The description by Graham Hughes of the "antiphospholipid syndrome" or Hughes Syndrome is one of the medical landmarks of the 20th century. Here is a disease, a medical discovery, which should turn such fashions around. In a series of brilliant clinical observations, Dr Hughes, not only pieced together what is now clearly a common and important disease, but also, with his team, set up the blood tests and treatment guidelines, which are used world-wide. In a series of clinical articles in the early 1980s, Dr Hughes and his team described the headaches, the miscarriages, the clotting tendency, the effect on platelets, the strokes, the memory loss.. and almost all of the clinical picture now recognised as a distinct syndrome. This was not an anecdotal observation. It was a prime example of meticulous clinical observation and dogged determination. Hughes Syndrome is now recognised as a major new disease. It has been described, by Dr Josep Font of Barcelona as, "one of the 2 new diseases (with AIDS) of the 20th century." Despite being 20 years old, and being of major importance in the diagnosis of strokes, migraine, multiple sclerosis, and miscarriage, the syndrome is still under diagnosed by doctors. This book by Kay Thackray is an important contribution to the understanding of the syndrome.