Dermatology at Blockley--100 years ago.

ONE HUNDRED years ago this summer the Dermatology Service at the Philadelphia General Hospital had its beginning. Louis A. Duhring, MD, "pathfinder for dermatology" (Fig 1), had received his MD degree from the University of Pennsylvania on March 14, 1867. Shortly thereafter, he started his 15-month internship at Blockley. There were ten young physicians to care for the several thousand sick poor of Philadelphia hospitalized at the Almshouse. 1 Early in his internship, one of Duhring's first patients was David W., an elderly Irish boilermaker (Fig 2). Duhring noted: the presence of a few small round nodules, situated in the skin of the left shoulder, attended with decided itching, but without pain. These nodules soon multiplied and increased in size. 2 He made a diagnosis of painful neuroma and attempted to treat the man with blisters and hypodermics of morphea. Nothing seemed to help. Years later, Duhring and a surgeon