Why is April Parkinson’s Awareness Month?
A. People with Parkinson’s tend to bound like bunnies.
B. There is a shortage of holidays in April.
C. Exposure to Easter Egg dye may cause Parkinson’s.
D. It seems appropriate to recognize Parkinson’s and April Fools Day in the same month.
E. None of the above.
While I think “D” is a great answer, the correct answer is of course, “E”, none of the above.
The reason April is Parkinson’s Awareness Month and April 11 is World Parkinson’s Day is because Dr. James Parkinson was born on April 11, 1755. He wrote “An Essay on the Shaking Palsy” 200 years ago in 1817. This remarkable essay described what Dr. Parkinson called “paralysis agitans”; it was renamed Parkinson’s Disease some 60 years later by Jean-Martin Charcot, an early French neurologist. (Note to self: Having a disease named after you does not strike me as a great career goal.)
Parkinson did not “discover” this disease. Individual symptoms had been described by physicians dating back to the Roman Galen. What Parkinson did was postulate a theory that the presence of certain symptoms grouped together was a distinct disease; he also recognized that the disease developed slowly but was progressive. He theorized on the basis of a tiny sample: three of his patients and three people he observed on the street. (I would guess this essay never would have passed review in today’s medical journals.)
What symptoms? Here they are, in their piquant antique wording, from the essay:
—Resting hand tremor: “a slight sense of weakness, with a proneness to trembling in some particular part…most commonly in the hands and arms…”
—Stooped posture: “After a few more months the patient is found to be less strict than usual in preserving an upright posture….”
—Resting leg tremor: “Sometime after the appearance of this symptom [posture], … one of the legs is discovered slightly to tremble….”
—Micrographia: “unsteadiness of his hand, whilst writing or employing himself in any nicer kind of manipulation.”
—Freezing of gait, Falls: “Walking becomes a task which cannot be performed without considerable attention. The legs are not raised to that height, or with that promptitude which the will directs, so that the utmost care is necessary to prevent frequent falls.”
—Forward posture: “…(A)s the malady proceeds….The propensity to lean forward becomes invincible…”
—Sleep issues: “… the sleep becomes much disturbed…”
—Constipation: “…The bowels….demand stimulating medicines of very considerable power…”
—Drooling: “…the saliva fails of being directed to the back part of the fauces [sic]…”
Compare the symptoms observed by Dr. Parkinson to modern diagnostic protocols.
The essay apparently drew little attention during Parkinson’s lifetime and for decades afterward, since there was nothing physicians could do to prevent or remedy this disease. But you can’t begin to solve a problem until you have identified it. Now — still too little in the medical toolbox, hence the reason for Parkinson Awareness Month. The best way to recognize Dr. Parkinson’s contribution is to make a contribution to your favorite Parkinson’s organization. (My favorite is Michael J. Fox Foundation.)