150 years of Dermatology in the Municipal Hospital Dresden-Friedrichstadt

Uwe Wollina

Department of Dermatology and Allergology, Municipal Hospital Dresden, 01067 Dresden, Germany

Corresponding author: Prof. Uwe Wollina, MD, PhD, E-mail: uwollina@gmail.com

How to cite this article: Wollina U. 150 years of Dermatology in the Municipal Hospital Dresden-Friedrichstadt. Our Dermatol Online. 2025;16(1):93-100.
Submission: 10.06.2024; Acceptance: 09.07.2024
DOI: 10.7241/ourd.20251.20

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ABSTRACT

The Department of Dermatology at the Municipal Hospital Dresden-Friedrichstadt was founded in 1874 and is the second oldest non-university department in the German-speaking countries. Founded in a former summer palace of nobles, the hospital has seen a tremendous development over time. In the early years cutaneous tuberculosis and sexually transmitted diseases dominated with limited treatment options, resulting in hospitalization and prolonged therapy. In the last decades derma-oncology and dermato-surgery become more important, but the COVID-19 pandemic has demonstrated that infectious diseases remain a challenge.

Key words: Dermatology, Dresden-Friedrichstadt, History of Medicine, Development


INTRODUCTION

In the German states, revolutions began in March 1848, propagating a National Assembly which prepared the first constitution (Reichsverfassung) for Germany. People in Dresden, Saxony, were faced with the repression of the democratic movement by the Saxonian king Friedrich August 2nd. As a result, the May Uprising began with prominent participants such as the publisher, composer and conductor August Röckel, the anarchist Mikhail Bakunin, the composer Richard Wagner, and the architect Gottfried Semper.

The number of dead rebels was later estimated at around 200, however, there is no data about the wounded people [1]. The Hospital Dresden-Friedrichstadt was founded 175 years ago in response to the needs resulting from the causalities of the revolution of 1848. It is basically located on a ground that was owned before by the Earl Heinrich von Brühl (*1700; †1763), one of the Saxonian king’s favorites [2]. The character of the hospital was deeply influenced by its history as a noble palace with historic artifacts and a beautiful park (Figs. 1a and 1b) [3].

Figure 1: (a) The Hospital Dresden-Friedrichstadt, main entrance of the Marcolini palais, 19th century.(b) Historical part of the Hospital Dresden-Friedrichstadt in recent times from inside with the Küfer (cellarman) fountain (U. Wollina).

THE EARLY YEARS WITH JULIUS OTTO MARTINI

Dermatology started in the year 1874 when the II. External Department, Department of Skin and Venereal Diseases and Minor Surgery was founded. It was descended from the Department for Syphilitic Women, which belonged to Surgery. The Department consisted of 71 inpatient beds, nursing staff and physicians. It was the second Municipal Department of Dermatology in the German-speaking countries after Nürnberg (Nuremberg) which opened 1845. Although Dresden had no Medical College until 1954, when the Medical Academy “Carl Gustav Carus” was founded, the Hospital Dresden-Friedrichstadt was highly regarded.

The first leading physician in the position of a Senior Physician (Oberarzt) was Julius Otto Martini (*1829; †1909) from the start of the department until 1901. Martini attended the Princely and Country School Grimma. He studied Medicine at the University of Leipzig. Before he got his employment by the Hospital Dresden-Friedrichstadt in 1866, he worked as a Military Doctor and General Practitioner. Under his leadership the inpatient capacity was expanded to 140 by 1888. He was involved in “Carl Christian Schmidt’s Yearbooks of Domestic and Foreign Medicine” (Carl Christian Schmidts Jahrbücher der in− und ausländischen Medizin) on systematic dermatology and treatment of skin diseases, which were published by Otto Wigand in primarily Leipzig and later also in Bonn (Fig. 2) [4]. He cooperated with the urologist Felix Martin Oberländer (*1850; †1915). Oberländer and the technician Maximilian Nitze (*1848; †1906) developed later the first cystoscope (Fig. 3) [5].

Figure 2: Year Books of Domestic and Foreign Medicine.
Figure 3: Julius Otto Martini (Plate 1116; CC BY-NC-SA @ Stadtmuseum Dresden).

JOHANNES WERTHER AND HIS COLLECTION OF MOULAGES

Martini was followed by Johannes Werther (*1865; †1936), who got his education in Dresden. He studied medicine at the University of Leipzig and completed his specialized training in Dermatology at the Hospital Dresden-Friedrichstadt and the Charité Berlin. Under his leadership the Department received its own laboratory facilities including rooms for microscopy and photography, and a procedure room for surgery. In 1907 an X-ray machine and a quartz lamp completed the equipment. Werther had an interest in venereal diseases, lupus vulgaris, bullous skin disorders, and psychogenic skin diseases. He is considered the first describer of the Naevus syringadenomatosus papilliferus in German speaking countries [6,7] (Fig. 4).

Figure 4: Prof. Dr. Werther, bronze plate.

On his initiative the Association of Dermatologists and Urologist in Dresden was founded, which held regular training evenings [8]. In 1903, he established the “Collection of Waxen Images of the Outer Department of the City Hospital of Dresden-Friedrichstadt” (Wachsbildersammlung der Äußeren Abteilung des Stadtkrankenhauses Dresden−Friedrichstadt) (Figs. 5a and 5b) [9].

Figure 5: (a) Moulage from Werther’s collection “Syphilitic rash in a newborn”. (b) The catalogue of Werther’s collection of moulages.

Moulages are three-dimensional individualized wax models to depict the important features of skin diseases. Originating from the 19th century they became very popular for education of ongoing physicians in dermatology until the 1930ies. The moulageurs Fritz Kolbow and Emmy Kürschner-Ziegfeld produced most of the wax models in Werther’s collection [10]. The collection was expanded to 368 moulages until 1930 and survived the II. World War. However, during post-war years most of the artifacts were destroyed. Several years ago, the last moulages were transferred to the Dresden Museum of Hygiene for conservatory reasons [11].

Werther and Galewsky organized in 1925 the 14th Congress of the German Dermatological Society, for the first time at a place without a Medical University. This reflects the high appreciation for both dermatologist from Dresden, and the Department of Dermatology and Venereology in Dresden-Friedrichstadt. Werther’s grave is on the Johannes cemetery in Dresden-Tolkewitz [12].

HANS MARTENSTEIN AND THE LEAGUE OF NATIONS

Hans Martenstein (*1892; †1945) became the successor of Werther in 1930. Martenstein studied Medicine at the University of Leipzig. At the University of Breslau (Wrocław) he acquired his dermatological education. His teachers were Albert Neisser (+1855; †1916), Joseph Jadassohn (*1863; †1936), and Heinrich Adolf Gottron (*1890; †1974). The University of Breslau was a Mecca for dermatologists and of outstanding impact on dermatology and venerology at the time [13].

His main interests during the years in Breslau were radiobiology and radiotherapy, cutaneous tuberculosis, and lupus erythematosus [1418]. His investigations in syphilis culminated in his review article “Syphilis Treatment: Part I. Enquiry in Five Countries Carried out under the Auspices of the Health Organisation of the League of Nations.” [19]. This may be considered as the first international guideline for diagnostics, treatment and follow-up for patients affected by syphilis.

The Committee of Experts headed by Jadassohn, made the following comments and recommendations:

  • (1) Treatment should be recommended as early as possible in the sero-negative primary stage. In this connection, the fullest possible use should be made, for purposes of diagnosis, of the microscopical examination of secretion from primary lesions or from lymph glands.

  • (2) It should be emphasised that, prior to the institution of either of the systems of treatment outlined below, there should be an adequate physical examination to determine the absence or otherwise of any indication for caution in respect of the dosage.

  • (3) It is essential that, in carrying out the treatment, a strict supervision of the patient be exercised, especially in respect of mucous membranes, skin, kidneys and liver.

  • (4) Observation, clinical and serological, after completion of treatment, should be adequate and in any case for not less than three years.

  • (5) Adequate examination of the spinal fluid, at least before dismissal from observation, is essential.

  • (6) The principles to be followed in carrying out the actual treatment should be as follows:

    • (a) To employ a comparatively heavy individual dosage of the arsenobenzene and of the bismuth or mercurial compounds, the doses being administered in comparatively rapid succession, especially at the commencement.

    • (b) To maintain a persistent attack on the disease, avoiding intervals of such length as to afford the parasite an opportunity of recovering.

    • (c) To administer approximately as much treatment to primary as to secondary cases.

There was a lot of discussion on the optimal way to treat syphilis, which was discussed in detail in other papers, especially between US-American and European Physicians [20,21].

Bruno Bloch (+1878; †1933) and Josef Jadassohn recommended Martenstein as a successor of Georg Arndt (*1874; †1929) at the Department of Dermatology, Charité Berlin, but eventually he got no vocation [22]. Instead, he moved to the capital of Saxony, to Dresden.

In 1933 the Dermatologist Eugen Galewski (*1864; †1935) prepared the commemorative document for Jadassohn’s 70th birthday. For this purpose, he was in close contact to Martenstein. But in this year the political situation in Germany changed dramatically, especially for Jewish people.

In a letter to Felix Pinkus (*1868; †1947) Galewsky wrote: „Under today’s circumstances Martenstein and I believed to abstain from all preparations to honor Jadassohn until circumstances have been clarified.” („Unter den heutigen Verhältnissen glaubten Martenstein und ich vorläufig von allen Vorbereitungen für die Ehrung von Jadassohn absehen zu müssen, bis sich die Verhältnisse geklärt haben werden.”) [23]. Eugen Galewsky died in 1935, probably by suicide.

The foundation of an independent Department of Dermatology and Venereology in 1937 at the Hospital Dresden-Friedrichstadt is a merit of Martenstein. The clinic had 225 inpatient beds and was one of the most modern Departments of Dermatology in Germany.

Martenstein has never been a member of the NSDAP, which was quite unusual for Chief Medical Doctors during the III. Reich [24]. He died from suicide in May 1945 (Fig. 6).

Figure 6: The grave of Hans Martenstein (https://commons.wikimedia.org/wiki/File: DD-AKF-Grabmal-Martenstein.jpg).

THE POST-WAR PERIOD AND HEINZ HERING

After the II. World War the clinic was managed for short periods by Karl Gottfried Linser (*1895; †1976), Rolf Bettermann (*1917, † unknown), and Roderich Helmke (*1906; †1980). Linser studied Medicine in Würzburg and Heidelberg. From 1933 to 1945 he was the Chief Physician of the Dermatologic Unit of the Forest Park Hospital (Waldparkkrankenhaus) and the Pediatric Policlinic of the Hospital Dresden-Johannstadt before he headed the Department of Dermatology and Venereology Dresden-Friedrichstadt in 1945-1946. Later he became Ordinary of the Department of Dermatology at the University of Leipzig.

During post-war years gonorrhea and syphilis showed a dramatic increase. In Eastern Germany, the Soviet Military Administration in Germany (SMAD) released the SMAD-instruction No. 030/46 on February 12th 1946 “About the measures to combat sexually transmitted diseases”. Several related instructions were published during the following years. Patients with syphilis and gonorrhea were treated in the Dermatological Hospitals, usually as inpatient treatment.

The Department of Dermatology and Venerology in Friedrichstadt had 300 inpatient beds. In 1947 the venereal patients were transferred to the Department of Infectious Diseases in Dresden-Trachau and to the Venereological Unit in the Bodelschwingh street which had nearly 180 inpatient beds. The free space was used for the Dermatological Policlinic to serve outpatients.

Heinz Hering (*1913; †1998) became the Chief Physician in 1950 and continued until 1974.

He studied Medicine in Jena, Breslau and Leipzig. Martenstein was his teacher during the dermatological specification training. In the year 1937, he habilitated on lipid metabolism in psoriasis [25]. In the same year he became a member of the NSDAP but left the party in 1944 probably while he was hold in captivity.

For several years he had a private practice. In the postwar period Hering was leading several makeshift hospitals to combat sexually transmitted diseases (STD). This made him qualified to head the Department of Dermatology and Venereology in Friedrichstadt. In 1958-59 he achieved a reconstruction of the Department with 150 dermatological inpatient beds and a separate unit of 30 beds for patients with STD. In 1961 the number of inpatient beds was reduced to 150.

His clinical engagement at the Hospital Dresden-Friedrichstadt was focused on X-ray therapy, allergology, cutaneous tuberculosis, phlebology, venereology, and occupational dermatology. He established the varicose sclerotherapy according to Paul Linser (*1871; †1963) in Dresden-Friedrichstadt.

On the initiative of Hering, the Society of Dermatologist of Leipzig and the Association of Dermatologist of Dresden merged in 1957 to create the Assembly of the Saxonian Dermatological Society [26].

His view on patients with STD would be unacceptable today. Patients with changing sex partners were characterized as “impulsive”, “moronic”, and “unrestrained”. He argued against ambulatory treatment of patients with gonorrhoea, because he feared that this would cause a higher promiscuity [27]. This statement cannot conceal the Janus face of East German health policy and morality. Prostitution was officially prohibited, but the Ministry for Internal Affairs used prostitutes to obtain information from visitors from Western countries [28].

In 1961 a secured ward for STD patients was founded that existed until 1974. Compulsory admissions to the venereological inpatients units were partially politically motivated based on the regulations of the SMAD in 1947 and continued until the mid 60ies [29].

The Department of Dermatology and Venereology also served as a burn center [30]. In the late 60ies Volker Tempel (*1939; †2022) raised a dermato-surgery unit which was also used for the treatment of burn patients. He was a surgeon and worked in the Department of Dermatology and Venereology.

After Hering had left the clinic, the department was managed for the next two years by senior physician Gerhard Goßrau (*1934), who was a specialist in photodermatology.

CLAUS SEEBACHER – A NEW START IN MYCOLOGY AND MELANOMA RESEARCH

In 1976 Claus Seebacher (*1935) became the new Head of the Department. He studied Medicine at the Universities of Greifswald, Leipzig and the Medical Academy in Dresden. Under his leadership, the department was modernized. In 1991 the reconstruction was completed, and the department had now 102 inpatient beds. He also established a special laboratory for mycology and the first digital database for cutaneous melanoma [31]. Mycology is his life. Together with Renate Blaschke−Hellmessen (*1931; †2022), microbiologist at the Medical Academy Dresden (later University Dresden) he edited in 1990 the definitive book “Mykosen: Epidemiologie – Diagnostik – Therapie” (Mycoses: Epidemiology – Diagnostics – Treatment) [32]. For many years, Seebacher served as Head of the Sub-Commission “Mycology” of the German Committee on Guidelines in Medicine (Fig. 7).

Figure 7: Prof. Claus Seebacher (left) and Prof. Uwe-Fritjof Haustein (right) at the Symposium on the 80th birthday of Prof. Seebacher in the Marcolini Palais.

Seebacher connected to the tradition of the “Verein Dresdner Dermatologen”, and founded in 1977 an annual symposium known as “Dresdner Dermatologische Demonstration” (Dresden Dermatological Demonstration). The tradition was only interrupted in 2020-2023 by the COVID-19 pandemic. It consisted of live patient demonstrations, short speeches on interesting case reports, and invited lectures [33,34].

Together with H. Bernhardt and Renate Blaschke-Hellmessen he organized the 5th Congress of the European Confederation of Medical Mycology and 33rd Congress of the Mycological Society of German Speaking Countries (DMyk) in June 1999 in Dresden [35]. He wrote reviews on the history of mycology in German-speaking countries and in former East Germany [36,37]. Seebacher was awarded as Honorary Member of the DMyk [38].

During Seebacher’s leadership, Erich Köstler (*1943; †2007) habilitated on cutaneous porphyria. He studied medicine at the University of Leipzig. In 1969 he began his special training in Dermatology at the Hospital Dresden-Friedrichstadt. He worked closely with the Centre for Porphyrias in Chemnitz, the largest in Germany, headed by Ulrich Stölzel (*1955). In 1990 he became Privat-Dozent and in 2003 he became an adjunct professor at the Technical University of Dresden. He was an excellent clinician and dermato-surgeon [39]. He published several papers on porphyria diagnostics and treatment and the role of hemochromatosis (HFE) gene mutations [4042].

THE LAST 2 DECADES

The successor of Claus Seebacher was Uwe Wollina in 2001. He studied Medicine at the Friedrich-Schiller-University of Jena. He headed the department for 22 years. The main interests of his clinical and scientific work were skin cancer, wound healing and chronic wounds, dermato-rheumatologic disorders, psoriasis, and dermato-surgery. The cooperation with the Porphyria Center Chemnitz was continued with Dr. André Koch, who is also connected to the Allergy Center of the Technical University of Dresden. Together with Birgit Heinig (Physical Therapy and Rehabilitative Medicine) Wollina established the Center for Lymphatic Diseases Dresden for patients with lymphedema and lipedema in conjunction with an outpatient clinic. The Department of Dermatology and Allergology became a certified Center for Dermato-Oncology (European Cancer Centers) with Dr. Gesina Hansel as Secretary. The spectrum of Dermato-Surgery was expanded for skin cancer and leg ulcers. Liposuction and laser surgery were established. Dr. Claudia Krönert became the Senior Physician for the surgery ward.

In 2011, the Department of Dermatology and Allergology moved to a modern new building, which significantly improved working conditions for the staff and comfort for the patients (Fig. 8). Processes were optimized and quality management was implemented.

Figure 8: The new building for the Department of Dermatology and Allergology, the ENT Department and the Department of Ophthalmology.

Wollina was a co-founder of the very popular interdisciplinary training series “Psoriasis and Psoriatic Arthritis” in conjunction with Hubert Nüsslein (Rheumatology) and Leonore Unger (Rheumatology, Osteology).

He organized the Congress of the European Society of Cosmetic and Aesthetic Dermatology COSMODERM XVI in 2010, the 5. Joint Lymphology Congress of the German Society of Lymphology and the Austrian Society of Manual Lymphdrainage (Dr. Vodder) in 2008, and the 1st International Dermatology Symposium and Regional Meeting of the International Society of Dermatology in Dresden [43,44].

A major challenge was the flooding of Dresden and the Hospital Dresden-Friedrichstadt in 2002 when 900 patients had to be evacuated from the hospital within a day [45].

The COVID-19 pandemic also had a strong impact on the Hospital and the Department of Dermatology and Allergology. Available inpatient beds and human resources became sustained restricted in university and non-university dermatologic departments, although necessary surgical interventions in cancer patients could be performed during the pandemic [46].

Wollina was last President of the Saxonian Society of Dermatology, Past-President of the ESCAD, and former Chairman of Regional Officers of the International Society of Dermatology (ISD). He is an Honorary Member of the Maltese Association of Dermatology and Venereology (MADV), Honorary Member of the Cosmetic Dermatology Society of India, and Honorary Member of the Jordanian Dermatological and Venereological Society. Wollina received the Certificate of Appreciation 2014 of the International League of Dermatological Societies (ILDS) for his engagement in the International Society of Dermatology [47].

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Notes

Source of Support: This article has no funding source.

Conflict of Interest: The authors have no conflict of interest to declare.

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