My name is Cyrus Rubin, and I have been on the University of Washington, School of Medicine faculty for over 50 years. I am a teacher, clinical investigator, and gastroenterologist whose early interest in celiac sprue and main research method was gastrointestinal pathology revealed by endoscopic biopsy. I regret that the early details of our early research have not been easily available, partly because we published our early findings in an obscure journal in summary fashion. In the following presentation, I will try to remedy this and will also present research of others that I think has historical value. I am doing this because I agree with the philosopher George Santayana that “those who do not learn from history are doomed to repeat it”.

In the 1940’s and 1950’s, pioneering work was done on the treatment of celiac disease, by Dr. Willem Dicke, a Dutch pediatrician, who proved the efficacy of the gluten free diet, and this revolutionized the care and treatment of this disease. In the 1960’s, my talented trainees in gastroenterology helped me study the acute small intestinal changes induced by wheat, barley and rye in celiac disease, in real time, using a hydraulic biopsy tube. I will also present research to bring us up to date on the present state of our knowledge about celiac sprue (CS) and related diseases.

I wish to acknowledge that I could never have done this research without the help of many other people. I am thankful to all of them. First, I would like to acknowledge my medical school mentor, Dr. A. Stone Freedberg. I never planned to become a teacher and clinical investigator until two other second year Harvard medical students and I were introduced to internal medicine by Al’s kindly and inspired use of Socratic teaching to analyze the patients we had worked up. It was a series of unforgettable experiences. During the course, he devoted himself to teaching 10 to 12 hour days. He was also an outstanding internist whom the faculty consulted for their own problems and those of their relatives and friends. I understand he went on house calls well into his 90’s. Recently, I called him during his 100th birthday celebration, and he sounded as sharp as he did in his late 30’s. I am dedicating the following teaching summary on celiac sprue to him because he is my role model and the main influence on my career.

Secondly, I would like to acknowledge my collaborating graduate fellows in gastroenterology who were remarkably talented and original. In my youth, I was a hard task master, but they tolerated me, albeit at times, with considerable difficulty. I am most thankful to them for their forbearance. They were young, original and ambitious, and it made all the difference. The work of our group was largely theirs. Most of them went on to teaching others and doing it well. And finally, there were the patients who tolerated our discomforting studies, fully informed that our findings would not necessarily help them personally, but who were happy to do anything that might help other patients with celiac disease. We all ended up being good friends.

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