Sir Robert Carswell

Sir Robert Carswell 
(1793–1857)
was a Scottish professor of pathology, who described and illustrated many of the clinical details of multiple sclerosis but did not identify it as a separate disease.

The first illustration of multiple sclerosis (MS) was by a young Scottish physician and artist, Dr Robert Carswell. Recognized as a talented illustrator by his teachers, he was encouraged to create an anatomy and pathology atlas. He spent years in the hospitals and mortuaries of Paris and Lyon painting watercolours and pen and ink drawings of patients and post mortem preparations. Of the 1034 paintings, 99 are of the brain and spinal cord and Plate 4, figure 4.4* in the atlas, is of MS. 

Carswell indicated he saw two examples of this pathology, but had not examined either patient, but illustrated one of them. We know little about the clinical history other than that the patient was paralyzed. 

About 200 of the atlases were printed, and it is still regarded as one of the greatest and most beautiful of all medical books.

Carswell was appointed as the first Professor of Anatomy at the North London Hospital, later renamed the University College Hospital UK, where the original copy of his great atlas is archived.

Due to ill health he resigned after a few years to reside in the healthier air outside Brussels, Belgium.
He was appointed physician to King Leopold, but was also noted for his care of the poor. 

Queen Victoria knighted him for his care of King Louis Philippe of France when he was in exile. 

Although English journals did not note his passing at the age of 64 years, his great atlas remains as his memorial.

*One of Carswell's most celebrated achievements was being the first to portray the plaques of multiple sclerosis, although he did not identify them as such. Illustrated here in the section on atrophy is 'a peculiar diseased state of the chord and pons Varolii, accompanied with atrophy of the discoloured portions ... the atrophy was more conspicuous in some points than in others, and is particularly well seen in the figure at H, where it affects a portion of the right olivary body'. Carswell notes in the introductory section that 'I have met with two cases of a remarkable lesion of the spinal cord accompanied with atrophy. One of the patients was under the care of Mons. Louis in the Hospital of La Pitié, the other under the care of Mons. Chomel, in the Hospital of La Charité, both of them affected with paralysis. I did not see either of the patients, but I could not ascertain that there was anything in the character of the paralysis or the history of the cases calculated to throw any light on the nature of the lesion found in the spinal cord'. Although unaware of their cause, Carswell meticulously recorded these strange lesions; their distinctive patterns show a specific damaging of the spinal cord and clearly identify them as multiple-sclerosis lesions.