s (1755-1824) treatise, "An Essay on the Shaking Palsy," was published in London in 1817. In the preface, James Parkinson writes, "β¦ [the shaking palsy] has not yet obtained a place in the classification of nosologists; some have regarded its characteristic symptoms as distinct and different diseases, and others have given its name to diseases differing essentially from it β¦" 1 If I interpret Dr. Parkinson in the correct way, he infers that the name, shaking palsy, was known (although by some given to different diseases) and he assumes that the symptoms had been observed by others but not given the correct classification. Parkinson also give examples of older descriptions of the disease, "tremores paralytoidei vocantur," from Galen to Sylvius, Juncker, and Cullen.
Medical historians have wondered why this prototypic and fairly common disease had not been described and classified before 1817. Possible new environmental changes at the time of Parkinson's report have been searched for without success. 2 Others have argued that Parkinsonism is essentially a disease of older age and that longer life expectancy in the eighteenth and nineteenth century brought about a larger number of typical patients. Although to some extent this observation is correct, people lived until their eighties even in the time of Elisabeth I.
Is it possible to find descriptions of Parkinsonism before 1817? 3,4 Some authors simply state that this is not the case. 5 Descriptions from earlier centuries can be found where Parkinsonism could be a possible diagnosis. Leonardo da Vinci (1452-1519) most probably described the symptoms. 6 A famous and well-documented case history deals with the French painter Nicolas Poussin (1594 -1665) and his known movement disorder. 7 The Indian medical teachings in the Ayurvedas are also said to describe Parkinsonism, even with the recommendation of an herb containing levodopa as a cure. 8 William Shakespeare (1564 -1616) shows in his 37 plays an astonishing knowledge of contemporary medicine. Some 700 quotations are said to be found in his work dealing with medical matters. 9 There is a large literature on Shakespeare and medicine, 10,11 but surprisingly little of it deals with references to neurological disorders. 13 The method for investigating the Bard's possible neurological knowledge is simple but time consuming: (1) Observant reading of all his works looking for words and subjects connected with the nervous system. (2) Careful reading of the literature on Shakespeare and medicine. (3) Using reference guides and lists of words used by Shakespeare. 13,14 Using this method in the search for passages that can possibly describe Parkinsonism, the following lines can be found in "Richard II", Act II, Scene III:
Duke of York:
How quickly should this arm of mine, Now prisoner to the palsy, chastise thee And minister correction to thy fault.