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17 Department of Dermatology AT THE TIME The Mount Sinai Hospital was founded in 1852, there was no formal dermatology department. Dermatology as a specialty was not officially recognized by the American Board of Medical Specialties until 1938, when the American Board of Dermatology and Syphilology was established, although the field had long been recognized in Europe. The fields of dermatology and syphilology were united because of the numerous dermatologic manifestations of syphilis. By 1872, when The Mount Sinai Hospital moved to its second location , at Lexington Avenue between 67th and 68th streets, there were many dermatologic cases. At the time, many dermatalgic conditions were treated with preparations that were derivatives of arsenic, mercury , sulfur, and tar.1 Psoriasis was treated with carbolic acid in glycerine , tar, oil of cade, or mercury ointment. Eczema was treated with 10 percent oil of cade. Basal cell carcinoma was treated by arsenic paste or cautery. For syphilis, “the great imitator,” as the saying went, “One night with Venus, and the rest of your life with mercury.” In 1891, a Clinic for Skin and Venereal Disease was created in the Out-Patient Department of the Hospital. In 1893, Sigmund Lustgarten was appointed Consulting Dermatologist for the patients on the Hospital wards. In 1900, a small number of beds were set aside for dermatology patients, and Lustgarten’s position was changed to Attending Dermatologist , the equivalent of Chief of Service. Lustgarten was a student of the great European dermatologists Ferdinand von Hebra and Moritz Kaposi. He came to the United States from his native Vienna in 1889 and became active in medical circles, quickly gaining a reputation as a skilled clinician and diagnostician. He did not—and could not, in these early years of specialization—limit his diagnostic work to dermatology alone, however, and he was frequently called to attend the general wards. At the time, diagnosis depended almost entirely on clinical knowledge . On one famous occasion, Lustgarten made the diagnosis of leprosy in a patient on the general wards. His diagnoses were usually 191 preceded by a mysterious approach. In this case, he asked to have a “pimple” pricked on the lip of the patient. He made a smear that could be used to test for the tubercle bacilli, as well as for leprosy. Many thought he was testing for tuberculosis, although everyone was sure this was not the correct diagnosis. Instead, the smear proved that the patient had leprosy. On another occasion, he visited a syphilitic patient who had broken out with a fiery, red rash, which was diagnosed as scarlet fever. The patient was put in isolation. Lustgarten examined the patient and diagnosed the rash as a case of overdose of mercury, which had been given to treat the syphilis. Associates claimed that Lustgarten was the first to give Salvarsan as a treatment for syphilis in the U.S.2 Lustgarten was a man of extreme discretion and tact. In going through a hotel lobby one day with another dermatologist, Richard Hoffman, Hoffman saw and greeted a man they both knew. Lustgarten did not acknowledge the acquaintance. When Hoffman pointed out that the person was someone they both knew, Lustgarten explained that he rarely greeted people in public because his reputation as a syphilis expert might embarrass some of his acquaintances.3 Lustgarten was also a man of culture and erudition, a lover of music, and a connoisseur of art. He was a good draftsman and a collector of fine engravings and etchings. Soft spoken and dignified, he was considered a man of great intellectual stature and commanded universal respect. On Lustgarten’s death in 1911 at age fifty-three, Hermann Goldenberg became the Chief of Service. Goldenberg had trained in Munich and did postgraduate work for several years in Europe. During his tenure as Chief of Dermatology, Mount Sinai was among the first to introduce modern methods in the treatment of syphilis. Goldenberg received some of the original allotment of Salvarsan before the drug was released for general use. It was said that he treated patients with early syphilis with miraculous results.4 As the years passed, the Department had eight allocated beds, with the privilege of also utilizing beds on the pediatric wards. These beds were always occupied. Many interesting cases from the ward and clinics were presented at the various grand rounds. As was noted later: In the early part of the twentieth century the skin clinics of Mount Sinai Hospital were outstanding for their large and...

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