Herbert Brown's Photographic Archive

Herbert Brown (1877-1958) qualified in medicine in Glasgow in 1901, working first in general practice and then in dermatology. Following service in the Royal Army Medical Corps during the Great War, he was appointed as the first Consulting Physician for Diseases of the Skin at the Victoria Infirmary of Glasgow. Extensive experience of venereology in peace and war - an astonishing 19,000 cases - together with his skill in photography, provided the material for his publication in 1920, with C F White, of the Atlas of the Primary and Cutaneous Lesions of Acquired Syphilis in the Male. This copiously illustrated volume is unusual in its inclusion of numerous stereoscopic clinical photographs. Brown was a founder member of the British Association of Dermatologists and its president in 1940-41. He was also a founder member and later Secretary of the North British (now the Scottish) Dermatological Society. His continuing interest in photography resulted in a large collection of clinical photographs, many of which illustrated the textbooks of his contemporaries. His collection of monochrome and hand-tinted, monoscopic and stereoscopic, clinical photographs and glass-plate negatives is now in the archives of the Royal College of Physicians and Surgeons of Glasgow .

Clinical Photographs

Herbert Brown's photographs were taken between about 1910 and 1940. The images shown here are too small to give more than an indication of the quality and scope of the collection, but provide some insight into skin disease and its treatment in the first half of the 20th century.

Bacterial infections
Impetigo, a bacterial infection of the skin due to staphylococci, is contagious, and was a particular problem in the days before antibiotics.

Impetigo Circinate impetigo

Viral infections
Shown here are a severe reaction to vaccination, and a widespread eruption to a pox virus, probably cowpox

Vaccination reaction Circinate Impetigo

Fungal infections
The picture on the left shows a farmer with ringworm of the face acquired from cattle. On the right is a boy with a severe infection with Trichophyton Schonleii, known as "favus". It is no longer seen in Britain, probably due to better social conditions. No specific antifungal drugs were available.

Kerion Favus

Tuberculosis
Tuberculosis of the skin, known as lupus vulgaris, causes severe scarring. No specific treatment was available until the late 1940's. This kind of infection is now almost unknown in Scotland.

Lupus vulgaris Lupus vulgaris

Reactions to tuberculosis elsewhere in the body were also much commoner. This picture shows Bazin's disease, or erythema induratum.

Bazin's disease

Blistering conditions
We now know that most inflammatory blistering disorders like dermatitis herpetiformis, shown here, are due to antibodies directed against the basement membrane of the epidermis. Drugs such as oral corticosteroids and dapsone, now used successfully, were not available to Brown and his contemporaries, and the conditions had a poor outlook.

Dermatitis herpetiformis

Tumours
Although malignant melanoma was rare, other forms of skin cancer were common. Treatment with radiation was less sophisticated. This pair of photographs shows effective treatment of a skin cancer with "radium needles" which were briefly implanted into the tumour.

Epithelioma before treatment Epithelioma after radium needles

Eczema
Infantile (atopic) eczema was relatively rare, but many other forms of eczema, and particularly infective eczema, were common. Work-related dermatitis is also common, for example of the hands in a mechanic, or the facial dermatitis in a dockyard worker loading hay and grains. Topical steroid ointments would now be used for these conditions, but were not available.

Hand dermatitis Occupational dermatitis

Other forms of eczema illustrated in the collection include contact allergic dermatitis. Although sensitivity to nickel is still common, the pattern shown here, due to nickel in suspender clips, is now unusual.

Nickel dermatitis due to suspenders

Acne
Severe acne such as this was sometimes treated with X-rays. Nowadays effect treatment with antibiotics and oral retinoids is available.

Nodulocystic Acne Nodulocystic Acne

Psoriasis
Extensive psoriasis remains a challenge for dermatologists, although treatments such as oral and topical retinoids, topical vitamin D analogues, and more sophisticated forms of phototherapy are now available.

Chronic Plaque Psoriasis

Reactions to treatment
There were fewer drugs used, and therefore fewer drug reactions, in the early 20th century. Bromide was widely used as a sedative, and bromide eruptions (left) well recognised. Arsenic was still sometimes used in the treatment of psoriasis until the late 1950s, despite the recognition that it caused keratoses (right) and skin cancer.

Bromide Eruption Arsenical keratoses

 

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