A HISTORY OF IMMUNOSUPPRESSIVE DRUGS IN THE TREATMENT OF INFLAMMATORYBOWEL-DISEASE - ORIGINS AT THE MOUNT-SINAI HOSPITAL

If the cause of Crohn's disease and ulcerative colitis turns out to be some immunopathologic mechanism, many of the steps leading to such an understanding of their pathogenesis can be attributed to concepts tha t originated at The Mount Sinai Hospital. Perhaps immodestly, we can c laim a role in the acceleration and the acceptance of these concepts; however, many contributions were made by others, including Moschkowitz , Klemperer, Otani, Crohn, Ginzburg, Oppenheimer, Marshak, and Janowit z. This does not mean that clinicians and researchers from other insti tutions did not contribute to this understanding. As happens so often in medical history, elucidation of many disease processes are serendip itous. The concept of autoimmune diseases was introduced when we were house officers at Mount Sinai. The early days of transplant surgery so on followed along with the introduction by Hitchings and Elion of azat hioprine to inhibit rejection. The concept of immunosuppression slowly evolved into possible treatment of any disease thought to be caused b y autoimmunity, including those diseases of the bowel, seen so frequen tly at The Mount Sinai Hospital: ileitis, granulomatous colitis, ileoc olitis, and ulcerative colitis. Although most of the world called gran ulomatous disease of the bowel Crohn's disease, it was only after the deaths of Drs. Crohn, Ginzburg, and Oppenheimer that we accepted this single eponym. However, we will always pay tribute to all three Mount Sinai physicians who wrote the original paper that described the disea se.