The miracle of St. Alfege’s Hospital and the history of the treatment of myasthenia gravis

Abstract

Abstract:Having a recent history, the neurological condition called myasthenia gravis has raised dilemmas and questions among doctors since it was first discovered in the 16th century and it has not ceased to be a challenge. Nowadays, neuroscience researchers from around the world have been striving to perfect a modern treatment of this condition. Our paper is an incursion into the past, more precisely into the history of the treatment of this disease, from its origin to date, when immunological therapy has progressed.

Mary Broadfoot Walker: 83 years since a historical discovery

“…The presentation of the dramatic improvement of the myasthenia patients took place at the clinical meeting of the Royal Society of Medicine (Neurology) at the National Hospital, Queen Square, London, on 17 February 1938, and was published in detail 2,3 . Mary concluded that myasthenia gravis was the pathological effect of a substance that entered the circulation and caused abnormal fatigability via the acetylcholine in the neuromuscular junction 4 . Mary' s observations were scientifically sound: she used placebo (saline) to confirm the effect of physostigmine and she established the dose-related effect of the drug.…”

“…The famous neurologist Denny-Brown, who earlier compared curare poisoning to myasthenia gravis (and this was how Mary thought of physostigmine as a potential treatment), stood against Mary' s discoveries and explanations Mary retired to her native Scotland and died in comparative obscurity in Wigtown in 1974, at the advanced age of 86 years. She was surrounded by her cats and with neighbors who had the nicest words about the lady who had a walnut tree in her garden 4,9,10 . Mary Broadfoot Walker was, perhaps, the only scientist to have made history with a "n = 1" treatment.…”