On the contribution of Thomas Clifford Allbutt, F.R.S., to the early history of neuromyelitis optica

Abstract

The term neuromyelitis optica was coined by Eugène Devic and Fernand Gault in 1894 and refers to the co-occurrence of optic neuritis and myelitis. Neuromyelitis optica (NMO), regarded for many decades as a clinical variant of multiple sclerosis (MS), has only very recently been recognized as a disorder in its own right with distinct pathogenesis, prognosis, and treatment. While the history of classical MS has been extensively studied, only very little is known about the early history of NMO. Here we re-present three forgotten early reports on patients with possible NMO by the later Cambridge Regius Professor of Physic Thomas Clifford Allbutt (1836–1925). To the best of our knowledge, these reports have never been cited before and were also overlooked by Devic and Gault in their seminal review of NMO. One of these reports is likely to correspond to the case briefly mentioned in Allbutt’s lecture “On the Ophthalmoscopic Signs of Spinal Disease”, published in The Lancet in 1870, which was until very recently considered the first account of NMO in the Western literature. In addition, we discuss the question of Allbutt’s primacy in the description of NMO as a syndrome, Allbutt’s ideas on the pathogenetic relationship of spinal cord and optic nerve damage, and the reception of those ideas in the medical literature of the nineteenth century.