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Here we show that he appreciated the weakness of the systematic 18th century nosologies, which presupposed that medical species, the building blocks of these Linnaean taxonomic schemes, were as distinct as plant and animal species; and that Parkinson made a conceptual leap about combinations of clinical phenomena in recurring patterns, now recognised to be one of the germs of neurological thinking about syndromes. The Essay\u2019s written style underpins another aspect of significance to contemporary neurological practice - an inherent intellectual humility. In this commemorative year we locate the continuing importance of the related notions of syndrome and disease in successive frameworks of knowledge about the shaking palsy. Syndrome and disease are interpreted as dual character concepts, one clinically-based and the other restricted to pathophysiological causation. They both remain fundamental to understanding Parkinson's syndrome-disease today.<\/jats:p>","DOI":"10.4997\/jrcpe.2017.220","type":"journal-article","created":{"date-parts":[[2017,7,4]],"date-time":"2017-07-04T10:08:59Z","timestamp":1499162939000},"page":"190-195","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["James Parkinson\u2019s Chimera: syndrome or disease?"],"prefix":"10.1177","volume":"47","author":[{"given":"PA","family":"Kempster","sequence":"first","affiliation":[{"name":"Neurologist, Neurosciences Department and Department of Medicine, Monash University, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Hurwitz","sequence":"additional","affiliation":[{"name":"Professor of Medicine and The Arts, Department of English Language and Literature University College, london, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AJ","family":"Lees","sequence":"additional","affiliation":[{"name":"Professor of Neurology, Reta Lila Weston Institute of Neurological\rStudies, University College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,3,1]]},"reference":[{"key":"bibr1-JRCPE.2017.220","volume-title":"An Essay on the Shaking Palsy","author":"Parkinson J."},{"key":"bibr2-JRCPE.2017.220","doi-asserted-by":"crossref","unstructured":"2 Stern G. The world's best known neurologist? Pract Neurol 2011; 11: 312-5.","DOI":"10.1136\/practneurol-2011-000075"},{"key":"bibr3-JRCPE.2017.220","unstructured":"3 Burke KD. A Grammar of Motives. New York: Prentice-Hall; 1945. p. 324."},{"key":"bibr4-JRCPE.2017.220","unstructured":"4 James W. The Principles of Psychology. Vol 1. New York: Henry Holt and Company; 1890. p. 488."},{"key":"bibr5-JRCPE.2017.220","unstructured":"5Boissier de\u00a0la\u00a0Croix, de\u00a0Sauvages  F. Nosologia methodica sistens morborum classes. Amsterdam: Fratrum de\u00a0Tournes; 1768."},{"key":"bibr6-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-192201000-00038"},{"key":"bibr7-JRCPE.2017.220","first-page":"444","volume-title":"In: Diseases of the Nervous System","author":"Brain W R."},{"key":"bibr8-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870130605"},{"key":"bibr9-JRCPE.2017.220","unstructured":"9Charcot J-M, Lecture V. On Paralysis Agitans. in: Lectures on the Diseases of the Nervous System. Sigerson G (trans). London: New Sydenham Society; 1877. p. 129-56."},{"key":"bibr10-JRCPE.2017.220","unstructured":"10 Trousseau A. Lectures on clinical medicine, delivered at the Hotel-Dieu, Paris. Bazire PV (trans). London: New Sydenham Society; 1868. p. 442-3."},{"key":"bibr11-JRCPE.2017.220","first-page":"22","volume":"2","author":"Ball B.","journal-title":"De l\u2019insanite dans la paralysie agitante"},{"key":"bibr12-JRCPE.2017.220","unstructured":"12 Naville F. Etudes sur les complications et les sequelles mentales de l\u2019encephalite epidemique. La bradyphrenie. L'Encephale 1922; 17: 369-75, 423-36."},{"key":"bibr13-JRCPE.2017.220","unstructured":"13Charcot J-M. Policlinique du Mardi 12 Juin, 1888. in: Charcot J-M. Legons du Mardi a la Saltpetriere. Tome 2. Paris: La Bibliotheque des introuvables; 2002. p. 123-40."},{"key":"bibr14-JRCPE.2017.220","volume-title":"A Manual of Diseases of the Nervous System","author":"Gowers WR."},{"key":"bibr15-JRCPE.2017.220","unstructured":"15 Tretiakoff C. Contribution a l\u2019etude de l\u2019anatomie pathologique du locus niger de\u00a0Soemmering avec quelques deductions relatives a la pathogenie des troubles du tonus musculaire et de la maladie de\u00a0Parkinson. These de\u00a0Paris; 1919."},{"key":"bibr16-JRCPE.2017.220","first-page":"50","volume":"1","author":"Lewy FH.","journal-title":"Zur pathologischen Anatomie der Paralysis agitans"},{"key":"bibr17-JRCPE.2017.220","first-page":"387","volume":"48","author":"Hassler R.","year":"1938","journal-title":"Zur Pathologie der Paralysis Agitans und des postenzephalitischen Parkinsonismus"},{"key":"bibr18-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.16.4.213"},{"key":"bibr19-JRCPE.2017.220","first-page":"593","volume":"28","author":"Foix C.","year":"1921","journal-title":"Rev Neurol"},{"key":"bibr20-JRCPE.2017.220","first-page":"587","volume":"28","author":"Lhermitte J","year":"1921","journal-title":"Rev Neurol"},{"key":"bibr21-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540020018011"},{"key":"bibr22-JRCPE.2017.220","first-page":"146","volume":"64","author":"Alzheimer A.","journal-title":"Liber eine eigenartige Erkrankung der Hirnrinde"},{"key":"bibr23-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21065"},{"key":"bibr24-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1016\/j.cognition.2013.01.005"},{"key":"bibr25-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"bibr26-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.6.745"},{"key":"bibr27-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26431"},{"key":"bibr28-JRCPE.2017.220","doi-asserted-by":"publisher","DOI":"10.5962\/bhl.title.51240"},{"key":"bibr29-JRCPE.2017.220","unstructured":"29 Parkinson J. Organic Remains of a Former World. Vol 1. London: Sherwood, Neely, and Jones; 1811. p. 265."},{"key":"bibr30-JRCPE.2017.220","unstructured":"30 Lovejoy AO. The Great Chain of Being. Cambridge, MA: Harvard University Press; 1936."},{"key":"bibr31-JRCPE.2017.220","first-page":"305","volume":"127","author":"Kendell RE.","journal-title":"The concept of disease and its implications for psychiatry"},{"key":"bibr32-JRCPE.2017.220","doi-asserted-by":"crossref","unstructured":"32 Aronowitz RA. When do symptoms become a disease? 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