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Parkinson of the disease

Nosologia methodica

Opening describing and identifying forms of tottering gaitOpening describing and identifying forms of tottering gaitBy the time Parkinson wrote the Essay, major elements of what would later be known as the ‘shaking palsy’ had been separately described and characterised. Boissier de Sauvages’ Nosologia methodica (first published in 1762) had defined tremor as a ‘side-to-side movement without a feeling of being cold’, and listed 19 species of it in his fourth class of disease which he called ‘Spasm and convulsive malady.’

The Scottish clinician William Cullen’s Nosology (1800) defined tremor as ‘an alternate and frequent motion of a joint to-and-fro’, 15 species of which were outlined in his second class of disease, the ‘Neuroses.’

De Sauvages also identified several forms of tottering gait termed scelotyrbe (from the Greek for lameness). Scelotyrbe of Galen he identified as ‘an impediment that prevents people walking in a straight line’, whereas scelotyrbe festinans (as shown in the opening here) was defined as hastiness of locomotion.

This form of gait was illustrated by the case of a fast-walking painter who was unable to divert his path ‘to the right or left, and on meeting an obstacle became almost fixed until, little by little, by shifting his position, he once again began to move forward in a straight line.’

Hieronymus Gaubius, of the University of Leiden, in his Institutiones pathologicae medicinalis. (1762) stressed the involuntary nature of scelotyrbe festinans, noting that:

It happens that the muscles by an involuntary agility and impetuosity accelerate their motions and hurry away against their determination … I have seen those that could run but could not walk.

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