Science and Religion: Multiple Sclerosis - Saint Lidwina and Rita Levi-Montalcini
Should we separate religion and science? There is an ongoing debate on whether the two can exist together harmoniously. When it comes to illness and suffering, balancing faith and logic is a difficult thing to do. In the history of multiple sclerosis, we identified two women whose religion influenced their important roles in this disease.
Saint Lidwina
The earliest documented case of multiple sclerosis dates back to the 14th century. A 16-year-old girl named Lidwina from the Netherlands fell violently while ice-skating, breaking one of her ribs. An abscess formed around the site of the fracture and for decades after, various ailments appeared. Lidwina developed walking difficulties, violent pain in her teeth, and headaches. Towards the end of her life (she died at the age of 53) she developed hypersensitivity to light and problems with her facial muscles. Various physicians who examined her failed to provide relief and everyone around her started believing that the illness was spiritual and came directly from God.
It was widely reported that when Lidwina was around 25 years old, she started experiencing paranormal phenomena where she would float over her bed. These events were believed as proof of her contact with God and Angels. During these times, she would be relieved of physical pains and able to get out of bed. She was also reported to have needed very little food – her relationship with God provided her adequate nourishment. Despite her own lifelong illness, Lidwina was reported to perform healing miracles on others. Her stories were legendary in her town and attracted many Catholic pilgrims. In 1890, Pope Leo XIII officially canonised Lidwina as a saint of both ice-skating and of the chronically ill.
In 1979, a group of neurologists from Belgium published a paper discussing Lidwina’s case. They analysed historical texts for descriptions of her symptoms, results from a 1957 examination of Lidwina’s bones and compared their findings to criteria for modern diagnosis. They came to the conclusion that her symptoms were consistent with those of multiple sclerosis. They believed the disease was provoked by the trauma of her ice-skating incident. However, taking into account that Lidwina was widely celebrated for miraculous incidents and phenomena, the scientists are wary that some descriptions might not be accurate. A lot more is understood about multiple sclerosis now compared to Lidwina’s time, but her case provided a unique perspective to the history of this disease.
Multiple Sclerosis
Our nervous system is our body’s electrical writing. The nervous system can be categorised into two: the central nervous system and the peripheral nervous system. The central nervous system (CNS) consists of the brain, spinal cord, and nerves. Meanwhile, the peripheral nervous system (PNS) consists mainly of nerves as well as sensory neurons and ganglia (clusters of neurons). The PNS functions to connect the CNS to the rest of the body. This complex system works together to ensure the body can detect changes going on both outside and inside and adapt to these changes.
Nerves are essentially the bundles of wires in this system. These wires are insulated by a fatty substance called the myelin sheath, ensuring smooth transmission of electrical impulses between different parts of the body. Smooth transmission is essential for normal motor function (movements such as walking), sensory function (hearing, listening, or feeling pain) and cognition (learning and retaining knowledge). Various conditions can affect the quality of the myelin sheath, causing impairment in nervous functions. Intriguingly, the most common cause of demyelination (damaged myelin sheath) is our own body.
Multiple sclerosis (MS) is an autoimmune disease that attacks the myelin sheath. Mistaking the myelin sheath as foreign agents, the body signals for the immune system to attack. The myelin sheath becomes inflamed and lesioned, disrupting the signals that go along the nerves. This disruption might slow the signals down, mix them up, or completely stop them. This results in disrupted sensory, motor and cognitive functions. Symptoms vary between individuals and can range from mild to severe disabilities. Commonly MS causes problems in movement, speech, and vision.
Multiple sclerosis is divided into two categories, relapsing remitting MS and primary progressive MS. The former the most common type of MS and it causes episodes of “relapses” where the symptoms appear and worsen over a short period of time. The time between relapses can go up to years and this remission period is strikingly similar to the times where Lidwina appeared stronger after her contacts with the deities. The latter type causes gradual worsening and accumulation of symptoms, with no remission or relief period.
This disease has been a topic of interest for hundreds of years but until today, no cure has been found. Various treatments are available to alleviate symptoms for the relapsing remitting MS, but treatment options depend on the severity and the type of symptoms one experiences. The main problem in developing a cure is that we understand what happens in MS but not why. One of the proposed cure is to directly repair the damaged myelin sheath by directly administering neurotrophins, a group of proteins that promote the development and survival of neurons.
One of these neurotrophins is called Nerve Growth Factor or NGF, a protein that promotes growth and survival of oligodendrocytes (the neurons that specifically produce myelin sheaths). However, a recent study in 2018 also found that NGF expression is high in the cerebrospinal fluid in MS patients. This contradictory finding indicates that NGF acts differently in different parts of the nervous system. Scientists still need to determine how to best utilise NGF, which brings me to our second woman – the woman who discovered it.
Rita Levi-Montalcini
Rita Levi-Montalcini was born in Turin, Italy, in 1909 into a wealthy Jewish family. Growing up in a strongly patriarchal family with an engineer father and an artist mother, she was discouraged from pursuing medicine. She considered a career in philosophy and creative writing but decided that she wasn’t as creative as her twin sister who became a well-known painter. At twenty, despite her father’s reluctance, she started medicine at university. She graduated from the University of Turin Medical School with a summa cum laude in Medicine and Surgery in 1939.
Upon graduation, Levi-Montalcini decided to pursue medical research instead. However, just before her graduation, Mussolini announced the Manifesto of Race which took away citizenship from Italian Jews and furthermore banned them from academic and professional careers. She withdrew from her position in the university, fearing that her non-Jewish colleagues would be persecuted for allowing her to continue her research. She briefly moved to Belgium for work but returned to Turin to be with family out of fear for their safety. Tragically, she was reunited with them just before the alliance between Mussolini and Hitler was announced.
Banned from even entering the university, Levi-Montalcini set up a laboratory in her bedroom. Manipulating household objects into scientific tools, she started new research inspired by neurologist Dr Hamburger in the USA. Hamburger’s research investigated how cells differentiate themselves from inside the uterus until birth, from one simple cell replicating to many and how each cell develops to have different characteristics and functions. Hamburger, and Levi-Montalcini, wanted to identify the driving force behind this process.
In her home laboratory, Levi-Montalcini dissected chick embryos and studied their motor neurons, the nerve cells responsible for movement, under the microscope. This research gave her solace amidst the growing tension in Italy, and she even recruited her former medical school mentor, Giuseppe Levi, to work with her. Levi had also been expelled from his work because of his religion. Together, they observed that these embryonic nerve cells go through stages — they proliferate, grow, then die. They proposed a theory that the death of these cells is a normal process, that these cells do not live forever, and managed to publish their findings in foreign journals outside Italy in the early 1940s. This theory, however, contradicted the initial research by Hamburger that inspired the project.
Despite the contradicting result, Hamburger invited Levi-Montalcini to join him in the USA after the end of WWII. There, Levi-Montalcini studied a tumour cell line called sarcoma 180, a cell line that Hamburger’s former student noticed to contain more nerve cells than normal. Putting the tumour cells into a normal chick embryo, Levi-Montalcini observed the same result. Something in the tumour cells promoted growth and development of nerve cells, later identified as Nerve Growth Factor. This discovery earned Hamburger and Levi-Montalcini the Nobel Prize in Physiology and Medicine in 1986. NGF has the potential to treat neurodegenerative diseases such as Alzheimer’s Disease and dementia as well as other diseases such as cancer and psychiatric disorders.
Levi-Montalcini continued doing and supporting research until her death in 2012 at the age of 103. When asked about her experience doing research in difficult times, Levi-Montalcini remarked that she believed that discrimination and persecution on the basis of her background were the main driving force behind her efforts. She recognised that others worldwide experience similar struggles — she founded institutes and charities to promote research in Europe and Africa and ensure her experience was heard through her position as a senator in Italy.
Science and Religion
Saint Lidwina and Rita Levi-Montalcini were two women whose religion and background greatly impacted their lives. Astoundingly, their lives contributed to two very different and interesting facets in the history of the same disease — multiple sclerosis. In the case of Saint Lidwina, religion might have meddled in the accuracy of her disease’s description. However, for Levi-Montalcini, the discrimination against her set her in a unique path that resulted in a Nobel Prize. Their stories are proof that science and religion have a complex relationship, one that dictates them to exist alongside each other and work harmoniously.
References:
Fine, M. (2019). Turning Darkness Into Light: The Life And Legacy Of Rita Levi-Montalcini. Forbes Magazine.
Holloway, M. (2012) Finding the Good in the Bad: A Profile of Rita Levi-Montalcini. Scientific American.
Medaer, R. (1979), Does the history of multiple sclerosis go back as far as the 14th century?. Acta Neurologica Scandinavica, 60: 189-192. doi:10.1111/j.1600-0404.1979.tb02968.x
Mumal, I. (2018). MS Patients with Brain and Spinal Nerve Pain Have High Levels of a Protein, Study Finds. Multiple Sclerosis News.
Murray TJ. (2004). Multiple Sclerosis: The History of a Disease. Demos Medical Publishing.
National Cancer Institute. SEER Training Modules: Introduction to the Nervous System.
Nobel Prize Organization. Rita Levi-Montalcini profile.