ABSTRACT
FIGURE 1.1 Franciscus de le Boë (1614-1672). Also known as Sylvius de le Boë, and Franciscus Sylvius, this early physician was Professor of Leiden and a celebrated anatomist. In his medical writings, he also described tremor and he may be among the very earliest writers on involuntary movement disorders (1). (All fi gures are from the private collection of Christopher G. Goetz, MD, Chicago, IL, unless otherwise noted.)
FIGURE 1.2 François Boissier de Sauvages de la Croix (1706-1767). Sauvages was cited by Parkinson himself and described patients with “running disturbances of the limbs”, scelotyrbe festinans. Such subjects had diffi culty walking, moving with short and hasty steps. He considered the problem due to diminished fl exibility of muscle fi bers, possibly his manner of describing rigidity (1,2).
FIGURE 1.3 William Shakespeare. A brilliant medical observer and writer, Shakespeare described many neurologic conditions, including epilepsy, somnambulism, and dementia. In Henry VI, fi rst produced in 1590, the character, Dick, notices that Say is trembling: “Why dost thou quiver, man,” he asks, and Say responds, “The palsy and not fear provokes me” (1). Jean-Martin Charcot frequently cited Shakespeare in his medical lectures and classroom presentations and disputed the concept that tremor was a natural accompaniment of normal aging. He rejected “senile tremor” as a separate nosographic entity. After reviewing his data from the Salpêtrière service where 2000 elderly inpatients lived, he turned to Shakespeare’s renditions of elderly fi gures: “Do not commit the error that many others do and misrepresent tremor as a natural accompaniment of old age. Remember that our venerated Dean, Dr. Chevreul, today 102 years old, has no tremor whatsoever. And you must remember in his marvelous descriptions of old age (Henry IV and As You Like It), the master observer, Shakespeare, never speaks of tremor” (3,4).
