It is both interesting and frequently depressing looking back at the historical medical literature: interesting because our predecessors were usually far better observational clinicians than we are today, and depressing because so much of what we believe to be new and exciting today can often be found perfectly described, although maybe not fully understood, 50 years ago. The lack of emphasis on observational and clinical skills and over-reliance on investigations without understanding their limitations is, at a personal level, one of the most worrying developments in medicine. Equally our reliance on computer based literature searching tends to eliminate older papers from the scope of searches, meaning that much useful clinical observation is simply consigned to dusty shelves, never to see the light of day again, or worse just scrapped as of …