New Directions for Future Research

Abstract

In his satire upon the weakness and misery of man, Samuel Butler wrote, “Diseases come of their own accord, but cures come difficult and hard.” So it is with Crohn’s disease; finding the cure is becoming difficult and hard. In 1913 Sir T. Kennedy Dalzeil described in the British Medical Journal a transmural inflammatory disease of the terminal ileum indistinguishable from that defined 19 years later by Crohn, which came to be known asCrohn’s disease. In concluding his report Dalzeil stated, “I can only regret that the etiology of the condition remains in obscurity, but I trust that ere long further considerations will clear up the difficulty” (1). Nevertheless, the difficulty remains. Decades have passed, and although clear, well-considered descriptions of Crohn’s disease have evolved and a multitude of theories have been promoted, the cause or causes of the illness remain obscure. Having the benefit of past mistakes, we should be able to project future courses leading toward an unraveling of the mysteries of the source (s) of this illness.