Historical Issues and Atypical Parkinsonian Disorders

Christopher G. Goetz

Studying archetypes is a fundamental task in nosography. Duchenne de Boulogne practiced it instinctively, and many others have done it before and after him: It is indispensable, and the only way to extract a specific pathological state from the chaos of imprecision. The history of medicine, which is long and grand, shows this truth well. But once the archetype is established, the second nosographic operation begins: dissect the archetype and analyze its parts. One must, in other words, learn how to recognize the imperfect cases, the formes frustes, or examples where only one feature occurs in isolation. Using this second method, the physician will see the archetypal illness in an entirely new light. One's scope enlarges, and the illness becomes much more important in the doctor's daily practice. To the patient's benefit, the doctor becomes attentive and sensitive to recognizing a disease, even when it is in its earliest developmental stages (1).

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