GENERAL SYMPTOMATOLOGY AND DIFFERENTIAL DIAGNOSIS OF DISSEMINATED SCLEROSIS

Abstract

There is need for careful study of multiple sclerosis in all its aspects, clinical and pathologic.Above all, we must agree on its clinical limitations.If we succeed in establishing a definite concept of disseminated sclerosis, we shall help to clarify a number of other diseases of the central nervous system and their relation to the disease we are discussing.Hitherto, there has been a wide divergence of opinion.Some have thought the disease rare; others that it is nearly as frequent as tabes.In this country the disease was at one time thought to be infrequent.In Japan, it is said to be practically unknown.On the other hand, Mar-$ burg 1 claimed that next to syphilis it is the most common organic disease of the nervous system, and Stieffler 2 has laid especial emphasis on the frequent occurrence of multiple sclerosis among German soldiers during the war.One group of authors has claimed that it is postinfect i o u s \ p = m -\ p o s s i b l y a form of encephalomyelitis (Marie3).Others have contended that it is more often endogenous and degenerative (Strümpell and Müller *) or that it is endogenous and toxic (Oppenheim).5Some of us were firmly convinced that multiple sclerosis is one of the few positively nonsyphilitic diseases of the central nervous system;