The first case of MS. The Madness of King George

Garrard P, Peters TJ. Multiple sclerosis or neuromyelitis optica? Re-evaluating an 18th-century illness using 21st-century software. JRSM Short Rep. 2012 Jan;3(1):1. Epub 2012 Jan 12.

In this paper we report the application of an extensive database of symptoms, signs, laboratory findings and illnesses, to the diagnosis of an historical figure. The medical diagnosis of Augustus d'Este (1794-1848) - widely held to be the first documented case of multiple sclerosis - is reviewed, using the detailed symptom diary, which he kept over many years, as clinical data. Some of the reported features prompted the competing claim that d'Este suffered from acute porphyria, which in turn was used in support of the hypothesis that his grandfather, King George III, also suffered from the disease. We find that multiple sclerosis is statistically the most likely diagnosis, with neuromyelitis optica a strong alternative possibility. The database did not support a diagnosis of any of the acute porphyrias.

King George

We have discussed Augustus d'Este before on the blog. He was the illegimate grandson of King George the III, who in his madness gave away the USA to the Americans. The King was mental and some thought he had porphyria, a disease associated with a defecit in production of a blood molecule. Using up to date tools......like reading the cases notes, a diagnosis of MS was made, rather than porphyria.

I am sure that many clinicians will love this as they like a bit of medical History, but to others it is like asking what happened one second before the beginning of time..it doesn't matter and not provable. Hopefully more interesting stuff tomorrow.

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