“Café-au-lait colored spots with associated tumors of the nerves, skin, and bones that progress sometimes into the giantism of an extremity or skin deformity.”
Through the Lens of Oncology History: A Century of Progress
The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The Anesthesia Era: 1845–1875.” To view additional photos from this series of books, visit burnsarchive.com.
In 1869, the first periodical produced with photographs appeared in Europe. Just 1 year later, The Photographic Review of Medicine and Surgery, with original photographs, was published in America. The publication was edited by Philadelphia surgeon Frank F. Maury, MD (1840–1879) and dermatologist Louis A. Duhring, MD (1843–1913). The journal was devoted to publishing monthly photographs and case reports of rare, unusual, or interesting patients.
Over a 2-year period, 1870 to 1872, 48 albumen prints were published. The images presented were the most fascinating pictures of the extremes of disease; they appeared for decades thereafter as illustrations in medical texts.
Ophthalmologist Richard J. Levis, MD (1827–1890) is remembered for introducing the wire loop used in cataract extraction. He presented this showcased photograph with its case history entitled, “Hypertrophic Tumor of the Integument of Forehead, Eyelid & Eyebrow,” in 1870.
“The patient, a 30-year-old man, was noted at birth to have a small protuberance in the left temple. By age 14, vision in his left eye was totally obscured. At age 30, the left eye has atrophied, and an entire quadrant of his face has been consumed by the persistent tumor. No treatment was advised.”
Neurofibromatosis, or von Recklinghausen’s disease, is a condition characterized by dermal, neural, and osseous deformities often progressing to severe and gross distortion. History’s most famous victim and extreme example of the disease is John Merrick, the “Elephant Man.” Typically, the disease presents as a small elevation around the eye or temple which, left untreated, may steadily grow to enormous proportions, as seen in the photo at right.
In 1882, a student of Rudolf Virchow, MD (founder of cellular pathology), Friedrich Daniel von Recklinghausen, MD (1833–1910), gave the classic description of the disease as a phakomatosis: “Café-au-lait colored spots with associated tumors of the nerves, skin, and bones that progress sometimes into the giantism of an extremity or skin deformity.”
The disease is genetically transmitted and there is no known cure for neurofibromatosis. Future therapy lies in medical genetics. The mapping of the human genome and the study of inherited DNA sequences have made it possible to establish the genetic linkage and chromosome map location for neurofibromatosis. In 1987, Barker, et al detailed the exact sequence (16220). ■
Excerpted from Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD. Photographs courtesy of Stanley B. Burns, MD, and The Burns Archive.