Parkinsonism-like disorders before Parkinson
James Parkinson indicated in the 1817 pamphlet on the disorder named for him that he was by no means describing a new disease, but rather one which until his time had been comparatively neglected by the medical community. Nevertheless, the question of the existence of parkinsonism before 1817 has often been posed since the appearance of his treatise, and not only through idle curiosity. The major factor that has impeded the development of an effective therapy for parkinsonism has been ignorance of its precise etiology. It is therefore important to know whether the disorder has long been a problem associated with aging, or whether it emerged only recently, perhaps in response to specific environmental, nutritional or social conditions. As the disease currently appears to be widely distributed geographically, it would appear unlikely that any single causative agent will suffice as an explanation for all cases of parkinsonism. But the temporal distribution of the disease in history is also important, as it might allow medical historians to correlate the disorder with a particular sets of specific environmental circumstances, including climate, other medical disorders or social and industrial development. References to tremor disorders and their treatment in pre-19th century literature will thus be discussed in this context. It is clear that retrospective diagnoses are rarely secure, and that parkinsonism is by no means the only disorder in which tremor is a prominent symptom, but the association of many of these disorders with old age or epidemic fever provides a tantalizing motivation for their cautious examination.
Session XI -- Scientific Methods and Metaphors
Los Angeles, California, USA