Chapter 1 - Historical perspective

Summary

The past is always with us, never to be escaped; it alone is enduring; but amidst the changes and chances which succeed one another so rapidly in this life, we are apt to live too much for the present and too much for the future.

Sir William Osier, Aequanimitas, 1889

Multiple sclerosis is a very conspicuous disease which, when full blown, has signs which no experienced clinician should fail to recognize. Nevertheless, until the Middle Ages, there are no descriptions in medical texts of any disease which we would recognize and diagnose as MS today. A possible exception to this may be the history of Saint Lidwina von Schiedham (1380–1422), a nun from the Netherlands (Medaer 1979). Over the course of 37 years, she showed waxing and waning clinical manifestations of symptoms which could be attributed to disorders of various parts of the nervous system.

The diary and letters of Augustus Frederick d'Este (1794–1848), an illegitimate grandson of the English King George III and cousin to Queen Victoria, do provide a record of a case of MS. In 1822, at the age of 28, he suffered from sudden visual disturbances after having attended the funeral of a close relative: “Soon after … and without anything having been done to my eyes, they completely recovered their strength and distinctness of vision.” Five years later, while in Florence, both his legs became paralyzed: “I remained in this extreme state of weakness for about 21 days, during which period I fell down about five times (never fainting) from my legs not being strong enough to carry my body.”