An Essay On The Shaking Palsy - …

It is remarkable, and a testament to Parkinson’s powers of observation, how much of the essay on the Shaking Palsy remains relevant to the description of patients with Parkinson’s disease today. His definition of the Shaking Palsy is worth reproducing in full. He described it as a disease characterised by: “Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.”

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The contents and first page of ‘An essay on the Shaking Palsy’, written by James Parkinson in 1817

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The centrepiece of the essay is Parkinson’s report of a typical history for the Shaking Palsy, illustrated with a series of six cases from in and around Hoxton, sharing a number of characteristic symptoms. Although varying in detail (only two of the cases were directly examined by Parkinson, and of these a detailed case history was taken in one case), these contain a wealth of information that neurologists today would recognise from their own interaction with Parkinson’s disease patients.

James Parkinson: the man behind the shaking palsy

Parkinson’s extensive clinical experience and observational skills, gleaned from several decades of medical practice in Hoxton, served him well in what was to be his outstanding contribution to medical science – his description of the Shaking Palsy. From the outset it is clear that he was well aware of how devastating the disease could be, describing how “the unhappy sufferer has considered it as an evil, from the domination of which he had no prospect of escape”.

What would James Parkinson think now about the Shaking Palsy

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It is important to note, when reading an essay on the Shaking Palsy, that Parkinson was working in uncharted territory. The study of neurological disease as we know it today was very much in its infancy, and the degenerative diseases that are so familiar now, such as Motor Neuron Disease or Alzheimer’s Dementia, were still many years from being established as clinical entities. As the medical discipline of neurology took shape over the course of the 19th century, a number of its founding fathers (most notably Jean-Martin Charcot in Paris and Williams Gowers in London) acknowledged the contribution that Parkinson had made in bringing together and synthesising the case reports that he published in his essay on the Shaking Palsy. The most obvious consequence of this was the naming of the disease in recognition of Parkinson’s influence on the field.

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What would James Parkinson think now about the Shaking Palsy? He would certainly marvel at the progress that has been made in terms of diagnosing and understanding the causes of the disease that now bears his name. It is likely that he would be pleased at the range of drugs now used to ease the symptoms that he described so clearly in his essay. But undoubtedly he would be both surprised and disappointed to discover that, two centuries after he had first noted the existence of the disease, there is still no cure for this devastating disorder.

This "An Essay on the Shaking Palsy" was written by James Parkinson in English language.

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James Parkinson, a surgeon and political activist working in London around the turn of the 19th century, was the first person to describe ‘paralysis agitans’, a condition that would later be renamed Parkinson’s disease. Here, to mark the 200th anniversary of the publication of his most famous work, ‘An Essay on the Shaking Palsy’, Dr Patrick Lewis, associate professor in cellular and molecular neuroscience at the University of Reading, UK, reflects on the man and his work

200th Anniversary of An Essay on the Shaking Palsy – …

An essay on the shaking palsy citation oil

In 1817, James Parkinson, after whom the disease was named, was the first to document cases of what he called "the shaking palsy" and in doing so, began the scientific crusade to determine the causes and manifestation of the disease (2).

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Much is made in the essay of the inadequacy of the treatments available to sufferers. The optimism of Parkinson’s humanist tendencies prompted him to suggest that: “there appears to be sufficient reason for hoping that some remedial process may ere long be discovered, by which, at least, the progress of the disease may be stopped”. Sadly it was to be 140 years before the work of Arvid Carlsson and others eventually led to the development of levodopa as a symptomatic treatment for the Shaking Palsy, and we still await an intervention that actually retards the progress of the disease.