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Academy obituaries
Academy
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MARION B. SULZBERGER (1895-1983)
On Nov 24, 1983, Marion B. Sulzberger, one of the most outstanding dermatologists of all time, died In his adopted city of San Francisco Mauon Sulzberger was born in New York City on March 12, 1895 After completing his grammar and high school education, he attended Harvard University There he devoted much of his time to ~ activities and was asked to leave after 1 year He subsequently traveled for 2 years, assuming various Jobs in Australia as a shepherd, a laborer, and a camel driver. He then worked his way back home as a stoker on a freighter. He spent the following 2 years traveling extensively in Latin America in connection with his father's meat packing business, surveying cattle, lands, and packing conditions, particularly in Paraguay and Argentina. During World War I he served for 2 years as a naval aviator (holding seaplane license No. 74 and landplane license No 1104). After his discharge from the Navy he went to visit his family, who at that time were living in Switzerland. This was the beginning of a period, spent in Europe, which had a profound influence on his future interests and actlvmes. It is essential to know about these early activities in his life because they help explain his character and productlwty. He was a willful, independent, nonconforming, intellectually curious, enterprising young man He did not spare himself any effort or hardship to accomplish goals in his chosen profession of medicine In 1920 he began to study me&clne, first in Geneva and then in Zurich. During that time he decided to specialize in dermatology Contributing to this decision was the influence of Bruno Bloch, head of the dermatology department in Zurich and an accomplished scientist who was the first to isolate a carcinogenic fraction from coal tar and who discovered the DOPA reaction. Another factor was that Marion Sulzberger's sister had had severe acne that left her with pronounced facial scarring. After his period of training in Zfirich, he con-
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'd
tlnued his dermatologic education in Breslau (now Wroclaw) with Joseph Jadassohn, another outstanding clinical dermatologist and scientist of that era Sulzberger's thinking about dermatology in general and his scientific approach to clinical and fundamental problems were greatly influenced by these two outstanding teachers. When he returned to live permanently in the United States m 1929, he had already done the work underlying several of his major clinical and smentlfic conmbutions, among them the description of incontinentia pigmenti (with Bruno Bloch), the discovery of the phenomenon that is now called specific acquired immunologic tolerance, and the immunologic aspects of superficial fungus infections of the skin, including the role of delayed-type hypersensitivity and of skin-sensitizing antibodies. Soon after his return to New York he became associated with two of the most respected American dermatologists of that era. He joined Fred Wise, an excellent clinician, in private practice and became a member of the faculty and staff of the department of dermatology at the New York Postgraduate Medical School and of the Skin and Cancer Unit, both of which were under the direction of George Miller MacKee. At that time he noted that the actiwUes of dermatologists in the United States were almost exclusively confned to chnlcal endeavors alone. In his view American dermatologists did not carry out fundamental scientific investigations on skin and skin diseases, as did the better dermatology departments m Europe, activities from which he had derived much stimulation. He was not shy in frankly telling his colleagues about this. At the same time he tried to remedy this deficiency by lmtiating a variety of fundamental investigations at the Skin and Cancer Unit and at Montefiore Hospital. Marion Sulzberger soon received worldwide recognition as an outstanding teacher, clinician, and mvestigator, particularly in the field of cutaneous allergy and immunology The volume Dermatologtc Allergy, published in 91A
92A
Journal of the American Academy of Dermatology
Academyobituaries
Marion B. Sulzberger
Volume 10 Number 6 June, 1984
1940 as the first and only textbook dealing with that subject, greatly contributed to his reputation. He became MacKee's successor as director of the Skin and Cancer Unit in 1947, and then became chairman of the Department of Dermatology at New York University Postgraduate Medical School in 1949. There he had the opportunity to bring two large existing departments, namely, the Skin and Cancer Unit and the already existing department of dermatology of New York University, under one aegis. Together with Mr. Charles C. Harris and Dr. MacKee a major achievement in this amalgamation was the preservation of the endowment funds of the Skin and Cancer Unit. Furthermore, they insisted that a modem Skin and Cancer Unit be constructed in the yet to be built new University Hospital. During his tenure as chairman (1949-1960) he had the responsibility for training hundreds of American dermatologists, as well as many from other countries. A significant number of these NYU-trained individuals became leaders in dermatology throughout the world. After his retirement from the chairmanship of the department of dermatology at New York University Medical Center in 1961, he moved to Washington, DC, where he served as technical director of research for the U.S. Army Medical Research and Development Command from 1961 to 1964. He then became technical director of the first U.S. Army Research Unit in San Francisco from 1964 to 1968. This unit was devoted solely to the study of diseases of the skin important to the military. At that point, when he was in his late sixties, he began yet another productive career. Together with his wife, Roberta, be founded the Institute of Dermatologic Communication and Education, which engaged them in the production of audiovisual aids for dermatology. These were characterized by the same high standards of careful preparation, content, and execution as those of his scientific publications, and they were specifically designed for various levels of learners, including schoolchildren, medical students, allied health professionals, nondermatologist physicians, residents in training, and dermatologists. His tremendous drive and productivity resulted
Academy obituaries 93A
in an impressive list of scientific articles, chapters, and books. "A Short Selected List of Key Publications" (page 95A) covers his most important works. Throughout his long and active life he maintained a current interest in his area of special expertise, namely, allergy and immunology. Indicative of this continuing interest is the very last letter received by one of us (R. L. B.) 1 month before his death, at age 8889 in which he wrote, "The contents of the article you were good enough to send me were extremely interesting: I still find this (i.e., the immunology of contact allergy) the most fascinating field for me. I understood it all, except what the hieroglyphs on the T's mean (Lytl+, 2 - ) . What I don't understand is why someone does not do the crucial and important practical experiment, etc." And on he went with suggestions on how to do it! Obviously a man with his achievements was bestowed innumerable honors both inside and outside dermatology (see "Curriculum Vitae"). The last and one of the most significant was his installation as honorary fellow in the Royal Society of Medicine in 1982, in his 87th year. Fellowships in this prestigious organizations are limited to 100 individuals worldwide in all branches of medicine and biologic sciences. However, no list of honors and medals received or of publications or high positions can do justice to Marion Sulzberger's extraordinary accomplishments as a person, teacher, clinician, and scientist. Probably his most significant accomplishment was that he had the foresight and possessed the leadership to help guide American dermatology from a largely morphologic and clinical period into its modem era in which fundamental research and knowledge form the underpinning for clinical dermatology. An important step in this direction was the foundation of the Society for Investigative Dermatology. Marion Sulzberger was a leading member of the small group of American dermatologists who founded this Society, and he was the first editor (from 1938 to 1951) of its Journal of Investigative Dermatology. Through his example he showed how dermatology could become a medical specialty that, while adhering to high standards of clinical performance, could participate in producing advances in
94A
Journal of the American Academy of Dermatology
Academy obituaries
fundamental knowledge in medicine in general. Over the years Sulzberger mellowed and, in 1978, he paid tribute to Howard Fox, perhaps the most prominent dermatologist in America during that largely clinically oriented era of the 1920s and 1930s, as one who had contributed to shape modem dermatology and as a "brilliant leader and distinguished gentleman. ' ' American dermatology mourns the death of a man who was a world leader in dermatology, a man who combined the qualities o f an outstanding clinical dermatologist and consultant, the abilities of an extraordinarily gifted and imaginative fundamental and clinical scientist, and the brilliance of a master teacher who was able to present even the most complex clinical and basic topics in a clear and readily understandable fashion. The generosity of spirit shown by Marion toward many individuals was particularly felt by his close collaborators and pupils, including the writers of this tribute, who acknowledge their personal indebtedness to this most unusual and inspiring man, their principal teacher and dear friend.
Rudolf L. Baer, M.D. Alfred W. Kopf, M.D.
Abbreviated curriculum vitae o f M a r i o n B. Sulzberger, M.D. I. Academic positions 1947-1961 Professor and chairman, New York Skin and Cancer Unit 1955-1961 First George Miller MacKee Professor, New York University 1961-1983 Professor emeritus, New York University 1961-1980 Clinical professor of dermatology, University of California, San Francisco 1980-1983 Emeritus clinical professor of dermatology, University of California, San Francisco 1961-1964 Technical director of research, Ofrice of the Surgeon General, United States Army 1964-1969 Technical director of research, then scientific advisor, Letterman Army Institute of Research, San Francisco
II. Positions held in dermatologic organizations 1952 Chairman, Section on Dermatology, New York Academy of Medicine 1938 First board of directors, American Academy of Dermatology 1959-1960 Board of directors, American Academy of Dermatology 1959-1960 A founder of the Dermatology Foundation 1950 President, The Society for Investigative Dermatology 1959 President, American Dermatological Association 1959-1962 International Committee of Dermatology and International League of Dermatological Societies 1959-1961 Member then chairman, Committee on the Cutaneous System, National Research Council 1955-1963 Member then chairman, Committee on Cutaneous Health and Cosmetics, American Medical Association 1956-1959 Member, Study Sections on Allergy and Immunology and on General Medicine, National Institutes o f Health 1961-1983 President, Institute for Dermatologic Communication and Education IIl. Honorary, corresponding, or life member or fellow Alpha Omega Alpha American College of Physicians Philadelphia College of Physicians American Academy of Allergy American College of Allergists American Dermatological Association American School Health Association American Academy of Dermatology Association of Military Dermatologists The Society of Medical Consultants to the Armed Forces Pacific Dermatological Association The Society for Investigative Dermatology International Society of Allergology San Francisco Dermatological Association The New York Dermatological Society The Royal Society of Medicine, Great Britain 41 honorary fellowships in Societies of Dermatology or Allergy in 29 countries IV. Publications Author and/or co-author: 1. Over 430 scientific papers
Volume 10 Number 6 June, 1984
2. Over 100 classified reports to United States Navy, World War II 3. Seven textbooks and numerous chapters in textbooks
V. Editor or co-editor 1938-1950 Journal of Investigative Dermatology (first editor) 1931-1953 Year Book for Dermatology and Syphilology Editorial boards of numerous other journals and newspapers VI. Named honorary lectureships and/or visiting professorships By 17 leading universities in the United States, and by the College de France, University of Munich, and University o f Frankfurt VII. Awards and decorations 1948 Commander of the Star of Anjouan, France 1949 Legion o f Merit and Permanent Citation, United States Navy 1950 New York State Conspicuous Service Cross 1960 Chevalier, Legion d'Honneur, France 1961 Award for Distinguished Achievement, Modern Medicine 1961 Doctor of Medicine, honoris causa, Central University of Venezuela 1966 James Clark White Award for Outstanding Achievement 1967 The yon Pirquet Award Lecture, Rudolf Virchow Medical Society, New York Academy of Medicine 1967 Stephen Rothman Award and Gold Medal, The Society for Investigative Dermatology 1967 Gold Medal of American Academy of Dermatology 1970 Clemens yon Pirquet Gold Medal, Annual Forum on Allergy 1970 Meritorious Civilian Service Medal, United States Army 1976 Citation for 50 years devoted to Service of Public, The Medical Society, State of New York 1978 Consultant Emeritus, United States Army Health Services Command 1978 Certificate of Appreciation, University of California, San Francisco, Department of Dermatology 1980 Alfred Marchionini Gold Medal The abstracts of the articles published by Dr. Marion B.
Academy obituaries
95A
Sulzberger appeared in " A Reminiscent Festschrift on the Centenary of the Skin and Cancer Unit of the Department of Dermatology of the New York University School of Medicine 18 8 2 - 1 8 8 3 - - 19 82-1983" edited by Dr. Morris Leider.
A short selected list of key publications 1. Uber eine bisher nicht beschriebene congenitale Pigmentanomalie, Incontinentia pigmenti. Arch Dermatol Syph 154:19-32, 1928. (This seminal article is the first description of incontinentia pigmenti.) 2. Hypersensitiveness to arsphenamine in guinea pigs. I. Experiments in prevention and in desensitization. Arch Dermatol Syph 20:669-697, 1929. (This paper was published in the year Sulzberger joined the Skin and Cancer facutty, but was based on work done in Breslau. This was the first demonstration of specific, acquired, enduring refractoriness to sensitization. This is the same or a closely related phenomenon that Medawar and Burnet demonstrated many years later (1950s) and called "immune tolerance." This perhaps is Sulzberger's most fundamental contribution.) 3. Arsphenamine hypersensitiveness in guinea pigs. II. Experiments demonstrating the role of the skin, both as originator and as site of the hypersensitiveness. Arch Dermatol Syph 22:839-849, 1930. (This work is important because very early it showed that allergens gaining access to the epidermis are processed there in some manner (Langerhans cells?) that determines their allergenieity.) 4. Studies in hypersensitiveness in certain dermatoses. I. Neurodematitis (disseminated type). (With W. C. Spain, Florence Sammis, and H. I. Shahon.) J Allergy 3:423, 1932. (The results of this study led Coca and Sulzberger to coin the title "atopie dermatitis," which is now universally used.) 5. Experiments in silk hypersensitivity and the inhalation of allergen in atopic dermatitis (neurodermatitis disseminatus). (With Warren T. Vaughn.) J Allergy 5:554-569, 1934. (This report showed experimentally that inhaled allergens can reach the skin in a quantity and quality capable of eliciting urticarial reactions.) 6. Evolution of atopic dermatitis. (With Lewis Webb Hill.) Arch Dermatol Syph 32:451-463, 1935. (This is the first study that demonstrated the tendency of atopic dermatitis to have remissions that, in many cases, separate the dermatosis into three phases, namely, the infantile [2 months to 2 years]; childhood [6 to 10 years]; and young adult [puberty to the mid twenties]:) 7. Nine cases of a distinctive exudative discoid and lichenoid chronic dermatosis. (With William Garbe.) Arch Dermatol Syph 36:247-272, 1937. (This paper was the first to delineate the features of a distinctive dermatosis that is often referred to by the eponym ' 'Sulzberger-Garbe. ' ') 8. Individual differences in susceptibility to eezematous sensitization with simple chemical substances. (With Karl Landsteiner and Adolph Rostenberg, Jr.) J Invest
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Academy obituaries
Dermatol 2:25-29, 1939. (This study reported the earliest use of simple chemicals (dinitrochlorobenzene and paranitrosodimethylaniline) to demonstrate induction of selective, constitutional (genetic) susceptibility to sensitization and subsequent elicitation of allergic contact dermatitis.) Studies in sensitization to skin. 1. The production of antibodies to skin by means of the synergistic action of homologous skin antigen and staphylococcal toxin. (With Rudolph Hecht and Harry Well.) J Exp Med 78:59-65, 1943. (This study was the first to demonstrate autosensitization to skin in laboratory animals and the part played by products of microorganisms (toxins) in potentiating sensitization to homologous tissues.) The absence of skin irritants in the contents of vesicles. (With J. Harry Katz.) U.S. Nav Med Bull 41:12581262, 1943. (This study demonstrated that the fluid and the blister tops of vesicles of the dermatitis caused by poison ivy contained no active allergen and therefore dissemination of the eruption could not be due to scratching or rubbing the lesions.) Penetration of allergens into the human skin. (With F. Herrmann and R. L. Baer.) NY State J Med 44:24522459, 1944. (This study was the first to prove that allergens that produce urticarial reactions can penetrate the skin from external contact and thus produce the reaction that the authors named "contact urticaria.") Studies in hypersensitivity to light. I. Preliminary report. (With Rudolf L. Baer.) J Invest Dermatol 6:345-348, 1945. (This study was the first to report experimental findings that led to the hypothesis that certain forms of solar urticaria are caused by an allergen produced by specific wavelengths of ultraviolet light in the skin of normal persons and that this allergen evokes skinsensitizing antibodies (IgE) in susceptible persons who then suffer solar urticaria upon exposure to sunshine.) Studies on prickly heat. II. Experimental and histologic findings. (With H. M. Zimmerman.) J Invest Dermatot 7:61-68, 1946. (This study showed that intraepidermal obstruction of sweat ducts is the initiating factor in miliaria.) Tropical anhidrotic asthenia (thermogenic anhidrosis) and its relationship to prickly heat. (With H. M. Zimmerman and Kendall Emerson.) J Invest Dermatol 7;153-164, 1946. (This study showed that prickly heat may be followed by long-lasting anhidrosis, which, by its interference with heat dissipation, may produce incapacitating heat exhaustion.) Studies of sweating. I. Preliminary report with particular emphasis on a sweat retention syndrome. (With Franz Herrmann and Frederick G. Zak.) J Invest Dermatol 9:221-242, 1947. (This study uncovered the various causes of obstruction or disruption of the pores of sweat glands that led to hypohidrosis. The term "sweat reten-
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tion syndrome" was coined and its manifestations were described.) Do roentgen-ray treatments as given by skin speciaiists produce skin cancers or other sequelae? (With R. L. Baer and A. Borota.) Arch Dermatol Syph 65:639-655, 1952. (In this retrospective study it was shown that there is no increase in number of skin cancers in sites of benign dermatoses treated by recommended dosage schedules of roentgen rays at the Skin and Cancer Unit during 15 years of follow-up observation.) The effects of topically applied Compound F in selected dermatoses. (With V. H. Witten.) J Invest Dermatol 19:101-102, 1952. (This was the first published demonstration of the therapeutic effectiveness of hydrocortisone when applied externally in various skin conditions.) Some new observations on the biology of the skin surface. (With Franz Herrmann.) Arch Dermatol 81:235244, 1960. (Based on numerous previous studies with Herrmann and Prose, this article proves that the human stratum corneum acts as receptacle with a fixed capacity, characteristic of particular individuals and particular sites.) Newer dermatologic methods for using corticosteroids more efficaciously. (With V. H. Witten.)Med Clin North Am 45:857-868, 1961. (In this article first mention was made of the use of occlusive dressings to increase efficacy of topical preparations of corticosteroids.) Studies on blisters produced by friction. I. Results of linear rubbing and twisting techniques. (With Thomas A. Cortese, Leonard Fishman, and Hugh S. Wiley.) J Invest Dermatol 47:456-465, 1966. (Scientific methods for producing friction blisters were employed on human skin. These studies led to the demonstration of the histologic site and nature of these exceedingly common causes of partial or total military incapacity and incapacity in sports and other occupations.) Three lessons learned in Bloch's clinic. Am J Dermatopathol 2:321-325, 1980. (1. By citing examples from personal experience it is shown that: Unknown variables may so alter experimental conditions that experimental results sometimes may not be duplicatable by other investigators, or even by the original experimenter himself on another occasion. 2. An investigator who fails to obtain the results reported by a previous investigator should never say the preceding investigator was wrong, but only that he, the later investigator, could not reproduce the results of the earlier one, perhaps due to hidden variables in the respective experimental conditions. 3. Innovative hypotheses and valuable experimental procedures that eventually prove successful sometimes have failed because the technical instrumentation and procedures were not at once available.
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MARION B. SULZBERGER (1895-1983)
On Nov 24, 1983, Marion B. Sulzberger, one of the most outstanding dermatologists of all time, died In his adopted city of San Francisco Mauon Sulzberger was born in New York City on March 12, 1895 After completing his grammar and high school education, he attended Harvard University There he devoted much of his time to ~ activities and was asked to leave after 1 year He subsequently traveled for 2 years, assuming various Jobs in Australia as a shepherd, a laborer, and a camel driver. He then worked his way back home as a stoker on a freighter. He spent the following 2 years traveling extensively in Latin America in connection with his father's meat packing business, surveying cattle, lands, and packing conditions, particularly in Paraguay and Argentina. During World War I he served for 2 years as a naval aviator (holding seaplane license No. 74 and landplane license No 1104). After his discharge from the Navy he went to visit his family, who at that time were living in Switzerland. This was the beginning of a period, spent in Europe, which had a profound influence on his future interests and actlvmes. It is essential to know about these early activities in his life because they help explain his character and productlwty. He was a willful, independent, nonconforming, intellectually curious, enterprising young man He did not spare himself any effort or hardship to accomplish goals in his chosen profession of medicine In 1920 he began to study me&clne, first in Geneva and then in Zurich. During that time he decided to specialize in dermatology Contributing to this decision was the influence of Bruno Bloch, head of the dermatology department in Zurich and an accomplished scientist who was the first to isolate a carcinogenic fraction from coal tar and who discovered the DOPA reaction. Another factor was that Marion Sulzberger's sister had had severe acne that left her with pronounced facial scarring. After his period of training in Zfirich, he con-
:'
,~ii
,i
'd
tlnued his dermatologic education in Breslau (now Wroclaw) with Joseph Jadassohn, another outstanding clinical dermatologist and scientist of that era Sulzberger's thinking about dermatology in general and his scientific approach to clinical and fundamental problems were greatly influenced by these two outstanding teachers. When he returned to live permanently in the United States m 1929, he had already done the work underlying several of his major clinical and smentlfic conmbutions, among them the description of incontinentia pigmenti (with Bruno Bloch), the discovery of the phenomenon that is now called specific acquired immunologic tolerance, and the immunologic aspects of superficial fungus infections of the skin, including the role of delayed-type hypersensitivity and of skin-sensitizing antibodies. Soon after his return to New York he became associated with two of the most respected American dermatologists of that era. He joined Fred Wise, an excellent clinician, in private practice and became a member of the faculty and staff of the department of dermatology at the New York Postgraduate Medical School and of the Skin and Cancer Unit, both of which were under the direction of George Miller MacKee. At that time he noted that the actiwUes of dermatologists in the United States were almost exclusively confned to chnlcal endeavors alone. In his view American dermatologists did not carry out fundamental scientific investigations on skin and skin diseases, as did the better dermatology departments m Europe, activities from which he had derived much stimulation. He was not shy in frankly telling his colleagues about this. At the same time he tried to remedy this deficiency by lmtiating a variety of fundamental investigations at the Skin and Cancer Unit and at Montefiore Hospital. Marion Sulzberger soon received worldwide recognition as an outstanding teacher, clinician, and mvestigator, particularly in the field of cutaneous allergy and immunology The volume Dermatologtc Allergy, published in 91A
92A
Journal of the American Academy of Dermatology
Academyobituaries
Marion B. Sulzberger
Volume 10 Number 6 June, 1984
1940 as the first and only textbook dealing with that subject, greatly contributed to his reputation. He became MacKee's successor as director of the Skin and Cancer Unit in 1947, and then became chairman of the Department of Dermatology at New York University Postgraduate Medical School in 1949. There he had the opportunity to bring two large existing departments, namely, the Skin and Cancer Unit and the already existing department of dermatology of New York University, under one aegis. Together with Mr. Charles C. Harris and Dr. MacKee a major achievement in this amalgamation was the preservation of the endowment funds of the Skin and Cancer Unit. Furthermore, they insisted that a modem Skin and Cancer Unit be constructed in the yet to be built new University Hospital. During his tenure as chairman (1949-1960) he had the responsibility for training hundreds of American dermatologists, as well as many from other countries. A significant number of these NYU-trained individuals became leaders in dermatology throughout the world. After his retirement from the chairmanship of the department of dermatology at New York University Medical Center in 1961, he moved to Washington, DC, where he served as technical director of research for the U.S. Army Medical Research and Development Command from 1961 to 1964. He then became technical director of the first U.S. Army Research Unit in San Francisco from 1964 to 1968. This unit was devoted solely to the study of diseases of the skin important to the military. At that point, when he was in his late sixties, he began yet another productive career. Together with his wife, Roberta, be founded the Institute of Dermatologic Communication and Education, which engaged them in the production of audiovisual aids for dermatology. These were characterized by the same high standards of careful preparation, content, and execution as those of his scientific publications, and they were specifically designed for various levels of learners, including schoolchildren, medical students, allied health professionals, nondermatologist physicians, residents in training, and dermatologists. His tremendous drive and productivity resulted
Academy obituaries 93A
in an impressive list of scientific articles, chapters, and books. "A Short Selected List of Key Publications" (page 95A) covers his most important works. Throughout his long and active life he maintained a current interest in his area of special expertise, namely, allergy and immunology. Indicative of this continuing interest is the very last letter received by one of us (R. L. B.) 1 month before his death, at age 8889 in which he wrote, "The contents of the article you were good enough to send me were extremely interesting: I still find this (i.e., the immunology of contact allergy) the most fascinating field for me. I understood it all, except what the hieroglyphs on the T's mean (Lytl+, 2 - ) . What I don't understand is why someone does not do the crucial and important practical experiment, etc." And on he went with suggestions on how to do it! Obviously a man with his achievements was bestowed innumerable honors both inside and outside dermatology (see "Curriculum Vitae"). The last and one of the most significant was his installation as honorary fellow in the Royal Society of Medicine in 1982, in his 87th year. Fellowships in this prestigious organizations are limited to 100 individuals worldwide in all branches of medicine and biologic sciences. However, no list of honors and medals received or of publications or high positions can do justice to Marion Sulzberger's extraordinary accomplishments as a person, teacher, clinician, and scientist. Probably his most significant accomplishment was that he had the foresight and possessed the leadership to help guide American dermatology from a largely morphologic and clinical period into its modem era in which fundamental research and knowledge form the underpinning for clinical dermatology. An important step in this direction was the foundation of the Society for Investigative Dermatology. Marion Sulzberger was a leading member of the small group of American dermatologists who founded this Society, and he was the first editor (from 1938 to 1951) of its Journal of Investigative Dermatology. Through his example he showed how dermatology could become a medical specialty that, while adhering to high standards of clinical performance, could participate in producing advances in
94A
Journal of the American Academy of Dermatology
Academy obituaries
fundamental knowledge in medicine in general. Over the years Sulzberger mellowed and, in 1978, he paid tribute to Howard Fox, perhaps the most prominent dermatologist in America during that largely clinically oriented era of the 1920s and 1930s, as one who had contributed to shape modem dermatology and as a "brilliant leader and distinguished gentleman. ' ' American dermatology mourns the death of a man who was a world leader in dermatology, a man who combined the qualities o f an outstanding clinical dermatologist and consultant, the abilities of an extraordinarily gifted and imaginative fundamental and clinical scientist, and the brilliance of a master teacher who was able to present even the most complex clinical and basic topics in a clear and readily understandable fashion. The generosity of spirit shown by Marion toward many individuals was particularly felt by his close collaborators and pupils, including the writers of this tribute, who acknowledge their personal indebtedness to this most unusual and inspiring man, their principal teacher and dear friend.
Rudolf L. Baer, M.D. Alfred W. Kopf, M.D.
Abbreviated curriculum vitae o f M a r i o n B. Sulzberger, M.D. I. Academic positions 1947-1961 Professor and chairman, New York Skin and Cancer Unit 1955-1961 First George Miller MacKee Professor, New York University 1961-1983 Professor emeritus, New York University 1961-1980 Clinical professor of dermatology, University of California, San Francisco 1980-1983 Emeritus clinical professor of dermatology, University of California, San Francisco 1961-1964 Technical director of research, Ofrice of the Surgeon General, United States Army 1964-1969 Technical director of research, then scientific advisor, Letterman Army Institute of Research, San Francisco
II. Positions held in dermatologic organizations 1952 Chairman, Section on Dermatology, New York Academy of Medicine 1938 First board of directors, American Academy of Dermatology 1959-1960 Board of directors, American Academy of Dermatology 1959-1960 A founder of the Dermatology Foundation 1950 President, The Society for Investigative Dermatology 1959 President, American Dermatological Association 1959-1962 International Committee of Dermatology and International League of Dermatological Societies 1959-1961 Member then chairman, Committee on the Cutaneous System, National Research Council 1955-1963 Member then chairman, Committee on Cutaneous Health and Cosmetics, American Medical Association 1956-1959 Member, Study Sections on Allergy and Immunology and on General Medicine, National Institutes o f Health 1961-1983 President, Institute for Dermatologic Communication and Education IIl. Honorary, corresponding, or life member or fellow Alpha Omega Alpha American College of Physicians Philadelphia College of Physicians American Academy of Allergy American College of Allergists American Dermatological Association American School Health Association American Academy of Dermatology Association of Military Dermatologists The Society of Medical Consultants to the Armed Forces Pacific Dermatological Association The Society for Investigative Dermatology International Society of Allergology San Francisco Dermatological Association The New York Dermatological Society The Royal Society of Medicine, Great Britain 41 honorary fellowships in Societies of Dermatology or Allergy in 29 countries IV. Publications Author and/or co-author: 1. Over 430 scientific papers
Volume 10 Number 6 June, 1984
2. Over 100 classified reports to United States Navy, World War II 3. Seven textbooks and numerous chapters in textbooks
V. Editor or co-editor 1938-1950 Journal of Investigative Dermatology (first editor) 1931-1953 Year Book for Dermatology and Syphilology Editorial boards of numerous other journals and newspapers VI. Named honorary lectureships and/or visiting professorships By 17 leading universities in the United States, and by the College de France, University of Munich, and University o f Frankfurt VII. Awards and decorations 1948 Commander of the Star of Anjouan, France 1949 Legion o f Merit and Permanent Citation, United States Navy 1950 New York State Conspicuous Service Cross 1960 Chevalier, Legion d'Honneur, France 1961 Award for Distinguished Achievement, Modern Medicine 1961 Doctor of Medicine, honoris causa, Central University of Venezuela 1966 James Clark White Award for Outstanding Achievement 1967 The yon Pirquet Award Lecture, Rudolf Virchow Medical Society, New York Academy of Medicine 1967 Stephen Rothman Award and Gold Medal, The Society for Investigative Dermatology 1967 Gold Medal of American Academy of Dermatology 1970 Clemens yon Pirquet Gold Medal, Annual Forum on Allergy 1970 Meritorious Civilian Service Medal, United States Army 1976 Citation for 50 years devoted to Service of Public, The Medical Society, State of New York 1978 Consultant Emeritus, United States Army Health Services Command 1978 Certificate of Appreciation, University of California, San Francisco, Department of Dermatology 1980 Alfred Marchionini Gold Medal The abstracts of the articles published by Dr. Marion B.
Academy obituaries
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Sulzberger appeared in " A Reminiscent Festschrift on the Centenary of the Skin and Cancer Unit of the Department of Dermatology of the New York University School of Medicine 18 8 2 - 1 8 8 3 - - 19 82-1983" edited by Dr. Morris Leider.
A short selected list of key publications 1. Uber eine bisher nicht beschriebene congenitale Pigmentanomalie, Incontinentia pigmenti. Arch Dermatol Syph 154:19-32, 1928. (This seminal article is the first description of incontinentia pigmenti.) 2. Hypersensitiveness to arsphenamine in guinea pigs. I. Experiments in prevention and in desensitization. Arch Dermatol Syph 20:669-697, 1929. (This paper was published in the year Sulzberger joined the Skin and Cancer facutty, but was based on work done in Breslau. This was the first demonstration of specific, acquired, enduring refractoriness to sensitization. This is the same or a closely related phenomenon that Medawar and Burnet demonstrated many years later (1950s) and called "immune tolerance." This perhaps is Sulzberger's most fundamental contribution.) 3. Arsphenamine hypersensitiveness in guinea pigs. II. Experiments demonstrating the role of the skin, both as originator and as site of the hypersensitiveness. Arch Dermatol Syph 22:839-849, 1930. (This work is important because very early it showed that allergens gaining access to the epidermis are processed there in some manner (Langerhans cells?) that determines their allergenieity.) 4. Studies in hypersensitiveness in certain dermatoses. I. Neurodematitis (disseminated type). (With W. C. Spain, Florence Sammis, and H. I. Shahon.) J Allergy 3:423, 1932. (The results of this study led Coca and Sulzberger to coin the title "atopie dermatitis," which is now universally used.) 5. Experiments in silk hypersensitivity and the inhalation of allergen in atopic dermatitis (neurodermatitis disseminatus). (With Warren T. Vaughn.) J Allergy 5:554-569, 1934. (This report showed experimentally that inhaled allergens can reach the skin in a quantity and quality capable of eliciting urticarial reactions.) 6. Evolution of atopic dermatitis. (With Lewis Webb Hill.) Arch Dermatol Syph 32:451-463, 1935. (This is the first study that demonstrated the tendency of atopic dermatitis to have remissions that, in many cases, separate the dermatosis into three phases, namely, the infantile [2 months to 2 years]; childhood [6 to 10 years]; and young adult [puberty to the mid twenties]:) 7. Nine cases of a distinctive exudative discoid and lichenoid chronic dermatosis. (With William Garbe.) Arch Dermatol Syph 36:247-272, 1937. (This paper was the first to delineate the features of a distinctive dermatosis that is often referred to by the eponym ' 'Sulzberger-Garbe. ' ') 8. Individual differences in susceptibility to eezematous sensitization with simple chemical substances. (With Karl Landsteiner and Adolph Rostenberg, Jr.) J Invest
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Journal of the American Academy of Dermatology
Academy obituaries
Dermatol 2:25-29, 1939. (This study reported the earliest use of simple chemicals (dinitrochlorobenzene and paranitrosodimethylaniline) to demonstrate induction of selective, constitutional (genetic) susceptibility to sensitization and subsequent elicitation of allergic contact dermatitis.) Studies in sensitization to skin. 1. The production of antibodies to skin by means of the synergistic action of homologous skin antigen and staphylococcal toxin. (With Rudolph Hecht and Harry Well.) J Exp Med 78:59-65, 1943. (This study was the first to demonstrate autosensitization to skin in laboratory animals and the part played by products of microorganisms (toxins) in potentiating sensitization to homologous tissues.) The absence of skin irritants in the contents of vesicles. (With J. Harry Katz.) U.S. Nav Med Bull 41:12581262, 1943. (This study demonstrated that the fluid and the blister tops of vesicles of the dermatitis caused by poison ivy contained no active allergen and therefore dissemination of the eruption could not be due to scratching or rubbing the lesions.) Penetration of allergens into the human skin. (With F. Herrmann and R. L. Baer.) NY State J Med 44:24522459, 1944. (This study was the first to prove that allergens that produce urticarial reactions can penetrate the skin from external contact and thus produce the reaction that the authors named "contact urticaria.") Studies in hypersensitivity to light. I. Preliminary report. (With Rudolf L. Baer.) J Invest Dermatol 6:345-348, 1945. (This study was the first to report experimental findings that led to the hypothesis that certain forms of solar urticaria are caused by an allergen produced by specific wavelengths of ultraviolet light in the skin of normal persons and that this allergen evokes skinsensitizing antibodies (IgE) in susceptible persons who then suffer solar urticaria upon exposure to sunshine.) Studies on prickly heat. II. Experimental and histologic findings. (With H. M. Zimmerman.) J Invest Dermatot 7:61-68, 1946. (This study showed that intraepidermal obstruction of sweat ducts is the initiating factor in miliaria.) Tropical anhidrotic asthenia (thermogenic anhidrosis) and its relationship to prickly heat. (With H. M. Zimmerman and Kendall Emerson.) J Invest Dermatol 7;153-164, 1946. (This study showed that prickly heat may be followed by long-lasting anhidrosis, which, by its interference with heat dissipation, may produce incapacitating heat exhaustion.) Studies of sweating. I. Preliminary report with particular emphasis on a sweat retention syndrome. (With Franz Herrmann and Frederick G. Zak.) J Invest Dermatol 9:221-242, 1947. (This study uncovered the various causes of obstruction or disruption of the pores of sweat glands that led to hypohidrosis. The term "sweat reten-
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tion syndrome" was coined and its manifestations were described.) Do roentgen-ray treatments as given by skin speciaiists produce skin cancers or other sequelae? (With R. L. Baer and A. Borota.) Arch Dermatol Syph 65:639-655, 1952. (In this retrospective study it was shown that there is no increase in number of skin cancers in sites of benign dermatoses treated by recommended dosage schedules of roentgen rays at the Skin and Cancer Unit during 15 years of follow-up observation.) The effects of topically applied Compound F in selected dermatoses. (With V. H. Witten.) J Invest Dermatol 19:101-102, 1952. (This was the first published demonstration of the therapeutic effectiveness of hydrocortisone when applied externally in various skin conditions.) Some new observations on the biology of the skin surface. (With Franz Herrmann.) Arch Dermatol 81:235244, 1960. (Based on numerous previous studies with Herrmann and Prose, this article proves that the human stratum corneum acts as receptacle with a fixed capacity, characteristic of particular individuals and particular sites.) Newer dermatologic methods for using corticosteroids more efficaciously. (With V. H. Witten.)Med Clin North Am 45:857-868, 1961. (In this article first mention was made of the use of occlusive dressings to increase efficacy of topical preparations of corticosteroids.) Studies on blisters produced by friction. I. Results of linear rubbing and twisting techniques. (With Thomas A. Cortese, Leonard Fishman, and Hugh S. Wiley.) J Invest Dermatol 47:456-465, 1966. (Scientific methods for producing friction blisters were employed on human skin. These studies led to the demonstration of the histologic site and nature of these exceedingly common causes of partial or total military incapacity and incapacity in sports and other occupations.) Three lessons learned in Bloch's clinic. Am J Dermatopathol 2:321-325, 1980. (1. By citing examples from personal experience it is shown that: Unknown variables may so alter experimental conditions that experimental results sometimes may not be duplicatable by other investigators, or even by the original experimenter himself on another occasion. 2. An investigator who fails to obtain the results reported by a previous investigator should never say the preceding investigator was wrong, but only that he, the later investigator, could not reproduce the results of the earlier one, perhaps due to hidden variables in the respective experimental conditions. 3. Innovative hypotheses and valuable experimental procedures that eventually prove successful sometimes have failed because the technical instrumentation and procedures were not at once available.