CLASSIC PAPERS IN RHEUMATOLOGY. Edited by P. Dieppe, F. A. Wollheim and H. R. Schumacher Jr. £65.00. Martin Dunitz Ltd, London, 2001. 452 pages. ISBN 1-901865-48-7.

R. Bernstein

I must admit to a commercial interest in the main topic of this book, the breadth and fundament of rheumatology. Now I know better where my debt lies.

The editors of Classic Papers in Rheumatology invited contributors to make a personal choice of the most important milestones or turning points in their areas of interest. Each contributor has selected between four and 14 classic papers on 27 aspects of rheumatology ranging across each of the important diseases, imaging, investigation, outcome measurement, clinical genetics, education, drug development and exercise. After an introduction to the topic, two pages are devoted to each classic paper, giving a summary, references to related work, paragraphs on the key message and its importance, and comments on strengths, weaknesses and relevance of the research. Here is the background to the folklore of rheumatology, or an album of some of rheumatology's best snap-shots, including some in sepia. But please don't forget all those other shots of enlightenment which may be slightly out of focus only from our current viewpoint.

Accepting this as a triumphal history of rheumatology, and being an adopted Mancunian, I was glad to see John Charnley as the man who has done most to relieve suffering from arthritis through his careful work on low-friction materials, cement and aseptic surgery. Then there is the late Jonky Kellgren: four contributors competed to select his work on patterns of pain referral after self-injection of hypertonic saline into muscles, and another cites his work on septic arthritis (a condition about which lawyers love to chide us). Given the expanding horizons of rheumatology, most of the papers are modern classics, and we can be particularly grateful to Maini and Feldmann for raising the profile of rheumatology by making it more expensive. We can also hear the cries of Waddell and Hadler that our patients are influenced by socio-political and economic factors; these need to be addressed at the political level if we are to prevent an ever-greater explosion of unwarranted illness.

Any fear that modesty might overwhelm a balanced opinion of contributors' own work is soon dispelled. A few contributors describe their work as excellent, of huge potential importance, or a superb summary, or cite their classic editorial. More often contributors cite their own work in quieter terms that are likely to indicate realism rather than awe.

If there is to be a second edition with post-modern classic papers to be added, then I make a plea for an index by author and subject, rather than the lists only of titles of the cited works by section and in alphabetical order (there is nearly a page of titles beginning with the word ‘the’). An index of classic authors with page references would serve utility as well as vanity and would counterbalance the list of contributors who have so kindly served as arbiters and humble messengers.

Every rheumatologist and trainee, and many specialist rheumatology nurses, will find insight, stimulus and encouragement in this book. Perhaps there could be a website for wider views on classic papers (www.classrheum.com). I could make a start with our own Anderson and Beck, who discovered by another name the antibodies to Ro/SS-A and La/SS-B (and their clinical context) and used tissue culture cells for immunofluorescence several years before the developments in America. It remains true that the prize goes not to the first discoverer but to those who convince the world. For the Heineken effect, overseas research fellows and an airline gold card are helpful.





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