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The course of the disease is unpredictable and mysterious. But it is usually progressive. However, it is characterized by attacks and remissions. With an attack, inherent in the progressive nature of the disease, there is an increased severity of symptoms. With a remission, there is a sudden improvement in symptoms. Most often, remissions are but transient blessings which end as mysteriously as they begin. The prevalence

MS is not a reportable disease, therefore, there is no positive record of the exact number of cases in the United States. However, the National Institute of Neurological Diseases and Blindness estimates that there are approximately 300,000 persons in the United States today with chronic, progressive, multiple sclerosis and related demyelinating diseases. This is comparable to the estimated 250,000 persons suffering from the after effects of polio. The National Office of Vital Statistics in Washington, D. C., reported for 1949 (latetst available figure) that 1,379 persons died of multiple sclerosis. But undoubtedly this was an incomplete figure, since the disease is the basic cause of death in many instances where the listed cause of death is some other disease such as pneumonia, heart, circulatory failure and infections which had been brought on by MS. In comparison with the 1,379 multiple sclerosis deaths in 1949, according to latest estimates of the National Office of Vital Statistics, acute infantile paralysis killed 1,321 persons in 1951. T'he victims

The victims of MS as usually stricken between the ages of 20 to 40. It is estimated, on the basis of current statistical information, that about 90 percent of all MS patients developed it before the age of 45—in the most productive period of their lives when they should be making their greatest contribution to their families and to society.

MS is not a prime killer. It is a foremost crippler.

Patients often have serious psychological problems. Their daily activities are severely limited. Many are confined to wheelchairs or are bedridden. They are dependent on others for help. They require understanding rather than sympathy. Tragedy enters the home when MS is present. The patient is often a financial burden to the family. Taking care of his daily wants is a strain and a hardship on the family.

Multiple sclerosis is a grave economic problem because millions of dollars, in terms of forced inactivity and man hours, are lost.

In many cases, group or individual therapy, under professional guidance is recommended. Several of the society's clinics offer group therapy to patients, but this is still on a limited scale and should be expanded. T'he cause and effective treatment

The cause of MS is not known. Many theories regarding possible causes are being tested in the society's research projects.

There is as yet no specific curative treatment. Current rms of treatment are aimed at: (1) alleviating symptoms, mostly through the use of drugs; (2) rehabilitation, including physiotherapy to enable the patient better to attend to his daily wants and to live more productively; and (3) keeping up the general level of the patient's health. Healthful living, adequate and proper nutrition, and the avoidance of infections and emotional disturbances, are of great importance.

The climatic factor in MS has been under study. It has been observed that MS is more common in cold northern climates than in southern warm climates. This observation has indicated the need of further study to determine whether climate affects the course of MS as well as its prevalence.

One conclusion with respect to treatment is particularly worth noting. Treatments now offered for MS are helpful in some cases but not in others. The most successful of treatments, whether in the form of drug therapy, or physical medicine, do not appear permanently to alter the course of MS, but rather to afford symptomatic relief.

Research to find the cause and control of MS is of primary concern. Accomplishments of the National Multiple Sclerosis Society

The society was formed to meet the great need of combating MS and counteracting long-standing ignorance and neglect. Discussion and investigation of the problems involved had been rather personal, individually pursued, and somewhat hushed. Research investigators with important ideas were discouraged because of inadequate funds and the lack of clinical material. All this tended to inculcate in the multiple sclerotic a feeling that he or she was socially undesirable. The primary purposes of the society are to provide

Research, to find the cause and effective treatment of MS.
Clinics, to provide diagnostic services and treatment centers.

Rehabilitation, to alleviate disabilities and enable a sufferer to become a more useful member of society.

Medical education, to provide the medical and allied professions with vital information relating to diagnosis, research, and treatment.

Lay education, to inform the public of the problems involved and solicit help in the work of the society.

Chapters, to further the program. Research

The society has thus far supported 27 research projects, and 8 research and treatment clinics at leading medical centers at a total cost of $554,246.58, including commitments. About 50 cents of each dollar of the society's funds have been allocated to basic and clinical research.

The society's research program is formulated and coordinated by a medical advisory board consisting of 50 outstanding physicians and research investigators in the field of multiple sclerosis and related nerve diseases. This board meets semiannually to exchange views, hear progress reports on research, and consider new applications for research grants.

In our present stage of knowledge, it is highly desirable to support studies of all worthwhile theories regarding MS. The research projects supported by the Society cover many diversified fields.

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$54, 126. 29

40,500.00

6, 600.00

2 years 3

5,000.00

29, 273. 88

3,300.00 36, 432, 69

10, 376. 12

20,000.00

27, 036.37

401. 28 8,726.34

3

Study of immunology and allergy in MS, Columbia University and New 5 years 1

York Neurological Institute, New York City.
Relationship between virus infection and myelin destruction, Tulane, Uni- 342 years 1.

versity of Louisiana, and University of Minnesota Medical School.
Study of myelin destruction by histochemical methods, Massachusetts Gen- 3 years ?

ersi Hospital and Harvard Medical School, Massachusetts.
Effect of ACTH and cortisone on MS, New York Neurological Institute,

New York City.
Bichemical studies in MS, H. L. Snyder Memorial Research Foundation,

2 years
Kansas.
Blood clotting in MS, Cedars of Lebanon Hospital, Los Angeles

1 year 3 Study of de nyelination, allergies, and instution of training program for neu

--...do.l rologists and other investigators, Massachusetts General Hospital and

Harvard Medic I School, Massachusetts,
Study of adrenal function in MS, Peter Bent Brigham Hospital, Harvard do.

Medical School, Massachusetts.
Study of possible infectious origin of MS, Southwest Rosearch Institute of do.

Applied Research, Texas.
National statistical survey with cooperation of U. S. Public Health Service. 544 years.
Statistical study of the prognosis of known cases of MS. England..

1 year a Psychological study of MS patients, New York University-Bellevue Medical 1/2 years

Center, New York,
Epide niological investigations of MS in Winnipeg and New Orleans

1 year 3 The course of disse minated sclerosis. A closeup of 105 atticks. Method for ----.do.3

evaluating therapeutic approaches, Copenbagen, Denmark. Study of cellular responses and sequences involved in areas of discontinuous

destruction of myelin crised by JHM virus in central nervous system,

Iadiana University School of Medicine, Indianapolis.
Study to determine amino-acid patterns of the spinal Nuids in MS and re- 6 months 3

lated neurological discases, Boston University School of Medicine,
Massachusetts.
Study to develop a simple technique for the determination of protein changes

1 year in orebro-spi ial fluid in MS, Jewish Sanitarium and Hospital for Chronic

Diseases, Brooklyn, N. Y.
Investigation of cerebral blood flow and intricate chemical changes occurring do.
in US and related demyelinating diseases, University of Miami Medical

Research Unit, Miami, Fla.
Investigation by infrared absorption spectra and pertinent chemical analysis do.

of the linid and lipid soluble materials involved in the demyelinating dis-
eases, University of Rochester Medical Center, Rochester, N. Y.
1 Projnet taken over by U.S. Public Health Service.
: Project taken over by Kresge Foundation,
? Research project completed.

3, 589. 63
1, 212.90

1 year

8, 450.00

850.00

6,000.00

5,000.00

8, 167.00

39087-53-pt, 4-7

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$5, 687.75

2, 056. 64

1,000.00

Cerebral metabolic studies in MS, University of California School of Medi- 1 year

cine, San Francisco, Calif.
Serological studies in MS, Neurologische Universitatsklinik, Hamburg- do.

Eppendorf, Germany.
Experimental work involving culturing of micro-organisms from spinal 6 months.

fluids in culture medium, Philadelphia, Pa.
Studies in the etiology of multiple sclerosis, dealing with the problems of the 1 year

infectious nature of the disease, suspecting a virus as the infective agent,

University of Buffalo School of Medicine, Buffalo, N. Y.
Study to observe the effect of vasodilating drugs on new symptoms of mul- 8 months.

tiple sclerosis, Columbia University, College of Physicians and Surgeons,
New York City.

26, 954. 00

1,000.00

4 Research project inaugurated after Dec. 15, 1952, for 1 year.

The research program is considered outstanding. According to a survey covering 18 leading voluntary health organizations in 1951, the National Multiple Sclerosis Society ranks first in the percentage of funds allocated to research. It is believed the year 1952 reflects relatively the same record of performance. Clinics

In addition to the research projects listed above, eight multiple sclerosis research and treatment clinics have been established by the society. The clinic is a pioneering innovation in the traditional treatment of multiple sclerotics. An MS clinic provides a center where multiple sclerotics may receive diagnosis, treatments which may be helpful, and physiotherapy. It is an adjunct to research which needs patients for evaluating experimental forms of therapy.

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1 Grant included in research project on demyclination, allergies, and training program, ? Supported by chapters in those States. s Grant included in research project on biochemical studies in MS.

Addendum to annual report, pp. 10–13, research projects supported by the

National Multiple Sclerosis Society, Jan. 1, 1953, through Dec. 31, 1953

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A quantitative study of the lipides of the nervous system

during myelination and demyelination.
Study to determine amino-acid patterns of the spinal

fluids in multiple sclerosis and related neurological

diseases.
Investigation of the ground substance in the central

nervous system in its relationship to functions of the

glia.
Extension of preliminary studies on polymorphonuclear

Hans H. Reese, University of

Wisconsin Medical School.

600

600

Hans H. Reese, University of

leucocytes in which abnormality (Hargraves' cells)
have been found warranting more detailed study.

Wisconsin Medical School.

Rehabilitation

The need for rehabilitation to cope with the disabilities manifest in MS is great. The society has published a rehabilitation manual, which has been distributed without charge to over 17,000 physicians and physiotherapists. Because of the pressing need for a “home care" program for patients, the society has published manuals for patients in all stages of the disease. These are intended to supplement the rehabilitation manual for physicians and are being distributed to patients through their doctors without charge.

Medical education

The society has become the recognized clearinghouse for information the world over on multiple sclerosis. Hundreds of letters are received from medical and nursing personnel asking our opinion on certain forms of treatment and other information.

A medical manual containing information on current developments in multiple sclerosis has been published. This manual, which is revised periodically, is distributed to 28,000 physicians on our medical mailing list and to all other interested physicians.

To reach the nursing profession, a reprint of an article appearing in the American Journal of Nursing, which gives guidance to nurses in the care of multiple sclerotics, has been distributed to interested nurses.

The society has organized a panel of international corresponding neurologists consisting of 56 neurologists from 27 countries. The purpose of the panel is to keep all research centers and investigators in the world posted on developments in the field. Lay education

An important function of the society is to inform some 23,000 members of its activities. A quarterly bulletin, AARMS Forward, not only informs members but also serves as a morale stimulant to patients and their friends.

Educating the public is difficult because of past neglect and public ignorance of MS, but there is great encouragement in the progress made as a result of the society's educational program. Many more people than ever before know something about MS, and its problems are being publicly discussed and studied. Chapters

Twenty-one chapters of the society are located in Alabama, California, Connecticut, District of Columbia, Kansas, Massachusetts, Michigan, Minnesota, Nebraska, New York, Ohio, Pennsylvania, Vermont, and Wisconsin. The function of these chapters is to provide essential services to patients and to aid in carrying out the program of the society. To organize more chapters is dependent only upon adequate field personnel which the society has heretofore not been financially able to engage. Past financial support

In the initial years of the society's existence, patients and their families and relatives assumed its financial support. Obviously, this placed severe limitations upon its program, since contributors were not large in number, and many of the patients were either not earning a livelihood or were compelled to save against a day of incapacity to work.

Later the nucleus of initial contributors was expanded by patients, their families and relatives seeking aid from their friends—and this primarily on the basis of membership dues ranging from $3 upward, with complimentary membership to patients who were unable to afford due

The society has literally been built and its work largely maintained through the funds and efforts of those whom it seeks to aid. It is unique, and it is deserv. ing of widespread interest and support because its research, educational, and rehabilitation program has evidenced a progress which warrants, if not, indeed, demands, a nationwide appeal for support of broadened plans. Financial support for 1953

Particularly it is essential to continue and broaden research. It is worthy of note that in 1952 approximately 45 percent of funds received in the year were spent for research, 18 percent for lay and professional education, 18 percent for medical and patient services, and only 10 percent for administration, and 9 percent for organization and development of chapters.

The directors and medical advisory board of the society, in the light of demonstrated need for continuing existing research projects, inaugurating other such projects and expanding the educational and rehabilitation program of the society, and developing additional chapters, urgently require a broader base of financial support and an appeal generally, on a nationwide basis, for financial aid to the society and its chapters. Accordingly it is the plan of the society to launch in March 1953 a nationwide appeal in an effort to raise an aggregate of $1,200,000 through the efforts of the society and its chapters and for the use of the society and its chapters.

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BOARD OF DIRECTORS OF NATIONAL MULTIPLE SCLEROSIS SOCIETY,

New York, N. Y.: We have examined the balance sheet of National Multiple Sclerosis Society (national headquarters) as of December 31, 1952, and the related statement of income, expenses, and grants for the year then ended. We did not examine the financial statements of the chapters of the society. Our examination was made in accordance with generally accepted auditing standards, and accordingly included such tests of the accounting records and such other auditing procedures as we considered necessary in the circumstances. It was not practicable for us to confirm by direct communication dues and contributions received from members or others, with respect to which we made test checks of records of dues and contributions with duplicates on file of receipts issued to contributors. Funds received from chapters of the society were confirmed to us by direct communication or accounted for by inspection of advices or reports on file.

The accounts of the society are maintained on the receipt and disbursement basis of accounting.

In our opinion, the accompanying balance sheet and statement of income, expenses, and grants present fairly the assets and fund balances of National Multiple Sclerosis Society (national headquarters) at December 31, 1952, and its income, expenses, and grants for the year then ended, on a basis consistent with that of the preceding year.

ERNST & ERNST. New York, N. Y., March 4, 1953.

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