October 25, 2018
105 years ago today, Thomas Kennedy Dalziel (1861-1924) published the first report of the chronic inflammatory intestinal condition that is now called Crohn’s disease; named for the first of three authors of the 1932 report describing the pathology and clinical presentation of this regional ileitis. Dalziel’s paper describes several cases, three of which have pathology reports. Noteworthy is that Dalziel mentions the gross and microscopic similarities of the intestines he removed from patients with those from cases of Johne’s disease in cattle. He mentions the 1895 work of Johne (misspelled as Henny) and Frothingham and cites the early work on the Johne’s disease pathology by McFadyen. The puzzling aspect is that while the pathology of the human and animal diseases is strikingly similar, acid-fast bacteria (MAP) can be seen in the animal tissues but not in the human tissues: a puzzle that remains today and is the essential feature leading some experts to view the human and animal forms of this chronic enteritis as having different causes.
Comment: This historically important publication (British Medical Journal vol. 2, no. 2756, pp 1068-1070, October 25, 1913) is made available by JSTOR at the link provided below. Without agencies such as JSTOR it is hard to obtain older literature such as this.
Thomas K. Dalziel was known for his charm, kindliness, extraordinary teaching skills, and marvelous manipulative dexterity. He was considered the best technical surgeon in the West of Scotland. His contributions to the medical literature were considerable, dealing mainly with abdominal surgery. His writings, including this “classic” paper, demonstrate a concise grasp of a new disease entity, chronic interstitial enteritis, later to become known as Crohn’s disease. It is generally believed that Dalziel was the first to draw attention to this condition (Diseases of the Colon and Rectum 32:12, pp 1076-1078, 1989).