Sir August d’Esté (1794-1848)

The next known description of MS did not appear until the 19th century (2), when the first personal account of the illness was given through a diary kept by Sir Augustus d’Esté (3), the illegitimate grandson of George III of England.

D’Esté documented the course of his 26-year illness, retrospectively diagnosed as MS. The slide shows two excerpts from the diary, above, an entry from the start of the diary, in 1822, and below, from January 1848, one of the last entries (3). The marked decline in handwriting is clearly visible as the writer loses motor control.

D’Esté meticulously recorded his symptoms which began soon after a bout of measles and included visual impairment, fatigue and unpleasant sensations. The disease became progressively debilitating with time and an entry made five years before his death stated that d’Esté was ataxic, numb below the waist and had spasms at night. An ‘episode’ at this time started the disease on a chronic progressive course with only partial recovery after each relapse.

Paralysed in both arms, d’Esté died in 1848 (3). His physician was unable to diagnose the illness, as MS was not recognised until twenty years after d’Esté 's death.

Reproduced with permission from The case of Augustus d’Esté, D. Firth, 1948, Cambridge

==> Robert Carswell (1793-1857)