The discovery of multiple sclerosis
The first clear description of the disease as first “a remarkable lesion of the spinal cord accompanied with atrophy” came from the English physician and pathologist Robert Carswell, working in Paris, in 1838. His findings were rapidly confirmed by the French anatomist Jean Cruveilhier and elaborated by the German patholgoist Friedrich Theodor von Frerichs, who was the first to describe the physical and cognitive consequences of MS. It was another German pathologist, Georg Eduard von Rindfleisch, who identified inflammation in the CNS as a key factor in the disease.
A fuller and more complete description of the disease came, three decades after Carswell’s initial observation, from the eminent 19th century French neurologist Jean-Martin Charcot. Working at the Salpêtrière hospital, an institution for the chronically ill, in Paris, together with his neurologist colleague Edmé Félix Alfred Vulpian, he outlined both the clinical and pathological features of the disease. It was in a lecture before the Société de Biologie, in 1868, that Charcot first described a young woman who presented with an unusual tremor, along with other neurological problems, including slurred speech and abnormal eye movements. When she died, he examined her brain and found multiple scars or "plaques" that now characterise MS, which he showed were attributable to a loss of myelin, the white fatty substance that surrounds nerve fibres. However, he was baffled by the cause of this demyelinating disease and frustrated by its resistance to all of his treatments, which included both electrical stimulation, strychnine administration and injections of both gold and silver, as both these precious metals showed some efficacy in the treatment of syphilis.
The first detailed description of MS in the English language came from the English physician William Moxon, working at Guys Hospital in London in 1875. His work, together with the 1878 report from the American neurologist Edward Seguin, led to the recognitions that MS was a specific disease that it is not directly inherited, and can produce a variety of neurological symptoms.