A history of immunosuppressive drugs in the treatment of inflammatory bowel 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 that originated at The Mount Sinai Hospital. Perhaps immodestly, we can claim 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 Janowitz. This does not mean that clinicians and researchers from other institutions did not contribute to this understanding. As happens so often in medical history, elucidation of many disease processes are serendipitous. The concept of autoimmune diseases was introduced when we were house officers at Mount Sinai. The early days of transplant surgery soon followed along with the introduction by Hitchings and Elion of azathioprine to inhibit rejection. The concept of immunosuppression slowly evolved into possible treatment of any disease thought to be caused by autoimmunity, including those diseases of the bowel, seen so frequently at The Mount Sinai Hospital: ileitis, granulomatous colitis, ileocolitis, and ulcerative colitis. Although most of the world called granulomatous 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 disease.