Rheumatology 50 years ago: a short personal history

This report reviews attitudes to the rheumatic diseases and treatment methods in use some 50 years ago. The focus is on Professor J. H. Kellgren's unit at the Manchester Royal Infirmary in the UK. For rheumatoid arthritis, aspirin, phenylbutazone, gold injections, antimalarials and prednisolone were all available and bed rest was probably overused. The Charnley hip replacement arthroplasty was being trialed but in 1960 had not been perfected. Kellgren and the two other great UK figures in rheumatology at the time, E. G. L. Bywaters and J. J. R. Duthie appeared to me to have only a limited interest in immunology, apart from the role of rheumatoid factor in rheumatoid arthritis and related conditions. Concentration remained to some extent on proteoglycans and collagen as befitting the 1950s concept of ‘collagen diseases’.