When Alfred Hardy and his staff, which consisted of only a single person, o
rganized the first International (World) Congress of Dermatology and Syphil
ology at the Hopital Saint-Louis in August 1889 in Paris, France, it was a
meeting of 220 scientists who sought to learn from each other by exchanging
experiences and ideas. In those days, dermatology was medicine that was ba
sed mainly on experience alone, although, even then, great dermatologists t
ried to practice medicine predicated on evidence as well. As one example of
that conflict in mentality, Wickham called attention to the fact that Page
t disease of the nipple could be recognized morphologically as distinct fro
m eczema. Despite his knowing that the process on the nipple was related to
cancer, he nonetheless asserted that it was a parasitic disease, "since th
e psorosperms could even be seen in the scales being shed."(l).