Talley Colin Lee
College of Physicians and Surgeons, Columbia university, New York, NY 10032, USA.
Perspect Biol Med. 2005 Summer;48(3):383-95. doi: 10.1353/pbm.2005.0079.
In 1868, Jean-Martin Charcot identified multiple sclerosis (MS) as a distinct nosological entity. By 1870, American neurologists became aware of the "new" disease and began to diagnose cases in the United States. For the next 50 years, however, American physicians thought it was a rare condition. From 1920 to 1950, this perception changed dramatically; by 1950, neurologists considered it among the most common neurological diseases in America. The increasing prevalence of MS between 1920 and 1950 can largely be explained as an effect of an increase in the number of trained neurologists, urbanization, a changed ecology of disease, and altered concepts of gender and disease. Physicians recognized MS more frequently because over time there were more neurologists who had the skills necessary to make the difficult diagnosis, and because patients were more likely to be seen by a trained neurologist. Significant numbers of patients with MS had been misdiagnosed with other diseases such as hysteria and neurosyphilis; over time, they were increasingly diagnosed correctly.
1868年，让 - 马丁·夏科将多发性硬化症（MS）确认为一种独特的病种。到1870年，美国神经学家开始知晓这种“新”疾病，并在美国开始诊断相关病例。然而，在接下来的50年里，美国医生认为这是一种罕见病症。从1920年到1950年，这种看法发生了巨大变化；到1950年，神经学家认为它是美国最常见的神经系统疾病之一。1920年至1950年间MS患病率的上升，很大程度上可以解释为训练有素的神经学家数量增加、城市化、疾病生态变化以及性别与疾病观念改变的结果。医生更频繁地诊断出MS，是因为随着时间推移，有更多具备做出困难诊断所需技能的神经学家，而且患者更有可能被训练有素的神经学家诊治。大量MS患者曾被误诊为癔症和神经梅毒等其他疾病；随着时间推移，他们越来越多地被正确诊断。
