The People of the Dermis

Jews and Skin—a small biopsy of forgotten history

Early in my medical career, I switched from pediatrics to dermatology. This change had little to do with being Jewish, other than to anticipate few emergencies to trouble Shabbat observance. Later on I was often asked to read the Torah portion of Tazria-Metzora (“That’s your parasha!”), because Metzora describes the skin and hair changes of tzara’at, mistranslated for a millennium as “leprosy.” That, and diagnosing the odd case of Lyme Disease while ladling cholent at kiddush in shul, were small drawbacks of a pleasant new calling.

I learned much later that Jews have a long and deep connection with the dermatology profession.  This historical fact may have escaped your attention.  It had certainly escaped mine when I joined the skin fraternity.

I had been practicing for twenty years when a pharmaceutical representative came into my office, handed me a book, and said, “This might interest you.”  It did.

The book was, The Death of Medicine in Nazi Germany. Its author was Wolfgang Weyer, a non-Jewish dermatologist who examined the corruption of medicine under the Nazis through the lens of the professional ejection of Jews from a field in which they had gained prominence.

The modern dermatology profession began around 1870 in Vienna.  Its founder, Karl Ferdinand Ritter von Hebra, was not Jewish.  (“Ritter” and “von Hebra” were aristocratic honorifics unavailable to Jews.  His actual name was quite long.)

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Ferdinand Karl Franz Schwarzmann Ritter von Hebra

His disciples, however, were Jewish.  All of them. They were ambitious Jewish boys from the boonies—Hungary, Slovakia—who flocked to Vienna, the city where, if you could make it there, you could make it anywhere, plus whipped cream.

Some grew famous.  One you may have heard of was Moritz Kaposi.  His name re-entered the news in the 1980’s when the disease he described, Kaposi’s Sarcoma, was found to be part of what came to be known as HIV-AIDS.

Moritz Kaposi (KA-poshi) was born Moshe Kohn.  He told people in Vienna that he changed his name to Kaposi to honor his town of birth, Kapsovar in southwestern Hungary, and because having so many doctors named Kohn in the hospital made things confusing.  Some were skeptical.  If you are not, there is a lovely bridge across the Danube on which I can get you an excellent price.

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Moshe Kohn (aka Moritz Kaposi)

Kohn changed his name when he converted to become Catholic in 1871.  He married the boss’s daughter, grew famous, lived happily ever after, and was buried in a non-denominational ceremony.

But why were Kaposi and so many of his fellow Jews attracted to dermatology?  It was not so they could plumb the meaning of Biblical tzara’at.

Their motives, as Weyer explains, were simpler.  At its start the skin profession was called, “Dermatology and Syphilology.”  (Syphilis causes many skin changes.)  The American branch of the profession did not remove “and Syphilology” from its name until 1960.  The Israeli profession never has, and to this day is: האיגוד הישראלי לרפואת עור ומין, the Israel Society of Dermatology and Venereology.

Back at the profession’s beginning, this meant that dermatologists had to take care of patients whom society considered dirty and immoral—and uninsured.  When Otto von Bismarck introduced national health insurance to Germany in 1883, coverage excluded patients with sexually-transmitted diseases.  Why should society pay for people at fault for their own illness?  (This policy changed in 1900.)

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Otto von Bismarck, the Prussian liberal snowflake who introduced national health insurance.  (The Socialists were pushing for it, and he wanted to win the next election.)

Who would choose a profession that cared for such people?  Ambitious young men who were blocked from entry into more prestigious medical departments like internal medicine and surgery.  Jews, in other words.

So many Jews entered the field of dermatology that many non-Jewish physicians avoided becoming skin doctors, because people would think they were Jewish.  Writes Weyer, “The public so closely identified Jews with the practice of dermatology that all dermatologists were regarded as Jews and were frequently referred to as Felljuden, a derogatory term that means ‘fur Jews.’”

Reviewing case after case in detail, with photographs of the leading dermatologic figures involved, Weyer shows that it took Germany five years, from 1933-38, for go-getting gentile dermatologists to oust and replace their Jewish academic bosses.  When Hitler marched into Austria in 1938, the Austrians got the same job done in three weeks.  Many of the Jews who were pushed out came to the US.  Some became leaders in the field.  One of them was an adjunct faculty member when I was in training.  He practiced in a small Massachusetts city.

Another well-known Jewish dermatologist of the time, was Paul Gerson Unna.  He was about 15 years younger than Kaposi, and fought for Germany in the Franco-Prussian War.

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Paul Gerson Unna

Unna resigned from the Jewish community when he was 30.  (This was an administrative move, not a religious one.)  He was interested in Monism, a religious/philosophical movement that asserts the basic unity of all things.

In 1912 he published a long and learned article in Das Monistische Jahrhundert [The Monist Century].  This was translated into English in 1983, suitably abridged for moderns with short attention spans.

In it, Unna reviewed tzara’at in the Torah, Mishnayot (where, he pointed out, the word tzara’at does not appear, not even in Massechet Nega’im), as well as Arab and classical Greek and Latin sources.  His analysis, informed by his dermatologic expertise, showed decisively that the Biblical term tzara’at is not compatible with the disease of leprosy (now called Hansen’s Disease.)  That people still associate tzara’at with leprosy says less about word meaning than about how people to this day often think of skin disease.

His hometown of Hamburg named a street for Professor Unna, near the headquarters of the Beiersdorf Corporation.  In an early example of celebrity advertising, the famous Professor pronounced himself “impressed” with their moisturizing product, Euzerin.  (He had not formulated this cream—that was done by a Jewish chemist named Isaac Lifshutz.)

Even if you never heard of Unna, you probably know Beiersdorf by its products, which include Eucerin and Nivea.  Nivea celebrated its 100^th anniversary not long ago.

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     Indian actress Anushka Sharma at Nivea’s 100^th Anniversary event

Mazal Tov, Nivea!  Till 120!

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I learned some personal details about Moritz Kaposi from the writings of Dr. Karl Holubar, an eminent dermatologist and medical historian who was born in Vienna in 1936.  Holubar, who was not Jewish, came to Jerusalem in 1983 and headed and reorganized the Dermatology Department at Hadassah Hospital for three years.  There he learned fluent Hebrew and passable Arabic before returning to Vienna to finish his distinguished career.

They say that those who do not know history are doomed to repeat it.  I did not know this history, and indeed did manage to repeat it, if only just a bit.