Dermatology and history in Wales (Cymru)

GEOFFREY HODGSON

University Hospital of Wales, Cardiff

British Journal of Dermatology (1974) 90, 699-712.

SUMMARY

The development of dermatology in Wales (Cymru) is traced against a short

history of the independent kingdom which became the Principality. Skin diseases

were treated by the earliest Cymry, Celtic druids, Celto-Christian priests, Anglo-

Saxon leeches and court physicians, and later by medieval university graduates and

unskilled village herbalists and, when industrialization came, by ‘truck doctors’ and

general practitioners. The early dermatologists are described. Traditional holy wells

and folk medicine form connecting links.

………………………………………………………………………………………

The mountains in Wales have made its history and dermatology. Sheltering the

Cymry, driven by invaders from Britain into the present confines of the Principality,

they isolated them as a pastoral people until iron and coal in the eighteenth and

nineteenth centuries initiated the modem changes. Even in 1840, the only towns of

any size were Merthyr Tydfil with 22,000, Swansea with 15,000 and Lardin with

6000 persons (Jones, 1972).

Peculiar to Wales are its triads (Trioedd). These are prose compositions with terse

statements of three related facts. The bards used them to help people to remember.

The oldest, which were historical ethical, theological and legal, were collected by

Caradoc of Llancarfan in the twelfth century in ‘Historie of Cambria’, translated by

Humphrey Llwyd, from a text of Brut y Tywysogion. Some persist today as Welsh

proverbs (Diarhebion Cymraeg), for example, 'three things that are difficult for a man

- to cool the fire, dry the water and please the world'. A Glamorgan tribon, or verse

form of a triad, runs: 'Tri pheth syn hynod poenus (Three things which are remarkably painful,

Sef dafaden ar y wefus Namely, a wart cancer (Dafaden wyllt) ('wild sheep') on the lip Cornwyd mawr o dan yr en An abscess under the chin,

A gwen yr eneth glwyfus'. And a smile of a wounded girl.)

In the background of Welsh dermatology there are always the mountains with

their streams running into holy wells. There are also the herbs of their valleys, whose

healing mysteries were known to Celtic druids and Celto-Christian priests, to be

recorded later in medieval manuscripts and to mature ultimately as modern drugs, or

to persist as superstitions or as country treatments for warts even today.

PREHISTORIC TIMES

Presumably dermatology in Stone Age tribes (Palaeolithic 12,000-8000 B.C. and

Megalithic 6500 B.C.) consisted of the treatment of minor wounds, and the removal

of stones and parasites by tribal mothers moistening, rubbing or squeezing the skin

(Cule, 1970). This is mentioned in a medieval Welsh leech book, 'What is the simplest

remedy?', followed by the answer, 'Scratch thy hand until it smart and then spit on it'

(Jones, 1959).

EARLY CYMRY AND CELTIC PEOPLE

Some of the ancient Cymry came from Iberia (modern Spain and Portugal) to

which they had migrated from Hindustan and the Middle East. Later came others such

as the Beaker folk (2000-1800 B.C.) with bronze weapons and distinctive pottery

(Chadwick, 1971). Medicine (Meddyginiaeth) was one of the rural arts practised by

the Cymry. The bardic priests were the teachers of knowledge (Gwybodaeth), which

included the healing herbs.

In the mountains lived the Welsh goat of ancient Cymru (Burroughs Wellcome,

1903), mentioned by Shakespeare in Henry V ('not for Cadwaladr and all his goats').

Then it was used for food, and its blood for medicine, now it is the parade mascot of

the Welsh Regiment.

There followed, in 500 B.C., a new people. These were the Celts (Keltoi or Galli)

from the region of the Upper Danube, now Austria and Czechoslovakia. They spread

over Europe to Italy, Belgium, France, Spain, and they even formed a state in Turkey,

as St Paul's Epistle to the Galatians reminds us (Fig. 1). Their influence declined in

the second century B.C. before the conquering Romans. They were fair-skinned,

blond, with flowing moustaches and swept-back hair, which may explain why cancer

of the skin is said to be most common in those of Celtic ancestry (Urbach, Davies &

Forbes, 1966). The Goidel Celts (Gaels) went to Ireland and later to Scotland; they

spoke Gaelic. The Brythons, in Wales, spoke the first written language of Britain,

which is the parent language of the Welsh of today and was spoken also in the north

of Cornwall, and which is the concern of many Welsh people today.

The bards were, in the tenth century, at the Court of Hywel Dda ('Howell the

Good' (A.D. 900-950) (Fig. 2)), divided into Chief bard (Pencerdd), bards of the royal

Household (Bardd Teulu) and minstrels (Cerddorion). Later and in medieval times

there were also bards on circuit (Cwrs) to the gentry and itinerant begging bards

(clerwyr) (Archdruid Cynan, 1973).

Gorsedd of Bards

The original ovate (green robes), bards, musicians, and literati (blue), and druidic

(white) orders, today compose the Gorsedd of the bards, who now proclaim the

annual National Eisteddfod. This is a competitive congress of bards, the earliest

recorded gathering of which was in Cardigan in 1176 under the patronage of Lord

Rhys.

In Celtic times the druids, being responsible for healing, would have treated skin

disease. Their white dress signified holiness and purity, they carried out secret and

religious rites, and they practised mysticism. They were next in importance to the

King. There were three types of female druids according to Irish sources (Moloney,

1919): the sisterhood with special powers of healing and divination, married women

who lived a short time with their own husbands and then with the druids and a menial

class. Their mysterious rites of healing together with human sacrifices and with

prophecies were performed in sacred groves.

They used applications of sacred herbs, such as the 'All Heal' (Pren Awyn)

mistletoe, which had to be cut with special ritual by a golden sickle on the sixth day

after the new moon in winter (Burroughs Wellcome, 1903). The sacred wheat was

gathered in autumn, the oak in summer and the shamrock (the Irish emblem) in

spring. Disorders were also treated by drinking from holy wells, dedicated to the

Celtic healer’ God Sirona, the source of sunlight and warmth (Wellcome Historical

Medical Museum, 1928), and probably also to Mercury, Apollo and Jupiter.

Treatment was also given at the temple of Nudd, or Noden, on the river Severn at

Lydney (Cule, 1971).

ROMAN TIMES

It was nearly a century after Julius Caesar landed in 55 B.C. before most of

Britain was conquered by Claudius (A.D. 43) with the defeat of Caractacus. But the

Welsh tribes (the Silures of Monmouth and Glamorgan in the south, and the

Ordovices of Powys in the north) withdrew into the mountains, and, nourished by the

Druid stronghold in the island of Anglesey (Dodd, 1972), put up fierce resistance,

until subdued in A.D. 74-78 by Agricola, who savagely destroyed the Druids' groves.

Their exhortative resistance was, however, later carried on by bards (Archdruid

Cynan, 1973). Conquered Wales was contained by legionary fortresses at Isca

(Caerleon) (A.D. 90) in Monmouth, and at Chester (A.D. 102). When in 406 A.D. the

Roman Emperor Constantine removed his troops, he left Wales and its dermatology

much as they had been before the Romans came, except perhaps for some military

practices based on Greek medicine.

THE EARLY WELSH KINGDOMS AND ANGLO-SAXON BRITAIN

During the Dark Ages, Wales was for some 200 years after Roman times

sporadically invaded by Irish tribes who brought Christianity, then by the Saxons, the

Norsemen and Danes, and finally by the Normans in the twelfth century. The Welsh

fought also among themselves, between princes and between north and south, until

union gradually came during the ninth and tenth centuries during the struggles for

supremacy. King Gruffydd ap Llewellyn defeated the English king Harold, at

Welshpool (A.D. 1039) and finally created the independent United Welsh kingdom.

During these centuries several important events occurred in Wales. The Dragon of the

great Pentragonship (the Welsh dragon of today's Welsh flag, from the standard of

King Cadwaladr, the last Welsh king of Britain) had been recognized circa A.D. 420,

when the Romans left. St David, 'Dewi Sant' (A.D. 462) (Fig. 2), the patron saint of

Wales, founded a Celtic church and finally destroyed pagan druidism. The leek,

tradition says, was worn by Welsh soldiers on St David's day A.D. 640 to distinguish

them from Saxons dressed as Welshmen (Burroughs Wellcome, 1903). Later the

Saxons built Offa's dyke, isolating Wales from Mercia (A.D. 700), and the great

Welsh king Hywel Dda (Fig. 3) codified the Cymric laws (A.D. 900-950), which were

later to be replaced by English common law.

Little is known of any dermatology in the early troubled years. Three groups of

persons probably practised dermatology. First were the Celtic monasteries and clergy,

until ordinances of the Popes in the twelfth and thirteenth centuries finally forbade the

practice of medicine. They used herbs from cultivated gardens, cast out devils with

insignia and continued to use the holy wells (ffynon). Among the holy wells of Wales

there are some 437 named after Celtic Christian saints (Jones, 1954), and of the many

others some had adjectival names indicating medicinal use. Outside the monasteries

the leech doctors (Laece; the Anglo-Saxon word) did the healing 'dermatology'. They

diagnosed 'Elf shot' (Grattan & Singer, 1956) by the magic puncture and denting of

the skin, and gave treatment by blood letting, cauterization and talismans inscribed

with magic words. Tumours, for instance, were exorcised by placing upon the man

iris leaf on which was written, 'In nomine Patris et Filii et Spiritus sancti. Amen'

(Jones, 1959). The dermatologist at the King's court was the Court Physician. King

Hywel Dda (A.D. 900-950) had granted him, in precedence, the twelfth place at court

with special privileges equal to those of the chief bard (Pencerdd). The Court

Physician treated the royal household free, but he could charge a fee of twelve legal

pence for 'a red ointment' (which is a mistranslation of treatment for a major blood

vessel; Cule, 1966) and four pence for an application of herbs for a swelling. The

most famous of these men was Rhiwallon, physician to Prince Rhys Gryg, Lord of

Llandovery and Dynevor Castles. He and his three sons, Cadwgan, Gruffydd and

Einion, are known as the 'Physicians of Myddfai' in Carmarthen. They made a

collection of herbal recipes for general illness and for many skin disorders, which had

been used at the Court of Hywel Dda and before. Direct descendants of the Myddfai

physicians practised medicine until 1739, when Jon Jones, the last lineal descendant

of Einion, died. The modern book, 'The Physicians of Myddfai', was written in Welsh,

was compiled by William Bone of Llanpumpsaint and preserved in his family until

1800, and was translated in 1861 into English by John Pughe, FRCS, of Aberdovey.

The first part is probably authentic and dates from the thirteenth century. Treatments

for eczema, impetigo, warts, smallpox, ringworm and leprosy are included. The origin

of the Myddfai Physicians is also given in the book as the ‘Legend of Llwyn-y-

fanbach’ - the 'Lady of the Lake' in Carmarthen.

The Legend of the Lady of the Lake

The son of a widow sees the beautiful fairy of the Lake, Rhiannon, and seeks to

marry her. Her fairy father makes him choose her from her beautiful sisters, all of

whom look alike. He can do this only when she puts her foot forward to identify

herself. She consents to live with him so long as she is not given three 'causeless

blows' (Tri ergyd diachos'), such as a playful tap on the shoulder or in another

interpretation, so long as she is not touched with iron (i.e. the Celtic iron feared by the

earlier Cymry). It was inevitable that she should vanish back into the lake, but she

reappeared to teach Rhiwallon, her son, the healing herbs.

MEDIEVAL WALES

Now began the disintegration of the early Welsh kingdom. The Norman wars in

Wales (A D 1087-11.0) are obscure but are recorded in ballads about King Arthur and

Merlin and the quest for the Holy Grail, although it seems improbable that Arthur

lived in Wales (Williams, 1941), and in tales recorded by Lady Charlotte Guest as

told by story-teller bards (Cyfarwydd) (in the Mabinogion, Jones & Jones 1957) who

nourished up to the fifteenth century. Then followed two wars of independence, and

Llewellyn ap Gruffyd (c.1258) was the first to style himself the Prince of Wales; the

second later became Edward II. Owen Glendower (A.D. 1400-1415) (Rees, 1972),

seeking aid from France, made sorties from the heights of Plynlimon mountain. He

established his authority over all Wales and made a parliament at Machynlleth until

Henry Tudor (Henry VII), bearing the standard of the red dragon at the battle of

Bosworth, ascended the English throne, and made a union of the two kingdoms of

England and Wales. Henry VIII (Fig. 4), however, by the Act of Union (1536), finally

destroyed the Welsh kingdom by incorporating all Welsh counties into England.

University education in England was available at Oxford and Cambridge, from the

thirteenth century, and also elsewhere in Europe, but not within Wales. Under the

Normans the Welsh holy wells became dedicated to other saints. Some curative wells

treated leprosy (clafr) but there were also established church lazar houses and, in

Cardiff, a leper hospital founded by the townspeople stood near the site of the old

Royal Infirmary (Cule, 1970) The ‘Black Death’ plague (1348-9) decimated both the

lowland Englishry and the upland Welshry (Ziegler, 1969).

By the sixteenth century there were two distinct medical traditions in England and

in Wales (Williams, 1928). The educated University graduate migrated to the towns to

treat the upper and the middle classes, and the ignorant village leech, or itinerant

quack, versed in druid herbs and Anglo-Saxon magic, treated the country folk and the

poor. The holy wells of medieval Wales became the doctors of the poor (Jones, 1954).

Many wells had dermatological reputations. At some, warts were pricked with pins

and needles, which were then thrown into the well. Others cured wens, sore legs,

erysipelas, cancers and sores. In Denbigh, at Fynnon Ddyfnog, special rooms were

provided for cure of scabs, the itch, and 'some said it cured Pox' (Jones, 1954).

Written contributions in dermatology began to be made by Welsh doctors, who had

been educated in law, theology and other disciplines, and also by rich landowners

who collected manuscripts. Thomas Phaire (1955), who died 1560, wrote the first

book on paediatrics in English, the 'Boke of Chyldren'. He recorded such skin diseases

as 'Scalles of the head', 'Scabbyness and ytche', 'canker in the mouth', 'failyng of the

skynne' and 'chafing of the skynne', 'small poches and measles', 'sacer ignis or

chingles', and 'swellyng of the head' as from the sides of bacon or salt beef falling

from hooks in the ceiling, as well as stiffness of the limbs as when a child is found in

the frost or street cast away by a wicked mother; which gives some idea of the then

current social conditions.

Humphrey Llwyd of Denbigh (1568), a geographer, translated the Thesauris

Pauperium', as the 'Treasury of Health', recommending arsenic for curing 'Wyddfire'

or ringworm, and David Samuel (1751-1798), travelling with Captain Cook,

described scurvy and syphilis in the Sandwich and Friendly Isles (Wellcome

Historical Medical Museum, 1928). There were also leech books compiled from the

old manuscripts, such as Hafod 16 (Jones, 1955, 1956, 1958, 1959) and 'the Welsh

Leech book', (Llyfr o Feddyginiaeth) (Lewis, 1914). Herein are treatments for

erysipelas, boils, bites, pockmarks and scales. Lice were removed by grinding wild

sage with a pennyworth of mercury and superfluous hair by nettles boiled with

vinegar.

MODERN WALES (17TH - 19TH CENTURIES)

After the Reformation, changes in religion, the awakening of scientific teaching

and the coming of industry significantly changed Wales and its dermatology. Non-

conformist doctrines led to the destruction of Roman Catholic churches and effigies,

with impairment of established well cults. Pilgrimages still continued to some wells,

such as St Winifred's at Holywell (Jones, 1954). The scientific possibility that

chemicals in the water, instead of miracles or magic, might be responsible for cures

encouraged analysis of the waters. After the discovery of minerals, curative spas

began to be established at Llandrindod Wells and Llandudno. The Reverend

Theophilus Evans, with scurvy, was encouraged to bathe at Llanwrtyd Wells after

seeing a very healthy frog emerge (Jones, 1954). 'Black sulphurous mineral springs' in

Llanbister, Radnorshire (Williams, 1905), and elsewhere were famed for the cure of

'cutaneous distempers'. The Industrial Revolution in Wales in the eighteenth and

nineteenth centuries, with its coal mines and steel works (1750), lead and copper

(1800-1850), wool and slate (1850) (Rees, 1972), led to canals and railways, and to

larger towns of coal miners and steel workers. Dermatology was part of the medical

care of workers by truck doctors (payment of wages in goods or cheques valid in

stores owned by the employers) and later by practitioners on contract to employers.

Occupational cellulitis in colliers later so increased that the Medical Research

Council eventually produced a report on cellulitis and bursitis in 'beat knee, beat hand

and beat elbow' (Collis & Llewellyn, 1924) in Wales and elsewhere.

The intellectual leaders of Wales in the seventeenth to nineteenth centuries were

still hymnists, preachers, musicians, poets, bards and revivalists, living in houses

isolated in the valleys (Edwards, 1931). A former Welsh prime minister, David Lloyd

George (1912), in the House of Commons described vividly the situation even in the

twentieth century. 'Anyone who has lived in these mountains knows what sickness

means. There are miles of track broken and rutted by the winter rains before you reach

the high road. The people there never send for medical aid for petty ailments. He is

not even summoned for important family events'. The village old lady, with her herbal

expertise, was thus often the dermatologist.

YESTERDAY AND TODAY

The dream that Wales might have its own university was not fulfilled until its

colleges began in Aberystwyth 1872, in Cardiff 1883, and later in Swansea and

Bangor. Preclinical medical teaching was available at the Cardiff Royal Infirmary

from 1893 to 1921, in which year a medical degree M.B., B.Ch. (Wales) was

instituted (Jones, 1971).

Probably one of the first persons with training in dermatology to practise in

hospital in Wales in the present century was Dr Owen Rhys at the Cardiff Royal

Infirmary (Glamorgan), but the first full consultant dermatologist to be appointed was

Dr Percy Ingram at the Royal Gwent Hospital in Newport (Monmouth).

Owen Llewellin Rhys M.D. B .Ch.(Edin.) (1875-1963) (Fig. 5)

Born at Neath, South Wales, he qualified at Edinburgh Royal Infirmary. He learnt

his dermatology as a house physician in the skin department. In 1901 he was

appointed resident medical and surgical officer at the Cardiff Royal Infirmary. His

later predominant interest in radiology was aroused by treatment of simple skin

disorders including tinea capitis by X-ray, with experience gained under the tutelage

of Dr Thurston Holland, the pioneer radiologist in Liverpool. He became in 1906

medical officer in charge of the 'electrical pavilion' at the Infirmary, a name which

still adorns the door of the old department of dermatology, and later lecturer in

radiology to the Welsh National School of Medicine.

His writings were on radiological subjects (Rhys, 1934) rather than on skin

disorders. As a territorial soldier he served in the 2nd Welsh Field Ambulance in the

1914-18 war. When president of the Cardiff Medical Society (1930) he was host to

the eminent dermatologist Dr Graham Little who, as MP for London University, was

his chief guest.

Cecil Parker Ingram M.R.C.S., L.R.C.P.(Lond.), M.B., B.S.(Lond) (1875-1955)

(Fig. 6)

Dr Ingram was educated at Guy's Hospital, qualifying in 1899. He was honorary

physician in diseases of the skin and medical officer in charge of the venereal diseases

department at the Royal Gwent Hospital, Newport, from 1920 to 1945. Later he was

consultant dermatologist also to Blaina and District general hospital and to Woolaston

House Emergency Medical Service. Coming under the influence of Colonel L.P.

Harrison, the eminent venereologist, his contributions were mostly on venereal

diseases (Ingram, 1926,1930, 1932). He was a member of the British Association of

Dermatology, and a medical referee for dermatology cases. He had the honour of

being commissioned as a deputy lieutenant for the county of Monmouthshire (1941).

Ointments with many ingredients were then individually compounded and

dispensed. A famous Cardiff chemist's shop was founded by Robert Drane F.L.S.,

first in Bute Street (1857) 'under the delusion that it must become the principal street

in the town' (Annotation, 1901). It was recommenced in Queen's Street in 1868 when

there were three pharmaceutical chemists in the town, and when the Pharmacy Bill,

setting up a register of pharmaceutical chemists, chemists and druggists, became law.

It continued to flourish during the first half of the twentieth century under the late Mr.

Alex. Johnson. The reliance of many patients from the Rhondda valleys upon 'Drane's

ointments' for skin disorders is well within the memory of many today.

The Welsh National School of Medicine was born in 1931. Dermatology still

continued to be combined with venereology.

During the next two decades, leading to the Second World War (1939-45) and the

introduction of the National Health Service (1948), other dermatologists were

appointed in the Principality.

In Cardiff these were:

James Beatty M.B. (Lond.), M.R.C.P. (Lond.), D.P.H. (1895-1947) (Fig. 7). When

he was appointed the first honorary dermatologist at the Cardiff Royal Infirmary

(1923-1937) and later lecturer in dermatology and in pharmacology, he initiated the

present dermatology department of the Welsh National School. He was also

dermatologist to the Queen Alexandra Hospital, Weston-super-Mare. He trained in

Dublin, and later in London, with honours and the gold medal for anatomy. He was

Vice-President of the section of Dermatology of the Royal Society of Medicine in

1928 and1934, and President of the Cardiff Medical Society 1940-41. During the war

years he came back from retirement to stand in for his successor at the Infirmary, Dr

Francis Bettley, who was on active service. Many remember his ability to diagnose

common skin diseases with considerable accuracy by touch when his sight was

failing.

Francis Ray Bettley. He followed Dr Beatty in 1937 as Consultant

Dermatologist at the Royal Infirmary and lecturer in dermatology, and resigned in

1946 to go to the Middlesex Hospital in London.

In Swansea there was:

David Rhys Lewis M.D., B.Ch.(Edin.), F.R.C.P.(Edin.) (1890-1957). He was the

first visiting physician for skin disorders on the staff of the Swansea General Hospital

(1930-1957), and in 1935 was also made medical officer in charge of the VD

department at Swansea. Graduating in Edinburgh in 1920, he trained in dermatology

in Paris and Vienna. He was clinical assistant at the skin department in Cardiff, 1928-

29. He started practice as a general practitioner in Llansamlet near Swansea and,

consequent upon his experience with the tin workers in this industrial area, 'industrial

dermatitis from radiant heat' was later included in the schedule of disorders under the

workman's compensation act. He had an exceptionally large 'parish' for any

dermatologist and throughout Wales, where so many have the same surname, he was

identified affectionately as 'Dai skins'. He became in turn dermatologist to Pembroke

Memorial Hospital (1934), West Glamorgan Hospital, Neath, Gorseinon and

Morrison Emergency Hospital (1935), Llanelly General Hospital (1943) and Aberdare

hospital (1945). In 1950 he became a part-time consultant dermatologist under the

NHS based on Swansea General Hospital, and was asked to continue 1 year after

reaching the age of retirement at 65.

A patriotic and knowledgeable Welshman, he was very honoured by his election

to the Court of Governors of the National Library of Wales and by being made High

Sheriff of Breconshire in 1950.

At Bangor: Dr Dorothy Lancaster (nee Godden) (1900-1961) (Fig. 8). Was made

physician with care of the female venereal disease department and temporary war-

time dermatologist in 1944, before being appointed in 1946 as the first consultant

dermatologist at the Caernarvon and Anglesey General hospital at Bangor. She started

the first skin department at this hospital and later in the Clwyd and Deeside area at the

Royal Alexandra Hospital, Rhyl. She trained at the London School of Medicine for

Women, at St Mary's Hospital in 1929, and later studied dermatology under

Oppenheim in Vienna for 1 year. She worked in 1930 in the Special Department in

Bristol under Dr Kenneth Wills. She was a great supporter of the Medical Women's

Federation, serving as its secretary and president, and she gave an address on skin

disorders at their International Conference in Italy in 1954. She was president of the

Caernarvon and Anglesey branch of the Royal College of Nursing, the Bangor Inner

Wheel and Soroptomists Club.

Since the expansion of the National Health services, many more dermatologists

have been appointed throughout the Principality. These are, in Wrexham, Netta Hay

(1940), in Newport, Dr Bernard Thomas (1945), and in Cardiff, G. A. Hodgson

(1946), A. J. Rook (1950), who later moved to Cambridge (1953) and was succeeded

by E. Waddington (1953). Elsewhere there were, in Swansea, Leighton Rees (1957),

in Neath, Roderick Howell (1958), in Clwyd and Deeside based on Rhyl, Ellen

Emslie (1962), in Pontypridd, Charles Long (1965), in Bangor, William Beer (1965),

and in Llandrindod Wells, Ann Lawton (1967).

The present University Hospital of Wales was commissioned in 1965 and opened

by H.M. the Queen on 19 November 1971. The dermatology department was

transferred from the Cardiff Royal Infirmary, and the dermatology ward was one of

the first two wards to be opened on that day. The first patient, who was specially

chosen to be admitted to the University Hospital of Wales, suffered from psoriasis!

The recent academic appointment of a senior lecturer, Dr Ronald Marks, in July 1973,

begins a new stage in the story of dermatology in Wales.

ACKNOWLEDGMENT

I wish to record my thanks to Dr John Cule, Lecturer in the history of medicine to

the University of Wales in Cardiff, for help in the preparation of this article.

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