The Treatment of Multiple Sclerosis in Los Angeles and the United States, 1947-1960

Two sets of multiple sclerosis (MS) patient records located in Los Angeles County from the 1940s and 1950s were analyzed within the historical perspective and biomedical context of the time. It was found that there were divergent treatment patterns, and a continuum of therapeutic activism in the treatment of MS: some physicians attempted to intervene aggressively in an attempt to prevent relapses or lessen the severity of attacks, while others adopted milder interventions, basing their therapeutic decisions on their knowledge of the pathology of MS. As long as a physician had a reasonable theory of the pathogenesis of the disease, it was thought permissible to experiment with therapies, despite equivocal evidence, as long as no harm was done. Indeed, for physicians faced with declining and suffering patients, there was a strong emotional imperative to attempt treatments without waiting for an agreed-upon proof of efficacy. This was sustained, in part, by pressure to treat from many patients who shared their physicians' willingness to experiment with treatments.