Rascol A, Clanet M
Rev Neurol (Paris). 1982;138(12):921-30.
The present paper reports the isolation of multiple sclerosis and the evolution of ideas about this disease since the end of the 19th century. Charcot and Vulpian were close friends during their university years and both were appointed physicians at the Salpêtrière in 1862. It is difficult to sort each other part in the beginning of researches which both devoted to "tremors". When Vulpian left the Salpêtrière in 1865 the main point was settled: a clear cut distinction between paralysis agitans vs patients whose tremor appeared during movement and in whom post-mortem had disclosed disseminated lesions "en plaques". For the 20 ensuing years Charcot built up an impressive corpus of pathological and clinical data which were the basis of his celebrated "Leçons". This history shows the pathological clinical method at ist acme in the hands of a physician of genius. Pathogenetic hypotheses, from vascular to toxic and infectious, the role of immunological, genetic and viral factors are also briefly reviewed.
本文报道了多发性硬化症的发现以及自19世纪末以来关于这种疾病的观念演变。夏科和维尔皮安在大学期间是亲密的朋友，两人于1862年都被任命为萨尔佩特里埃医院的医生。在最初致力于“震颤”研究时，很难区分彼此的研究部分。1865年维尔皮安离开萨尔佩特里埃医院时，主要问题得到了解决：明确区分震颤麻痹与那些在运动时出现震颤且尸检显示有“斑块状”播散性病变的患者。在随后的20年里，夏科积累了大量令人印象深刻的病理和临床数据，这些数据是他著名的“讲座”的基础。这段历史展示了病理临床方法在一位天才医生手中达到了顶峰。还简要回顾了从血管到毒性和感染性的发病机制假说，以及免疫、遗传和病毒因素的作用。
