University of Wisconsin–Madison

Landmark paper defining Crohn’s disease (1932)

Eighty-seven years ago, Burrill B. Crohn, Leon Ginzburg, and Gordon D. Oppenheimer published a paper titled Regional Ileitis – A Pathologic and Clinical Entity in the Journal of the American Medical Association (vol. 99, no. 16, pp 1323-1329, October 15, 1932). Honoring the importance of this report, the article was later reprinted as a Landmark Article in The Mount Sinai Journal of Medicine (vol 67, no. 3, pp 263-268, May 2006). We provide the original JAMA article here for users interested in reading this influential publication in its original form. Note: the reprinted version in the Mount Sinai Journal of Medicine has better print quality.

Comment: I appreciate history more as I grow older. Also, it is important to read original published reports to avoid misquoting or perpetuating misunderstandings. Interesting note: As described in Wikipedia, Crohn always preferred the medically descriptive terms “regional ileitis” and “regional enteritis” to “Crohn’s disease”, but he was not able to prevent the appropriation of his name for the disease.

Without providing much detail, B.B. Crohn’s article mentions efforts to determine if Mycobacterium tuberculosis was involved in the regional ileitis cases he described including culture for M. tuberculosis, inoculation of lymph node homogenates from five patients into guinea pigs, rabbits, and chickens, and acid-fast staining of tissue sections. He concludes that M. tuberculosis was not a cause of these cases of regional ileitis. However, he never mentions the 1913 report by Dalziel or makes any mention of Mycobacterium paratuberculosis or the similarities of regional ileitis in humans to that of cattle, as described by H.A. Johne in 1895. Clearly, Dr. Crohn recognized how the pathology in his afflicted patients resembled that caused by a mycobacterial infection. How might history be different had Dr. Crohn considered the possibility M. a. paratuberculosis was the cause?

Johne’s disease is a regional ileitis affecting ruminants.

Dr. Robert Greenstein compared Crohn’s disease and Johne’s disease in his “personal view” article published in Lancet Infectious Diseases in 2003 (Lancet Infect Dis 2003; 3:507-14).

If you are interested in the history of Johne’s disease, check out our timeline of major events.

The picture of B.B. Crohn is credited to Wikipedia.