John Hughlings Jackson

Last updated

John Hughlings Jackson
John Hughlings-Jackson bust.jpg
Bust of John Hughlings Jackson, resident in the Institute of Neurology, London
Born(1835-04-04)4 April 1835
Providence Green, Green Hammerton, Yorkshire, England
Died7 October 1911(1911-10-07) (aged 76)
London, England
Nationality English
Scientific career
Fields Neurology

John Hughlings Jackson, FRS (4 April 1835 – 7 October 1911) was an English neurologist. He is best known for his research on epilepsy.



He was born at Providence Green, Green Hammerton, near Harrogate, Yorkshire, the youngest son of Samuel Jackson, a brewer and yeoman who owned and farmed his land, and Sarah Jackson (née Hughlings), the daughter of a Welsh revenue collector. His mother died just over a year after giving birth to him. He had three brothers and a sister; his brothers emigrated to New Zealand and his sister married a physician. [1] He was educated at Tadcaster, Yorkshire and Nailsworth, Gloucestershire before attending the York Medical and Surgical School. After qualifying at St Barts in 1856 he became house physician to the York Dispensary.

In 1859 he returned to London to work at the Metropolitan Free Hospital and the London Hospital. In 1862 he was appointed Assistant Physician, later (1869) full Physician at the National Hospital for Paralysis and Epilepsy located in Queen Square, London (now the National Hospital for Neurology and Neurosurgery) as well as Physician (1874) at the London Hospital. During this period he established his reputation as a neurologist. He was elected a Fellow of the Royal Society in 1878.

Jackson died in London on 7 October 1911 and was buried in Highgate cemetery. He was an atheist. [2] [3] The Hull York Medical School building at the University of York is named in his honour.

Science and research

Jackson was an innovative thinker and a prolific and lucid, if sometimes repetitive, writer. Though his range of interests was wide, he is best remembered for his seminal contributions to the diagnosis and understanding of epilepsy in all its forms and complexities. [4] [5] His name is attached eponymously to the characteristic "march" (The Jacksonian March) of symptoms in focal motor seizures [6] and to the so-called "dreamy state" of psychomotor seizures of temporal lobe origin. [7] His papers on the latter variety of epilepsy have seldom been bettered in their descriptive clinical detail or in their analysis of the relationship of psychomotor epilepsy to various patterns of pathological automatism and other mental and behavioural disorders.

Jackson also did research on aphasia, noting that some aphasic children were able to sing, even though they had lost the power of ordinary speech. [8] [9] He also studied what types of language loss was found in patients with left-brain injury, including set phrases, such as "Good bye" and "Oh, dear." [10] [11]

In his youth Jackson had been interested in conceptual issues and it is believed that in 1859 he contemplated the idea of abandoning medicine for philosophy. [12] Thus, an important part of his work concerned the evolutionary organization of the nervous system for which he proposed three levels: a lower, a middle, [13] and a higher. At the lowest level, movements were to be represented in their least complex form; such centres lie in the medulla and spinal cord. The middle level consists of the so-called motor area of the cortex, and the highest motor levels are found in the prefrontal area.

The higher centres inhibited the lower ones and hence lesions thereat caused ‘negative’ symptoms (due to an absence of function). ‘Positive’ symptoms were caused by the functional release of the lower centres. This process Jackson called ‘dissolution’, a term he borrowed from Herbert Spencer. [14] The ‘positive-negative’ distinction he took from Sir John Reynolds. [15]

Continental psychiatrists and psychologists (e.g. Théodule Ribot, Pierre Janet, Sigmund Freud, Henri Ey) have been more influenced by Jackson’s theoretical ideas than their British counterparts. [16] During the 1980s, the ‘positive-negative’ distinction was introduced in relation to the symptoms of schizophrenia. [17]

He was one of only a few physicians to have delivered the Goulstonian (1869), Croonian (1884) and Lumleian (1890) lectures to the Royal College of Physicians [18] He also delivered the 1872 Hunterian Oration to the Hunterian Society.


Jackson could not use modern sophisticated neuro-investigative technology (it had not been invented), but had to rely upon his own powers of clinical observation, deductive logic and autopsy data. [19] Some of his eminent successors in the field of British neurology have been critical of many of his theories and concepts; but as Sir Francis Walshe remarked of his work in 1943, " ... when all that is obsolete or irrelevant is discarded there remains a rich treasure of physiological insight we cannot afford to ignore."

In Otfrid Foerster's research on the motor cortex, he cites exclusively Hughlings Jackson for the initial discovery (although without evidence) of the brain as the spring of neurological motor signalling. [20]


Together with his friends Sir David Ferrier and Sir James Crichton-Browne, two eminent neuropsychiatrists of his time, Jackson was one of the founders of the important journal Brain , which was dedicated to the interaction between experimental and clinical neurology (still being published today). Its inaugural issue was published in 1878.

In 1892, Jackson was one of the founding members of the National Society for the Employment of Epileptics (now the National Society for Epilepsy), along with Sir William Gowers and Sir David Ferrier.

Oliver Sacks repeatedly cited Jackson as an inspiration in his neurologic work.

Related Research Articles

Déjà vu is the feeling that one has lived through the present situation before. The phrase translates literally as "already seen". Although some interpret déjà vu in a paranormal context, mainstream scientific approaches reject the explanation of déjà vu as "precognition" or "prophecy". Rather, they explain it as the feeling that one has lived through the present situation before. It is an anomaly of memory whereby, despite the strong sense of recollection, the time, place, and practical context of the "previous" experience are uncertain or believed to be impossible. Two types of déjà vu are recognized: the pathological déjà vu usually associated with epilepsy or that which, when unusually prolonged or frequent, or associated with other symptoms such as hallucinations, may be an indicator of neurological or psychiatric illness, and the non-pathological type characteristic of healthy people, about two-thirds of whom have had déjà vu experiences. People who travel more or watch more movies are more likely to experience déjà vu than others. Furthermore, people also tend to experience déjà vu more in fragile conditions or under high pressure, and research shows that the experience of déjà vu also decreases with age.

Neurology Medical specialty dealing with disorders of the nervous system

Neurology is a branch of medicine dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the central and peripheral nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.

Brain damage Destruction or degeneration of brain cells

Neurotrauma, brain damage or brain injury (BI) is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors. In general, brain damage refers to significant, undiscriminating trauma-induced damage, while neurotoxicity typically refers to selective, chemically induced neuron damage.

Wilder Penfield Canadian neurosurgeon, college football player and coach

Wilder Graves Penfield was an American-Canadian neurosurgeon. He expanded brain surgery's methods and techniques, including mapping the functions of various regions of the brain such as the cortical homunculus. His scientific contributions on neural stimulation expand across a variety of topics including hallucinations, illusions, and déjà vu. Penfield devoted much of his thinking to mental processes, including contemplation of whether there was any scientific basis for the existence of the human soul.

Carl Wernicke German physician and neuropathologist (1848–1905)

CarlWernicke was a German physician, anatomist, psychiatrist and neuropathologist. He is known for his influential research into the pathological effects of specific forms of encephalopathy and also the study of receptive aphasia, both of which are commonly associated with Wernicke's name and referred to as Wernicke encephalopathy and Wernicke's aphasia, respectively. His research, along with that of Paul Broca, led to groundbreaking realizations of the localization of brain function, specifically in speech. As such, Wernicke's area has been named after the scientist.

William Gowers (neurologist) British neurologist

Sir William Richard Gowers was a British neurologist, described by Macdonald Critchley in 1949 as "probably the greatest clinical neurologist of all time". He practised at the National Hospital for the Paralysed and Epileptics, Queen Square, London from 1870–1910, ran a consultancy from his home in Queen Anne Street, W1, and lectured at University College Hospital. He published extensively, but is probably best remembered for his two-volume Manual of Diseases of the Nervous System (1886, 1888), affectionately referred to at Queen Square as the Bible of Neurology.

David Ferrier british neurologist and psychologist

Sir David Ferrier FRS was a pioneering Scottish neurologist and psychologist. Ferrier conducted experiments on the brains of animals such as monkeys and was in 1881 he became the first scientist to be tried under the Cruelty to Animals Act, 1876 which had been enacted following a major public debate over vivisection.

The study of neurology and neurosurgery dates back to prehistoric times, but the academic disciplines did not begin until the 16th century. From an observational science they developed a systematic way of approaching the nervous system and possible interventions in neurological disease.

Otfrid Foerster German neurologist

Otfrid Foerster was a German neurologist and neurosurgeon, who made innovative contributions to neurology and neurosurgery, such as rhizotomy for the treatment of spasticity, anterolateral cordotomy for pain, the hyperventilation test for epilepsy, Foerster's syndrome, the first electrocorticogram of a brain tumor, and the first surgeries for epilepsy. He is also known as the first to describe the dermatomes, and he helped map the motor cortex of the cerebrum.

Focal seizures are seizures which affect initially only one hemisphere of the brain. The brain is divided into two hemispheres, each consisting of four lobes – the frontal, temporal, parietal and occipital lobes. A focal seizure is generated in and affects just one part of the brain – a whole hemisphere or part of a lobe. Symptoms will vary according to where the seizure occurs. In the frontal lobe symptoms may include a wave-like sensation in the head; in the temporal lobe, a feeling of déjà vu; in the parietal lobe, a numbness or tingling; and in the occipital lobe, visual disturbance or hallucination.

Macdonald Critchley CBE was a British neurologist. He was former president of The World Federation of Neurology, and the author of over 200 published articles on neurology and 20 books, including The Parietal Lobes (1953), Aphasiology, and biographies of James Parkinson and Sir William Gowers.

Gordon Morgan Holmes Anglo-Irish neurologist

Sir Gordon Morgan Holmes, was an Anglo-Irish neurologist. He is best known for carrying out pioneering research into the cerebellum and the visual cortex.

James Crichton-Browne British psychiatrist

Sir James Crichton-Browne MD FRS FRSE was a leading Scottish psychiatrist, neurologist and medical psychologist. He is known for studies on the relationship of mental illness to brain injury and for the development of public health policies in relation to mental health. Crichton-Browne's father was the asylum reformer Dr William A.F. Browne, a prominent member of the Edinburgh Phrenological Society and, from 1838 until 1857, the superintendent of the Crichton Royal at Dumfries where Crichton-Browne spent much of his childhood.

Norman Geschwind was a pioneering American behavioral neurologist, best known for his exploration of behavioral neurology through disconnection models based on lesion analysis.

Jargon aphasia is a type of fluent aphasia in which an individual's speech is incomprehensible, but appears to make sense to the individual. Persons experiencing this condition will either replace a desired word with another that sounds or looks like the original one, or has some other connection to it, or they will replace it with random sounds. Accordingly, persons with jargon aphasia often use neologisms, and may perseverate if they try to replace the words they can not find with sounds.

Disconnection syndrome

Disconnection syndrome is a general term for a collection of neurological symptoms caused -- via lesions to associational or commissural nerve fibres -- by damage to the white matter axons of communication pathways in the cerebrum(not to be confused with the cerebellum), independent of any lesions to the cortex. The behavioral effects of such disconnections are relatively predictable in adults. Disconnection syndromes usually reflect circumstances where regions A and B still have their functional specializations except in domains that depend on the interconnections between the two regions.

A functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts. In the past, the brain of a patient with functional neurological symptom disorder was believed to be structurally normal, but functioning incorrectly. Patients with FND were marginalized for much of the 20th century, with limited clinical and neuroscientific interest. Converging evidence from several studies using different techniques and paradigms has now demonstrated distinctive brain activation patterns associated with functional deficits, unlike those seen in actors simulating similar deficits. New research has uncovered pathways in the brain’s white matter that may be altered in patients with functional neurological disorder (FND). The new findings advance current understanding of the mechanisms involved in this disease, and offer the possibility of identifying markers of the condition and patients’ prognosis.

Thomas Buzzard English physician 1831-1919

Thomas Lovell Buzzard MD FRCP was a Victorian doctor who worked at the National Hospital, Queen Square. He was a pioneering neurologist who founded an epilepsy society and wrote also on Parkinson's disease. One of the last doctors to be trained through the apprenticeship route, Buzzard witnessed the Crimean War and later was a role model for the famous painting The Doctor.

John David "Jerry" Spillane (1909–1985) was a Welsh neurologist and a pioneer of tropical neurology.

Denis John Williams (1908–1990) was a Welsh neurologist and epileptologist.


  1. Critchley, Macdonald; Critchley, Eileen A. (1998). John Hughlings Jackson : Father of English Neurology (PDF). Oxford University Press. pp. 7–8. Retrieved 17 May 2013.[ permanent dead link ]
  2. "J. Hughlings Jackson".
  3. Siegman, Aron Wolfe., and Stanley Feldstein. Nonverbal Behavior and Communication. Hillsdale, NJ: L. Erlbaum Associates, 1978. Print.
  4. Janković, SM; Sokić, DV; Lević, Z; Susić, V (1997). "Dr. John Hughlings Jackson". Srp Arh Celok Lek. 125 (11–12): 381–6. PMID   9480576.
  5. Balcells Riba, M (1999). "[Contribution of John Hughlings Jackson to the understanding of epilepsy]". Neurología. 14 (1): 23–28. PMID   10079688. He systematized what we today know as complex partial crisis, establishing the link between the function of the temporal lobe and the sensorial auras, automatism's, déjà-vu and jamais vu phenomena.
  6. York, George K; Steinberg, David A (2011). "Hughlings Jackson's neurological ideas". Brain : A Journal of Neurology. 134 (Pt 10): 3106–3113. doi: 10.1093/brain/awr219 . PMID   21903729. Lay summary. By observing the march of epileptic seizures he developed the idea of somatotopic representation.
  7. Lardreau, Esther (2011). "An approach to nineteenth-century medical lexicon: the term "dreamy state"". Journal of the History of the Neurosciences. 20 (1): 34–41. doi:10.1080/09647041003740937. PMID   21253938. Lay summary. Hughlings-Jackson coined the concept of dreamy state: According to him, one of the sensations of a "dreamy state" was an odd feeling of recognition and familiarity, often called "deja vu". A clear sense of strangeness could also be experienced in the "dreamy state" ("jamais vu").
  8. Johnson, Julene K; Graziano, Amy B (2015). "Some early cases of aphasia and the capacity to sing" (PDF). Progress in Brain Research. 216: 73–89. doi:10.1016/bs.pbr.2014.11.004. ISBN   9780444633996. PMID   25684286. Lay summary. The observation that some patients with aphasia and limited speech output were able to sing the texts of songs inspired scholars to examine the relationship between music and language. Early ideas about the capacity to sing were provided by well-known neurologists, such as John Hughlings Jackson and Adolf Kussmaul.
  9. Lorch, Marjorie Perlman; Greenblatt, Samuel H (2015). Singing by speechless (aphasic) children: Victorian medical observations. Progress in Brain Research. 216. pp. 53–72. doi:10.1016/bs.pbr.2014.11.003. ISBN   9780444633996. PMID   25684285. Lay summary. One notable publication was of two cases of children briefly observed by John Hughlings Jackson (1835-1911) in 1871. These children were speechless but could produce some musical expression.
  10. Hughlings Jackson, J. (1874a/1932). On the nature of the duality of the brain. In J. Taylor (Ed.), Selected writings of John Hughlings Jackson (Vol. 2, pp. 129–145). London, United Kingdom: Hodder & Stoughton.
  11. Hughlings Jackson, J. (1874b/1932). On affections of speech from disease of the brain. In J. Taylor (Ed.), Selected writings of John Hughlings Jackson (Vol. 2, pp. 155–204). London, United Kingdom: Hodder & Stoughton.
  12. James Taylor, ‘Jackson, John Hughlings (1835–1911)’, rev. Walton of Detchant, Oxford Dictionary of National Biography, Oxford University Press, 2004
  13. Phillips, C G (1973). "Proceedings: Hughlings Jackson Lecture. Cortical localization and "sensori motor processes" at the "middle level" in primates". Proceedings of the Royal Society of Medicine. 66 (10): 987–1002. doi:10.1177/003591577306601015. PMC   1645607 . PMID   4202444.
  14. Berrios, G. E. (2001). "The factors of insanities: J. Hughlings Jackson. Classic Text No. 47". History of Psychiatry. 12 (47 Pt 3): 353–73. doi:10.1177/0957154x0101204705. PMID   11954572.
  15. Berrios, G. E. (1985). "Positive and negative symptoms and Jackson. A conceptual history". Archives of General Psychiatry. 42 (1): 95–7. doi:10.1001/archpsyc.1985.01790240097011. PMID   3881095.
  16. Berrios G E (1977) Henri Ey, Jackson et les idées obsédantes. L'Evolution Psychiatrique 42: 685–699
  17. Berrios, G. E. (1991). "Positive and Negative Signals: A Conceptual History". Negative Versus Positive Schizophrenia. pp. 8–27. doi:10.1007/978-3-642-76841-5_2. ISBN   978-3-642-76843-9.
  18. Hughesnet Internet | Satellite Internet Deals | 1-855-267-3692 [ permanent dead link ]. Retrieved on 29 May 2014.
  19. Eadie, MJ (1990). "The evolution of J. Hughlings Jackson's thought on epilepsy". Clinical and Experimental Neurology. 27: 29–41. PMID   2129959. Lay summary. By 1870, and within 5 or 6 years of his beginning to analyse the clinical phenomena of epilepsy and to correlate them with autopsy data, the 35-year-old John Hughlings Jackson had come to a view of the nature of epilepsy that was radically different from that of his contemporaries
  20. Foerster, O. (1936). "The Motor Cortex in Man in the Light of Hughlings Jackson's Doctrines". Brain. 59 (2): 135–159. doi:10.1093/brain/59.2.135.