Reviewed by: Why Arthritis? Searching for the Cause and the Cure of Rheumatoid Disease David Cantor Harold W. Clark. Why Arthritis? Searching for the Cause and the Cure of Rheumatoid Disease. Tampa Bay, Fla.: Axelrod, 1997. xxv + 237 pp. Ill. $U.S. 18.95; $Can. 26.95 (paperbound). This book claims to show why the medical establishment has taken more than forty years to test and recognize an effective antibiotic treatment for rheumatoid [End Page 744] arthritis. It is, for Harold W. Clark, the story of one man, the late rheumatologist Thomas McPherson Brown (d. 1989), Clark’s former colleague and director of the Arthritis Institute of the National Hospital in Arlington, Virginia. While working at the Rockefeller Institute in the late 1930s, Brown isolated mycoplasma—a nonmotile microorganism, lacking a rigid cell wall, and sometimes thought to be a primitive form of bacteria—from the exudate and tissue of rheumatic patients. In 1949, he reported the results of a trial with seventeen patients of the new tetracycline antibiotic, aureomycin, which had recently been shown to inhibit mycoplasmal growth; according to Clark, this was the first successful use of the drug in treating rheumatoid disease. This was followed in 1951 by the announcement that rheumatoid arthritis was not a typical infectious and transmissible disease process, but the result of an immunologic reaction in which the body treated mycoplasma as an antigen. Yet these and subsequent claims have been greeted with skepticism and disbelief by most rheumatologists, unwilling to accept Brown’s theory that mycoplasma might be the primary cause of rheumatoid disease. Clark (now director of the Mycoplasma Research Institute in Florida) maintains that research on antimycoplasma therapy has been impeded because a safe and simple treatment threatens the medical establishment, since patients would require less medical intervention. This book is an attempt to bring to a broader public Clark and Brown’s claims about mycoplasma and the antibiotic therapy of rheumatoid disease. Whatever the truth of such claims, readers of the Bulletin are unlikely to be persuaded by Clark’s historical method. The book is primarily an explication of Clark and Brown’s scientific ideas on rheumatoid disease, and it touches on the history of the rheumatic diseases at several points. It includes a conventional, if idiosyncratic, internalist history of the medical ideas about the rheumatic diseases and their treatment, that serves to validate the author’s claims about the neglect of antimycoplasma therapy in rheumatoid disease. Yet, Clark provides an inadequate account of the history of microbial theories of rheumatoid arthritis out of which this work emerged, and the reasons why it was largely ignored by the rest of the profession. Like most other antimicrobial treatments, tetracycline therapy was overwhelmed in the late 1940s by the enthusiasm for cortisone and hormonal-deficiency explanations of rheumatoid arthritis; however, Clark prefers an account that relies on conspiracy, ignorance, and what he regards as illegitimate professional interests to explain why his theory and treatment were ignored by rheumatologists. Such an account also represents him and his mentor as unrecognized prophets, unjustly cast as quacks by a threatened profession. Overall, this book may provide a source for historians interested in infective theories of rheumatoid and other chronic diseases. It does not provide an adequate history itself. David Cantor Manchester Metropolitan University, U.K. Copyright © 1999 The Johns Hopkins University Press