Ferdinand Ritter von Hebra
Biography of Ferdinand Ritter von Hebra
Ferdinand Ritter von Hebra was one of the founders of the new Vienna School of dermatology, which became a basis for modern dermatology. He described and named many diseases of the skin, among them lupus, pityriasis, rubra and tinea cruris, and was the first to describe dermatitis herpetiformes.
Hebra began studying in Graz, attending the so-called philosophical classes, but moved to Vienna where he graduated in medicine in 1841 and got a position as assistant at the Lehrkanzel für Staatsarzneikunde. In 1842 he aroused some public interest with a work on the history of surgery.
Shortly afterwards he came to Josef Skoda’s (1805-1881) department for diseases of the chest, first as an aspirant, later as secondary physician. Connected to this was a ward for diseases of the skin, popularly called the "rash room". This ward was overcrowded with patients suffering from serious skin diseases; it was a place the interns considered a necessary evil on their climb up the career ladder of medicine. Hebra, however, immediately became interested in trying to understand and improve the treatment of these conditions.
Despite the achievements of the Vienna School, dermatology in these days was still a highly neglected field in the general hospitals. Skoda left Hebra in charge of the ward, himself remaining director by name only. Hebra was ready to devote himself to the study of dermatology, knowing that a scientific dermatology was already established in London by Robert Willan (1757-1812) and Thomas Bateman (1778-1821); and in Paris by Jean-Louis-Marc Alibert (1768-1837), Laurent-Théodore Biett (1781-1840), Pierre Louis Alphée Cazenave (1795-1877), and Pierre François Olive Rayer (1793-1867).
Most of his patients suffered from scabies, but besides this Hebra had at his disposal an extremely diverse observational material, and soon was able to differentiate between different skin diseases - declaring common methods of treatment - mostly the use of humoralpathological substances - to be insufficient.
Hebra emphasised local factors in skin diseases, maintaining that diseases of the skin were related to local irritation, disputing the previously held humoral doctrine that related them to a disease-producing condition of body fluids, that skin diseases were secondary to a general metabolic upset of blood poisoning. In this he was at odd with the constitutionalists, whose therapeutic nihilism he rejected, himself applying active therapy successfully to many types of skin disorders. He maintained his view in, among other things, demonstrating that scabies was due to parasites. In 1841, of 2.700 patients at his ward almost 2200 had scabies
Hebra was one of the doyens of dermatology; his book Lehrbuch der Hautkrankheiten (Textbook of Skin Diseases) contains a complete new presentation of dermatology and spread his repute all over Europe. The book was translated into English, French, Italian and Russian, and for years to come would be the Bible of dermatology. The second part of this book was written almost in its entirety by Moriz Kaposi (of sarcoma fame).
Hebra had been strongly influenced by Karl von Rokitansky (1804-1878), one of the founders of modern pathological anatomy. Hebra applied his training in pathology to a classification of skin diseases in accordance with pathological anatomy (1845). The resulting classification was used for almost a century.
In 1852 Hebra undertook a journey to Norway to study lepra. As early as in 1845 he had been made director - ordinarius - of the independent department of dermatology in Vienna; in 1848 he was appointed Primarius at the Allgemeines Krankenhaus in Vienna, in 1849 extraordinary professor of dermatology, and in 1869 full professor. In his time Vienna was a world centre of dermatology, attracting both students and physicians from many countries. He was an extremely popular lecturer, not the least because of his humorous presentations. His position in dermatology is equivalent to that of Albrecht von Graefe (1828-1870) in ophthalmology.
His son, Hans von Hebra, also became professor of dermatology.