Hematology
1844 CE — the case of Thomas Alexander McBean, documented by London physicians Samuel Solly and later by Henry Bence Jones, represented the first well-documented clinical case that subsequent investigators recognized as multiple myeloma
Multiple myeloma was a disease whose characteristic destruction of bone and production of abnormal proteins in the blood and urine confounded physicians for much of medical history, as the tools necessary to recognize it as a distinct entity did not exist until the nineteenth century. Early observers documented pieces of the clinical puzzle — crumbling bones, unusual urinary deposits, profound weakness — without possessing a framework that could assemble these findings into a coherent diagnosis. The gradual construction of that framework over the nineteenth and twentieth centuries drew on contributions from pathology, chemistry, and eventually cellular biology.
Historical Narrative
The history of multiple myeloma as a recognized medical entity was relatively compressed compared to many ancient diseases, owing to the fact that its identification depended entirely on the development of post-mortem pathological examination and chemical analysis of bodily fluids — techniques that matured only in the nineteenth century. Earlier physicians had certainly encountered and documented patients suffering from the profound bone pain, pathological fractures, and extreme weakness that the disease produced, but these symptoms were absorbed into broader categories of constitutional illness, scurvy, rheumatism, or wasting fever without any recognition of a unifying cause.
The pivotal case that launched the formal history of the disease involved a London tradesman named Thomas Alexander McBean, who sought medical attention in 1844 for severe bone pain, recurring fractures, and an unusual foamy quality to his urine. The physician William Macintyre examined McBean and collected urine samples, noting the strange behavior of the urinary deposit, which dissolved upon heating and then reprecipitated upon cooling — a property unlike anything Macintyre had previously observed. Macintyre referred the samples to the distinguished chemist and physician Henry Bence Jones, who published his chemical analysis of the protein in 1848, describing what became known as Bence Jones protein in a contribution that represented the first chemical characterization of a disease-specific urinary substance.
Samuel Solly performed the post-mortem examination of McBean following his death and described the remarkable softening and destruction of the bones, which appeared to have been replaced by a reddish gelatinous material. These combined clinical, chemical, and pathological observations constituted the first documented case of what later investigators would classify as multiple myeloma, although the disease lacked that name or any unified conceptual identity for several more decades.
The German physician J. von Rustizky coined the term multiple myeloma in 1873 after performing an autopsy revealing multiple distinct tumorous growths within the bone marrow, recognizing that the disease characteristically affected many skeletal sites simultaneously rather than producing a solitary tumor. The Austrian physician Otto Kahler published a comprehensive clinical description in 1889 of a patient followed over many years, providing such a thorough account that the disease was called Kahler's disease in German-speaking medical communities for generations.
The cellular identity of the malignant cells was clarified in the early twentieth century when James Homer Wright demonstrated in 1900 that the tumorous cells filling the bone marrow in myeloma patients were plasma cells — a class of cells involved in the production of antibodies. This pathological insight proved transformative, connecting multiple myeloma to the broader landscape of immune cell biology and establishing the foundation upon which later investigators would build their understanding of the disease as a malignancy of antibody-producing cells. Jan Gosta Waldenström's mid-twentieth century work on plasma cell dyscrasias and abnormal serum proteins further refined the classification of diseases arising from this cellular lineage, helping to distinguish multiple myeloma from related but distinct conditions.
Key Historical Figures
Historical narrative only — this page describes how Multiple myeloma was understood historically. It is not medical advice and does not describe current diagnosis or treatment. Sourced from verified medical history references (NIH, Encyclopaedia Britannica, and standard medical history texts). See our medical disclaimer.