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View Full Version : An Examination of Multiple Sclerosis in the mid-nineteenth century



NoahBriggs
04-14-2009, 09:41 PM
Summary of the modern definition of MS:
http://www.ninds.nih.gov/disorders/muftiple_sclerosis/multiple_sclerosis.htm
accessed 6/15/07.

An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted. Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.

Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or “pins and needles” sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.

A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.

History
http://en.wikipedia.org/wiki/Muitiple_sclerosis#History

The French neurologist Jean-Martin Charcot (1825—93) was the first person to recognize multiple sclerosis as a distinct, separate disease in 1868. Summarizing previous reports and adding his own important clinical and pathological observations, Charcot called the disease scierose en plaques. The three signs of MS now known as Charcot’s triad are dysarthria (problems with speech), ataxia (problems with coordination), and tremor. Charcot also observed cognition changes in MS since he described his patients as having a “marked enfeeblement of the memory” and “with conceptions that formed slowly”.

Prior to Charcot, Robert Hooper (1773—1835), a British pathologist and practicing physician Robert Carswell (1793—1857), a British professor of pathology and Jean Cruveilhier (179 1— 1873), a French professor of pathologic anatomy had described and illustrated many of the disease’s clinical details.

After this, several people, such as Eugene Devic (1858—1930), Jozsef Balo (1895—1979), Ferdinand Schilder (1886—1940), and Otto Marburg (1874—1948) found special cases of the disease that some authors consider different diseases and now are called the borderline forms of multiple sclerosis.

There are several historical accounts of people who probably had MS. Saint Lidwina of Schiedam (1380—1433), a Dutch may be one of the first identifiable MS patients. From the age of sixteen until her death at age 53, she suffered intermittent pain, weakness of the legs, and vision loss—symptoms typical of MS. Almost a hundred years before there is a story from Iceland of a young woman called Halla. This girl suddenly lost her vision and capacity to talk; but after praying to the saints recovered them seven days after. Augustus Frederick d’Este (1794-1 848), an illegitimate grandson of King George III of Great Britain almost certainly suffered from MS. D’Este left a detailed diary describing his 22 years living with the disease. His symptoms began at age 28 with a sudden transient visual loss after the funeral of a friend. During the course of his disease he developed weakness of the legs, clumsiness of the hands, numbness, dizziness, bladder disturbances, and erectile dysfunction. In 1844, he began to use a wheelchair. Despite his illness, he kept an optimistic view of life. Another early account of MS was kept by the British diarist N. P. Barbellion who maintained a detailed log of his diagnosis and struggle with MS. His diary was published in 1919 as The Journal of a Disappointed Man.

Charcot, J. Histologie de Ia scierose en plaques. Gazette des hopitaux, Paris, 1868; 41: 554—555.
Poser C (1994). “The dissemination of multiple sclerosis: a Viking saga? A historical essay”. Ann. Neurol. 36 Suppl 2: S23 1-43. PMID 7998792
A Firth, D (1948). The Case of August D’Esté. Cambridge: Cambridge University Press.

took me to:
http ://www.mult-sclerosis.org/chooseglossary.html

I then went to work with searching the history of MS:
http://www.google.comlsearch?source=ig&hl=en&q=history+of+multiple+sclerosis&btnG=Google+Search

The History of Multiple Sclerosis
http://www.protector.pair.comlms/#The%2OHistory%2OoWo2OMultiple%2OSclerosis
The history of multiple sclerosis (MS) is a detective story spanning more than a century. Many clues have been pieced together, but only now are answers emerging. To appreciate why the trail to a solution has been so long and hard, it is necessary to understand what we scientists now believe to be true about MS.

Multiple sclerosis is one of the most common diseases of the nervous system, afflicting people of virtually all ages around the world, although it has a special preference for young people, especially women, and for those who grew up in northern latitudes.

We believe MS involves a genetic susceptibility, but it is not directly inherited. It usually causes sudden neurological symptoms including vision loss, paralysis, numbness, and walking difficulties. The symptoms can be diverse and confusing, often coming and going without any pattern, making it difficult to diagnose, even today.
The symptoms appear because nerves in the brain and spinal cord lose their ability to transmit signals. Myelin, a complex substance that surrounds and insulates nerve fibers, is essential for nerves to conduct electricity and carry out their function. Myelin is destroyed in MS.

In MS, cells and proteins of the body’s immune system, which normally defend the body against infections, leave the blood vessels serving the central nervous system, pour into the brain and spinal cord, and destroy myelin. The specific triggering mechanism which causes an immune system to attack its own myelin remains unknown, although a viral infection on top of an inherited genetic susceptibility is a leading suspect.

Continued -

NoahBriggs
04-14-2009, 09:42 PM
The discovery of MS
Until the early years of the 19th century, physicians relied on superstition, hearsay, and the wisdom of the ancients to care for the sick. Medical ideas were not scientifically tested. Even so, physicians were sometimes good observers and we can identify people who undoubtedly had MS from descriptions written as long ago as the Middle Ages. MS has always been with us.

Once the scientific method took hold in medicine, MS was among the first diseases to be described scientifically. The 19th-century doctors did not understand what they saw and recorded, but drawings from autopsies done as early as 1838 clearly show what we today recognize as MS.

Then, in 1868, Jean-Martin Charcot, a professor of neurology at the University of Paris, who has been called “the father of neurology”, carefully examined a young woman with a tremor of a sort he had never seen before. He noted her other neurological problems including slurred speech and abnormal eye movements, and compared them to those of other patients he had seen. When she died, he examined her brain and found the characteristic scars or “plaques” of MS.

Dr. Charcot wrote a complete description of the disease and the changes in the brain which accompany it. However, he was baffled by its cause and frustrated by its resistance to all of his treatments. They included electrical stimulation and strychnine-because this poison is a nerve stimulant. He also tried injections of gold and silver, as they were somewhat helpful in the other major nerve disorder common at that time-syphilis.

http://www.fire1ady40.com/ms/mshistory.html :
1. It was Dr. Jean Martin Charcot (1825 - 1893) who first scientifically described, documented, and named the disease process, we still call Multiple Sclerosis. So named from the many scars found widely dispersed throughout the central nervous system (CNS),but are usually found to be arrayed in a symmetrical pattern near the Cerebrum’s Lateral Ventricles.

2. The first patient Dr. Freud ever treated was his former Nanny, who had Multiple Sclerosis. “Creeping paralysis” as it was called in those days, was considered a mental condition caused by “female hysteria”. As such, little or no extensive research was conducted into the mysteries of MS until very recent times.

My note:
However “creeping paralysis” is defined by the Paul Smith’s archaic medical terms as “Guillain Barre syndrome. This is a paralysis, which begins in the feet and spreads upward to the head. The cause may be a virus. It is very rare.”
http://www.paulsmith.doctors.org.uklArchaicMedicalTerms.h tm

Armed with this information I went back to the Manual of Psychological Medicine, written by John Charles Bucknill, and published in 1879. I looked up “creeping paralysis” and “Paralysis” in the index. No hit on the creeping paralysis, but an examination of pages 312-335 which discusses the presence of physical symptoms such as loss of coordination, paralysis and other aetiological insanities

Definitions were not standardized back then, so my interpretation would say it could be either/or, particularly since MS was - and still is - difficult to diagnose.