A young woman called Halldora, who lived in Iceland around the year 1200,
suddenly lost her vision and mobility, but after praying to the saints,
recovered them seven days after. Saint Lidwina of Schiedam
(1380-1433), a Dutch nun, may be one of the first clearly identifiable multiple
sclerosis (MS) patients. From the age of 16 until her death at 53, she suffered
intermittent pain, weakness of the legs, and vision loss indicating symptoms
typical of MS. Both cases have led to the proposal of a "Viking gene" hypothesis
for the dissemination of the disease.
Augustus Frederick d'Este (1794-1848), 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 diary began in 1822 and ended in 1846, although it
remained unknown until 1948. 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
W. N. P. Barbellion, nom-de-plume of
Bruce Frederick Cummings (1889-1919), 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.
Robert Carswell (1793-1857), a British professor of
Jean Cruveilhier (1791-1873), a French professor of
pathologic anatomy, had described and illustrated many of the disease's clinical
details, but didn't identify it as a separate disease.
Jean-Martin Charcot (1825-1893) was an eminent 19th
century French neurologist who worked at the Salpêtrière hospital in Paris.
Without any doubt, Charcot was one of the most important characters in the
history of MS, his findings representing a huge breakthrough for the clinical
understanding of the disease. Charcot the first person to recognize Multiple
Sclerosis as a distinct disease in 1868.
In 1868, Charcot 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.
Charcot's contribution extended to the development of diagnostic criteria, which
included the now famous Charcot's triad, diplopia (double vision), ataxia
(disturbances of balance or co-ordination) and dysarthria (difficulties with, or
slurred speech) which he observed in his own housekeeper. Charcot also observed
cognition changes, describing his patients as having a "marked enfeeblement of
the memory" and "conceptions that formed slowly".
Charcot was the first to make definite links between the hitherto mysterious
symptomatology, now known to be MS, and the pathological changes seen in
post-mortem samples. For the first time, almost forty years after the discovery
of the lesions, the clinical condition was described by Charcot as 'sclérose en
plaques' and MS as recognised as a distinct disease entity.
Charcot also gave the first complete histological account of MS lesions,
describing many important features including loss of myelin and proliferation of
glial fibres and nuclei.
In the latter half of the 19th century, examinations of MS symptoms began to be
published. The first was by Dr. William Moxon in
England in 1873 followed by Dr. Edward Seguin in
the United States in 1878. Most of the observations that the doctors made at
the time are common place now. Since both doctors were not knowledgeable of the
immune system, they could not identify it as an autoimmune disease.
Also in 1878, the French histologist and pathologist Louis
Ranvier discovered myelin, the protective covering around nerves that is
damaged by MS.
At the Salpêtrière, the hospital in Paris where he worked, therapy was attempted
for cases of MS and the approach for ataxia was a suspension apparatus that held
the person elevated by straps around the chest and under the arms.
In the early 1900s, researchers discovered chemicals that allowed them to observe
nerve cells under a microscope. In 1916, Dr. James Dawson
of Scotland, described the inflammation and damage to myelin he saw when he looked at
brain cells from those with MS under a microscope. The cells that make myelin
(oligodendrocytes) were identified in 1928. Later in 1943 the composition of myelin
After Charcot's description, Eugène Devic
(1858-1930), Jozsef Balo (1895-1979),
Paul Ferdinand Schilder (1886-1940), and
Otto Marburg (1874-1948) described special cases of
An English neurologist of the early 20th century, Sir
Gordon Holmes (1876-1965), noted that the intention tremor of cerebellar
involvement had errors of rate, range, direction and force of movement, and
neurologists developed specific tests to observe the tremor, the best known
being the finger-to-nose test and the heel-shin test.
During the 20th century, neurologists following the description by Charcot
recognized that tremor and ataxia were very difficult to treat and were very
disabling to the patient. The basis of the tremor and ataxia was an
incoordination of muscle movements and resulted in the unsteady action of the
limbs and other muscles.
The year 1913 brought the first reliable diagnosis of the disease through a
lumbar puncture. It was found that the spinal fluid contains antibodies or
proteins that are typical to MS and can be identified by electrophoresis.
There were major technological advances in magnetic resonance imaging (MRI)
during the late 1970s. It became more useful as a diagnostic tool for disease.
1981 marked the first time that MRI was used to view the brain of someone with
MS. Dr. I.R. Young performed the honors in England,
and within a few years, it was clear that this new technology could show doctors
the damage incurred by MS, even when patients experienced no outward symptoms.
Now when her brother became ill with MS, Sylvia Lawry
realized that there was no effective treatment for the disease. After publishing
an appeal in the New York Times, she was able to recruit 20 neurologists and was
able to create the National Multilple Sclerosis Society in the United States. This
brought forth the 43 MS Societies throughout the world and all with the same
purpose, to end MS.