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Sir Archibald Garrod is well known for his book Inborn Errors of Metabolism, published in 1909, which is often regarded as the starting point of human biochemical genetics and in which he established the concept of biochemical individuality. The book reprinted here, originally published in 1931, is much less known. Indeed the publishers were reluctant to take it on believing, rightly as it happened, that few would be seriously interested in it. The difference in contemporary reaction to the two books is hardly surprising. The first gave physicians if not a treatment at least an explanation for a number of well known disease entities. The second concentrated on Garrod’s ideas about diathesis, individual inherited susceptibility to disease, something of little practical value to the physicians of the time who were more interested in treatment of infectious diseases. Today the situation is different. Inherited diseases form a much larger proportion of a physician’s caseload and with the advances in genetics and biochemistry since Garrod’s time they are rightly now more concerned with diathesis in the sense he used the word. For this reason alone the publication of this facsimile of Garrod’s second book together with a prologue setting it in its period and an epilogue on genetic predisposition since his time is welcome. It will ‘be useful to historians of science and medicine and, it is to be hoped, will also be read by more physicians of this generation than of Garrod’s own. Inborn Factors in Disease is quite fascinating to read. The style is rather archaic compared with modern scientific papers, it comes from a more leisurely age and was written towards the end of Garrod’s life … he was born in 1858. As Scriver and Childs point out, it is wrong to read into Garrod’s words meanings which suggest that he anticipated modern ideas. The temptation to do so, however, is almost irresistible and it seems certain that at least on occasion his thinking was far ahead of his time. On first seeing a new patient a physician asks "What disease does this patient have and how do I treat it?" To Scriver and Childs, Garrod’s book attempted to answer a different question: "Why does this patient have this disease now?" In the 1930s it was probably unrealistic to expect physicians to look beyond immediate diagnosis and treatment. In the 1990s it is essential that they too try to answer the second form of the question. Garrod, in 1931, showed the way. JOHN TIMSON | ||||||