One hundred and fifty years ago Charcot reported multiple sclerosis as a new neurological disease.

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In May 1868, Jean Martin Charcot (1825–93) (Fig. 1A) delivered a series of major lectures, establishing multiple sclerosis as a novel disease of the nervous system. Delving into the early 19th century medico-scientific literature illustrates how confusions delayed the identification of multiple sclerosis as a single nosological entity. The confusion arose in part from the difficulty to relate polymorph symptoms to the same disease as clinical signs are highly variable during the course of the disease, reflecting either spinal, or cerebrospinal or purely cerebral neurological symptoms. Charcot’s merit was to realize, applying his rigorous methodology inherited from Laennec (1781–1826) and Claude Bernard (1813–78), to bring together clinical observation, anatomo-pathology and physiology. This approach, along with detailed observations from others, led to Charcot’s proposition that these apparently unrelated symptoms belonged to the same disease, which he named Sclerose en plaques, a term that (from 1954) became multiple sclerosis in the English literature. Here I wish to commemorate the 150th anniversary of Charcot’s brilliant demonstration and tentatively decipher the reasoning that led Charcot to successfully ‘extract the sclerose en plaques from the chaos of chronic myelitis’. Open in a separate window Figure 1 Charcot's tribute paid by his students. (A) Portrait of J.M. Charcot designed and engraved by Dr P. Richer ‘one of JM Charcot most distinguished students’ on the front page of the sixth edition of ‘Oeuvres completes de JM Charcot’. The importance of Charcot’s international reputation is shown by the fact that, between 1874 and 1882, his ‘Lecons cliniques’ were translated into German, Russian, English, Italian, Magyar, and Spanish. (B) Charcot’s statue, which was melted down in 1942; the stone pedestal was removed in 1967. (C) Main entrance of the Hospice de la Salpetriere (c. 1900) showing the statue of Charcot placed on the left. Sources: A: Charcot (1892); B and C: http://paris1900.lartnouveau.com/paris13/lieux/hopital_de_la_salpetriere.htm.