Burrill Bernard Crohn (1884-1983): the man behind the disease.

Burrill Bernard Crohn was born in June 13th, 1884, in the city of New York. From a family of jewish emigrants from Europe, Theodore and Leah Crohn had 12 children, educated as Jewish orthodoxy, still spread over the generations5. In New York, he attended City College (Class of 1902) where his interest for the medical career was born. According to his own biography, he decided to follow the medical pathway because his father used to have terrible digestion problems; so, he chose to help him by studying medicine. He received his medical degree at Columbia University’s College of Physicians and Surgeons (1907), at the age of 233. At this University, Crohn developed many experimental researches concerning intra-abdominal hemorrhage, for what he gained an M.A. and a PhD in addition to his M.D degree. However, he felt obliged to decline the first two degrees, because of their price at that time (US$35), and he did not wish to ask his father for the extra money8. After this period, he was admitted as one of the 120 candidates for eight positions as an intern at Mount Sinai Hospital. Crohn had spent two and a half years at this position, a mixed rotation for surgery and medical diseases, and an extra year of pathology, mentored by brilliant Dr. Emanuel Libman (1872–1946). He believed that this rotation at the pathology department gave him the proper balance of combined scientific laboratory and clinical medicine8. Most of his medical activities were developed in Mount Sinai Hospital. He joined this hospital as an intern in pathology, then as assistant in pathology and then physiological chemistry from 1911 to 1923. Finally, Crohn joined the clinical staff in 1926. As a local general practitioner, he referred most of his patients to Mount Sinai, today known as a prestigious teaching and postgraduate hospital3. One curiosity of those old days was that Crohn was married to Lucile Pels in 1912, having two children, Ruth (born in 1912) and Edward (born in 1917). However, without having any time for the family mainly because of daily house calls almost every evening and his dedication to “Affections of the Stomach”, published in 1928 -, they had to dissolve their marriage by divorce8. His special interest in bowel diseases is demonstrated in his biography: “It has been my misfortune (or perhaps my fortune) to spend most of my professional life as a student of constipation and diarrhea. Sometimes I could wish to have chosen ear, nose and throat as a specialty rather than the tail end of the human anatomy...”3. Gastroenterologists existed much earlier than gastroenterology was recognized, and defined as one of the internal medicine’s specialties. That was what happened with Crohn, as most of the digestive diseases wards were in held of surgeons at that time. He was only recognized as a full member of the American Gastroenterological Association (AGA) in 1917, mentored and helped by William J. Mayo, who was introduced to Crohn by Dr. Libman8. After that, he spent some years until 1921 studying the functions and the diseases from the pancreas. He studied normal function of the pancreas using himself as a volunteer, by swallowing a 36-inch rubber catheter and studying the aspirated pancreatic secretions after having a glass of milk8. Much of his dedication to treat inflammatory bowel diseases also came from the close friendship with Dr. Jesse Shapiro (working at the Mount Sinai Hospital), also diagnosed with the disease in himself. Another reason was that his hospital used to admit lots of Jews, who have a higher incidence of the disease. For all these continuous efforts, he was nominated the first chief of Mount Sinai’s Gastroenterology Clinic and continued associated with Mount Sinai for 60 years, where generations of physicians developed a special interest in inflammatory bowel diseases, until today8. In the beginning of the 20th century, the eminent surgeon Dr. A. A. Berg stimulated his assistant Leon Ginzburg (a clinical professor of surgery) and his colleague Dr. Gordon David Oppenheimer (consultant physician and surgeon), to study inflammatory granulomatous diseases of the bowel. These investigators started a project to describe and categorize specimens of bowel tumors and strictures. As some specimens did not fit any previously symptoms patterns, they presented their results to Burrill B. Crohn, who had previously collaborated with Dr. Berg. Actually, it was Dr. Berg who stimulated Crohn, Ginzburg and Oppenheimer to join their efforts and case series in order to achieve a significant sample of patients to develop the final presentation and publication of one study4,8. Crohn wrote a letter for the American