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Over centuries, mercury ointments in combination with epilation of the affected hair were the basic therapy for “Erbgrind”. The observation that “Erbgrind” could be cured through epilation of the entire hair led to the painful and potentially dangerous therapy with the “tar cap”:
A leather cap brushed with tar pitch on the inside was put on the close-cropped hair and ripped off after a few days, when the pitch was firmly stuck to the hair. This procedure had to be repeated over several weeks.
Over time, this epilation technique changed to the epilation with tweezers, the use of epilation powder and epilation ointments. In Paris in 1830, the brothers Mahon successfully used their secret formula of powders and ointments.
Microsporosis, treated with X-rays. In 1895 Conrad Röntgen discovered the rays that were subsequently named after him. Shortly afterwards, it was found that the applied dose of X-rays coincided with temporary or permanent hair loss. Only two years later, radio epilation was suggested as treatment of fungal infections of the hairy head. This was the therapy of choice until the introduction of Griseofulvin, the first antifungal agent in form of a pill, in the year 1958.
Nowadays, microsporosis, which is rare but very infectious, is usually transferred by domestic animals and pets. Especially kids are affected. Usually the root of the hair stays intact and the hair grows back after healing.
The implementation of hygienic preventive measures and the possibility of an easy and effective therapy with X-rays let the favus disappear almost entirely by the beginning of the 21st century.
The affection of the beard by dermatophytes is not common anymore, either. The barber’s itch (mentagra) spread epidemically, especially in Germany around 1900. Because of its transfer from the shaving brush at the barber’s onto the hair, it was called barber’s or hairdresser’s itch.
In 1905, a hairdresser was convicted to one month in prison in Eisenach (Germany) due to the repeated transferring of barber’s itch. Apart from educating barbers about the appearance and characteristics of the disease and the adequate disinfection of the instruments, self-shaving was broadly recommended.
Crucial for the massive decrease of the disease was the launching of the patented razor with short blades by King Camp Gillette in 1901. From then on, the razor was a success and barbers were no longer necessary.
Compared to the fungi of the hairy head, mycosis of the feet was uncommon in 1890. At a congress in Paris in 1892, the Turkish physician Djelaleddin-Moukhtar, later a professor for dermatology in Istanbul, presented the case of a patient with Athlete’s foot as a curiosum.
Only about 100 years ago Athlete’s foot became more frequent. Maybe the reason lies in wearing synthetic stockings and shoes with rubber soles, in the setup of common changing rooms, gyms, and indoor swimming pools.
Despite great progress in the therapy of Athlete’s foot, it remains the most frequent and common infectious disease in countries like Switzerland.
Athlete’s foot with blisters.
Further moulages on mycosis in showcases 27, 28 and 47.
Catalogue p.91
Today, the affection of the skin with mycobacteria tuberculosis rarely occurs in Europe. The moulages on display are from patients of the former Zürcher Kantonsspital (Hospital of the Canton of Zurich) in 1920. At this time, tuberculosis was so frequent that almost everybody at the age of 30 was infected. Nevertheless, not every infected person fell ill.
The huge number of infected people was the reason why tuberculosis of the skin occurred rather frequently. Compared with the affection of the lung, however, tuberculosis of the skin has always been a rare clinical picture.
Lupus vulgaris was the most common form of skin affection. Spontaneuos healing rarely ever occurred. In some cases, light therapy, X-rays, and cryosurgery brought success. The patient presented in moulage 488 was irradiated with an UV-lamp over several months.
The chronic tuberculous inflammation of the skin enhances the risk for developing skin cancer.
Moulage 371
The inflammatory defence mechanisms of the body in reaction to the chronic infection and the slow progressing of the illness may scar the face and erode the nose (lupus = wolf, meaning cancerous lichen)
Moulage K40
In modern textbooks, scrofula cannot be found anymore. Presumably, it was an immunological hypersensitivity to tuberculosis with eczema and inflamed mucous membranes as well as swellings of neck and upper lip. Special disposition and links to certain nutritional and hygienic aspects were also discussed at the time.
Tuberculosis cutis verrucosa is the rare and direct infection with the bacteria over a skin injury. It was known as an occupational disease of physicians whose contact with the germ lay well above average. Pathologists were affected the most because at the time they dissected without protective gloves. For this reason, the disease was also known as Tuberculum anatomicum.
Moulages 993 and 435
Robert Koch (1843-1910) developed an extract of tubercle germs for the therapy of tuberculosis: tuberculin. The injection provoked a massive skin reaction. The expected success did not follow suit. However, the reaction provided evidence of an infection with tuberculosis.
The intracutaneous Mendel-Mantoux-Test is still a potential way of testing whether a patient was exposed to Tbc (infected or vaccinated) and shows the force of the immunological response.
Paul Clairmont, Zurich, 1931
In the textbook of the Zurich professor for surgery, Paul Clairmont, some of the patient’s stories were illustrated with drawings and pictures of moulages produced by Adolf Fleischmann in Zurich.
Abscess of a tuberculosis in the region of an upper arm fracture.
Tuberculosis of the pharynx, larynx, and severe lung tuberculosis.
Tuberculous tongue ulcer; previously admitted to the clinic as patient with cancer of the tongue.
Moulages of surgical diseases are a rarity. Over 500 moulages of the Surgical clinic fabricated between 1919 and 1927 belong to the Museum of Wax Moulages Zurich. They were commissioned by Paul Clairmont, the former chief physician at the Surgical Clinic. They were made by Adolf Fleischmann, a scientific illustrator who was specifically trained as a mouleur.
The extraordinary diseases on display and the fact that many of the patient stories documented in this way were published in scientific publications, suggest that these moulages were not used for student education, but for research documentation.
Today, the surgical moulages bear a unique testimony to the possibilities and limits of surgical therapies in the past, confronting us impressively with the fate of historical patients.
Keloids on combustion scars.
After a hydrochloric acid injury as a baby, this combustion scar was not only stressful in an aesthetic sense, but also restricted the patient’s movements considerably.
In 1908, a surgical technique was published for the therapy of severe cases of varicose veins, developed by surgical professor Rindfleisch from Stendal. Attempting to destroy the varicose veins, a deep spiral cut (“Spiralschnitt”) with up to seven circles from the knee to the back of the foot was made. The daring cut needed to heal without stitching in order for the veins to scar over.
Moulage 40 was made ten years after the operation. As the open ulcers on his leg indicate, the patient was not healed at all. This operation did not only destroy the sick veins but also the skin nerves and lymphatic vessels. But in this case, the therapy was probably done too moderately, so that there were still some deeper-lying varicose veins left.
Until 1935, this operation was performed on hopeless cases as an alternative to amputation, most of the time with better results than shown here.
Small varicose veins below the ankle, named Corona phlebectatica. The cosmetically disturbing finding occurs frequently. However, usually there are no other complaints.
"What the mask can hide..."
During the Corona pandemic, wearing a hygiene mask temporarily became the new normal. For most, it was and remains an uncomfortable but necessary new accessory, but sometimes the protective mask also provides an opportunity to hide one’s features.
Moulages from the ORL* clinic
* ORL stands for Oto-Rhino-Laryngology, the study of ear, nose and throat diseases.
Our collection of over 2000 moulages also includes a small collection of moulages of the nasopharynx from the ORL Clinic, supplemented by a few pieces from the Dental Institute of the former Zurich Cantonal Hospital (today’s University Hospital). They were produced between 1919 and 1941 by the moulageur Lotte Volger and were used for scientific publications and presumably also for demonstration at specialist conferences and in student teaching.
This collection is exceptional in many respects:
There are very few moulage collections worldwide that were made for ORL or dental clinics.
The production of these moulages is technically very difficult, and precise information on the historical production technique is lacking at present. Since plaster cannot be used in the oral cavity, impressions were probably taken with alginates or soft waxes. Because of the gag reflex, findings of the posterior pharynx had to be modelled freely. It is also very difficult to make an impression of the tongue, as it is nearly impossible to keep the tongue still for several minutes.
Ancillary findings were also modelled as realistically as possible. Therefore, we can assume that the replicated teeth really looked like this. Thanks to fluoridation, dental hygiene and dentistry, we do not have to hide our teeth behind a mask today. 100 years ago, this was different: among all the moulages from 1919 to 1941 there is not a single completely healthy set of teeth!
Diagnosis list
120 Glossitis
137 Dental fistula of the chin
146 Lichen ruber planus
169 Tongue bite after fall
209 Haemangioma of the lower lip
220 Ca linguae (carcinoma of the tongue)
238 Tuberculosis of the tongue
257 Ca linguae (carcinoma of the tongue)
282 Lymphangio-acanthoma
343 Carcinoma of the lower lip
382 Lupus vulgaris mucosae
455 Carcinoma of the tongue
462 Pressure ulcer of the tongue
466 Granuloma
477 Carcinoma of tonsil (tonsils)
477 Furuncle of the lips
485 Gumma (syphilis stage III)
499 Secondary syphilis, plâques muqueuses on lips, palate, tonsils
506 Herpes vulgaris (mucous membrane of the upper jaw)
525 Ca linguae with leukoplakia
977 Lichen ruber verrucosus
1003 Tuberculosis of tonsil
1009 tuberculous primary complex
1045 Primary tuberculous complex
1048 Primary tuberculous complex
1064 Paget's disease
1199 Aphtae
1490 Tuberculosis of the tongue
Environmental control is of utmost importance for a long-term conservation of all museum objects. Temperature, humidity, UV- and other light rays have to be controllable and are monitored on a regular basis. Exposure to mould, dust, pollutants or pests must be avoided. Mechanical stress, occurring for example during transportation, is a high-risk factor for damage. Continuous inventory and documentation are the basis for optimal conservation.
As environmental conditions are hardly ever ideal, damage may occur. In the case of wax moulages, these damages range from surface staining and abrasion, cracks and fissures in the wax, rusty nails or the distortion of the wooden boards to the loosening of the wax model from the board.
Due to conservational measures on and around the object, damage may partly be contained, for example through careful removal of dust or rust. In other cases, a more extensive restoration might be taken into consideration. A broken-off piece of wax for example can be reattached to the moulage, followed by retouching of the breaking line.
Nevertheless, restoration measures themselves may pose a risk of damage. Insufficient know-how and the use of unsuitable materials may lead to drastic changes in the colouring or the level of detail of the wax moulage’s surface. As a consequence, the realistic aspect and thus the readability of the wax moulage may be irretrievably lost. A gapless documentation is essential, because otherwise a piece of the object’s history gets lost with every single restoration.
Hence, the collaboration of experts in restoration, medicine, history of medicine and science is crucial for the professional restoration of wax moulages.
In 2013, a two-year project in collaboration with the University of Applied Science in Bern (Hochschule der Künste Bern, HKB) was finalized, which enabled the museum to plan and implement an extensive conservation concept.
Manufacturing of a Moulage, Finger Series by Johanna Stierlin, 2012, item on loan
Original moulage No. 316, made by Adolf Fleischmann in 1924
Moulage No. 316, after unprofessional restoration in 1992
The recipe was first published by Elsbeth Stoiber and got passed on to the museum.
Manufacturing of a negative form, made of plaster or silicone, of the body part which is to be reproduced. Certain overlaps or undercuts require multiple plaster casts.
Bleached beeswax, calcium carbonate and dammar resin* are merged in a water bath and subsequently filtered several times to remove contaminants.
The plaster negative is grouted layer by layer with the warm moulage mixture
by a swivelling moulding technique.
Hardening and subsequent careful separation of the “raw moulage” from the plaster cast in a temperate, cooling water bath.
Removing of plaster residues and adjusting of overlapping wax edges with a warm spatula. Evening out of air holes or smaller elevations in the wax.
With the patient present and in daylight, the moulage is painted with almost transparent layers by smoothly stippling with a fine brush. Each layer has to dry completely before painting can be continued. According to the Zurich recipe, only four oil colours solved in turpentine are applied: gamboge, bitumen, madder lake dark and cobalt blue dark.
Details like shiny, scabby or hairy patches, eyes or blisters are represented by lacquers, hair, glass and other accessories. The finished moulage is mounted on a black wooden board and enveloped by a cotton cloth. Generally, the year of manufacture, the name of the manufacturer and the diagnosis are added.
*During the research project “Diseases molded in Wax – The Conservation of the Zurich Wax Moulage Collection” in collaboration with the University of Applied Arts in Bern (Hochschule der Künste Bern, HKB), chemical analysis revealed the total or near absence of dammar resin in many of the traditionally fabricated Zurich moulages. The significance of Dammar resin for the stability of the moulage is subject of further research.
Photos by Tine Edel
Historical wax moulages are unique and fragile museum exhibits and barely reproducible. However, because of their use for teaching in various medical occupational groups, they stand within the conflicting priorities of their value as museum objects and their use as “objects of utility”. Furthermore, the moulages are occasionally on loan to other institutions.
In order to ensure an optimal conservation or to loan moulages to other institutions, the production of duplicates would be desirable. Therefore, options for a non-intrusive duplication of wax moulages were explored.
In collaboration with the Institute for Rapid Product Development (irpd) of the ETH Zurich, a moulage was scanned and also measured by X-rays in a CT. Using an additive production process (3D-printing), an epoxy resin model could be printed three dimensionally. This model could be used as a replacement for the original. By manufacturing a silicone negative of the epoxy resin model, wax duplicates can be moulded any number of times.
The surfaces of the epoxy resin model, and thus of the newly moulded wax moulage, are slightly less detailed in structure as the one of the original moulage – a fact which reflects the current state of 3D-scanning and -printing, and which needs to be optimised with its further development.
The current state of non-intrusive reproduction is also illustrated by the models in showcase 18, produced by the company “Pocketsize Me”. After scanning and complex post-editing, the models are printed three-dimensionally, layer by layer, out of plaster, vinyl, ceramics and polymers.
Photos
Inside the laboratory of irpd, St. Gallen 2013
Screen shot of the scanned original moulage, irpd, St. Gallen 2013
As old plaster negatives in the archives of the museum confirm, moulages were duplicated as early as 1949. The technique was similar to the manufacturing of a new moulage, by making a plaster cast directly from the original moulage. In 1999, in order to facilitate a long-term loan of a moulage, a duplicate had to be produced. As the existing plaster negative was damaged, a new one was needed.
The production of a plaster or silicone negative of the original moulage comes with great risks for the original: cracks and fissures in the wax; extraction of hair, scabs or other structures which are attached during fabrication, or plaster residues on the original. From a present perspective, this method is inacceptable.
In order to protect the original moulage, the museum is currently researching the possibility to produce duplicates using contemporary 3D-scanners and 3D-printers. Despite the great success these technologies have achieved in science and industry, it wasn’t until recently that three-dimensional scanning of semi-transparent wax objects in workable file sizes and sufficient resolution became possible.
Produced by scanning, digital interpolation and 3D-printing with a mixture of plaster, vinyl, ceramic and polymers.
Pocketsize Me AG, www.pocketsizeme.ch
Cancellous bone of the head of femur (bone structure); epoxy resin (VeroBlue)
Various bone models made of epoxy resin
Item made by inspire/irpd – institute for rapid product development, www.inspire.ethz.ch
At present, the direct and high-resolution 3D-print of a coloured wax moulage is not yet possible. In our latest project, however, we succeeded in producing an outstanding duplicate with the help of a three-dimensional printed negative cast, which was generated using data from a 3D-scan.
Angiokeratoma Mibelli, made by Lotte Volger ca. 1940; and corresponding non-intrusively produced duplicate according to the description above (Aleksija Geiges, 2017)
Printed negative form of moulage 1092, generated using 3D-scan data; and unpainted moulage.
By using duplicates instead of originals, the historically precious moulages are protected and preserved. In a next step, the Museum of Wax Moulages wants to apply this technique to the restoration of damaged moulages: A damaged moulage gets scanned, so that the 3D-version on the computer can be “repaired” digitally. Using a negative cast of the digitally repaired moulage, a restored version can be produced without ever touching the damaged original.
