MULTIPLE SCLEROSIS

Abstract

The results of the tabulation of multiple sclerosis as one of the defects found in drafted men are plotted on the accompanying map.It shows that the maximum rate for this disease was found in Michigan and Minnesota, in which there were eighteen persons with this disease per 100,000.The Michigan rate is based on six cases so diagnosed by local boards and on nine at Camp Dodge.Excepting Delaware and the District of Columbia (whose rates depend on one and two cases, respec- tively), the next highest ratio is that for Wisconsin, fourteen per 100,- 000, where five cases were found by local boards and six by examiners at Camp Grant.That these states with a high ratio for multiple sclerosis are adjacent states, bordering on the Great Lakes, is of great interest.Since examinations were made at three different camps, the result cannot be ascribed to the idiosyncrasy of a neuropsychiatric examiner at one camp (Fig. 1).The nearest approach to the distribution of multiple sclerosis found in any other diseases is in goiter, exophthalmic goiter, chorea, varicose veins, varicocele and allied diseases and various heart diseases and defects.The cardiovascular diseases are associated with the tall stature of the men living about the Great Lakes-largely Scandinavians.The resemblance between the distribution of multiple sclerosis and chorea is considerable, except that chorea is abundant also in Texas, Mississippi, Missouri and the states of the North Atlantic coast and of the eastern slopes of the drainage basin of the Ohio River ; that is, high rates of chorea are more widespread than of multiple sclerosis.It is rather interesting that especially high rates for chorea, as for multiple sclerosis, are found, outside the Great Lakes region, also in the states of Wash¬ ington, Mississippi and Maine.The resemblance of the distribution of multiple sclerosis to that of simple goiter is somewhat striking.In both diseases comparatively few cases are found south of the Ohio River.The maximum rate is found in Michigan, Wisconsin and the extreme Northwest.Various hypotheses are suggested for these facts.One is that some race inhabits the Great Lakes region and the state of Washington that