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The Gray Degeneration of the Brain and Spinal Cord

A Story of the Once Favored Diagnosis With Subsequent Vessel-Based Etiopathological Studies in Multiple Sclerosis

Ganesh, Aravind, MD, DPhil (Oxon)*†; Stahnisch, Frank W., MD, MSc (Edin), PhD

The Journal of Nervous and Mental Disease: June 2019 - Volume 207 - Issue 6 - p 505–514
doi: 10.1097/NMD.0000000000001002
Original Articles

In 1857, French-Austrian psychiatrist Bénédict Augustin Morel (1809–1873) published his infamous though highly successful Traité des dégénérescences physiques, intellectuelles et morales de l'espèce humaine, which was fully dedicated to the social problem of “degeneration” and its psychiatric and neurological underpinnings. European psychiatrists, neurologists, and pathologists integrated Morel's approach into their neuropsychiatric theories and searched for the somatic and morphological alterations in the human brain, as did the versatile pupil of Rudolph Virchow (1821–1902), Georg Eduard von Rindfleisch (1836–1908), in his Lehrbuch der pathologischen Gewebelehre (1867). This can be seen as a starting point of research into the vascular genesis of “multiple sclerosis” by observing that the changes of blood vessels and nerve elements could be the result of inflammation and increased blood flow. We examine the waxing and waning of a 19th century diagnostic condition, which fell out of favor and resurfaced during the 20th century.

*Department of Clinical Neurosciences, Cumming School of Medicine, The University of Calgary, Calgary, Alberta, Canada;

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; and

Departments of Community Health Sciences and History, Cumming School of Medicine and Faculty of Arts, The University of Calgary, Calgary, Alberta, Canada.

Send reprint requests to Frank W. Stahnisch, MD, MSc (Edin), PhD, Department of Community Health Sciences, Cumming School of Medicine, The University of Calgary, 3280 Hospital Dr NW, Calgary, Alberta, Canada T2N 4Z6. E-mail:

Online date: May 13, 2019

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