The history of rheumatology and the Heberden Society

Rheumatology and rehabilitation were once the same specialty in the UK. In 1983, the British Society for Rheumatology and Rehabilitation and the Heberden Society met to consider the future of these specialties. The rheumatologists formed the British Society for Rheumatology (BSR), whilst rehabilitation specialists formed the Medical Disability Society (MDS) which later became the British Society of Rehabilitation Medicine (BSRM). 

The Heberden Society was named after William Heberden (1710–1801), who is considered to be the father of rheumatology. He was the first physician to distinguish between osteoarthritis and gout. In his book, Commentaries on the history and cure of disease, he describes the digitorum nodi of osteoarthritis, which are now known as Heberden’s nodes. 

William Heberden (1710–1801). Oil on canvas by studio of William Beechey (1753–1839), c.1796.

The first edition of the Commentaries is held at the RCP as part of the BSR’s Heberden Library, a special collection of over 1,000 titles dating from 1534 to 1983 concerning rheumatism, gout and other allied conditions. The collection was built up by a series of honorary librarians, starting with William Copeman (1900–1970), and Eric Bywaters (1910–2003).

One of the oldest books in the collection is the small German pamphlet Eyn Verantworttung Podagrae vor dem Richter. The title translates as ‘Gout answers before the judge’, and the book was published in the city of Mainz in 1537. It begins with two woodcut allegories of the disease (known historically as podagra). On the right, a judge sits on a throne above a room full of gout sufferers who complain miserably about their suffering. On the left, a goddess stands above three Roman gods holding a banner saying ‘medicine does not know how to solve the knotty gout’. Immediately preceding these images is a verse addressing this goddess directly, describing her as the ‘Queen of Gout, feared by Jupiter, Pluto and Neptune’. It asks her to bring peace to swollen feet and knobbly fingers and to ‘give us poor boys rest and make us trot happily around’.

Eyn Verantworttung Podagrae vor dem Richter. Author unknown, published Mainz, 1537.

Other books in the Heberden Library include Thomas Tryon’s 1691 New art of brewing beer which blames the development of gout on the consumption of ‘ill quality’ alcohol such as ‘strong, hot, sharp, intoxicating stale Liquors, and fiery prepared drinks’. As well as examining the causes of rheumatic diseases, many books in the collection recommend specific treatment. Many titles concern the benefits of bathing, particularly in the mineral waters of Bath.

One of the more recent items is a 1970 first edition of An introduction to clinical rheumatology, signed by co-editor Harry Lloyd Fairbridge Currey (1925–1998). Currey was an advocate of the early use of immunosuppressives in rheumatoid arthritis, correctly insisting on proper assessment of these drugs which led to the first fully controlled trial of the use of azathioprine.

When in 1971 the Heberden Society hosted the European Congress of Rheumatology, Currey was determined to improve its scientific and educational value by abolishing the usual concurrent sessions at which short papers were read one after the other. He gained the support of his colleagues in organising sessions in which papers were taken by title or abstract for discussion after a review of the subject by an expert, leading to a free discussion time. This was an outstanding success and the pattern has been followed and developed at many conferences since then. Currey became president of the Heberden Society in 1981.

Karen Reid, library manager

Rheumatology is the RCP specialty spotlight for October2016.

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