The Diagnosis and Treatment of Myasthenia Gravis

The syndrome of myasthenia gravis was first suggested by Thomas Willis¹in 1672, but the disease was not clearly delineated until the reports of Erb²in 1878, Goldflam³in 1893 and Jolly⁴in 1895. The first patient to enter the wards of the Massachusetts General Hospital with myasthenia gravis was admitted in 1905. In the period between 1905 and 1934 inclusive thirty-one patients received this diagnosis in the wards (fig. 1) and possibly a few more in the outpatient department. The disease was thus rare, only one patient a year, on the average, being seen in a moderately large general hospital. Seven of the thirty-one are known to have died either within a few weeks in the hospital or within a year at home. The disease was rapidly fatal, probably even more so since our follow-up records were not complete, than our ratio of 7 in