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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 Sclérose 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 sclérose en plaques from the chaos of chronic myelitis’.

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