This is a chronic affection characterized by weakness and tremor, also rigidity.

Etiology

This disease develops in men oftener than in women. It is a disease that rarely develops under forty to forty-five years of age; yet cases have been reported under twenty-five years of age. In all probability, however, these were choreic in nature.

The exciting causes may be exposure, cold, wet, worries and anxieties of all kinds. In some cases it is brought on from mental shock or an injury. Any toxins may produce this disease in those who are predisposed to it. Not everyone will take on paralysis agitans. It belongs to those of neurotic diathesis who have intensified their nervousness by the use of all kinds of stimulants, alcoholics, tobacco, coffee, tea, etc. There is no question but that Parkinson's disease is only one manifestation of arteriosclerosis, or old age, disease. I never have met with a case yet that did not present most pronounced symptoms of arteriosclerosis. In those who are predisposed to take on the disease it is liable to develop in middle life. Some authors declare that it is not a neurosis. Why is it not? The blood vessels are controlled by the nervous system; arteriosclerosis is built by over-stimulation; and, certainly, if there were not nerves to be over-stimulated, it would be a very difficult matter to stimulate the organism, or produce all the diseases that come under the head of sclerosis.

Symptoms

The disease begins gradually with an unsteady hand. The tremor may be constant or intermittent. With this may be associated weakness or stiffness. Indeed, such cases are inclined to have rheumatism. This will account for the stiffness. When a slight rheumatism takes place in the joints of the hands, the appearance is that there is a great loss of power, This, however, is not true; for if the sensitiveness is taken out of the hands, they can grip or show evidence of power equal to that of any time previous to the development of the disease.

The four leading symptoms are tremor, weakness, rigidity, and an attitude.

Tremor

The tremor may develop in all four of the extremities, or it may be confined to the hands or to the feet. The head is not so inclined to take on the affection; yet the disease is met with seemingly confined to the neck, where there is a choreic jerk of the head. The trembling is often decidedly marked in the hands, the thumb and forefinger displaying the peculiar motions that are likened to rolling a pill. When the tremor has been developed for a long time in the hands and legs, or feet, there is an inclination for an unsteadiness of the head to take place.

Weakness

All cases lack power. This, however, belongs to the last stages.

Rigidity Or Stiffness

This may be expressed in the slowness of movements. The time comes when all voluntary movements are made slowly, but with considerable effort. The actions become very deliberate.

Attitude Or Gait

The head leans forward; the back is bowed; the arms stand from the body and are somewhat fixed. The face is expressionless. The motions of the lips are slow. The whole expression is masklike; indeed, it is called Parkinson's mask. The voice is often shrill and piping. Sometimes the disease is confined to one side, or often to just one limb. However, before the patient dies, unless some intercurrent affection takes him away, he will live to become generally paralyzed.

Treatment

The leading authorities declare that there is no treatment that is satisfactory, but they recommend arsenic, opium, hyoscyamin, and other drugs that act on the nerve centers. I should expect cases to grow worse on drugging. Indeed, there is nothing to do except to correct the errors of life, whatever they are. Overstimulation must be gotten rid of. Patients must be induced to live on just barely enough food to keep soul and body together; otherwise they stimulate and build this disease. Everything that is of a stimulating or shocking nature must be kept from such patients. Disagreeable people, domestic and all other irritations, must be got rid of; for such patients are often very excitable, and all excitement is stimulating, and all stimulation brings on more and more enervation.