James Parkinson 1755-I824
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MUTISH MEDICAL 9 1973 601 BRITISH MEDICAL JOURNAL 9 JUNE 1973 601 Medical History Br Med J: first published as 10.1136/bmj.2.5866.601 on 9 June 1973. Downloaded from James Parkinson 1755-I824 MICHAEL JEFFERSON British Medical journal, 1973, 2, 601-603 Formative Years Of his schooling there is no direct record, but from his own comments it evidently included solid grounding in Greek and Since Parkinsonism is a topic of wide medical interest it is as well as natural philosophy (that is, natural to feel curiousity about the life and character of the Latin mathematics, and biology), and some knowledge of man who was the founder of it all, James Parkinson. An physics, chemistry, with the dead languages was a vital ac- obvious source for biographical material might seem to lie in French. Familiarity the texts of many ancient medical contemporary obituaries, yet this turns out to be a false complishment, because expectation for, in fact, the leading medical jounals of the authorities still widely read and admied, from Hippocrates day-the Medico-Chirurgical Review, the London Medical and Galen onwards, were not available in English translation, though by the end of the eighteenth century the emergent pres- and Physical Yournal, and the London Medical Repository- sure new of all kinds was beginning made no reference to his death, although all had given flattering of scientific knowledge to is there real evidence of his attention a few years earlier to his Essay on the Shaking Palsy. eclipse their importance. Nor that he was apprenticed Or again as a beginning, one might search for a portrait of medical education. It is known only an would have carried him h-im, because to know what a man looked like helps under- to his father, apprenticeship which or His was by no means standing of his thought and personality. But none is known through to the age of 22 23. father surgeon who was to exist, either in the National Portrait Gallery or at the Royal an unlettered medical quack but a diplomaed one College of Surgeons, of which he was a member (the Fellow- for some part of his career anatomical warden-what to ship not being created until 1832). According to a brief verbal might call prosector or lecturer in anatomy- the Company out sketch of his appearance in later life recorded by his friend of Surgeons, an elitist corps of the old Barber Surgeons, must http://www.bmj.com/ Gideon Mantell, however, he was "rather below the middle of which the Royal College of Surgeons later grew. He local as he stature, with an energetic, intelligent and pleasing countenance have been a man of some standing in society, a residential and of mild and courteous manners; readily imparting inform- practised from a large house in fashionable his ation on his favourite subjects," and the deficiency of early square in Shoreditch, later used by James and finally by obituarists in chronicling his life has been made good in son. The house was visited by Rowntree,1 who found it out- recalled of more recent times by the biographical studies of Rowntree,1 wardly dilapidated, but inside it still days Williamson,2 Morris,3 McMenemy,4 and Jewesbury.5 prosperity and culture, with spacious rooms, impressive fire- He was born on 11 April 1755, the son of John Parkinson, places, and handsome panelling. his it may be inferred an apothecary and surgeon (in modem terminology, a general At some stage during apprenticeship on 26 September 2021 by guest. Protected copyright. wards of one of the practitioner) in Shoreditch, which was then no more than a that his father sent him to walk the and to attend lectures large village close to London with open country beyond it. London hospitals as clerk and dresser well as medicine and He married in 1781 and had six children, one of whom (his in anatomy and physiology as surgery, without the modem eldest surviving son, John) ultimately joined him in practice which then ran concurrently dichotomy In later life he was a just as he had joined his own father as a young man, so into clinical and preclinical subjects. exemplifiying the kind of vocational dynastic succession which passionate opponent of the apprenticeship system of medical too often that a was bound was then a commonplace life-style which pervaded not merely education which meant only youth the professional classes but the ranks of craftsmen and artisans for years to some pillpushing apothecary, where he grubbed medical lore as his wits would allow while of all sorts. He never held a hospital appointment though his such snippets of and behind talents would have fitted him well for a consultant career, spending his days compounding dispensing drugs in the end knew little more of real medicine than and one may judge that his choice of general practice as a young a counter, and of and the to an enema. It man was forced on him by private financial exigencies rather the technique bleeding way give Parkinson which could not fit a than by lack of ambition, as appears from his ironic comment was a farce, said, possibly man for a lifetime in unless backed by a stint of years later: "I need hardly repeat to you the vulgar observ- practice and this opinion forcefully expressed ation that a physician seldom obtains bread by his profession formal hospital teaching, of his book on medical education. The Hospital until he has no teeth left to eat it. Indeed it is so late before in the pages must have been one of the seminal influences which a physician goes into full practice, that it almost seems many Pupil, about the educational and other reforms think him too young for consultation, unless he has reached eventually brought Act of 1815. his dotage." He spent the whole of his life in Shoreditch and embodied in the Apothecaries was a believer in the of anatomy died there at the age of 69 on 21 December 1824. He great importance (shades of his father's influence here), and even more so in the value of clinical teaching, whether by lecture or by demonstation for these he insisted were the means "whereby disease is embodied and brought before the student." So it Queen Elizabeth Hospital, Bminsham B15 2TH is no surprise to find that in 1785, when he was already in MICHAEL JEFFERSON, D.M., F.R.C.P., COnsultant Neurologist practice, he managed to attend a series of lectures by the 602 BRITISH MEDICAL JOURNAL 9 JUNE 1973 great John Hunter, of which he took notes and transcribed in the creation of isolation hospitals, though none were built until narrative form afterwards. These lecture notes were published years after his death. In addition, in 1805 he published a posthumously in 1833 (edited by his son J. W. K. Parlinson scholarly monograph on gout, an affection which intrigued Br Med J: first published as 10.1136/bmj.2.5866.601 on 9 June 1973. Downloaded from under the title of Hunterian Reminiscences) and give a fascinat- him because both he and his father before him suffered from ing glimpse of Hunter as a teacher as well as an insight into it. He implied that its cause lay in what he termed "a peculiar t-he state of medical theory and practice in the latter part of salic acrimony in the blood, which irritates and excites morbid the eighteenth century. action in certain parts of the body," a view he based on Wollaston's demonstration in 1797 that the concretions of gout are composed of uric acid salts. He made this imaginative jump at the concept of hyperuricaemia so far ahead of its Political and Scientific Interests time that he was sharply criticized for holding too fanciful an opinion. Whatever the facts of his education, James Parkinson emerged into adult life as a man of brisk intelligence, with interests which extended beyond the confines of medicine. In the Neurological Observations 1790s, when ideas of radical change in the established order of society were much in the air, stemming from the example For the modern reader Parkinson's medical masterpiece is of the French Revolution, he became an ardent disciple of his Essay on the Shaking Palsy. When it first appeared in political reform. He published a number of pamphlets under 1817 it sharply illuminated a clinical entity which had been a pseudonym which, though sometiimes violently worded, only dimly apprehended before that date. Although earlier were always in support of change by peaceful means. He also writers had recognized that certain affections of the nervous belonged to two or three societies which had a political system might combine weakness with tremor and had ap- orientation: in retrospect they sound harmless enough, but in preciated that tremor fell into two main categories, tremor their day they were suspect as a serious source of sedition. in action and tremor at rest, the symptoms of Parkinson's It was even alleged in 1794 that certain members of one of disease had previously been confused with a number of these societies had planned to assassinate George III, and nosologically quite different maladies, including chorea, torsion arising out of this Parkinson was subpoenaed to give evidence spasm, forms of cerebellar disease, senile and alcoholic tremor, at a special court of inquiry, where he was sharply cross- and even multiple sclerosis. The fact that his essay broke new questioned by, among others, William Pitt the younger, who ground is amply proved by the reviews in contemporary was then Prime Minister.