Course of exacerbations of multiple sclerosis in hospitalized patients.

Multiple sclerosis is a disease characterized by exacerbations and remissions. While various factors, such as psychic or physical stress, operations, or anesthesia, have been propounded as possible precipitants in bouts of this disease, little has been linked with remissions except "rest."1The occurrence of remissions has been the basis for the many proposed therapeutic measures, but spontaneous improvement has been assumed to be the mechanism in effect when early results were not confirmed. It is the purpose of this paper to investigate factors possibly associated with such spontaneous improvement, with the goal of discovering the course of attacks in groups of patients, and any features of the bout which may be of prognostic value. Methods and Material At the Bronx VA Hospital over 300 patients were hospitalized between 1944 and 1953 for whom the diagnosis of multiple sclerosis was entertained. Of these patients, those were omitted for whom the