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James Parkinson (1755-1824) was an English apothecary-surgeon, geologist, paleontologist
and political activist. He spent his radical youth in political agitation, later pursuing
his medical practice and his interests in medicine and the earth sciences. His 1817
“Essay on the Shaking Palsy” brought together the elements of resting tremor, stiffness
and the characteristic station and gait in the illness that he called paralysis agitans.
Fragments of the disease can be discerned in ancient Chinese, Indian, Babylonian and
Greek texts, but in an 1872 lecture Jean-Martin Charcot added bradykinesia to the
cardinal signs and coined the eponym Parkinson’s Disease. Charcot’s school advocated the use of anticholinergic medication. The French neurologist
Édouard Brissaud described the characteristic pathology in the substantia nigra, a
finding confirmed in 1953 by Greenfield and Bosanquet. Barger and Ewens synthesized
dopamine in 1910, but it was not until the late 1950s that neurochemists associated
the depletion of dopamine in the substantia nigra with James Parkinson’s disease.
When Birkmayer and Hornykiewicz injected the dopamine precursor l-dihydrophenylalanine
(levodopa) into patients with Parkinson’s disease in 1961 they found immediate but
short-lived improvement. The subsequent development of peripherally-acting dopamine
blockers increased levodopa’s absorption into the central nervous system and decreased
the frequency of side effects. Invasive techniques, including interruption of the
globus pallidus and placement of deep brain electrodes in the midbrain, are contemporary
treatments with unsettled indications for their use. James Parkinson’s disease has
become a model for combined chemical and surgical attacks on a globally distributed
degenerative neurological disease.
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