History of AS: Bernard O'Connor

Three hundred years ago, on 30 October 1698, a young Irish doctor died in London from fever, possibly malaria, at the age of 32 years.

Bernard O'Connor was born in Kerry in 1666. At the age of 20 he went to France to study medicine, first at Montpelier and then at Rheims, graduating Doctor of Physic in 1693. He set up in practice in Paris but before long he was asked to accompany the sons of the chancellor of Poland on their journey home. They travelled through Italy, Germany and Austria, visiting leading medical centres on the way. Arriving in Warsaw early in 1694, O'Connor was introduced to the royal court and was invited to become personal physician to the king.

King John III Sobieski was one of the heroes of Poland and of Europe in the late 17th century. In 1673 he had defeated the invading Turks at Khotin. In 1683, allied to Austria, he again overwhelmed the Turks at Vienna, thus ending the threat of a successful Turkish occupation of Eastern Europe.

After nearly a year in Warsaw, O'Connor was on the move again. The King appointed him to escort his daughter to Brussels for her wedding with the Elector of Bavaria. While in the Low Countries he visited more medical centres before travelling to England. He set up practice in London, soon gaining a reputation as a teacher, and anglicising his name to Connor. He gave a course of lectures on medicine and natural philosophy at the University of Oxford in 1695 and was invited to lecture in Cambridge the following year. The Archbishop of Canterbury allowed Connor the use of his library for experiments.

The main interest of orthopaedic surgeons and of rheumatologists in Bernard O'Connor is that he was the first to describe Ankylosing spondylitis, although he did not give it a name. In a letter in French, published in Paris in 1693 he describes the appearance of part of a skeleton ; pelvis,lumbar and dorsal spine and ribs up to the mid thoracic level. An English translation of parts of the letter was published in Philosophical Transactions in 1695, and a Latin version was included in Connor's book "Dissertationes Medico-Physicae" published in Oxford in 1695.

"All of these Bones ...... were so straightly and intimately joyned, their Ligaments perfectly Bony and their articulations so effaced, that they really made but one continuous Bone.... The Figure of this Trunk was crooked, making part of a Circle...... If the other Vertebrae of the back and neck had been preserved, and had bent in the same Curve, they would have made near the half of a Circle...."

In London Connor published "Evangelium Medici" in 1697. This latter book was very controversial, some people claiming that Connor suggested natural explanations for some of the miracles in the Gospel. Connor had to defend himself against charges of heresy and wrote a long letter to his benefactor,the Archbishop of Canterbury. He also wrote to a friend: "I am resolv'd not to meddle any more with Matters of this kind, but to apply myself entirely to the Practice of Physick". Not the first, nor last, doctor to get "a belt of a crozier"!

Connor was elected a fellow of the Royal Society, a fellow of the Royal College of Physicians and Membre de l'Academie Francaise, remarkable achievements in such a short time. He became ill in October 1698 and died within a couple of weeks.

Further cases of ankylosing spondylitis with clinical descriptions were later published - Delpeche in 1828 and Strumpell in 1884. Pierre Marie gave a very full description in 1898, giving it the name "Ankylosis rhizomelique". The name "ankylosing spondylitis" was first used by C.W.Buckley in 1935.