The ACR/ARHP Annual Meeting Provides Look Back at History of Rheumatology

Simon M. Helfgott, MD

“You will notice that there are many, many papers selected for today—we have 21—and you see a great many which are recorded by title only. It is unfortunate we cannot hear all of these papers.” —From the opening remarks of L. Maxwell Lockie MD, president of the American Rheumatism Association, addressing its Annual Scientific Meeting, Bethesda, Md. (1957)

In 1957, the Fourth Interim Scientific Session of the American Rheumatism Association (ARA; now the ACR) began inauspiciously with a December snowstorm. No doubt the 254 attendees had to scramble to find their way to the National Institutes of Health campus in a region of the country where traffic grinds to a halt whenever just a few snowflakes fall. Thankfully, our recent meetings in Washington D.C., were not marred by such adverse weather.

Realistically, holding a major event in December in the northeastern United States is asking for meteorological trouble. Falling temperatures, bone chilling winds, and precipitation that lands either as drenching rains, fluffy snow, black ice, or all of the above, are strong predictors for lowered attendance numbers. For the past few decades, our annual meetings have been held in either late October or early November, when the fading autumn sun can still provide some gentle warmth and the bright autumn colors have yet to fade. Before settling on this particular time of year, the ACR meetings used to be held in the spring, either late May or early June. However, springtime can serve up its own set of weather issues. With an average daily high of 92 degrees, San Antonio can get pretty hot in June. I wonder whether those sweltering days under the hot Texas sun during the 1993 convention convinced our leadership to move the annual meetings to autumn.

The Backbone of Rheumatology

Looking back at some of the earliest meetings of the ARA, we can see how much we have grown as a specialty. In reality, rheumatology has fairly shallow roots compared with other internal medicine specialties, such as cardiology or gastroenterology. Cardiologists have long recognized the physiologic underpinnings of cardiac auscultation, and gastroenterologists practicing in the early twentieth century understood the pathogenesis of some common digestive disorders and their clinical correlates. For example, aortic stenosis and cholecystitis were pretty well understood by clinicians for well over a century. In contrast, when seeing patients with musculoskeletal complaints, practitioners were often left to deal with a paucity of clinical clues coupled with a severely limited knowledge of their pathophysiology. It was Sir William Osler who once quipped that when a patient with arthritis comes through the front door, he runs through the back door!