Dr. Parkinson, the Polymath

At 1 Hoxton Square in London there is one of the city’s famous Blue Plaques—it says “James Parkinson, 1755-1824, Physician and Geologist, lived here.” Were It bigger it could continue”…surgeon, apothecary, paleontologist, social reformer, political activist and pamphleteer, the later as ‘Old Hubert’”. He wrote on gout and appendicitis, tracts for patients and political essays. He was even touched by rumors of a plot to kill King George III. But it was hIs Essay on Shaking Palsy that earned his place in medical history. It was mostly ignored for forty years after publication.

At 1 Hoxton Square in London there is one of the city’s famous Blue Plaques—it says “James Parkinson, 1755-1824, Physician and Geologist, lived here.” Were It bigger it could continue”…surgeon, apothecary, paleontologist, social reformer, political activist and pamphleteer, the later as ‘Old Hubert’”. He wrote on gout and appendicitis, tracts for patients and political essays. He was even touched by rumors of a plot to kill King George III. But it was hIs Essay on Shaking Palsy that earned his place in medical history. It was mostly ignored for forty years after publication.

 From waymark.com

From waymark.com

The essay was written in 1817. Parkinson was a member of the Royal College of Surgeons at the time. Despite that prestige, the author’s tone is charmingly humble. This is from his preface, with translation for the modern ear:

Essay on Shaking Palsy

“The advantages which have been derived from the caution with which hypothetical statements are admitted, are in no instance more obvious than in those sciences which more particularly belong to the healing art.

[Science has been well served by a cautious approach to accepting evidence based on hypotheses, especially so for medicine.]

It therefore is necessary, that some conciliatory explanation should be offered for the present publication: in which, it is acknowledged, that mere conjecture takes the place of experiment; and, that analogy is the substitute for anatomical examination, the only sure foundation for pathological knowledge”.

[We concede that this paper is descriptive, not experimental, and that we offer an hypothesis, not anatomical evidence.]

 The picture of paralysis agitans

The picture of paralysis agitans

That said, he went on to describe the very distinctive features of a disease that was undoubtedly known even to the ancient Egyptians, to Ayurvedic medicine and to Galen, who noted the phenomenon of tremor at rest. To this add the shuffling gait, and progressive muscle weakness and we have features that signify paralysis agitans—as it was known for some 60 years, when Dr. Jean-Marie Charcot made further landmark discoveries and renamed the disease “Parkinson’s”. Curiously, there is a strong suggestion that Parkinson’s observations of six patients was motivated by ideas contained in the famous 1785 lectures of the anatomist John Hunter, leaving us to consider that in a parallel universe, we might be discussing Hunter’s Disease.

Parkinson's Disease

Before outlining James Parkinson’s remarkable interests, let’s put in perspective his discovery of paralyses agitans. It affects about a million people in the US and remains incurable, accounting for about 100,000 deaths per year globally. Knowledge of the condition has gone from descriptive to refined with the discovery of brain deposits by Lewy (192), localization to the substantia nigra by Tretiakoff (1919), the discovery of the role of dopamine by Nobel Laureate Carlsson (1957) and the importance of alpha-synuclein protein. (1997). Currently the highest of technologies is being applied to it’s biology (LRRK2 and SNCA genes to sort out genetic and environmental causes), to diagnosis (CRISPR) and to treatment (experimental CVT-301 from Acorda). There are celebrity patients and the cause taken up by a Google founder.

 Lewy Body

Lewy Body

April 11th has become Parkinson’s Awareness Day, symbolized by a red tulip, representing the Parkinson Tulip cultivar named in his honor by a Dutch horticulturist with Parkinson’s Disease. This brings us back to nature and James Parkinson’s own broad interests.

 Namesake red tulip

Namesake red tulip

Polymath

Born in Shoreditch, London to John Parkinson, himself a surgeon and apothecary, he had eight children, one of whom was also a physician and eventually published James notes from the Hunterian Lectures. James Parkinson was an activist. He belonged to secret societies opposing the Pitt government, before which he was interrogated about any role in the ‘popgun plot’ to assassinate the King. As the pamphleteer “Old Hubert”, he advocated for women’s suffrage, rights for the mentally ill and the French Revolution. 

 Megatherium. Text and illustration by James Parkinson.

Megatherium. Text and illustration by James Parkinson.

Having made his mark in medicine, he turned to nature at large. He wrote a very popular lay book on chemistry, The Chemical Pocketbook. In 1804 came his praiseworthy popular treatment of paleontology with Organic Remains of a Former World, illustrated by him and his daughter. He contributed to the Geological Society’s Transactions, having cofounded the Geological Society of London. The Royal College of Surgeons awarded him a gold medal for his work on fossils, one of which, a species of Ammonite, was named after him, saying “The fruits of your exertions are distinguished by the stamp of simplicity and truth…”.

Despite his love of oryctology—the science of things dug up (fossils and minerals)—Parkinson was a humanist. Of his patients with paralysis agitans he says “the unhappy sufferer has considered it as an evil, from the domination of which he had no prospect of escape”. He hoped “…that some remedial process may ere long be discovered, by which, at least, the progress of the disease may be stopped”. That remedial process was 140 years in the coming.

We have no portrait of the man, only his legacy, which is estimable. And yet, his life has not been chronicled in proportion. One of the few full length biographies, James Parkinson—His Life and Times, by Morris and Rose, is available as a reprint from Amazon etc, or free online from Google Books. There is also a short essay of interest and a Wordpress Blog devoted the Searching4James, and a gorgeous photo essay that is a must-look.

 James Parkinson's alehouse sermon. Wellcome Library.

James Parkinson's alehouse sermon. Wellcome Library.

Further reading:

The hospital pupil; or, an essay intended to facilitate the study of medicine and surgery. In four letters. ... By James Parkinson


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