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ARTICLE |

The Management of Parkinson's Disease

ALBERT C. ENGLAND, M.D.; ROBERT S. SCHWAB, M.D.
AMA Arch Intern Med. 1959;104(3):439-468. doi:10.1001/archinte.1959.00270090093017.
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I. Historical Review  In 1817, James Parkinson 1 described six cases of the condition which now bears his name. These were all men with a disease state he characterized by tremor, loss of finger and arm dexterity, propulsion, festination and falling, insomnia, constipation, and dorsal kyphosis. Finally, there came on aphonia, dysphagia, and incontinence. From reading the text, it is apparent that these cases had generalized slowness of movement and marked dependence on others for the ordinary tasks such as eating, dressing, and walking. Rigidity is curiously not mentioned, but it is fair to say that it must have been present in order that the other symptoms might appear. The following quotation will remind present-day students of the acuity of his observations:.... [p. 3] The first symptoms perceived are, a slight sense of weakness with a proneness to trembling in some particular part; sometimes in the head but most commonly

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