Crohn's disease: ancient and modern.

In 1932, Crohn, Ginzburg and Oppenheimer published their classical paper on regional ileitis in the Journal of the American Medical Association (JAMA).' Since then, it has been a popular pastime to document the many case descriptions ofCrohn's disease whch were published beforehand.2-4 Most of these were brief reports of small numbers.5-7 The most thorough studies were those of Moschowitz and Wilensky in 1923 which Crohn cited,8 and of Lesniowski in 19039 and Dalziel in 191310 which he did not. Lesniowski's description is limited but his contribution is remembered in Poland where the disease is known as Lesniowski-Crohn disease." Dalziel recognized the similarity between regional enteritis in humans and Johne's disease in cattle, a condition caused by Mycobacterium paratuberculosis.'0 This likeness passed Crohn by, although he and his co-workers went to great lengths to exclude known enteric pathogens in the patients they reported. Dalziel's description of his cases is much less thorough than Crohn's but he did describe colonic lesions which he believed to be part of the same disease. In this respect, he was much closer to the modern concept of Crohn's disease than Crohn himself. It was not until the descriptions both of Brooke, and of Morson and Lockhart-Mummery in 1959 and 1960 that Crohn's colitis became generally accepted.'2-'4 It has often been said that the 1932 paper gave rise to the eponym of Crohn's disease through two quirks of fate. The first was the policy of JAMA to list authors alphabetically rather than by the importance of their contribution;'5 the second was the reluctance of the senior surgeon, Dr Berg, to put his name to a paper that he had not written.'6 Another twist to the story is the assertion by Ginzburg that he and Oppenheimer wrote the majority of the paper.'6 Ginzburg maintained that Crohn bor-