Mr. Parkinson and the disease that bears his name

The key to start this blog has been the inspiration after reading Michael Faraday’s biography in which I learnt about his very humble beginnings, struggle for proper schooling,  attending lectures and learning from borrowed books, he can later become one of the greatest scientist to usher in the electrical revolution. His life long passion is to learn and having poor memory always wanted it to be recorded for future reference. And this record keeping in the form of a blog has been continuing since long and hope to keep up for foreseeable future to at least an entry per month.  Similar to M. Faraday, next quintessential English gentleman that I admire and respect is Parkinson. He has similar thought process and background, worked very hard meet ends, was an active advocate for freedom of expression, universal suffrage and stood for abolishing dynastic rule. Being a medical practitioner, he was also interested in paleontology and fossils and a literary figure of his own making by publishing political propaganda and later tomes on medical and fossil science. Reading his biography ‘The Enlightened Mr. Parkinson’ by Cherry Lewis was an eye opener about this great English apothecary who had written about ‘physical tremors’ with great detail based on his careful and penetrating observations, that this disease bears his name. A great testimony to his service to medical science and its appreciation back. Let’s look at some excerpts from this book that I want to record that will be useful for those who want to pursue the book to find out more – a teaser of sorts:

Political Advocacy
Daniel Isaac Newton was the publisher of Hog’s Wash which ran for 60 numbers between Sep 1793 and Mar 1795, and it was renamed to Politics of the People – a sort of political propaganda for freedom wishers in England. Partly original material, partly excerpts from other works, and enlivened by satire, irony, humor and verse, the magazine was hugely successful. throughout the series ran an irregular , but al;ways ‘to be continued’ ‘Sketch of the Most Memorable Events in the History of England from the Landing of Julius Caesar, to reign of William the Conqueror’. Written by Parkinson masquerading as Old Hilbert, it was a clever parody of the Government, using examples from history to illustrate its current failings. Throughout, both Eaton and Parkinson advocated votes for all, annual parliaments, peace among nations, education of the poor, and unfettered discussion on politics and religion.

Trials and Tribulations
He was interrogated by Prime Minister and host of judges for sheltering a friend who committed treason. Possibly as Parkinson was a familiar face in the literary and magazine world and he not actually publishing his work may have prompted the then government not to punish him as his publishing friends. He did escape unscathed on all possible charges and emboldened to write about it and finally he withdrew from  London Corresponding Society that provided a political front for his literary proposition and started focusing on his career and writing.

Writings

  • Medical Admonishments – a 2 volume tome
  • The Villager’s Friend and Physician – aimed those who could not afford the above
  • The Way to Health – fireside easy reference
  • Hints for the Improvement of Trusses – especially for manual laborers to stop hernias
  • The Chemical Pocket Book – assemblage of chemical facts
  • Organic remains of a Former World – ultimately a textbook in geology
  • An Essay on shaking Palsy – (Eventually) About Parkinson’s Disease
  • Outlines of Oryctology – a text book on fossils

Child Welfare
Parkinson was also concerned for the welfare of working children and was moved to act when a child apprenticed in an adjacent parish was murdered by her mistress. The Vestry was responsible for some 70 orphans, most of whom were required to work, but those apprenticed in other parishes were often left to the almost unrestrained caprice of their masters or mistresses, ‘no law existing by which the duties of the master are defined, or any inspectors of his conduct appointed’. Parkinson proposed the introduction of a register of poor children seeking employment and advocated measures to monitor their working conditions, suggesting they were ‘visited by a committee of the trustees and overseers of the poor twice every year’. The Vestry appears to have accepted his recommendations, as a panel of inspectors was immediately appointed to make regular visits to the homes of apprentices. They checked that the children were being adequately fed and clothed, that they were not made to work excessive hours, and that they were being trained in work that would enable them to earn a living when the apprenticeship expired. Six months later the first inspections had been completed. The accompanying report illustrates how Parkinson’s concerns about ill treatment had been fully justified with the committee finding itself under the ‘painful necessity of reporting a ‘shocking instance of seduction and depravity’. A young girl had been seduced by her master, a married man and father of six children. On discovering that she was pregnant, the master ran away, leaving the young girl to deliver her child in the workhouse; tragically, both mother and child died shortly afterwards.

Parkinson served on the new committee set up to oversee these children and made detailed reports of his visits; these show that he called on no fewer than 72 houses each year, spread over a wide area of the parish. He then established a set of regulations governing the apprenticeship of these children, which included not allowing the children to work on Sundays and making sure that they went to church at least once every week. No child could be apprenticed before the age of twelve and they were not allowed to ‘work longer than twelve hours in any one day, and not before six in the morning, nor after nine o’clock in the evening’. Their masters were expected to furnish the children with new clothing on the first day of May each year, and no more than two children were permitted to sleep in a bed. Finally, each child was to be given a copy of the regulations — even though many could not read — and the name of someone in the Vestry to whom they could apply if they were mistreated. Six years later the committee noted that things were much improved: ‘Mr Parkinson reported that the Officers, himself and several of the Committee, visited the children apprenticed and found them in general comfortably situated.’

Pursuits for Children
The antidote to hazardous pursuits, Parkinson recommends, is to sit quietly at home reading a book, learning by rote ‘some little geographical table . the characters of some plant, or the natural history of some animal’, or examining the night sky ‘bespangled with suns and other worlds’. The micro- scope was also a source of endless instruction, demonstrating how ‘works of art are exceeded by those of nature’, and pro- viding far more amusement than ‘two or three of those foolish toys which are often destroyed weekly’. And if exercise was required, what better than a game of shuttlecock? ‘It is truly curious to see, in this sport, that almost every muscle in the body is called into action and that the whole might of a man may be employed to combat four feathers and a cork,’ he muses. We can well imagine Parkinson playing shuttlecock with his children in the park opposite their house. Despite his deep concern for the well-being of his children, he was nevertheless quite a disciplinarian, as was common at a time when a strict code of etiquette controlled social behavior, and children who misbehaved could ruin the reputation of their parents. Thus he entreats parents to regulate their infants’ passions and teach them to distinguish between right and wrong, lest the child becomes a ‘wretched nuisance’ which would ‘render him odious to all around him’. At the same time, it was important to administer restraint with mercy

Gout Prescription
Observations on the Nature and Cure of Gout was published in 1805, while he was following his self-prescribed diet and treatment, and in a period of remission. It relates a number of case histories, including his father’s and his own, and details the cure he had found in the hope that his observations might benefit his fellow sufferers. He opens the book with the statement that ‘gout is a hereditary disease’, notes correctly that men are more subject to the disease than women, and that it ‘seldom attacks those who live on a spare diet’. He therefore advises ‘that acids of every kind should be used with great moderation; spirituous liquors must never be drunk wines, particularly those of foreign production, and even malt liquors, must be avoided with equal care’. He may not have fully understood the origins of the disease, but careful observation over the years had shown him that insobriety, luxury, indolence and voluptuousness’ were likely to bring on an attack and should be avoided at all costs. Attempting to address what, exactly, gout is, he explains that it involves the deposition of a ‘concrete saline substance, which sometimes accumulates in considerable quantities, particularly on the joints of the fingers and hands’, and recalls that in 1797 Dr. William Wollaston had reported to the Royal Society that this ‘gouty matter’ contained a ‘peculiar lithic acid’. Six months later, Dr. George Pearson, also in a communication to the Royal Society, had recommended that lithic acid be more accurately termed uric acid. Today gout is known to be caused by an excess of uric acid in the blood, which crystallizes and settles in the joint spaces causing swelling in joints.


Shaking Palsy
James Parkinson’s treatise, An Essay on the Shaking Palsy, published in 1817 when Parkinson was 62, has deservedly become a medical classic.l Original copies of the work are now rare, although facsimiles have been reproduced from time to time and scanned versions of the original can be found online. Its significance lies in the fact that Parkinson was the first to identify and describe the symptoms that defined the shaking palsy, known to us today as Parkinson’s disease. The Essay opens with Parkinson’s famous definition of the shaking palsy, in which he captures the very essence of the disease:

SHAKING PALSY. (Paralysis Agitans.) Involuntary tremulous motion, with lessened muscular power, in parts [limbs] not in action and even when supported; with a propensity to bend the trunk forward, and to pass from a walking to a running pace: the senses and intellects being uninjured. As with so much of Parkinson’s work, it was not only his acute observational powers and attention to detail that enabled him to provide such an insightful commentary on the shaking palsy;

It was not until the 1860s that Parkinson’s Essay became widely cited. Daniel Maciachlan in his book A Practical Treatise on the Diseases and Infirmities of Advanced Life, written in 1863 refers to ‘Mr. Parkinson whose interesting essay must ever be referred to, as giving a faithful account of the symptoms of the disease from beginning to the end, and is still the best work on the subject’.8 Two years later, William Sanders, in a paper on an unusual case of nervous disease, which he called ‘pseudo-paralysis agitans’, also referred to Parkinson’s work and implied others were now following Parkinson’s classification of the symptoms. When going on to discuss a more appropriate name for the shaking palsy or paralysis agitans, Sanders refers to it as ‘Parkinson’s disease’, but in doing so he means the disease as described by Parkinson, and is not suggesting it should be called that. Along with several alternative names, he does propose paralysis agitans Parkinsonii, but this rather cumbersome mouthful did not catch on.9 It was more than 50 years after publication of Parkinson’s Essay before anyone seriously turned their attention to the disease, as Thomas Buzzard pointed out in 1882:

The disease ‘shaking palsy’, or ‘paralysis agitans’ … was first regularly described by our countryman Parkinson in 1817. Parkinson was a member of the Royal College of Surgeons, and his Essay on the Shaking Palsy presents so graphic and admirable a description of the disease that comparatively little has been left for subsequent observers to add to his account.

In our time Charcot has also made the disease the subject Of clinical investigation. In 1872, when giving a lecture on paralysis agitans, Charcot explained to his students that ‘The first regular description of it only dates from 1817; it is due to Dr Parkinson who published a little work entitled Essay on the Shaking Palsy’ .15 He also remarked how existing names for the disease were inappropriate since patients were not markedly weak or paralysed (paralysis agitans), but neither did they always have tremor, so the term shaking palsy was also unsuitable; it was then he suggested using the term maladie de Parkinson to describe the condition. ‘Parkinson’s disease’, he considered, was a much more appropriate name.

Accolades
Within weeks of the publication of Outlines, Parkinson received a most welcome surprise. Back in 1800 the Company of Surgeons had been granted a Royal Charter, becoming the Royal College of Surgeons, as it is still known today. Two years later the College established an Honorary Gold Medal to be awarded for ‘liberal acts or distinguished labors, researches and discoveries eminently conducive to the improvement of natural knowledge and of the healing art’. After twenty years, they still had not found anyone of sufficient caliber to be its first recipient, so it was to Parkinson’s great astonishment that a letter informed him the first Honorary Gold Medal would be awarded to ‘Mr. James Parkinson of Hoxton Square’,

… in consideration of his useful labors for the Promotion of natural Knowledge, particularly that expressed by his splendid Work on Organic Remains — and of his liberal and valuable information, when called upon by the College, in its Research for facts relating to its scientific Designs:

Accordingly, and appropriately on Parkinson’s 68th birthday,s he was made an Honorary Member of the Royal College of Surgeons and decorated with its Gold Medal. Sir William Blizard, the College President, delivered the oration, praising Parkinson for having provided the College, whenever asked, with information about fossils, for allowing other naturalists to consult his collection, and for the general ‘tenor’ of his scientific life. In particular, he considered that Parkinson’s work on both characterizing fossils and identifying the means by which they had been altered over long periods of time would prove invaluable not only to understanding the ‘physical Changes of this Globe’, but also to the sciences of anatomy, physiology and chemistry. Furthermore, by inspiring others to take up the subject, his work would live on. Sir William then conferred the medal on him: Mr. James Parkinson: by the Authority, and in the Name, of the Royal College of Surgeons in London, I deliver to you this Honorary Medal … And may you long enjoy the sweetest Solace of life, Reflect[ing] on your useful Works. Mr. Parkinson stood up and thanked Sir William, modestly protesting that the council had overestimated the value of his work. He went on to explain how his interest in fossils had been sparked by having seen Hunter’s collection almost 40 years ago, but he felt obliged to point out that solving some of the problems in paleontology would not necessarily contribute to a better understanding of anatomy and physiology, because the fossil remains of extinct species were so different from animals living today. Having thanked everyone for their favorable opinion of his exertions, Mr. Parkinson withdrew while the council finished its business.
Before the dinner could commence it was necessary for the council to suspend its regulation which prohibited ‘any member of the College in actual practice’ to dine with council members, which they accordingly enacted. It was an exceptional honor. Once the meeting was over, Parkinson sat down to dine with Sir William and eighteen members of council, which included all the great surgeons of the day: John Abernethy, Henry Cline, Sir Astley Cooper, Sir David Dundas, who had been physician to King George Ill; Sir Anthony Carlisle, then Surgeon Extraordinary to George IV; as well as his predecessor Professor Thomas Chevalier and twelve others. It was a magnificent gathering. 

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Machiavellian Wisdom

Most controversial and misunderstood author of 15th century ambassador and statesman is Machiavelli. Even though his concepts are ethically divisive, for common good and safety of citizens some are inevitable but the cruelty is still debatable. One example is the North Korean case where the accusation is the state has master-minded the assassination of current leader’s step-brother. In Machiavellian ethics, it may be allowed but the cruelty and atrocity in my opinion is still unacceptable – may be a middle ground is to devise ways that removes total threat and incapacitates that threat whatsoever without any harm to both the country and the individual – is what needed than total eradication but in extremes where annihilation if perpetrated by an individual as in cases of terrorism requires a befitting reply in similar kind to protect innocents – no doubt there.
Philip Bobbitt argues in his book ‘The Garments of Court and Palace’ about the general misunderstandings of Machiavelli’s masterpieces in the light that he was the first to foresee the advent of republic from monarchial to fiduciary to constitutional democracy as an evolvement to princely states to a modern era country-hood hinged on republican values.

Some excerpts:

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Princely Morality of State

  1. It is the nature of man that he’ll behave badly in order to get what he wants
  2. As a consequence, sometimes this will create a situation in which necessity – the necessity of preserving the sate – requires that a prince depart from the customary virtues in order to to cope with adversaries who are deceitful, greedy,n etc.
  3. Therefore, it is a prudent rule that the prince who governs a state must do unto others as they would do unto him.

Imagine you wish to train yourself to be poker player.Part of the training must be learning all the trick of the cardsharp, dealing from the bottom of the deck, palming a card, marking a deck, etc. You must learn these things so you can spot them when someone is trying to cheat you. But must you practice these tricks yourself? I suppose it depends on how good your game is, and whether the person with whom you are playing will enforce the rules once you have exposed the cheat. To the question. ‘Must it be this way? Can’t we do better?, the answer does not lies entirely within your power.

It is instructive that Machiavelli was thoroughly honest in his public service and dealings. When accused of corruption by jealous courtiers, an investigation cleared him of all charges. And despite the fact that he was chronically underpaid. There’s something appealing, to the present world about the misleading portrait of Machiavelli to which we are accustomed. It is consistent with our current contempt for bureaucrats, for politicians, for lawyers – the superstitious reaction of people who are frightened by the forces that they identify with those who are trying to master those forces, rather like blaming a volcanologists for a volcano eruption. Perhaps it was always so, at least since the birth of state that gave us the bureaucrats, lawyers and politicians that are its creation.

Statecraft as Stagecraft

The idea that the perception of a prince’s acts and qualities are an important elements in his ability to govern is a persistent and subtle theme of Machiavelli’s. In other words, the promises that the obligations of love impose on others, on which we rely, can always be unilaterally broken, because we can always break the commitments love exact from us without the consent of the loved one.
by contrast, the fear and dread imposed by another person, a person with power to execute his threats, creates habits and responses it is not in our power to dissolve unilaterally

The book also addresses the dichotomies like:

  1. The Prince is mirror book
  2. The Prince advocates autocracy, while The Discourses endorses a republican form of government
  3. The Prince separates ethics from politics
  4. Machiavelli both asserts and contradicts the claim that man can control his fate
  5. The Prince, with its flamboyant exhortation to liberate Italy, is a dramatic departure from the rest of the book

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A wise and enlightening read on politics and its machinations. Staying in power and doing good and reining the masses to ensure goodness should prevail in spite of human tendencies to topple, wreak havoc and endanger welfare schemes – requires a thoughtful study of masters to adopt a humane yet powerful approach to statecraft that embodies common and progressive goodness at heart while providing stability and growth for a nation especially at its infancy from a 3rd world to an advanced nation.

Making Laws and making Sausage in Capitol

A very short introduction on The U.S. Congress by Donald A. Ritchie was an informative read and I enjoyed this section the most and want to capture it for reference.

Laws are like sausages” goes the old saying. “It’s better not to see them being made“. A mix of persuasion, pressure and bargaining will be ground into every bill that becomes law. Managing legislation through to enactment involves finding something to offer to as many member as possible. On those where they have little stake, members may trade votes, supporting someone else’s pet projects in return for a promise of support of theirs. a practice called logrolling. members will feel pressure from President, their party, their constituents and lobbyists on how to vote. some will not make up their minds until last minute, on the way to cast their vote. They have compared this situation to “seminar on the run”, as they try to determine how to vote from notes stuffed in their pockets, briefing books, whispers from staff, hurried briefing from collogues, and last minute calls from white house.