Saturday 3 March 2012

Essay On The Shaking Palsy-Movement Disorder-Medical Scientist-James Parkinson

James Parkinson's Legacy

Next Monday, April 11, we will be observing the 256th anniversary of the birth of James Parkinson, the English scientist whose masterpiece of medical observation – An Essay on the Shaking Palsy, published in 1817 – defined the condition that we know today as Parkinson’s disease.What do we know about this man? Why was he so important? Well, first off, free yourself of any image you may have of James Parkinson as a medical scientist who spent his whole career studying movement disorders. He was actually one of those Renaissance men and women who roamed England and Western Europe during the period we call the Enlightenment, and who seemed to have inexhaustible appetites for knowledge of many kinds. He was a surgeon, an apothecary, a geologist, a paleontologist and a political activist in the Radical movement. In fact, about the only thing he wasn’t was a physician! A couple of weeks ago, I had the pleasure of attending a talk on the subject of Mr. Parkinson given by Gerald Stern, M.D., a well-known Parkinson’s scientist from London. Remarkably, Dr. Stern told us, his subject died virtually unknown in 1824, and wasn’t rediscovered until some more than six decades later, when Jean Martin Charcot, the brilliant French physician who is considered the founder of modern neurology, renamed the disease (then known as Paralysis Agitans) for the man who had first written about it. And Parkinson’s disease it has been ever since. Indeed, if Mr. Parkinson was known for anything during his lifetime, it wasn’t so much for his medical observations but for his interesting early work on the emerging sciences of archeology, paleontology and minerology – he published several articles in these fields – and for his political tracts on such subjects as extending the franchise in England, which got him into trouble with some of the conservative authorities of the time (shaken as they were by their problems with the American colonies and later by the Reign of Terror that followed the revolution in France). He was subversive, certainly, but was opposed to violence; one of his more important writings, in 1794, was entitled “Revolutions without Bloodshed, or Reformation Preferable to Revolt.”As to medicine, Dr. Stern told us, his interests – true to form – ranged widely, from:the effects of being struck by lightning; to medical education (and the importance of being on the alert for quacks); to the study of epilepsy, for which he devised a treatment involving blood and salt.He showed a deep compassion for people, and some of his thinking was quite advanced for the period – for example, his view of hypochondria (which he said should “not be summarily dismissed” in all cases), and his insistence that one should always “respect the poor.” Perhaps most startling for the study of Parkinson’s, he thought that the palsy might be traced not just to the movement-controlling sections of the brain but to other parts of the brain as well – in some sense, foreshadowing today’s conception of PD as much more than just a movement disorder.He was also a religious man, and sometimes his devoutness conflicted with his instincts as a scientist. For example, as he was growing up, most people were convinced that the Earth had been formed precisely in 4004 BC, the product of the labors of James Usher, a respected Irish bishop. Seeking to reconcile his own skepticism about Usher’s theory with his religious beliefs in an article he published in 1822, Parkinson came up with a very clever question, which Dr. Stern quoted for us: “May not the days of creation be considered periods of infinite duration?” Although Parkinson was never widely known in his lifetime for his work on the shaking palsy, it is nice to know that he understood something of the importance of his own work. In his usual modest style, he wrote that he was happy that his writing may have “excited the attention of those who want to ease a tedious and troublesome mala read more..

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