This year, 2024, marks the 75th anniversary of the presentation of a landmark discovery in the biology and management of rheumatoid arthritis. On 13 April 1949, Philip S Hench (1896–1965) gave a lecture to an overfilled Mayo Clinic staff meeting in Rochester, Minnesota, USA, on observations of ‘The effect of a hormone of the adrenal cortex (17-hydroxy-11-dehydrocorticosterone: compound E) and of pituitary adrenocorticotropic hormone on rheumatoid arthritis’.1

The sensational results were soon known worldwide, making further headlines on 31 May 1949 when Hench presented a more complete report and motion pictures of treated patients at the Seventh International Congress of Rheumatic Diseases held at the Waldorf Astoria Hotel in New York City (figure 1). As reported by physicians present at the lecture, excitement about an effective treatment, and possibly even cure of one of humankind’s most poorly understood and heretofore untreatable disease was greeted by the hundreds of attendees with thunderous applause and shouting, with many physicians rushing on the stage to congratulate and embrace Hench, possibly the only time a discovery in rheumatology has ever been so celebrated.2

Cover of Charles Slocumb’s copy of the programme of the Seventh International Congress on Rheumatic Diseases. Courtesy Slocumb family.

News of the dramatic effects of what became called the ‘wonder’ and ‘miracle’ drug very soon found its way into the medical and the lay press.3 4 What nominally would have been a treatment for a less common endocrine disorder, hypocortisolism due to primary or secondary adrenal failure, would in a short time become a breakthrough treatment for hundreds of diseases and conditions in almost every field of medicine, ranging from a host of autoimmune rheumatic diseases in addition to rheumatoid arthritis such a vasculitis and lupus, to allergies, skin diseases and malignancies.

For the discovery and use of …