The emergence of multiple sclerosis as a nosological category in France, 1838-1868.

Neurologists have retold a story about the discovery of multiple sclerosis (MS) in essentially the same form from the 1870s to the present. Upon close analysis this narrative was found to be problematic. Once the nosological category of MS came into existence in 1868, physicians reread the scientific past through this new category and created a linear story. Following generations received this story uncritically, rereading the past through the conceptual lens of their own times. Writers selected the earlier cases, illustrations, and medical writings in the literature for inclusion in the discovery narrative and did not analyze them in their original historical contexts. The author offers an alternative account of the discovery of MS. The creation of the disease category of MS by Charcot in France was the result of several converging factors including a new histopathological technology, a unique relationship between patient and physicians in the clinic, a unique relationship between the clinic and the autopsy room, and a neurological culture emphasizing disease specificity.