and after Duhring! 
But this is more than a sto ry of one man and his influence. A 
g reat strength of The T radition of Excellence is that it provides a 
b alanced perspective of the entire history of dermatology in Phil-
a d elphia and at Penn . Herman Beerman is able to blend history 
vvith anecdo te and personality, providing a truly interesting sto ry 
of the men w ho built derm atology at Penn. We follow the growth 
o f dermatology from a disorganized " non-specialty," throu gh 
the development o f prescientific derm atology, to a sophistica ted 
specialty based on scientific background . 
The histo ry of conflict, change, and discovery th at occur red 
over this 11S-year period will fascinate those interes ted in the 
institutional growth of American medicine and dermatology. This 
book is also compelling as a personal story of g reat chairmen and 
the men and wo men that they trained. We meet Louis A. Duhr-
ing, w ho disposed of a considerable personal fo rtune in es tab-
lishin g his department, and others of "The Big Six" of Phila-
delphia dermatology of the era. Duhring's successor, Milton B. 
Hartzell, fou nded the laboratories of dermatologic research at 
BOOK REVIEW 
Penn , applying Duhring's philosoph y of resea rch and original 
thought mixed with clinical derm atology. We observe the inter-
es tin g "stand off ' between John Hinchman Stokes as chairman 
and pro fessor of dermatologic research and head of the derma-
tology laboratories, which, in a sense created two departments 
at Penn . The emergence of D onald Pillsbury as the m aj or fi gure 
in american dermatology after World War II, and its effect on 
the influence of the department o f Penn are also presented. 
The flu ctuation of fo rtunes and conflicts in this m ajor aca demic 
department are truly educational. John Stokes' influence was un-
dermined w hen his academic interes t-traditional syphilology-
was erradicated by penicillin . The conflict between the tradi tional 
" prescientific" dermatology of Stokes and the new research-based 
approach of Weidman was not to be resolved until Pillsbu ry 
emerged to fi ll the laboratories at Penn with young, inquisitive 
minds and inaugura te a "golden era" of derma tology at Penn . 
The tradition of clinical dermatology mixed w ith research was 
continued by Beerman in the Graduate School and by the irre-
pressible Albert Kligman and Walter Shelley in the D uhring Lab-
oratories. The interviews of the Duhring associates presented in 
this book do mu ch to develop the character o f the postwar years 
at Penn. 
Dr. Kligman's description of his experiences at Holmes burg 
Prison are typical of the anecdotes in this book and exemplify 
this period: 
" I began to go to the prison regularl y, although I had no 
autho riza tion. It was years befo re the authorities knew that 
I was conducting various studies on prison volunteers. Things 
were simpler then. Informed consent was unheard of. N o 
one as ked me w hat I was doing . It w as a wonderful time. " 
The fin al chapters and appendices of The T radition of Excellence 
cite the improvements in physical plant and clinical , laboratory, 
and teaching fa cilities that have recently occurred at Penn under 
the leadership of Gerald S. Lazarus, and the outline of the training 
programs at Penn . 
The Society for Investigative D ermatology was fo unded in 
John Stokes' office in Philadelphia, and this book provides a unique 
and fortuitous dOClln;entation of the environment in w hich the 
SID and The Journal of Inves tigative D ermatology were con-
ceived fi fty yea rs ago. T his book w ill be of interest, not just to 
the trainees o f the University of Pennsylvania, but to many read-
ers interes ted in the development of medical institutions and to 
the development of American dermatology. 
Funds from the sale of Th e T radition of Excellence will be placed 
in the Beerman Scholar Fund to support research in 
dermatopa thology. 
D avid A. N orris, M .D. 
D enver, Colo rado 
0022-202X/87/S03. S0 Copyright © 1987 by T he Society for Investigative Dermatology, Inc. 
625 


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The Tradition of Excellence: Dermatology at the University of Pennsylvania, 1870–1985 (Book)

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