A century of American rheumatology

In reviewing the development of rheumatology in the United States, I begin with the understanding of rheumatic diseases in the previous century and then consider subsequent scientific and organizational events that were important in the creation of rheumatology as a recognized medical specialty. The perception had to evolve that rheumatic diseases can be analyzed beyond their gross clinical description and that effective therapy is possible. The virtual coincidence of the discoveries of the rheumatoid factor, the lupus erythematosus cell, and cortisone in 1948-49 satisfied these requirements. The publicity that was generated is considered to have been most responsible for the unusually abrupt recognition of rheumatology as a specialty.