Dermatologists

Many in the medical profession opposed specialization when it began to occur in the 19th century. They thought treatments would be too fragmented for patients' own good. Several factors, however, made specialization inevitable. The amount of medical information was increasing and complex new techniques were developing at such a rapid pace that doctors could not keep up with the advances. They began to send patients to physicians who concentrated on one type of illness or manipulation. Specialization was also attractive because it gave doctors the opportunity to demand higher fees, work fewer hours, and command greater respect from peers and the public. Medical experts gradually abandoned their ideas that general disease was caused by problems of the humors, or elemental fluids of the body, and began to diagnose and treat local organs instead.

The specialty of dermatology had its beginnings in the mid-1800s in Vienna, Austria, when a doctor named Ferdinand von Hebra, one of the first to specialize entirely in skin diseases, founded a division of dermatology. At that time, medicine concentrated primarily on abnormalities in the four humors—blood, phlegm, black bile, and yellow bile—and they believed symptoms were caused by those abnormalities. Hebra made classifications based on changes in the tissues instead of on symptoms or on general disease categories. As a result, his treatment was directed toward the local problem rather than treating imbalances in the humors. He was responsible for the discovery that scabies was transmissible from person to person and could be cured by the destruction of the itch-mite parasite. Innumerable discoveries have been made in the field of dermatology, including new medicines, treatments, and equipment. Lasers and computer technology, for example, have drastically changed dermatology, improving diagnostic techniques and allowing certain surgical procedures to be performed without using a scalpel.