James Parkinson MD (1755-1824)

20151026-17

Illustration of Parkinson’s disease by William Richard Gowers, which was first published in A Manual of Diseases of the Nervous System (1886)

 

Several early sources, including an Egyptian papyrus, an Ayurvedic medical treatise, the Bible, and Galen’s writings, describe symptoms resembling those of Parkinson’s disease (PD). After Galen there are no references unambiguously related to PD until the 17th century. In the 17th and 18th centuries, several authors wrote about elements of the disease, including Sylvius, Gaubius, Hunter and Chomel.

 

In 1817 an English doctor, James Parkinson, published his essay reporting six cases of paralysis agitans. An Essay on the Shaking Palsy described the characteristic resting tremor, abnormal posture and gait, paralysis and diminished muscle strength, and the way that the disease progresses over time. Early neurologists who made further additions to the knowledge of the disease include Trousseau, Gowers, Kinnier, Wilson and Erb, and most notably Jean-Martin Charcot, whose studies between 1868 and 1881 were a landmark in the understanding of the disease. Among other advances, he made the distinction between rigidity, weakness and bradykinesia. He also championed the renaming of the disease in honor of James Parkinson.

 

In 1912 Frederic Lewy described microscopic particles in affected brains, later named “Lewy bodies“. In 1919 Konstantin Tretiakoff reported that the substantia nigra was the main cerebral structure affected, but this finding was not widely accepted until it was confirmed by further studies published by Rolf Hassler in 1938. The underlying biochemical changes in the brain were identified in the 1950s, due largely to the work of Arvid Carlsson on the neurotransmitter dopamine and Oleh Hornykiewicz on its role on PD. In 1997, alpha-synuclein was found to be the main component of Lewy bodies by Spillantini, Trojanowski, Goedert and others.

 

Anticholinergics and surgery (lesioning of the corticospinal pathway or some of the basal ganglia structures) were the only treatments until the arrival of levodopa, which reduced their use dramatically. Levodopa was first synthesized in 1911 by Casimir Funk, but it received little attention until the mid-20th century. It entered clinical practice in 1967 and brought about a revolution in the management of PD. By the late 1980s deep brain stimulation introduced by Alim-Louis Benabid and colleagues at Grenoble, France, emerged as a possible treatment.

 

James Parkinson FGS (11 April 1755 – 21 December 1824) was an English surgeon, apothecary, geologist, paleontologist, and political activist. He is most famous for his 1817 work, An Essay on the Shaking Palsy in which he was the first to describe “paralysis agitans“, a condition that would later be renamed Parkinson’s disease by Jean-Martin Charcot. James Parkinson was born in Shoreditch, London, England. He was the son of John Parkinson, an apothecary and surgeon practicing in Hoxton Square in London. He was the oldest of three siblings, which included his brother William and his sister Mary Sedgewood. In 1784 Parkinson was approved by the City of London Corporation as a surgeon. On 21 May 1783, he married Mary Dale, with whom he subsequently had eight children; two did not survive past childhood. Soon after he was married, Parkinson succeeded his father in his practice in 1 Hoxton Square. He believed that any worthwhile surgeon should know shorthand, at which he was adept. In addition to his flourishing medical practice, Parkinson had an avid interest in geology and paleontology, as well as the politics of the day. Parkinson was a strong advocate for the under-privileged, and an outspoken critic of the Pitt-government. His early career was marred by his being involved in a variety of social and revolutionary causes, and some historians think it most likely that he was a strong proponent for the French Revolution. He published nearly twenty political pamphlets in the post-French Revolution period, while Britain was in political chaos. Writing under his own name and his pseudonym “Old Hubert“, he called for radical social reforms and universal suffrage.

 

Parkinson called for representation of the people in the House of Commons, the institution of annual parliaments, and universal suffrage. He was a member of several secret political societies, including the London Corresponding Society and the Society of Constitutional Information. In 1794 his membership in the organization led to his being examined under oath before William Pitt and the Privy Council to give evidence about a trumped-up plot to assassinate King George III. He refused to testify regarding his part in the popgun plot, until he was certain he would not be forced to incriminate himself. The plan was to use a poisoned dart fired from a pop-gun to bring the king’s reign to a premature conclusion. No charges were ever brought against Parkinson but several of his friends languished in prison for many months before being acquitted.

 

 

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First page of Parkinson’s classical essay on shaking palsy

 

Parkinson turned away from his tumultuous political career, and between 1799 and 1807 published several medical works, including a work on gout in 1805. He was also responsible for early writings on ruptured appendix in English medical literature. Parkinson was also interested in improving the general health and well-being of the population. He wrote several medical doctrines that exposed a similar zeal for the health and welfare of the people that was expressed by his political activism. He was a crusader for legal protection for the mentally ill, as well as their doctors and families. In 1812 Parkinson assisted his son with the first described case of appendicitis in English, and the first instance in which perforation was shown to be the cause of death. Parkinson was the first person to systematically describe six individuals with symptoms of the disease that bears his name. In his “An Essay on the Shaking Palsy“, he reported on three of his own patients and three persons who he saw in the street. He referred to the disease that would later bear his name as paralysis agitans, or shaking palsy. He distinguished between resting tremors and the tremors with motion. Jean-Martin Charcot coined the term “Parkinson’s disease“ some 60 years later. Parkinson erroneously predicted that the tremors in these patients were due to lesions in the cervical spinal cord.

 

 

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Fossilized turtle, puppigerus, found in the London Clay on the Isle of Sheppey and named for Parkinson, in a collection at Teylers Museum

 

Parkinson’s interest gradually turned from medicine to nature, specifically the relatively new field of geology, and paleontology. He began collecting specimens and drawings of fossils in the latter part of the eighteenth century. He took his children and friends on excursions to collect and observe fossil plants and animals. His attempts to learn more about fossil identification and interpretation were frustrated by a lack of available literature in English, and so he took the decision to improve matters by writing his own introduction to the study of fossils. In 1804, the first volume of his Organic Remains of a Former World was published. Gideon Mantell praised it as “the first attempt to give a familiar and scientific account of fossils“. A second volume was published in 1808, and a third in 1811. Parkinson illustrated each volume and his daughter Emma colored some of the plates. The plates were later re-used by Gideon Mantell. In 1822 Parkinson published the shorter “Elements of Oryctology: an Introduction to the Study of Fossil Organic Remains, especially of those found in British Strata“. Parkinson also contributed several papers to William Nicholson’s “A Journal of Natural Philosophy, Chemistry and the Arts“, and in the first, second, and fifth volumes of the “Geological Society’s Transactions“. He wrote a single volume ‘Outlines of Orytology’ in 1822, a more popularized work.

 

On 13 November 1807, Parkinson and other distinguished gentlemen met at the Freemasons’ Tavern in London. The gathering included such great names as Sir Humphry Davy, Arthur Aikin and George Bellas Greenough. This was to be the first meeting of the Geological Society of London. Parkinson belonged to a school of thought, Catastrophism, that concerned itself with the belief that the Earth’s geology and biosphere were shaped by recent large-scale cataclysms. He cited the Noachian deluge of Genesis as an example, and he firmly believed that creation and extinction were processes guided by the hand of God. His view on Creation was that each ‘day’ was actually a much longer period that lasted perhaps tens of thousands of years in length.

 

Parkinson died on 21 December 1824 after a stroke that interfered with his speech, bequeathing his houses in Langthorne to his sons and wife and his apothecary’s shop to his son, John. His collection of organic remains was given to his wife and much of it went on to be sold in 1827, a catalogue of the sale has never been found. He was buried at St. Leonard’s Church, Shoreditch. Parkinson’s life is commemorated with a stone tablet inside the church of St Leonard’s, Shoreditch, where he was a member of the congregation; the exact site of his grave is not known and his body may lie in the crypt or in the churchyard. In addition, a blue plaque at 1 Hoxton Square, marks the site of his home. Several fossils were also named after him. There is no known portrait of him: a photograph, sometimes published and identified as Dr. James Parkinson, is of a dentist of the same name. The better known, James Parkinson died before photography was invented. World Parkinson’s Dayis held each year on his birthday, 11 April.

 

 

20151026-20

A photograph of Jean-Martin Charcot, who made important contributions to the understanding of the disease and proposed its current name honoring James Parkinson.

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