An Essay On The Shaking Palsy

An Essay On The Shaking Palsy-20
The individual cases immediately follow the “History,” readers thereby encountering an iterated clinical narrative: a generalized story of the malady told in the “History” and in a patchwork of separate narratives made up of the case descriptions.

The individual cases immediately follow the “History,” readers thereby encountering an iterated clinical narrative: a generalized story of the malady told in the “History” and in a patchwork of separate narratives made up of the case descriptions.

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This diversity of observational base generates an exceptionally detailed clinical and human picture that incorporates external appearances, functional losses and the frustrated volition which patients experienced, and their attempts to ameliorate the situation.

Involuntary tremulous motion, with lessened voluntary power, in parts not in action, and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured of tremor ‘when supported’ with disorders of posture and gait that had not previously been perceived, and which marks Parkinson’s clinical breakthrough.

Hardly any clinical examination as we know it today undergirds what remains an exemplary account of disciplined medical witness.

The set out a closely observed clinical account of a progressive, disabling condition, which was swiftly recognized to be an important description that since has attained the status of a classic medical text. Parkinson redefined a hitherto imprecise term, “paralysis agitans,” as the “Shaking Palsy,” so as to designate henceforth a specific conjunction of major symptoms which manifest in afflicted patients as a slowly debilitating disorder of movement that ultimately proves fatal. The first of these is its most important and capacious section, presented in three parts: “DEFINITION—HISTORY—ILLUSTRATIVE CASES.” Parkinson first defined the condition, then located its features as the conjunction of already described components of movement disorders previously believed separate and unrelated, and contended that the different components coexisted in the Shaking Palsy.

Parkinson incorporated medical observation with a clear focus on patient experience and subjectivity in a deeply affecting narrative, fusing clinical and urban case-descriptions within the genre of a sentimental natural history.

His detailed, diagnostic portrayal of the malady recast earlier descriptions of trembling, posture and gait disorder within a new narrative order, simultaneously recruiting reader involvement to the plight of sufferers.

The contemporary reception of by clinicians at the height of their careers, including John Elliotson in 1830 and Marshall Hall in 1838.

Later in the century it proved influential on international clinical authorities developing the field of clinical neurology, including Moritz Romberg, Armand Trousseau, Jean-Martin Charcot, Edmé Vulpian and William Gowers.

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