The figure of José Eugenio de Olavide y Landazábal is well known to readers: his life, books, and other publications have been the focus of several articles.1–4 Dr. Olavide's book of aphorisms—those brief, doctrinal sentences that propose a general rule in a science or art—is perhaps one of the less well-known of his many works.3

To comprehend the meaning of Olavide's aphorisms, we should bear in mind 2 aspects of his view of science. First, Olavide gave credit to postulates that describe a constitutional theory of health, as expressed in the following 3 affirmations2:

• 1.

  Disease is a ‘state of a man’ as a whole, not of one of the parts of his body.

• 2.

  We cannot speak, therefore, of diseases of the skin, except when these have external causes (i.e., diseases from parasites or other agents).

• 3.

  “In all other cases, a skin lesion is not itself the disease but merely its manifestation.”

Second, Olavide classified skin diseases as follows:

• 1.

  Diseases of known causes, which are zooparasitic or phytoparasitic.

• 2.

  Natural, or spontaneous, diseases, which are general, or constitutional.

• 3.

  Artificial diseases, or those externally caused.

This article briefly discusses Olavide's views of the practice of dermatologic therapy, as it is expressed through his aphorisms.

We studied Olavide's Aphorisms on the Practice of Dermatology.5 The cover (Fig. 1) names him as Sr. Dr. D. José Eugenio Olavide, and the publisher is given as the printing establishment of the Real Hospicio de San Fernando (Oficina Tipográfica del Hospicio) in Madrid. The year of publication was 1880.

Figure 1.

Cover of José Eugenio de Olavide y Landazábal's Aphorisms on the Practice of Dermatology.

(0.23MB).

Olavide's aphorisms were published in the series of semiannual monographs issued by the Specialist Journal of Ophthalmology, Syphilology, Dermatology and Urinary Diseases (Revista Especial de Oftalmología, Sifiliografía, Dermatología y Afecciones Urinarias). Each monograph cost 1 Spanish peseta (1000 pesetas=€6). A journal page advertising the monographs included the habitual warning that no credit would be extended to enquiring parties and that orders for the monograph would not be processed unless accompanied by payment.

The author is described on the cover (Fig. 1) as a physician of Madrid's Hospital de San Juan de Dios and of the royal household, a member of the Royal Academy of Medicine, and decorated with the Grand Cross of the Royal and Distinguished American Order of Isabel the Catholic, among other honors. Dr. Olavide himself described the collection of aphorisms for the practice of dermatology as “a loose collection of ideas about diseases of the skin presented in no particular order,” suggesting that they were jotted down whenever and however they occurred to him “on the fly,” which is to say he wrote them quickly, improvising and expressing his ideas without stopping to review or revise and without any premeditated structure or logical order that is evident.

The monograph brings together 257 aphorisms on 49 pages. We found 13 that are relevant to topical treatments (Table 1) and 12 that are relevant to spa therapies (Table 2).

Before focusing on Dr. Olavide's aphorisms on treatments, we mention 2 of them that sum up his opinion on why many physicians have trouble treating skin diseases. The first states his view of certain colleagues baldly: “many physicians are afraid to treat skin diseases because they don’t know how” (aphorism 24). The second qualifies that statement, explaining that “sometimes they themselves have no fear, but they instill it in their patient to cover for their own inaction or ignorance” (aphorism 25).

Olavide states that the approach to treating a condition must depend on whether it is acute or chronic: “wise waiting is the great remedy for acute skin diseases” (aphorism 1), whereas “chronic skin diseases should be fought with internal and external remedies. The first type neutralize maladies within the patient, whether known or unknown, because fortunately there exist treatments even for conditions whose natures are still a mystery. Treating them also serves to halt the gradual progression of constitutional changes, which sustain, or reproduce, processes that become chronic. The second type (topical treatments) check the progression of the local malady—which is to say, the skin lesion, which is almost always a symptom of an altered constitution” (aphorism 2). Olavide adds that “there are numerous other treatments of noteworthy value in special cases that cannot be applied generally without creating problems” (aphorism 3).

Some of the aphorisms on topical therapies listed in Table 1 express principles that we might well share today, while others no longer have a place in our therapeutic arsenal.

Olavide was a great proponent of spa therapy, for which he particularly recommended the Spanish spas of Archena, in Murcia, and Arnedillo, in La Rioja, for treating skin diseases. Table 2 brings together his aphorisms on the use of their resources. He never missed a chance to give his opinion about the veracity of certain notions advocated by lay practitioners who were inexpert in skin problems. Thus, he says, “a common opinion of non-experts, and of many physicians too, when presented with a chronic rash, is to fail to take time for a deeper, more detailed look before calling the eruption herpes, and then to recommend avoiding topical treatments so the herpes does not go further inside. Their only advice is to take sulfurous baths in summer. A routine like that is ridiculous and out of step with the scientific advances of our day” (aphorism 64). Or, he wonders, “What ridiculous notion underlies the common belief that patients should take no baths in spa waters?” (aphorism 66). Or, he asks, “Is there any common sense in seeking a radical cure for a skin condition that has been present for many years, just by spending 7 or 9 days taking the waters and bathing?” (aphorism 67).

The monograph ends with aphorism 257, dedicated to what we might call the new treatments of those times. Perhaps they seem completely dated to us now, but Olavide and his follow dermatologists logically enthused that “today dermatology has two new topical medications, pyrogallic acid and chrysophanic acid, which offer advantages over coal tar and juniper oil to combat psoriasis, pityriasis and all dry skin diseases or conditions in phases of desiccation or peeling. They should be mixed with butter in a ratio of 5 to 100 to create an ointment to rub gently into the eruption once a day.”

• 1.

  The Aphorisms of Dr. José Eugenio Olavide is a historical document that sheds light on the practices of Spanish dermatology at the end of the 19th century.

• 2.

  Some of the doctor's aphorisms continue to be relevant today.

The authors declare they have no conflict of interest.