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 often good observers and we can look back today and identify people who undoubtedly had MS from descriptions written as long ago as the Middle Ages.
Drawings from autopsies done as early as 1838 clearly show what we now recognize as MS. Then, in 1868, Jean-Martin Charcot, a professor 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 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 that accompany it. However, he was baffled by its cause and frustrated by its resistance to all of his treatments, including strychnine, a deadly poison that in small doses can stimulate nerves. He also tried injections of gold and silver, as they were standard treatments for the other major nerve disorder common at that time—syphilis.
In the last decades of the 19th century, the leading physicians of the world came to understand that MS was a specific disease. MS was recognized in England by Dr Walter Moxon in 1873, and in the United States by Dr Edward Seguin in 1878. By the end of the century, much of what can be learned about MS from careful observation was known—that the disease is more common in women than men, that it is not directly inherited, and that it can produce many different neurological symptoms.
Further knowledge of MS could not advance without a better understanding of biology and better research tools. For example, MS could not be considered an immune disease because the very existence of the immune system was still unknown (doctors of the time assumed a disease rarely struck the same person twice because the disease “used up” the materials in the body it needed to live, much the way crops use up soil nutrients and die unless they are rotated).
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