Perspectives in Biology and Medicine

LETTERS TO THE EDITOR Dear Sir: In an excellent paper in Perspectives on the early history of multiple sclerosis (MS) Frederikson and Kam-Hansen [1] discussed whether MS was a new disease or a new concept when MS was first described in the beginning of the nineteenth century. They concluded that the evidence from the early history spoke in favour of MS as a new disease. Among the evidence was the posthumous diagnosis of Sir Augustus d'Esté. The reports on MS started in France and then over the years spread to Germany , England, and the United States with an increasing number of cases of MS [2]. This would be in favour of MS as a new disease. However, Medaer [3] has presented convincing evidence that St. Lidwina of Schiedam (1380-1433) had MS. If that is accepted, the descriptions in the nineteenth centuryjust reflected that MS was a new concept. Through the past 150 years numerous infectious agents have been suspected, but never proved to be the cause of MS [4]. Recently Borrelia [5] and retrovirus [6] have been investigated with inconclusive results. Most MS researchers believe in etiological theories combining the effects and influence of genetics, virus infection, and autoimmunity—that is, a multifactorial etiology [7, 8]. This would also be in accordance with MS as a new concept when first described in the beginning of the nineteenth century. REFERENCES Fredrikson, S., and Kam-Hansen, S. The 150-year anniversary of multiple sclerosis: does its early history give an etiological clue? Perspect. Biol. Med. 32:237-244, 1989. Stenager, E.; Knudsen, L.; and Jensen, K. Historical notes on mental aspects of multiple sclerosis. In Mental Disorders and Cognition Deficits in Multiple Sclerosis, edited by K. Jensen, L. Knudsen, E. Stenager and I. Grant. London: Libbey, 1989. Medaer, R. Does the history of multiple sclerosis go back as far as the 14th century? Acta Neurol. Scand. 60:189-192, 1979. Larner, A. J. Aetiological role of virus in multiple sclerosis: a review./. R. Soc. Med. 79:412-417, 1986. Coyle, P. K. Borrelia burgdorferi antibodies in multiple sclerosis patients. Neurology 39:760-761, 1989. Greenberg, S. J.; Ehrlich, G.D.; Abbott, M. A.; Hurwitz, B. J.; Waldmann, T. ?.; and Poiesz, B. J. Detection of sequences homologous to human retroviral DNA in multiple sclerosis by gene amplification. Proc. Natl. Acad. Sci. USA 86:2878-2882, 1989. Seboun, E.; Robinson, M. A.; Doolittle, T. H.; Ciulla, T. A.; Kindt, T. ].; and Permission to reprint a letter printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 34, 2 ¦ Winter 1991 \ 3 1 1 Hauser, S. L. A susceptibility locus for multiple sclerosis is linked to the cell receptor ß chain complex. Cell 57:1095-1100, 1989. 8. Hashimoto, S. A., and Paty, D. W. Multiple sclerosis. Dis. Mon., pp. 518-589, 1986. E. Stenager and K. Jensen Clinical Neuro-Psychiatric Research Unit Odense University Hospital DK-5000 Odense, Denmark Dear Sir: The posthumous diagnosis of multiple sclerosis (MS) of St. Lidwina of Schiedam (1380-1443) was suggested in 1979, that is, 583 years after the onset of her symptoms in 1396 [I]. We found her diagnosis too uncertain and anecdotal to be included in an article about the early history of MS [2]. REFERENCES Meader, R. Does the history of multiple sclerosis go back as far as the 14th century? Acta Neurol. Scand. 60:189-192, 1979. Fredrikson, S., and Kam-Hansen, S. The 150-year anniversary of multiple sclerosis: does its early history give an etiological clue? Perspect. Biol. Med. 32:237-243, 1989. Sten Fredrikson Department of Neurology Huddinge Hospital S-141 86 Huddinge, Sweden Dear Sir: The only embarrassment and surprise about T. P. Millar's gentle review "The Sterile Couch" is die editor's note that apologizes for the "Controversial nature of this essay" (Perspectives 32: 272, 1989). Surely any literate medical student who has read Claude Bernard's "Introduction to the Study of Experimental Medicine," or has learned any of its derivative ideas, could not find the display of the Freudian fraud to be disputatious. Whether one considers the early Clark University lectures and "A General Introduction to Psychoanalysis," or the...