Harold Wordsworth Barber, the son of Robert Barber, solicitor, of Nottingham, was educated at Repton School from which he won a scholarship to Clare College, Cambridge. In 1908 he took a first class in the natural sciences tripos and three years later he qualified from Guy’s Hospital. In 1912 he was awarded the Arthur Durham travelling scholarship, and having decided on dermatology as a career he spent the greater part of the year’s tenure studying at the St. Louis Hospital, Paris, under Darier, and the remainder in Hamburg under Unna.
He returned to Guy’s Hospital as medical registrar and in 1915 was appointed dermatologist to the Evelina Hospital for Children and to the Prince of Wales’s Hospital, Tottenham. In the same year he joined the R.A.M.C.; he served in India, Mesopotamia, German East Africa and France. After demobilisation he again returned to Guy’s Hospital as medical registrar and later in the year was appointed physician-in-charge of the department for diseases of the skin.
He was consulting dermatologist to the Royal Navy, and served as president of the section of dermatology of the Royal Society of Medicine in 1935-6 and of the British Association of Dermatology in 1944 and 1955. In 1928 he gave the Lettsomian lectures to the Medical Society of London on the relationship of dermatology to other branches of medicine and in 1953 the Prosser White oration to the St. John’s Hospital Dermatological Society.
Barber was the first physician at Guy’s to be appointed to the department for diseases of the skin with no other duties. Since 1850 the care of skin diseases had been given to a succession of general physicians, among them Addison, Gull, Hilton Fagge, Pye-Smith, Samuel Wilks and finally Cooper Perry. Barber matched these illustrious predecessors in outstanding qualities of mind and personality.
He had been an impressive medical registrar at a time when his generation was rich in talent and in those days the Arthur Durham scholarship was, whenever possible, reserved for those who were thought likely to be appointed in due course to the senior staff. At that time (1912) Paris with Brocq, Sabouraud and Darier led the world of dermatology, and Barber always looked on his period of study there as a great and very valuable experience. He liked the French, whose language he spoke fluently, and with his teacher, Darier, he formed a deep and enduring friendship.
He began to contribute to dermatological literature during the latter part of the Great War, and his writing attracted immediate attention. Before very long he was to dominate thought in British dermatology and this he did by infusing life and movement into a somewhat sluggish subject, thinking, teaching and writing in terms of broad aetiological concepts and rejecting as nearly always useless the ‘botanical’ attitude of mind towards skin diseases. Endowed with fine powers of observation and with the ability to speak and write in an interesting and very persuasive manner, he quickly became recognised both at home and abroad as a clinical dermatologist of the first order. This he was without question, even though his reasoning did not always conform strictly to the rules of evidence.
The age of concepts suited him and he soon became occupied with two main themes. In 1918 he began to write from France about seborrhoea and its manifestations (Brit. med. J., 1918,2,245-8) and a few years later he described an elaborate syndrome which he named the ‘seborrhoeic state’(ibid., 1922, 2, 754-7). In this the mucous membranes of the mouth and of the upper respiratory and alimentary tracts were involved as well as the skin. Among the causes were unnatural conditions of life, especially the common dietary errors and excesses of modern civilisation. The syndrome is described at length in Barber’s contributions on dermatology in Sir Frederick Taylor’s Practice of medicine between 1922 and 1936. It was much discussed for a number of years, but it eluded close definition and not much is heard of it nowadays.
Otherwise his earlier contributions mainly concerned focal infection which he held to be at the root of much common skin disease, especially alopecia areata, certain cases of chronic urticaria, and the various erythematous eruptions including lupus erythematosus.
The Lettsomian lectures (Brit. med. J.,1929,1,412,512,615-16) are an exposition of his observations up to that time and the conclusions that he drew from them. Subsequently he most often wrote to elaborate on his by now well-known views, and occasionally to consider the application to dermatological problems of other general hypotheses. In 1950, for example, he wrote in his most interesting and persuasive style on psoriasis, one of the aetiological factors of which could well be, in his view, the faulty adaption to stress that Selye had recently described. His final publication was the Prosser White oration, given to the St. John’s Hospital Dermatological Society and published in its Transactions (1953, 32, 5-15). He entitled it ‘What is truth?’ This, in effect, is a review of his life’s work, largely spent in trying to throw light on obscurities by means which appeared valid to him as well as to many other clinicians of his era.
He subtracted nothing from his faith but he knew of course that the times were changing and during the course of the talk he said that, while no-one could appreciate more than he the modern urge to seek knowledge by controlled experiment and statistical analysis, he would plead that the art of the great clinicians should never be allowed to wane.
Barber enjoyed the affection and the deep respect of his colleagues, not all of whom shared his enthusiastic faith in the general hypotheses and their application to dermatology. He was furthermore a warmhearted, generous man, who though he would often criticise the views of others or deplore a lack of them, was never known to speak unkindly of anyone.
His appearance and bearing were aristocratic, and his delivery in speaking rather quiet and restrained but always clear and well heard, even in large rooms. His outlook, both romantic and firmly conservative, was reflected in the elegance of his home, his charm as a host, his cultivated tastes and in his attachment to great institutions, especially his university and the hospital whose great clinical tradition he upheld so ably.
His tastes were in some respects sophisticated, for example in wine and food about which he knew everything, in others very simple. He liked cricket, knew all about cricketers and their performances and followed with regret the fortunes of his apparently talented but usually disappointing county. He enjoyed light reading; for example, in the earlier days the books of current good story writers such as Phillips Oppenheim and Seton Merriman whose strong taciturn heroes pleased him. He was a race-goer and in later years a keen bird-watcher.
With his immense enthusiasm, erudition and outstanding personal attractiveness it was inevitable that Barber should attract to himself a large following of students of all ages who regarded him as quite incomparable. The same qualities brought him an almost overwhelming practice with its attendant responsibilities and unremitting hard work. He worked very hard all his life and he died too young, but with Kipling’s Tramp he could well have said in the end:
‘So write before I die, he liked it all’.
He married Juliette Louise, daughter of Mme. Veuve Champrenaud, of Paris. There were no children of the marriage.
Richard R Trail
[Brit.J.Derm., 1955, 67, 230-31; Brit.med.J., 1955, 1, 234-5 (p); Lancet, 1955,1, 207 (p); Times, 15 Jan. 1955.]