World MS Day: A Look at the History of Multiple Sclerosis

For World MS Day 2022, we're taking a look at the history of multiple sclerosis (MS). Read on to learn the answers to these questions and more: When was the first case of MS documented? How has MS been treated throughout history? And what major scientific breakthroughs got us to where we are today?

The first records of MS

While doctors haven't always known what they were looking at or treating, they have taken good notes about what they saw. Notes about suspected cases of MS date all the way back to the Middle Ages.¹

Two of the earliest known cases of MS are Saint Ludwina of Schiedam and Augustus d'Este. Ludwina, who lived in Holland in the 1300s, started having leg weakness when she was 16. She then had persistent progression her whole life, including balance and vision issues.²

Augustus d'Este, a grandson of King George III and a cousin of Queen Victoria of England, recorded his progressive symptoms in the early 1800s. He first experienced vision loss, followed by muscle weakness and motor problems. Experts now think his vision issues were optic neuritis.²

Discovery and naming

In the early 1800s, the medical field identified a general class of "nervous disorders." MS, as we know it today, was placed in the class of paraplegias. But there was a lack of interest among some top researchers to investigate its causes and symptoms. One doctor in London noted in a lecture that the disorder was “not sufficiently interesting to discuss further."²

Eventually, researchers started using autopsies to learn more about the disease. In the 1830s, they discovered plaques during autopsies. Drawings from these autopsies show clear signs of MS.^1,2

Jean Martin Charcot is most often given credit for the discovery of MS. In the 1860s, he described MS as a disease of the nervous system. He stated that even though the symptoms seemed unrelated, they belonged to the same disease: "sclérose en plaques."^1,2

Around the same time, J. C. Morris and Silas Weir Mitchell published the first description of MS in North America to the College of Physicians of Philadelphia. In the 1950s, the English adopted the name multiple sclerosis.^2,3

Early thoughts on the cause of MS

In the late 1800s and early 1900s, there was a wide range of ideas about what caused MS. This included higher geographical latitudes, genetics, and infection. In the 1930s, some researchers believed MS was caused by a toxin. But they did not have hard evidence for many of these ideas. They also were not able to test enough people with symptoms of MS to get useful evidence.^1,2

By 1950, most experts believed that MS was the result of a "transmissible agent" (like a virus or chemical) or a specific reaction of the nervous system to an external cause. Later findings included that MS is more common in women than men, is not directly inherited, and can cause many different symptoms. Experts still do not agree on the cause of MS.^1,4

Harmful treatments

In the mid-19th century, some doctors treated MS symptoms with methods that were not effective or even harmful to patients. These included:^2,4

• Herbs, some highly toxic
• Chloroform
• Electrotherapy
• Hydrotherapy
• Arsenic
• Bleeding/leeches
• Cooling with sponges, spa baths
• Silver nitrate, topically or through IV
• Potassium iodide

Treatments used in the 1930s and 40s included blood thinners and antibacterial, antifungal, and antiviral drugs. These seemed logical at the time because many researchers believed MS was caused by circulation issues or infection.^1,2

Major historical breakthroughs

There were several major milestones in the history of MS. Some of the main scientific breakthroughs for treatment were:^1,2

• Autopsies. Looking at the brains and spinal cords of those who had lived with symptoms of MS gave researchers much more insight into the condition.
• An enhanced look at nerve cells. In 1906, Dr. Camillo Golgi and Dr. Santiago Ramon y Cajal earned the Nobel Prize for Medicine for finding new chemicals that helped them see nerve cells better under the microscope.
• The discovery of myelin. This led to later discoveries of the cell that makes myelin and of abnormalities in spinal fluid.
• The first electrical recording of nerve transmission. This allowed researchers to study active nerves and better understand how the whole nervous system works.
• Nerve tissue research. In 1935, Dr. Thomas Rivers found that MS was caused by changes in the nerve tissue rather than a virus. His laboratory work became known as experimental allergic encephalomyelitis (EAE), a very important model in future MS treatment.
• The founding of the National Multiple Sclerosis Society. The organization was founded in 1945 by Sylvia Lawry, whose brother Benjamin had MS. This was a new resource for community, information, and support. It also led to the creation of the National Institute of Neurological Disorders and Stroke.
• CT scanning. In the 1970s, computerized tomography (CT) scans showed that many MS patients had lesions.
• Clinical trial guidelines. In 1979, a group of international neurologists built a framework for MS clinical trials. This led to many of the treatments we use today.
• Magnetic resonance imaging (MRI). MRI technology was developed in 1981. It became one of the most important advancements in MS diagnosis and treatment.
• Corticosteroid therapy. Steroid treatment is still one of the most common treatments for MS attacks and many MS-related symptoms.

All of these advancements led to MS now being a treatable disease. Today, disease-modifying treatments (DMTs) have drastically changed the treatment landscape and quality of life for those living with MS. DMTs slow the progression of the disease and decrease the number of attacks, or relapses. There are currently 9 injectable, 10 oral, and 4 infusion drugs approved by the US Food and Drug Administration (FDA) to treat MS.^2,5

There is much more work to be done to find a cure for MS. But the strides made by the medical field so far offer hope for the future!