Abstract Details

Title Meriwether Lewis's Possible Early Description of Parkinson's Disease

Topic Research Methodology, Education, and History

Presentation(s) History of Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 004

Background On the return leg of the famed Lewis and Clark Expedition, the explorers spent time amongst the Nez Perce people. During May of 1806, the explorers assisted the tribe with various medical needs. They kept detailed journals of their travels, including descriptions of people they encountered. They received medical training and supplies from Dr. Benjamin Rush of Philadelphia before the expedition.

Objective To shed light on Meriwether Lewis's description and treatment of a Parkinson's-like patient presentation that pre-dated James Parkinson's 1817 An Essay on the Shaking Palsy.

Design/Methods Literature Review

Results Lewis describes a Nez Perce "chief of considerable note" who came to the explorers for medical treatment. He is reported to have had a three-year complaint of difficulty moving his limbs as well as remaining in whatever position he is placed. The explorers recorded successfully treating his movement difficulties over the course of a month through a series of sweats and laudanum. Laudanum is an opium-based tincture with known anticholinergic properties similar to early Parkinson's treatments such as benztropine and trihexyphenidyl.

Conclusions Though the description in Lewis's journals could allow for a broad differential diagnosis, the context and efficacy of the treatments given suggests that the explorers encountered and successfully treated a patient 11 years prior to Dr. Parkinson's essay and more than 60 years prior to the earliest evidence of Dr. Jean-Martin Charcot utilizing anticholinergics in therapy.

Authors/Disclosures
Adam S. Ross, MD (Cleveland Clinic Foundation) PRESENTER	Mr. Ross has nothing to disclose.
Demetrius M. Maraganore, MD, FAAN (Tulane University School of Medicine)	The institution of Dr. Maraganore has received research support from Agency for Healthcare Research and Quality. The institution of Dr. Maraganore has received research support from Florida Department of Health.