A History of Multiple Sclerosis (review)

This volume is part of the Healing Science: Disease, Medicine, and History series edited by John Parascandola. The goal of this series is to present history of medicine to a broad-based general audience, rather than limiting its readership to medical historians and physicians. With the exception of the final chapter, this book fulfills this mission. The author, Colin Talley, is an assistant professor of Behavioral Science and Health Education at Emory University who took his history of medicine training at the prestigious University of California at San Francisco program.

The author begins his short text by defining multiple sclerosis as a disease of the spinal cord and brain that strikes adults between 20 and 50 years of age. In 2007 there were between 266,000 and 400,000 cases reported in the United States and over 2.5 million worldwide. He then outlines this book's content by asking a series of questions he intends to answer in his book. Why did multiple sclerosis emerge as a distinct neurological disease at the end of the nineteenth century in France? Talley credits this medical breakthrough to the clinical work conducted by Jean-Martin Charcot at the La Salpetriere hospital in Paris, beginning in the late 1860s. Until then multiple sclerosis had been misdiagnosed as a wide variety of neurological disorders. The author then asks, why did multiple sclerosis go from being a little diagnosed disease in the first half of the twentieth century in the United States to becoming a major neurological disorder by the late 1940s? He credits this major change to the rise of the neurology specialty and the impact of lay activities lead by the National Multiple Sclerosis Society, which started its work in 1946.

Special attention is paid to what the author refers to as the political economy of disease. The author applauds the positive impact of 1972 Supplemental Security Income on the daily lives of multiple sclerosis patients. Also in that year they became eligible for Medicare funding. Finally, in 1990 the passage of Americans with Disabilities Act helped provide for better physical access to buildings for multiple sclerosis patients. Talley credits the National Multiple Sclerosis Society and lay disabilities activists for pushing the government to pass this legislation and for providing funding to the biomedical infrastructure to conduct research on the causes of and treatments for multiple sclerosis, leading to the significant advances in the handling of this disease in the last quarter of the twentieth century.

In his final chapter the author examines the recent emergence of the auto-immunity paradigm to explain multiple sclerosis. This chapter is replete with very technical terminology that will force readers to rely on a medical dictionary to understand the author's contention that this new approach to understanding this disease has raised hopes of major breakthroughs in the diagnosis of and treatments for multiple sclerosis.

This review would be remiss if it did not point out that there is a recent, much more comprehensive study of the history of multiple sclerosis. Multiple Sclerosis: The History of a Disease, written by the noted neurologist and medical historian, T. Jock Murray, was published in 2005 by Demos Medical Pub (New York: Demos Medical Publications, 2005). This nearly 600-page tome provides the readers with a more complete history of this disease than Talley's work and should prove to be the definitive history of this disease, from its ancient origins into the twenty-first century.