History of MS (9): the first reported case of MS

H
Epub: Lincoln MR, Ebers GC. Robert Whytt, Benjamin Franklin, and the first probable case of multiple sclerosis. Ann Neurol. 2012 Apr 6. doi: 10.1002/ana.23605.



Robert Whytt  1714-1766

“Whilst much emphasis is places on the writings of Jean Martin Charcot in 1868 as the first clinicopathological description of MS, there had been earlier case presentations in the 1820s. This current study re-reports on the writings from a Scottish physician called Robert Whytt postumously reprinted in 1768. The report that was noted by Benjamin Franklin and then forgotten and discusses the case of Elisabeth Foster (so much for patient confidentiality) reported by Patrick Drydone in 1757.” 

…. till the month of July, 1755, when she was again taken ill ….. troubled with worse nervous symptoms than ever, ending at last in a paralytic disorder, which sometimes affected the arm, sometimes the leg, of the left side; in such a manner as that these parts, tho’ deprived of all motion for the time, yet still retained their sensibility. In this condition she remained till the spring 1756, when unexpectedly she grew much better; but not so far as to get quite rid of her paralytic complaints; which, in cold weather, seldom failed to manifest themselves by a numbness, trembling, sensation of cold, and a loss of motion in the left side…..

“This section describes intermittent episodes of weakness or paralysis affecting the arm or leg that remitted or improved.”


….. about the end of August, in the same year, her symptoms gradually increased, and in a very short time, she lost all motion and sensation in her left side. In this state she continued throughout last winter with the addition of some new complaints; for now her head shook constantly; her tongue faltered so much, when she attempted to speak, that she could not articulate a word; her left eye grew so dim, that she could not distinguish colours with it; ….

“In this section the case report refers to another episode of paralysis of the left side of the body associated with loss of feeling. It also describes slurring of speech and shaking of the head. These signs are probably due to a lesion or lesions in the cerebellum or brainstem. The dimming of vision in the left eye would be compatible with optic neuritis. The loss of colour vision is typical of optic neuritis.”


“A very interesting read. I am fascinated to find out why MS was so rare in those days. If it had been more common it would have been described as a specific disease entity. What happened to cause the incidence to increase so greatly?”

Other posts of interest:

18 Jan 2012
History of MS (1): Russell Brains · History of MS (2): St. Lidwina of Schiedam · History of MS (3): Sir August d’Esté · History of MS (4): Robert Carswell · History of MS (5):  History of MS (6): Friedrich von Frerichs. Posted by 
09 Oct 2011
History of MS (6): Friedrich von Frerichs (1819-1885). In 1849, the German pathologist Friedrich Theodor von Frerichs, brought medical recognition of MS a step closer by elaborating on the clinical description of MS provided 
01 Jul 2011
After St. Lidwina the next historical description of MS appeared in 19th century; a personal account of the illness by Sir Augustus d’Esté, the illegitimate grandson of George III of England. D’Esté documented the course of his 
10 Jul 2011
History of MS (4): Robert Carswell (1793-1857). The first description of the pathology of MS was made by Robert Carswell, a pathologist of the mid 19th century. During a postmortem, Carswell found lesions in the spinal cord 
23 Jun 2011
History of MS (1): Russell Brains Monologue. Murray T. Russell Brains Review of MS. Int MS J. 2011 May;17(2):50-3. In 1930 there were many conflicting views on the cause, incidence, precipitating factors, inheritance and 
26 Jun 2011
History of MS (2): St. Lidwina of Schiedam (1380-1433). “I believe that studying or being aware of the history of MS is important; it may provide important insights into the origins of the disease and important clues to its cause.” 
21 Jul 2011
History of MS (5): Jean Cruveilhier (1791 – 1874). Jean Cruveilhier was an eminent Parisian anatomist who also described the pathology of MS lesions. Cruveilhier and Robert Carswell worked independently, with their 

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

4 comments

  • >>I am fascinated to find out why MS was so rare in those days.

    I guess it wasn't. In these days a lot of ppl still lived outside cities and couldn't afford docotors or any medical teatment. So if someone developed MS symptomes it wasn't recognized.

    This also explains why there is a "rise in MS".

  • Why was MS so rare in those days? Some ideas..

    1. As the above post suggests, the rise in diagnostics and evidence based science, along with access to doctors, has identified more people with MS.
    2. Population numbers are rising… hence the 1/1000 number of people with MS is rising.
    3. The idea that MS is triggered by viral infection… this virus is spreading.
    4. The hygiene hypothesis… people in 17th century Scotland had helminths and other bacterial diseases that modulated their immune systems against the development / presentation of MS.
    5. Mortality – people died from other conditions earlier… so that many people with MS died before RRMS developed into SPMS.
    6. Medical records – a paucity thereof.
    7. MS is increasing influenced by environmental pollutants… (and I don't mean aspartame).
    8. People spend more time indoors nowadays than then. And we rise with our alarm clocks, not the sun.

    Interestingly – this early diagnostic instance seems to run contrary some pollutant theories (i.e. aspartame wasn't around then). And the diet thesis is challenged too… as in I am sure people can get access to healthier meals than a 17th century seamstress…

  • "as in I am sure people can get access to healthier meals than a 17th century seamstress…"

    Really, you mean with all the chemicals inside the stuff we are stuffing ourselves with?

  • I addressed the chemical issue in point 7.

    I was more referring to access to types of food and vitamin deficiencies. We can satisfy the cravings that our bodies have when we are vitamin deficient in the modern world. They couldn't necessarily in the 17th century.

    The high early mortality rates at the time were not just to lack of access to drugs. Stunted growth and bad teeth show a very poor diet by many.

    I am just not 100% sold on the idea that MS is a disease that is created by poor diet. In many parts of the world there are very poor diets (Tonga has a terrible diet for instance – mainly consisting of tins from the US) but low incidence of MS. And the idea that MS is 'cured' by a low fat diet… the Inuit of North America have low MS rates but eat a very saturated fat diet. Go figure.

    Before I had my first attack I lived on a mediterranean diet (my wife is Greek)… I almost never ate processed foods. Still got the attack though.

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