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See article by Fernandez-L [6] (pages 235–248) in this issue. Epistaxis is a reasonably common and usually minor condition, although in rare cases it can be severe and life threatening. Benjamin Guy Babington described a family with individual members in five generations who had commonly and at times severe epistaxis, and he recognized this as an inherited epistaxis syndrome [1]. Diagnostic acuity of the time was limited, leading to confusion between familial epistaxis and other hemorrhagic diatheses, especially hemophilia. Henri Rendu's observations provided some clarification. He described the case of a 52-year-old male with frequent epistaxis and a similar history in his brother and mother. Moreover, Rendu recognized blanching angiomata on the nose, cheek, and lips of his patient [2]. A more detailed study of cases of the cutaneous-telangiectases-with-epistaxis syndrome was provided by William Osler and Frederick Parks Weber [3,4]. Osler noted that frequent and severe nose bleeds in these patients occur without similar bleeding from other minor injuries. One of the three subjects in Osler's initial publication lost more than 1 L of blood from epistaxis, yet his coagulation time was reduced [3]. Hanes, a pathology resident at Johns Hopkins University Hospital, coined the term of hereditary hemorrhagic telangiectasia (HHT) for this familial disorder, which was later also named Osler–Weber–Rendu disease (OWR) [5]. Recently, progress has been made in defining the gene disorders underlying OWR. However, it remains poorly understood how these gene mutations relate to the molecular and cellular pathophysiology and to the clinical abnormalities in these patients. The seminal observations on blood outgrowth endothelial cells from OWR-patients in the studies by Fernandez-L and her associates in this issue of Cardiovascular Research provide novel insights into OWR pathogenesis and perhaps into general aspects of endothelial cell functions [6].HHT or OWR disease … *Tel.: +1 310 222 3891; fax: +1 310 782 1837. Email address: rhirschberg{at}labiomed.org

What Benjamin Babington, William Osler, Frederick Weber, and Henri Rendu did not know