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August 12, 1939

THE DIAGNOSIS AND TREATMENT OF MYASTHENIA GRAVIS: WITH SPECIAL REFERENCE TO THE USE OF PROSTIGMINE

JAMA. 1939;113(7):559-563. doi:10.1001/jama.1939.02800320011003
Abstract

The syndrome of myasthenia gravis was first suggested by Thomas Willis1 in 1672, but the disease was not clearly delineated until the reports of Erb2 in 1878, Goldflam3 in 1893 and Jolly4 in 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

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