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Multiple sclerosis
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    The recognition of multiple sclerosis as a clinical entity different from other movement disorders or spinal paraplegias was made by Charcot in 1868. Previously multiple sclerosis had been repeatedly confused with paralysis agitans. It was Charcot who made the first definitive pathological description that distinguished the two diseases. The pathological lesions of multiple sclerosis, probably first illustrated 30 years earlier in 1838 by Robert Carswell, were those of an unnamed French patient. Carswell, a Scotsman, held the inaugural chair of pathology at London University. (Compston A. The 150th anniversary of the first depiction of the lesions of multiple sclerosis. J Neurol Neurosurg Psychiatry1988; 51:1249-52.) Until the mid-1960s little was known about the disordered physiology produced by demyelination. In 1963 Professor Ian McDonald demonstrated that electrical signs of conduction block developed abruptly at the junction of normal and demyelinated parts of nerves. McDonald and Sears, in 1969, showed that conduction block occurred at the margin of the lesions produced in the posterior columns of cats and that portions of the nerve fibres distal to the block retained their ability to conduct impulses. One hundred and forty three years after Carswell’s illustration the ability of NMR to disclose abnormalities with multiple sclerosis on a scale not previously seen, except at necropsy, was demonstrated. The potential of NMR to assist in the diagnosis of MS was established. (Young IR et al. Lancet 1981; ii: 1063-5.)

    In 1962 Monaco produced this stamp showing the sun, flowers, and a chest filled with hope (Stanley Gibbons 151, Scott 506). It was another 30 years before realistically hopeful therapies for the disorder began to emerge.

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