ADA History

The First One-Hundred Forty-Four Years

The year was 1876. The Centennial Celebration of the United States opened on a rainy day
in Philadelphia (Figs. 1 and 2). The American Medical Association and the International Medical
Congress were also meting in Philadelphia.

Fig. 1. 1876 was the Centennial Year for the
United States.

Fig. 2. Opening day for the Centennial Exposition
in Philadelphia.

Fig. 3. The transcontinental express.

An express train called the Transcontinental
Express arrived on June 4 in San Francisco via the first
transcontinental railroad only 83 hours and 39 minutes
after leaving New York City (Fig. 3).
Alexander Graham Bell made the first telephone call
to Thomas Watson on February 14. Bell and Elisha Gray
applied separately for telephone patents. The Supreme
Court eventually ruled that Bell was the rightful inventor
(Fig. 4).
Johns Hopkins University opened on February 22
followed by Meharry Medical College on November 7.

Fig. 4. Alexander Graham Bell and the first
telephone call.

The American Dermatological Association was founded on September 7, 1876

George Henry Fox, Lucious Duncan Bulkley, Louis A. Duhring, Isaac E. Atkinson, Lunsford P. Yandell, and Edward Wigglesworth met at a meeting of the Section of Practical Medicine of the American Medical Association (AMA) on June 7, 1876, and decided to form a national society of physicians with a special interest in Dermatology

Fig. 5. Isaac E.
Atkinson (1846-1906)

Isaac E. Atkinson (Fig. 5) was a graduate of the University of Maryland in 1865
and the first clinical professor of Dermatology in Baltimore. He was the dean of
the medical school from 1886 to 1900 and his published articles were mostly
about syphilis. Atkinson was also the author of the “Report of the Lunacy
Commission” to the governor of Maryland in 1902. Writing in the Archives of
Dermatology and Syphilology in 1926, George Henry Fox described Atkinson
as “keen and clearly expressed views on all vexed questions.”

Fig. 6. Lucius Duncan
Bulkley (1845-1928).

Lucius Duncan Bulkley (Fig. 6) (whose father Henry Daggett Bulkley
[1803-1872] is credited with being the first American dermatologist) studied
at L’Hôpital Saint-Louis in Paris. He was associated with Columbia Physicians
and Surgeons from 1869 and also attended at the “Hospital for the Ruptured
and Crippled.” The younger Bulkely founded the New York Skin and Cancer
Hospital in 1883, where he was a frequent lecturer. Bulkley was president
of the New York Dermatological Society (NYDS) in 1880 although he later
resigned from the NYDS in 1914. He is credited with the formation of the
Section of Dermatology and Syphilology of the AMA in 1888.

Fig. 7. Louis Adolphus
Duhring (1845-1913)

Louis Adolphus Duhring (Fig. 7) studied dermatology in Vienna with Hebra,
(also in Berlin, London, and Paris and studied leprosy in Constantinople
and Norway) and was associated for his entire career with the University
of Pennsylvania. He published the third American textbook on cutaneous
diseases and, according to George Henry Fox, had the “meticulous manner of
a fine gentleman, not easy of approach, but a genial easy companion”.

Fig. 8. George Henry
Fox (1846-1937).

George Henry Fox (Fig. 8) graduated from the University of Pennsylvania in
1869. He served an internship with Duhring and Van Harlingen, trained in
dermatology in Berlin under Virchow, in Vienna under Hebra, Neumann and
Schroetter; in Paris under Bazin, Hardy and Vidal, and in London under W.
Tilbury Fox and Hutchinson. His son, Howard Fox, later a leader of the ADA
and first president of the American Academy of Dermatology and Syphilology
(AAD&S), was born in London in 1873. G. H. Fox was Professor of Diseases
of the Skin at Women’s Medical College in Columbus, Ohio, the New York
Postgraduate Medical and Hospital and Columbia University College of
Physicians and Surgeons from 1875 to 1907. In 1952 Bechet wrote that “He
was perhaps the friend of more American dermatologists than any one of his
generation.”

Fig. 9. Edward Wigglesworth (1840-1896).

Edward Wigglesworth (Fig. 9) was a graduate of Harvard Medical School in
1865. After five years’ postgraduate work in Europe, he established a free
clinic in Boston in 1870 and joined the Boston City Hospital in 1877 as a
dermatologist. He was also an instructor in Dermatology at Harvard. He is
credited as the founder of the Boston Medical Library. G. H. Fox wrote that he
“smoked his pipe with grace and dignity.”

Fig. 10. Lunsford P. Yandell (1805-1878).

Lunsford P. Yandell (Fig. 10) graduated from the University of Maryland in 1825
and was an ordained minister. He founded the Medical Institute of Louisville,
which later became the University of Louisville. His publications were mostly
on religion and paleontology, none on Dermatology. Yandell was the oldest
ADA founder and died in 1878, shortly after presenting a paper at the first
Annual meeting in 1877.

These six men decided to hold an organizational meeting at the University of Pennsylvania in Philadelphia on Wednesday, September 6, 1876, at 6:00 PM, immediately after the close of the Section of Dermatology and Syphilology meeting of the International Medical Congress then in session. An invitation was mailed to approximately fifty physicians in various parts of the United States whose names were known in connection with Dermatology (Fig. 11).

Fig. 11. Letter sent to dermatologists informing them of the establishment of the American Dermatological Association and inviting them to an organizational meeting.

The following physicians responded to the invitation and were present at the organizational meeting in Philadelphia. These dermatologists, all men, are considered to be the founders of the Association:
 
Isaac E. Atkinson, Baltimore

Thomas R. Brown, Baltimore

Lucius Duncan Bulkley, New York City

Samuel C. Busey, Washington

Louis A. Duhring, Philadelphia

Carl Heitzman, New York City

Edward L. Keyes, New York City

John A Octerlony, Louisville

Henry G. Piffard, New York City

Robert W. Taylor, New York City

Arthur Van Harlingen, Philadelphia

Faneuil D. Weisse, New York City

James C. White, Boston

Edward Wigglesworth, Boston
 
Prominently missing from this organizational meeting were George H. Fox and Lunsford P Yandell, who nevertheless are included as Founders.

Dr. Wigglesworth was elected Chairman, and Dr. Bulkley was elected Secretary of the organizational meeting. A committee was appointed, consisting of Dr. Bulkley, Dr. Octerlony, and Dr. Van Harlingen, to prepare a Constitution and by laws and to make nominations of officers for the ensuing year. Just one day later a Constitution and by-laws were presented to the meeting. The documents were discussed section by section, amended and approved on September 7, 1876. They were adopted in toto and the American Dermatological Association was declared organized.

 

The following officers were elected for 1876-1877: President James C. White of Boston; Vice Presidents Louis A. Duhring of Philadelphia and Robert W. Taylor of New York City; Secretary L. Duncan Bulkley of New York City; Treasurer James N. Hyde of Chicago.

 

Fig. 12. The Cataract House, Niagara Falls, New York. Site of the first ADA Annual Meeting

The organizational meeting then
adjourned to hold its first regular annual
meeting in Niagara Falls at the Cataract
House on September 4-6, 1877 (Fig 12).
The members who attended the
first regular annual meeting in 1877 are
considered to be charter members.

 

Membership in the Association:

The original constitution and by-laws stated that the membership shall consist of no more than fifty active members, all of whom were residents of the United States, and honorary members (limited to ten at any one time), who could be residents of the United States or any other country. In 1878, at the second annual meeting, the by-laws were amended to read “active members, residents of the United States and Canada.” In 1879, Dr. James E. Graham of Toronto was the first Canadian elected to membership.

 

While the active membership was originally limited to fifty physicians, this number has been gradually increased over the years. In 1906, the active membership was increased to sixty. In 1911, the number was raised to seventy-five, and in 1915, to one hundred. In 1929, upon motion by Dr. William A. Pusey, the by-laws were amended to increase the active membership to 125 with no limit on the number of honorary and international honorary memberships. In 1936, a proposal to increase the active membership to 150 was defeated in the context of a discussion related to the formation of the American Academy of Dermatology and Syphilology. The limit on Active Members was 200 in 1993 when a motion was made, and defeated, to reduce the membership to 150. Since 2001, the number of active members has been limited to 250 and a category of senior membership has been created which is not limited in number. There have been 1,127 dermatologists inducted as active members into the Association between 1876 and 2020.

 

Since the Association’s organization, membership has been offered on a selective basis to the teachers, investigators, writers, and leaders of North American Dermatology. Honorary international membership has been offered to other dermatologists with global status. Dr. Jay F. Schamberg of Philadelphia, President of the Association in 1920, stated that as qualifications for membership, he would place: first, personal character; second, scientific attainment; and third, dermatological achievement.

Governance and Management:

From inception until 1930, the American Dermatological Association was an unincorporated association governed by a “Council” which consisted of the officers and one or two members elected at large. The Council met irregularly as the need arose during each year, often in conjunction with another meeting or even on occasion in the home of the ADA President. The
subject of formal incorporation of the society was discussed multiple times. In 1914 at the annual meeting at the La Salle Hotel in Chicago, Dr. Sigmund Pollitzer, an early influential leader very active in the Association, reported that “after consultation with eminent legal authorities he was advised that incorporation had no advantages whatever for our Association and was attended with a great deal of trouble and some expense.” By 1930, Dr. Pollitzer had changed his mind and the Association was incorporated (Figs. 13 and 14).

Fig. 13. Minutes of 1930 meeting. Dr. Pollitzer moves for incorporation of the Association.

From 1930 to the present, the Association has been governed by a Board of Directors consisting of the officers and up to four directors. In recent years there have been two Board members elected at-large in addition to the officers. The Association received 501(c)6 status in 1956 as a tax-exempt organization.

 

For nearly its entire history, the society has been managed by its members and has accepted no outside financial support. In the early years a member from the host city arranged the meetings; however, in recent years the logistical planning of the meeting has been the duty of the SecretaryTreasurer supported by a committee (and often supported by the Secretary-Treasurer’s spouse), while the scientific content of the meeting has

Fig. 14. Certificate of Incorporation issued to the
ADA from the State of New York on July 31, 1930.

been planned by a committee appointed by the President. For a brief period between 1997 and 2002, the administrative management of the society was delegated to Dermatology Services, Inc., a subsidiary of the American Academy of Dermatology. Starting in 2001, Michelle Gratz became the first ADA employee working directly for the Secretary-Treasurer. She was followed in 2006 by Julie Odessky and later the addition of Phyllis Segaloff, both of whom currently manage the affairs of the Association under the direction of the Secretary-Treasurer and the Board.

 

In 1952, the American Dermatological Association Research and Educational Fund, Inc., (ADARE) was formed and incorporated and received 501(c)3 tax exempt designation. ADARE was organized to promote research in the fields of dermatology and syphilology. This entity also receives money or property from which either the principal or income is distributed for scientific and educational purposes; it also partially supports the scientific content of the annual educational meeting as well as providing grants to medical students and residents in Dermatology.

Preservation of History:

Early in the Association’s history it was realized that keeping records was important. The task of maintaining the records was left to the Secretary until the office of Historian was established in 1915. George Thomas Jackson was elected as the first Historian but died that same year. After Dr. Jackson’s death, Dr. Howard Fox served as Historian for 32 years from 1916 until 1948. During his term, it was the task of the historian to prepare obituary notices in honor of deceased members; these notices were published verbatim in the Association’s minutes each year. Fox started the collection of individual member photographs; this practice is still maintained, and photographs of almost every member from 1876 until 2020 are included in this book.

Fig. 15. A portion of the Archives of the American
Dermatological Association maintained at the offices
of the American Academy of Dermatology.

Subsequent Historians of the Association were: Paul Bechet 1949-1954, Herbert Rattner 1955- 1960, Marcus Caro 1961-1962, Frederick Szymanski 1964-1986, J. Graham Smith 1987-1991,
Robert Pittelkow 1993-2001, Robert Jackson 2002-2004, John E. Wolf 2005-2012, and David Pariser 2013 to the present. The Archives of the Association were passed from one Historian to the next, and the minutes were passed from one Secretary-Treasurer to the next. A committee chaired by Evan Farmer in 2000 worked with a professional archivist to consolidate, catalog, and preserve the collection and developed policies and procedures for archiving material and the following mission statement for the Archives: “The Archives of the American
Dermatological Association is the institutional memory of the Association. Its mission is to serve the membership and staff by preserving, organizing and making accessible the historical, administrative and legal records of enduring value

of the Association.” Its goals are to document past and ongoing activities of the Association and its members and to develop pride in membership by exhibiting and offering access to the historical records of the Association. The current Historian, along with a professional archivist, has collected and catalogued photographs, minutes, financial records, biographies of members and artifacts some of which are presented in this volume.

The Archives are physically maintained at the office of the American Academy of Dermatology, which is currently in Rosemont, Illinois (Fig. 15). The Archives are available for viewing by request to the Historian or the Secretary-Treasurer. In addition to the member photographs, the Archives contain meeting programs, verbatim transactions of the scientific sessions, detailed minutes of executive sessions, formal portraits of members, “candid” photographs of meetings, original membership applications, financial records, and artifacts.

Presentation of History:

 
In 1906, a compilation of the member photographs was published. There were further compilations of photographs and brief biographies of members published in 1952 by Dr. Paul
Bechet, in 1976 by Dr. Frederick Symanski, and in 1994 by Dr. Robert Pittelkow. This current volume has relied heavily on the work of these previous Historians for biographies of members inducted prior
to 1994.

Minutes of the meetings:

 
The minutes were written in the beautiful handwriting style of each of the early Secretaries from 1876 until 1910. Verbatim typed transcripts of scientific sessions and executive sessions began in 1911 and continued into the 1960’s. A “Mrs. Snyder” was acknowledged at the 1927 meeting as the Association’s long-time stenographer. Minutes are missing for the years 1959, 1965, 1966, 1967, 1972, 1974, 1975, 1976, 1978, and 1995 but are otherwise intact from 1876 until the present. Verbatim transcriptions of the minutes stopped in
the 1960’s; during the 1960’s, 1970’s, 1980’s, and early 1990’s the minutes are very sketchy. During the period of 1997 to 2002, when Dermatology Services, Inc. provided management for the Association, the minutes were improved but then became less “colorful.” In 2019, with permission of the presenters, PowerPoint presentations were stored on USB drives and in printed form in the Archives. It is planned to continue this practice in the hope that it will provide important information for ADA Historians in the future.

Fig. 16. First few lines of the minutes of the
1890 meeting in Richfield Springs, New York.
Handwriting of George T. Jackson, SecretaryTreasurer. ADA Archives.

Meetings of the Association:

Since the first meeting in 1877 and until 2019, the Association has met 139 times in 95 different locations. On a number of occasions, meetings were held outside the United States: including: Montreal in 1895; Toronto in 1931; Havana in 1932; Quebec City in 1939; Murray Bay, Quebec in 1947; Jasper Park, Alberta in 1948; Bermuda in 1961; Acapulco in 1973; Banff, Alberta in 1981; Whistler, British Columbia in 1995; St. Moritz, Switzerland in 1988, and Vienna in 2000. The most popular meeting sites were: The Homestead, Hot Springs, Virginia; seven times; The Ocean House in Newport, Rhode Island, and the Greenbrier in White Sulphur Springs, West Virginia, each four times. Hosting the meeting three times each were the Arlington Hotel in Washington, DC; the New York Academy of Medicine; the Broadmoor in Colorado Springs, Colorado; The Boca Raton Hotel and Club in Boca Raton, Florida; The Breakers in Palm Beach, Florida; and the Silverado Resort and Spa, Napa Valley, California. There were no meetings in 1918, 1942, 1943, and 1945 due to wartime restrictions; the 2020 meeting was cancelled due to the COVID-19 pandemic, otherwise meetings have been held every year. Meetings featured formal presentations of papers by members, business meetings called “Executive Sessions” and always very lively discussions whether about the scientific papers presented or the items of business before the Association. This author has read the complete record of the Association in its entirety from 1876 to the present; in addition to confirming much of the historical record previously published, the reader has discovered some interesting and previously unreported information about our Association’s illustrious past. Following are some of the highlights of interesting meeting locations and events. While some could be considered trivial, others are momentous.

 

The first Annual Meeting was held on September 4-6, 1877, at the Cataract House Hotel, Niagara Falls, New York. James Clarke White, the first President, opened the meeting with the
following quote:

“We assemble now for the first time prepared to present to each other our views in relation to the general interests of dermatology, to report and
discuss the results of our special studies and to form that more intimate personal acquaintanceship amongst ourselves, dermatologists of a wide country which is so essential to mutual support and understanding. This meeting marks an important era in American Dermatology – that of its fully recognized independent position.”

Twelve members were present to hear the first paper presented, appropriately by George Henry Fox, entitled “On Molluscum Contagiosum.” Other papers presented included: “On the eczema marginatum of Hebra (tinea trichophytina cruris) as observed in America” by L. Duncan Bulkley; “Acute conditions of disease excited by iodide of potassium” by Almon P. Brooks; “The lymphatic theory of syphilitic infection with a new view of the relation between chancre and chancroid and suggestions for the radical cure of syphilis” by William Hardaway. Seventeen papers in all were presented, some in toto and some by title only.

Fig. 17. First record of transactions of the society, 1877

Transactions of each meeting were diligently recorded in the minutes (Fig. 17); in addition, the Association published and disseminated its transactions. Beginning with the first Annual meeting in 1877 and following each meeting until 1909, the ADA published its own transactions. Early transactions were paperback pamphlets (Fig. 18) but were hardback volumes from 1900 until 1910.

Fig. 18. First volume of Transactions of the
American Dermatological Association published
in 1878.

Only ten members attended the second annual meeting at the Grand Union Hotel in Saratoga Springs, New York, in 1878. Dues at that time were assessed at $5.00 per member. By 1882 at the Ocean House in Newport, Rhode Island, it was necessary to levy a special assessment of $3.00 per member. Only eight registered for the 1884 meeting at the Highland Villa Hotel in West Point, New York. The members heard the treasurer’s report:
 
Cash on Hand – $68.00
Dues from members to date this year – $132.00
Total – $200.05
 
The 1885 meeting hosted 14 members at the Indian Harbor Hotel in Greenwich, Connecticut (Fig. 19). Tranactions of the Association were first published in the Journal of Cutaeneous Diseases, but by 1887 there was discontent with this journal; the Association decided to look for alternatives or even publish its own transactions independent of any journal.

Fig. 19. 1885 Annual Meeting, Indian Harbor Hotel, Greenwich, Connecticut. Back row L to R:
Wigglesworth, Greenough, Duhring, Hardaway, Taylor, Heitzman, Hyde, White, Tilden, Stelwagon.
Front: Robinson, Piffard, Fox, Alexander

Fig. 20. 1890 Annual Meeting, Back row L to R: Hardaway, White, Howe, Shepherd, Allen, Morrow, Graham, Klotz, Duhring. Bottom row L to R: Jackson, Taylor, Stelwagon, Bronson, Corlett.

Fig. 21. . Silver-tipped batons used as pointers made from the wood of the canes of Heitzell, Stelwagon and Schamberg. ADA
Archives

Note the bowler hats and canes of some of the members in the photograph of the 1890 meeting at the New Bath House Hotel in Richfield Springs New York (Fig. 20).

Present in the Archives are some of the actual canes of some of these early members. Apparently the woods of the canes were tipped with silver and used as pointers when lantern slide projection came to the Association (Fig. 21).

At the 1891 meeting in Washington, DC, Association President Francis B. Greenough announced that the members had been invited to a reception at the White House by the President of the
United States, Benjamin Harrison.
 
In 1897, an Association dinner was suggested, but only eleven of twenty-three members favored it, so the idea was abandoned.
 
At the 1899 meeting in Philadelphia, a new technology for teaching known as the “Magic Lantern” was demonstrated. These lantern slides became a standard in dermatology until the development of 35 mm slides decades later.

At the meeting in 1900, there was growing discontent expressed with the publication of the Association’s transactions, which were then published in the Journal of Cutaneous and Genitourinary Diseases. A committee was formed which concluded that continuation with the Journal of Cutaneous and Genitourinary Diseases was “not feasible” and recommended that the Association have its own Journal.

Fig. 22. The Journal of Cutaneous Diseases Including Syphilis – The official Organ of the American Dermatological Association from 1902-1920.

At the twenty-fifth anniversary meeting in 1901, twenty-four members were present. There was a lively debate as to whether the Association should pay the expenses incurred by its delegates to the recently held International Congress of Dermatology in Paris.

By 1902, due to the uncertainty of irregular publication of the ADA Transactions, the Association was able to assume control of the Journal of Cutaneous and Genitourinary Diseases
and renamed it the Journal of Cutaneous Diseases Including Syphilis – The Official Organ of the American Dermatological Association (Fig. 22).
 
In 1904 at the Intercontinental Hotel in Niagara Falls, a request was received from the American Medical Association that the American Dermatological Association [and other specialty societies] “give up their identity and allow themselves to be absorbed into the American Medical Association.” The Association rejected that proposal and voted that “the matter be laid upon the table.” Also recorded in the 1904 minutes was a visit by the members to the power generating facility at Niagara Falls.

Fig. 23. Minutes of the ADA meeting December 29, 1905. First mention of possible membership for women.

In 1905, at the meeting held at the New York Academy of Medicine, William Thomas Corlett heralded the acceptance of Dermatology as a bona fide specialty in his Presidential Address entitled “An Epoch in the Evolution of American Medical Education – The Almost General Recognition of Dermatology in the Curriculum.” That evening the members attended a performance at the New York Hippodrome.

It was at the 1905 meeting that the first reference to women as members appears. The Association received a recommendation from the Council that “…women should be eligible for membership in the Association provided that they meet all the requirements of the Committee on Nominations and receive the necessary vote of the Association.”

The minutes record that “Dr. Hyde said that the question had been debated upon previously” [although there is no record of such a discussion] “and had revealed such strenuous opposition from some of the most valued members that he arose to prevent any reopening of the question whatsoever.” Dr. Hyde moved that the subject be laid on the table. Dr. Stelwagon seconded the motion and it was carried (Fig. 23).

Fig. 24. Minutes of 1911 meeting. Daisy Orleman Robinson (and
others) are proposed for active membership

Fig. 25. Minutes of the 1913 meeting, where Daisy Orleman
Robinson’s (and others’) candidacy was approved. Note that
her name is listed as D. O. M. Robinson, perhaps so that it
would not be obvious that she was a woman.

Previous histories of the American Dermatologic Association have recorded that the first woman member was Beatrice M. Kesten in 1951; however, the minutes of the 1911 meeting clearly say that Daisy Orleman Robinson of New York, the first documented woman dermatologist in the United States, was among those proposed that year for membership (Fig. 24).
 
It was the practice to wait for two years after proposal before a final vote on induction. The 1913 minutes report a favorable recommendation and action by the Association on her
membership along with that of others that year (Fig 25). Even though she was clearly inducted as a member, there is no record that she ever attended a meeting.
 
Beatrice M. Kesten, traditionally considered to be the first female member, was elected in 1951 and regularly attended meetings. The next woman member to be elected was
June C. Shafer in 1954. She was also the first woman member of the Board of Directors of the American Academy of Dermatology. June Shafer was followed by Ruth Freinkel in 1972 and Marie-Louise Johnson in 1973. Marie-Louise was the Association’s first woman president in 2002. Other early women members included Margaret Storken, elected in 1973, who was the first woman officer of the AAD as vice-president in 1973; Dorothy Windhorst, elected to the Association in 1976; Wilma Fowler Bergfeld, the Association’s President in 2019, who
was elected in 1980 and who was also the first woman president of the AAD in 1982; and Nancy Esterly, elected to the Association in 1981.

 
In 1912, at the thirty-sixth meeting in St. Louis at the Barnard Free Skin and Cancer Hospital, the members were driven by automobile (quite a treat for the day) through the parks and city. They visited the Shaw Gardens, where the members witnessed a demonstration by Prof. George T. Moore on the “Production of Disease in Plants and Animals by Parasitic Plants.” The Association also took the following actions: voted to hold future annual meetings during the Christmas holidays, formed a Board of Trustees to manage the Journal, resolved to accept “ethical advertisements’ according to standards set by the AMA, and decided to abandon separate publications of the Transactions.
 
1914 was a busy year. The following items were discussed and extensively debated: (1) There should be a requirement for an “Entrance Thesis” for ADA membership – not adopted; (2) New members should be required to present a paper in the first 2 years – adopted; (3) A letter will be sent to the President of the United States and to the Congress requesting the establishment of a national home for lepers – adopted; (4) A committee will be formed to join with the Committee on Education of the AMA to standardize dermatologic teaching and to oppose the removal of syphilology from the specialty of dermatology – adopted.

Fig. 26. An ampoule of French Neosalvarsan which,
according to the note from Donald Pillsbury, MD,
who donated it to the Archives, was brought to the
US in the submarine Deutschland during the War.
ADA Archives.

At the Hotel Powhattan in Washington, DC, in 1916, there was a lengthy discussion about the problem of disruption of supply of Salvarsan (arsphenimine) for treatment of
syphilis due to the World War. Arsphenimine was the first organic antisyphilitic and was a great improvement over inorganic mercury and bismuth (Fig. 26).
 
In response to the shortage, Drs. Schamberg, Raiziss, and Kolmer formed a “Research Institute” governed by an ”independent board” and “after extensive research” developed arsenobenzol as an alternative to arsphenimine. In 1921, Dr. Schamberg and his colleagues contributed $511,000 (over $7.3 million in 2020 dollars) to their Research Institute from the sales of arsenobenzol and arsphenimine. At the 1922 meeting, it was reported that the proprietor of German Salvarsan made unflattering remarks about the honesty and sincerity of the Research Institute and undercut the price of Salvarsan by 20 cents per 0.9-gram dose. The ADA discussed this action by the German company and argued that this was “…typical German propaganda and every man should support the Research Institute by using only American Salvarsan.”

By 1919, it was increasingly clear that the Association’s Journal was losing too much money; by the 1920 meeting at the Grove Park Inn in Asheville, North Carolina, the Association voted to give the Journal to the AMA, whereupon it was renamed the Archives of Dermatology and Syphilology. It was reported that many members lamented that they now needed to refer to the publication of their transactions as the “Archives” instead of the “Journal.”
 
Also in 1920, the Association voted to send $1,000 to colleagues in foreign universities who were disrupted by the World War, even if their countries were “our late enemies.”
 
In 1921 at the New Ocean House in Swampscott, Massachusetts, a new gavel was presented to President Oliver Ormsby. The cane that belonged to 1903 President Joseph Zeisler was used
to make the handle of the gavel and the cane of Dr. James Clarke White, ADA founder and first President, was used to make the head of the gavel. Another item discussed at the 1921 meeting was the difficulty in obtaining alcohol for compounding prescriptions due to Prohibition. Dr. Ravogli made the point that the alcohol used was often diluted or “contaminated with materials irritating to the skin.” The Association concluded that “this was the fault of the druggists and their disreputable activities, not of the Government.”
 
The discussions at the 1925 meeting, again at the Hotel Powhattan in Washington, DC, were dominated by the planning for the 50th anniversary of the Association for the following year. George Henry Fox, then 79, the oldest living Founder was elected President for the 50-year Golden Anniversary celebration to come in 1926. Fox declined the election because his son, Howard Fox, was the 1925 Association President. After Andrew P. Biddle was elected to the 1926 Presidency, the Association unanimously elected George Henry Fox as the Honorary President for the Golden Anniversary celebration.
 
Sixty-two members signed in at the Golden Anniversary meeting in 1926 at the Bellevue Stratford Hotel in Philadelphia. In his address to the members as Honorary President, George Henry Fox not only recounted the successes of the previous 50 years but also looked forward to the next 50:
 
“In 1976 there certainly will be a centennial celebration of the founding of our Association. I do not expect to attend it and most of you will be absent on that occasion. But possibly someone here tonight may be present at that meeting, which will of course be held in Philadelphia, and I would like to suggest that in the event of such a case he be instructed by those of us here tonight to convey to our colleagues of the future a greeting from the past. I am sure you will join with me in extending to these unknown successors of ours hearty congratulations and sincere regards and our very best wishes for the continued prosperity and perpetuity of the American Dermatological Association.”
 
It was at the 1926 meeting that Howard Fox announced that he had assembled photographs of all current and previous Association members “except those who refused to be photographed.”
The Historian was directed “to purchase a proper chest or trunk to keep the photographs and the historical objects of the Association.”
 
Part of the 1927 meeting was held aboard the S. S. Alabama in the Chesapeake Bay off the Baltimore coast. At that meeting, Dr. T. Caspar Gilchrist moved that there be a special assessment of five dollars to cover the extra expenses of cigars, White Rock water, and tips. An initiation fee of $25 was instituted and the annual dues were increased to $20 after an extensive debate.

Fig. 27. Minutes of the 1931 meeting recommending
establishment of specialty certifying board.

Fig. 28. 1932 letter to ADA members from the United Fruit
Company offering 4-day “luxury steamer” transportation from
New York to Havana on the “Great White Fleet.” A shorter trip
was available from New Orleans.

In 1931 at the Royal Oak Hotel in Toronto, the Association recommended that a Board of Examiners in Dermatology and Syphilology be created (Fig. 27); a committee was formed to collaborate with the section of Dermatology and Syphilology of the AMA. The American Board of Dermatology and Syphilology was established the following year, in 1932.
 
The 1932 meeting was held in Havana, Cuba, the first meeting to be held outside of either the US or Canada. Adventurous members could take the Sikorsky S-40 seaplane (the “Flying
Boat” operated by Pan American Air Ways), which began service from Miami to Havana in 1932, or they could travel by ship from either New York or New Orleans (Fig. 28).
 
It was at this meeting in 1932 that the Association voted to lend the newly established American Board of Dermatology and Syphilology $500 without interest “for the purpose of furnishing funds for beginning its work.” The members attending the meeting in Havana were advised that they were allowed to bring back 50 cigars and 300 cigarettes, but that “plumage of wild birds was liable to confiscation by United States authorities.”
 
The 1933 meeting at the Edgewater Beach Hotel in Chicago was the first to hear a report from the newly established American Board of Dermatology and Syphilology. Detailed reports of the actions of the Board were given at each subsequent year’s meeting.

From 1933 to 1936 any ADA member who was a Professor, Associate Professor, Clinical Professor, Assistant Professor or who could document 15 years of practice in dermatology could have a certificate from the Board without examination. These 122 ADA members who took advantage of this opportunity representing nearly all members were known as “The Founders Group.” Starting in 1934, all new ADA members needed to be Board Certified and starting in 1938 all candidates for the Board Certification were required to have a three-year residency.

Fig. 29. Announcement of the formation of the SID. Archives
of Dermatology and Syphilology October 1937.

Fig. 30. Earliest written record of mention of the idea of an American
Academy of Dermatology and Syphilology by Howard Fox from the
minutes of the ADA meeting June, 1936, page 209.

In 1937 at the ADA meeting at the Skytop Lodge in Cresco, Pennsylvania, Dr. John Stokes of the University of Pennsylvania formally suggested the creation of a new dermatologic society
and journal to accommodate the “physiologic and pathologic” work related to Dermatology which was being done by non-dermatologists and published in nondermatologic journals. The Society for Investigative Dermatology was formally founded at the Hotel Dennis in Atlantic City on June 10, 1937 (Fig. 29).
 
Histories of the formation of the American Academy of Dermatology and Syphilology (AAD&S) record that the concept of such a society was first discussed at the first meeting of the SID on June 10, 1937, by Earl Osborne of Buffalo and Harold Cole of Cleveland and introduced on the next day to the AMA section on dermatology then in session. Paul O’Leary of Rochester, the chair of the AMA section, then appointed a committee to “study the advisability of forming an American Academy of Dermatology and Syphilology.”
 
Actually, the earliest record of mention of the AAD&S occurred at the ADA meeting a year earlier in 1936 by Howard Fox at the New Ocean House in Swampscott, Massachusetts, in the context of a motion which was on the floor to expand the membership of the ADA, the only national dermatologic organization. By this time, there were more than 500 dermatologists in the United States who had been certified by the American Board of Dermatology and Syphilology and the ADA could not (or would not) accommodate them (Fig 30). The American Medical Association had a section on Dermatology and Syphilology which any physician who expressed an interest in Dermatology could join but there was no national organization for the growing number of boardcertified dermatologists.

Fig. 32. Golf Trophy. ADA Archives. Engraved Inscriptions: 1965: A. Fletcher Hall; 1966: H. H. Johnson; 1966: Eugene Traub; 1969: Albert Slepyan; 1970: Stanley Huff; 1971: Lawrence Nelson; 1972: J. Lamar Callaway; 1973: J. Lamar Callaway; 1974 Gerard DeOreo; 1975: John Haserick; 1976 Frederic Becker; 1977: A. Fletcher Hall; 1978: Robert Buchanan; 1980: Richard Dobson; 1981: Stanley Huff; 1982 Harry Hurley; 1983: Albert Slepyan; 1984: Albert Slepyan; 1985: Richard Dobson; 1987: Robert Morgan; 1988: J. Fred Mullins; 1990: Paul Lazar; 1991: Hurley, Izumi,. McNamara; 1992: Buchanan, Hurley, Jansen, Szymanski; 1993: Hurley, Jansen, McNamara, Mullins; 1994: Hurley, Jansen McNamara, Mullins; 1995, 1996 and 2001: J. and D. Baker, J, and L. Olerud; 2002: C. and C. Cockerell, D. and A. Rigel; 2003: Ceiley, Cockerell, Olsen, Rigel.

Social and ‘extracurricular’ activities have always been important to the Association, have been an integral part of the meetings, and have facilitated the personal interactions
of the members. At the 1940 meeting at the Broadmoor in Colorado Springs, the first item on the agenda of the Executive Session was the presentation of the golf trophy (Fig. 31). For many years starting in 1965, the name of the winner of the golf tournament was engraved on a silver plate which is maintained in the ADA Archives (Fig. 32).
 
Also in 1940, other equally important business was discussed. The composition of the American Board of Dermatology was changed such that there were three members from the AAD, three from the ADA, and three from the AMA section on Dermatology and Syphilology. Also at the 1940 meeting, 10 cents per member was appropriated to the International League of Dermatologic Societies.
 
Golf was not the only competitive sport at ADA meetings. There were trophies for Lawn Tennis, “Ladies Golf,” and Contract Bridge (Figs 33, 34, 35).

Fig. 31. Presentation of the Golf Trophy 1940. ADA minutes.
There was a trophy cup those years.

Fig. 33. “Ladies” Golf Trophy. ADA Archives. Inscriptions: 1981 Mrs. Harry Hurley, 1982 Mrs. Harry Hurley, 1983 Mrs. Susan Strauss, 1984 Mrs. Frederick Szymanski, 1985 Mrs. Stanley Huff, 1987 Mrs. Mutcuko Urabe, 1989 Mrs. Stuart Maddin.

Fig. 34. Lawn Tennis Trophy. ADA Archives. Inscriptions: William Dobes: 1955, 1957; Denny Tufanelli: 1970, 1971, 1974, 1975, 1977, 1978,1978, 1979, 1980, 1981; Maximillian Obermayer: 1956; Samuel Ayres, III: 1958, 1965, 1966, 1967, 1968; Herbert Mescon: 1959, 1969; Miltyon Orkin 1982, Carroll F. Burgoon 1971

Fig. 35. Sterling silver Contract Bridge trophy. First awarded 1956. ADA Archives.

The 1941 meeting at the Hotel Roosevelt in New Orleans was highlighted by a field trip to the “National Leprosarium” in Carville, Louisiana.
 
There were no meetings in 1942, 1944, and 1945 due to the War but when the Association met in 1946 at the Homestead in Hot Springs, Virginia, there was an extended debate covering two singlespaced typewritten pages regarding a request from Dr. Lucien-Marie Pautrier of Strasbourg, France, whose clinic was damaged in the War and was in need of “an apparatus for electric coagulation and a large photographic apparatus on a tripod.” The Association voted to help Dr. Pautrier. There were no more live patient presentations at ADA meetings after World War II.
 
One hundred twenty-one members, the largest attendance to date, came to the seventy-fifth anniversary meeting in 1951, held again at The Homestead in Hot Springs, Virginia (Fig. 36).

Fig. 36. Group photo from the 75th anniversary meeting at The Homestead, Hot Springs, Virginia 1951

At the 1952 meeting of the ADA at the Broadmoor in Colorado Springs, the American Dermatological Association Research and Educational Fund, Inc. (ADARE) was formed and incorporated as a 501(c)3 tax-exempt entity. Its stated purpose was and still is to promote education and research in Dermatology. Funds from ADARE are used to support some of the educational functions of the ADA annual meeting and are used for medical student and resident grants.
 
Dr. Marion Sulzberger was president at the 1960 meeting at the Boca Raton Hotel and Club in Florida. The verbatim minutes were especially verbose that year. A highlight of the meeting was a bridge tournament with a director of the American Contract Bridge League in attendance. Winners were given books personally autographed by Charles Goren and their names inscribed on the sterling silver bridge trophy.
 
In 1974 at the meeting in Kona, Hawaii, Secretary Thomas Merrill, Jr. proclaimed that “Every member who is not lame or maimed has voiced his or her intention to celebrate the Centennial Anniversary at Williamsburg, Virginia, from May 8 to 13, 1976.”
 
Unfortunately, the minutes from the 1976 Centennial Celebration are among the few years that are missing from the Archives of the Association, but the program for the 1976 meeting was preserved. The Association heard an address from Justice Lewis F. Powell, Jr. of the Supreme Court of the United States followed by historical presentations from Association President Walter B. Shelley and from Association Historian Frederick Szymanski.
 
In the 1980’s and 1990’s there were ongoing debates over the formality of the social events in
the meeting and whether the formality should continue. Specific criticism was leveled at the longterm practice of having a formal receiving line at the President’s dinner. Gloria (Gogo) Bauer relates of
Gene’s induction into the ADA in 1984: “I was instructed by Gene at the time that it was unheard of for some upstart his age to be admitted so I must be on my best behavior and dress appropriately for each occasion. At that time the president’s dinner was extremely formal and preceded by a receiving line of (at least) President, Vice President and spouses. I had gone to a very expensive shop in St. Louis … and found a burgundy gown trimmed in gold on sale. I had long white gloves. I also bought a velvet cocktail dress for one of the other evenings so I felt equipped! When the receiving line reached the president’s wife, she took one look and said in a syrupy southern drawl… ‘Why my dear, you look like you are going to your senior prom!’” Gogo also remembers getting politely admonished for not wearing “whites” while playing croquet.
 
The issue of the receiving line and the formal dress came to a head in 1999 when some members objected to packing formal wear for the upcoming meeting the following year in Vienna.
After extensive debate, it was decided that the receiving line would be continued but a tremendous concession was made allowing the dress for the President’s Dinner to be black tie optional for that meeting only. The receiving line was eventually dropped in the early 2000’s and dress for the meeting became more casual except for the black-tie tradition of the President’s Dinner which continues to the present with only two other exceptions in recent times: the 2003 meeting held at the Mauna Lani Bay Hotel in Hawaii, when Hawaiian flowered shirts embroidered with the ADA logo were distributed and the 2009 meeting at the Stein Eriksen Lodge in Park City Utah, when President John Voorhees preferred a casual dinner.
 
In 1990 at The Cloister, Sea Island, Georgia, Association President Harold O. Perry presided over a goals retreat meeting. It was becoming more clear that many political activities were occurring nationwide and much discussion occurred regarding the goals and missions of the American Dermatological Association. A mission statement was developed and formally adopted: “The American Dermatological Association is a society of leaders of our specialty whose purpose is to recognize, discuss and develop solutions for problems in the area of dermatologic health care, research, and education specifically in North America and more generally, in the world.” It was not until two and a half decades later that this mission statement was translated into a pivot in the Association’s programs.

Fig. 37. Congratulatory letter from President George W. Bush on the
occasion of the Association’s 125th anniversary in 2001.

In 1992, the Association was the beneficiary of a large testamentary gift from the estate of Dr. Everett C. Fox of Texas to ADARE. This gift continues to help give the Association continued financial independence. In this same year, the Association contributed $7,500 to the International Foundation for Dermatology to help start the Regional Dermatology Training Centre in Moshi, Tanzania.
 
At the 1998 meeting at the El Dorado Hotel in Santa Fe, New Mexico, there was the first discussion of the ADA establishing a website.
 
Relaxation of the dress code for the meetings occurred in 2000 when business casual dress was officially adopted with the exception of the President’s Dinner which was to remain
Black Tie.
 
At the 125th anniversary meeting (quasquicentennial) in 2001 at The Breakers in Palm Beach, Florida, the Association received a congratulatory letter from George W. Bush, President
of the United States (Fig. 37).

Over several meetings in the early 2000’s, the Board, led by Secretary-Treasurer Darrell Rigel and Presidents Alan Shalita, Lowell Goldsmith, Charles McDonald, Evan Farmer, and Lee Nesbitt, made some changes in the meeting to better accommodate the needs of the members. The management of the Association and the Annual Meeting was moved from Dermatology Services, Inc., a subsidiary of the AAD, to an internal full-time staff. The meeting schedule was changed to the current Thursday thru Sunday format from the previous format of a week-long meeting with a day off. As the membership was aging, a formal push was made to expand membership with a focus on younger members, including the establishment of the First Five Year group with the intent to make them a more active part of the organization. Before 1990, it was very unusual for more than ten members to be inducted in any given year, so there was a conscious effort to increase membership up to the current limit of 250 active members. During the three decades from 1990 to 2019, there have been 472 new members inducted, in some years as many as 22. This influx of new members has kept up with the number of members reaching senior status or retiring. At the meetings in the early 2000’s,
the second formal dinner with receiving line for the new members was replaced with an informal evening event with the sponsor introducing the new member at randomly seated tables to more personalize the introduction to the ADA. To add to the goal of enhancing social interaction, a daily spouse breakfast, spouse book club, barbeque lunch, and new afternoon sports and tour events were incorporated. New members were also recognized with ribbons on their badges so that all attendees could better welcome them to the organization. The meetings were made more interesting adding outside speakers and topics beyond what would be found at a more typical dermatology meeting. The meetings were made warmer, more attendee and spouse/guest friendly and fun while keeping the quality of the academic sessions. All of these things led to a significant increase in attendance at the meetings and a greater demand to join the organization.
 
In his 2003 presidential address in Hawaii entitled “American Dermatological Association a New Beginning”, President Lowell Goldsmith charged the ADA to “Make the ADA the forum and the format for asking and discussing the most difficult questions facing Dermatology, Medicine and Society; assuring the ADA has the membership, structure and organization to address the most important questions.” A decade and a half later, much of this charge would be realized. During the presidency of Evan Farmer in 2005, formal and informal topics of discussion included the value of maintenance of certification, future Dermatology workforce needs, the role of physician extenders and the changing practice of Dermatology with increased emphasis on cosmetic and non-cosmetic procedures, development and use of biologics for specific diseases, and the potential isolation of Dermatology from the house of medicine.
 
Discussions about these and other issues continued until 2014 when the Board built on previous actions and took stock of the ADA and its place in the house of medicine. There was a realization that in the decades following the formation of the American Academy of Dermatology (AAD) and the Society for Investigative Dermatology, the ADA remained a vital force in Dermatology, primarily performing the task of peer recognition for outstanding and meritorious contributions to the specialty.

Fig. 38. It wasn’t all work. At the 2010 meeting in New York (the largest attendance of any
meeting to date with 227 members and 149 spouses/guests), the ADA was welcomed to Yankee
Stadium.

However, with the passage of a half-century and the slow adaptation of progressive membership parameters, the ADA’s mission became more ethereal. The AAD had become a premier leader in Dermatology education, and its associated advocacy efforts and political action committee worked to advance and solve problems in the operational issues that evolved in clinical care with changes in American Medicine. At the same time, subspecialty societies began aggressively advocating for the narrower issues that affected their interests.
 
The ADA faced an identity crisis. For several decades, leadership made a number of attempts, to study, define, and rationalize an appropriate mission for the ADA. In 2014, the Board of the ADA queried the membership for their perspectives on the challenges that face Dermatology and issues that could present existential threats to a thriving specialty. This initial outreach included a note to members indicating the following; As was noted by Dr. Rex Amonette in his Presidential Address of 2013: “We are a family of dermatology – clinical, medical, surgical, aesthetic, investigative. It behooves all of us to think deeply about the future of our specialty. We face the palpable threat of marginalization in a health care environment that – for its own reasons – may wish to view us as dealing with only cosmetic problems.” Responses to the survey varied, were sometimes contradictory and many were laden with the frustration. Clinical medicine was increasing regulated. Research resources were markedly constrained. Metrics for resident education were continuously changing.
 
By 2015, the Board of Directors of the ADA had contemplated the amalgamated responses and decided to focus on two major issues: the value of the integral nature of dermatology in Medicine and issues leading to the marginalization of Dermatology within the house of Medicine. With this new clarity, ADA could concentrate its membership bandwidth to begin a magnificent transformation into an institution that could and would comment and opine on Dermatology’s issues within the context of patient well-being and the advancement of the general public health. It issued an ethos statement that articulated the new direction of the organization.

Ethos: The American Dermatological Association maintains a leadership role in the contemplation and implementation of initiatives that advance the field of Dermatology through research, education, and advocacy. This, in turn, advances the care and treatment of patients with skin disease. As an independent, non-profit, self-funded organization, the American Dermatological Association provides objective analyses and recommendations regarding the complex challenges faced by Dermatology. This is accomplished through stewardship and collaboration with other organizations committed to the ongoing process of advancing the field of Dermatology in the house of Medicine.

In 2016, at the annual meeting in Santa Barbara, California. The central themes of Antoinette Hood’s presidential address were the questions of “what is Dermatology, what is a dermatologist and what should be a primary role of the American Dermatological Association.” The conversation continued at the ADA board meeting which further crystallized the issues and approved the following specific initiatives: 1. incorporate the 1990 mission statement into the bylaws and prominently displayed it on the ADA website and membership certificates, 2. restructure the annual program to focus on the purpose of the ADA, 3. develop one or two important topics for the ADA to address for the coming year and each following year, and 4. publish the results of the topic presentations and discussions and/or in a white paper on the ADA website after each meeting.
 
As President-Elect in 2016, David Cohen spearheaded a mission to issue the first public health statement in ADA’s history and challenged all future presidents to take charge of studying and considering strategic initiatives that encourage, advance, and support policies that improve the public health. The first strategic initiative resulted in a co-sponsorship of a position paper of the American Academy of Ophthalmology, encouraging Herpes zoster (shingles) vaccination. This publication resulted in thousands of press impressions that ultimately removed the stealth cloak that kept the ADA from the routine conversation and collective consciousness of Dermatology. Commensurate with this pivot was the transformation of the decades-long medical student stipends into Dermatology resident and fellow awards for research focused on ADA’s mission. It provided awardees the capacity to attend the annual meetings, to engage with members and gain insight into the ADA’s operations. Since that first public health statement, ADA has deliberated many issues and announcements that have been well received by the medical and patient community. A position statement in support for HPV vaccination was promulgated in 2018.
 
In 2019, under the leadership of President Wilma Bergfeld, the outward look of the ADA was changed and amplified by the adoption of a new logo (Fig. 39) and by establishment of both a Communications Committee and an International Committee to involve more international members and to become more prominent in the House of Medicine and to the public. She also made the ADA’s budgeting process more formal and recounted the accomplishments of women in her Presidential Address.
 
Responding to the inability to convene an in-person Board of Directors meeting in March, 2020, due to the COVID-19 pandemic, President Brian Berman chaired the first “real-time, virtual” Board of Directors meeting during which he advanced two position statements in 2020: 1) Optimizing patient access to medications: Pharmacy Benefit Managers (PBMs) and patient access to affordable and appropriate medications; and, 2) Transplant patients needing to be examined by a dermatologist: Endorsement of enhanced screening, surveillance, and prevention of skin cancer and skin infection in patients with solid organ transplants.
 
The annual meeting scheduled for October, 2020 was canceled due to the COVID-19 pandemic and was replaced with a virtual on-line meeting. This cancellation was a mere speed-bump in the long and illustrious history of the Association.
 
In a sense, the ADA has been reborn as an Institute for Dermatology and thrives today as a reinvigorated organization with a resolute mission and keen self-awareness. Its proud members continue to be leaders across the entirety of Dermatology

Fig. 39. The ADA corporate seal (left) used as the Association’s logo from 1930-2019 and the current logo.