Doctor's Review: Medicine on the Move

October 23, 2017
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Shaking things up

Who knew that Dr James Parkinson was a politician, paleontologist and pediatrician?

While most physicians dedicated themselves to the study of their chosen field, James Parkinson’s professional and personal interest seem to know no bounds. He dabbled not just in neurology, but notably in pediatrics, politics, law, geology, even paleontology. Before long, the man for whom the disease would be named played an important role in the formation of entire scientific specialities.

And yet, despite his great influence on so many fields, not a single picture or painting of James Parkinson is known to exist. No matter. His body of work speaks for itself… sometimes in the unlikeliest of ways.

Parkinson the politician

James Parkinson was born in Shoreditch, London on April 11, 1755. Not much is known about his early life, except that he followed his father, a local apothecary and surgeon, into his chosen field, attending the London Hospital Medical College and graduating as a surgeon in 1784. In a sense, Parkinson never really left home. After school, he returned with his new wife to the very house where he was born to both live and practice, and there he remained until his death in 1824.

After taking over his father’s practice, Parkinson’s interests broadened. Despite his thriving medical practice and six children to keep him busy, he soon heard the call of his social conscience. A radical thinker and outspoken critic of the British government, Parkinson wrote many political pamphlets — for some of which he used the pseudonym “Old Hubert.” He was in favour of the French Revolution, fought for representation of the people in government and advocated social reform through universal suffrage.

His political leanings got him into a fair bit of trouble. In 1794, his membership in the London Corresponding Society for Reform of Parliamentary Representation became an issue when the society was charged with being complicit in an alleged plot to assassinate King George III by poison dart. Although the “Popgun Plot,” as it came to be known, was the imaginings of an overly zealous prosecutor, Parkinson willingly testified for the defence and helped acquit the five men involved, even later writing an exposé on the brutal examination he endured.

Pioneering spirit

Parkinson’s professional career was even more noteworthy. Alongside his father, he pioneered resuscitation techniques, which they put to good use bringing back from the dead a man who’d hung himself — no mean feat for a physician in the 1770s.

Parkinson was also the first to provide an account of appendicitis in the literature. “A Case of Diseased Appendix Vermiformis” appeared in the 1812 edition of Medical Chirurgical Transactions, in which Parkinson was also the first to point to peritonitis as resulting from a burst appendix and as a cause of death.

In keeping with his sense of social justice, Parkinson treated the poor for free. He worked at the local insane asylum for more than 30 years, attempted to reform the regulation of mental asylums and fought for better treatment of the mentally ill. He wrote extensively on the importance of distinguishing between different types of mental illnesses and advocated for the legal and moral rights of asylum patients, their families, caretakers and physicians.

Lucky number six

Ever the interested observer, Parkinson based the 66-page work for which he is most famous on simply watching only six people who appeared to have similar symptoms. “An Essay on the Shaking Palsy” was published in 1817 and it contains the first clinical description of what would later be known as Parkinson’s Disease. Although it wasn’t the first time such neurological symptoms were described — the 12th-century Arab philosopher and physician Averroës hinted at the existence of a shaking disease — Parkinson was the first to formally conclude that a distinct diagnostic entity, which he termed paralysis agitans, was responsible.

Considering the historical importance of the essay, it’s surprising that Parkinson only examined three of the six patients himself! The others were people he’d observed strolling around the neighbourhood. And yet, he still managed to give an accurate clinical description of the newly coined illness: “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 the intellects being uninjured.”

An early Dr Spock?

Not content to limit himself to the study of the human condition, Parkinson turned his eye to the natural world. He was one of 13 founding members of the Geological Society of London, courtesy of his love of rock collecting.

The somewhat romantically named “Organic Remains of a Former World” was Parkinson’s gift to paleontology in 1804, a well-received tome that he followed up with Volumes II and III in subsequent years. The physician produced illustrations of fossils of ancient plant and animal life, putting forth some very adept descriptions of the flora and fauna of epochs gone by.

Parkinson was also attuned to the plight of children living in poverty and sickness. He fought for children’s rights, especially those who lived in workhouses. He studied first-aid for kids, resuscitation and trauma techniques, and preached prevention and hygiene as a way to improve the health of children.

He also published papers and books on the theory of child raising and pediatrics, marking him as one of the first physicians devoted to the emerging speciality.

Better late than never

When the famous French neurologist Jean-Martin Charcot (1825-1893) studied Parkinson’s Disease some 60 years after the 66-page essay was first published, he concluded that the ailment known as paralysis agitans should, from then on, be named for the first physician to describe the neurodegenerative disorder. An honour not to be taken lightly — Charcot was widely known as an eponym hog.

It’s been nearly 200 years since Parkinson penned his famous essay and yet modern medicine is still unable to pinpoint the exact cause of primary Parkinsonism. James Parkinson would no doubt, however, be thrilled to learn of the progress made over the last few decades.

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