In 1860 Jackson took the Doctor of Medicine degree at the University of St. Andrews.
Career
Gallery of John Jackson
1895
John Hughlings Jackson, photogravure after L. Calkin, 1895.
Achievements
Institute of Neurology, London, England
Bust of John Hughlings Jackson in the Institute of Neurology, London.
Membership
Royal Society
1878 - 1911
Royal Society, London, England
Jackson was appointed Fellow of the Royal Society in 1878.
National Society for Epilepsy
1892 - 1911
National Society for Epilepsy, London, England
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.
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.
John Hughlings Jackson was an English physician. His studies of epilepsy, speech defects, and nervous-system disorders arising from injury to the brain and spinal cord helped to define modern neurology.
Background
Ethnicity:
Jackson's father was of English descent, and his mother was of Welsh extraction.
John Hughlings Jackson was born on April 4, 1835, in Providence Green, Green Hammerton, near Yorkshire, England. His father, Samuel, was a yeoman who owned and farmed his land; his mother was the former Sarah Hughlings, the daughter of a Welsh revenue collector. She died just over a year after giving birth to Jackson. There were three sons and a daughter besides him; his brothers emigrated to New Zealand, and his sister married Doctor Langdale.
Education
Jackson attended small country schools, and little is known of this period of his life except that his general education was limited. At the age of fifteen he was apprenticed to Doctor Anderson, a lecturer at the now-defunct York Hospital Medical School, and completed his medical education at St. Bartholomew’s Hospital Medical school in London from 1855 to 1856, when he gained the form of English medical qualification usual at that time: Member of the Royal College of Surgeons and Licentiate of the Society of Apothecaries. In 1860 he took the Doctor of Medicine degree at the University of St. Andrews.
In 1856 Jackson went back to York Hospital as house surgeon to the dispensary, a post he held until 1859, when he returned to London, intending to study philosophy rather than medicine.
Jonathan Hutchinson, also from York, dissuaded Jackson, and he was appointed to the staff of the Metropolitan Free Hospital in 1859 and at the same time was made lecturer on pathology at the London Hospital. In 1861 he was admitted Member of the Royal College of Physicians of London. By 1863 he was an assistant physician at the London Hospital and, in 1874, physician; he remained on the active staff until 1894, thereafter until 1911 serving as consulting physician. Jackson’s other main attachment, to the National Hospital for the Paralysed and Epileptic, Queen Square, began in 1862 as an assistant physician; elevated to a full physician in 1867, he retired in 1906 as a consulting physician. Jackson also had other appointments to London hospitals, the most consequential being that to Moorfields Eye Hospital from 1861; in addition, he had a private practice. In 1868 Jackson was elected a Fellow of the Royal College of Physicians of London, and over the ensuing years, he was invited to give several of the important named lectures of the College and to assist in its administration.
Jackson’s first paper was published in 1861, his last in 1909. Unfortunately, he never recorded a systematic account of his views, but his scattered contributions to the neurological sciences can be considered under six specific areas. When Jackson first entered the field of clinical neurology, it was a chaotic mass of clinical and pathological data concerning diseases that were usually of unknown etiology. Neurophysiology was also in its infancy. During his lifetime and as a result of the combined activity of neurological clinics mainly in Paris, Heidelberg, Vienna, New York, and Philadelphia and of his own institution in Queen Square, order was established, methods of clinical examination were introduced, etiologies were discovered, advances in physiology were made, and the roots of modern neurology were created. It was in this milieu that Jackson excelled because of his versatility in the collection of data and the enunciation of basic principles. Thus armed, Jackson profoundly influenced all of the neurological sciences.
Jackson’s earlier papers deal primarily with ophthalmological problems. The ophthalmoscope had been invented in 1851 by Helmholtz; and when Jackson began his neurological career ten years later he emphasized its importance as a diagnostic instrument and the need for neurologists to study eye diseases. In London he began a tradition, which still exists, of neurologists being affiliated with ophthalmological hospitals. He was one of the first to insist upon the relationships between ocular and cerebral disease and wrote extensively on papilledema and “optic neuritis”; he published a summary of this work in 1871 and also wrote many papers on ocular palsies. Jackson’s contribution to the growth of ophthalmology and neuro-ophthalmology was, therefore, a significant one, and it continued throughout his career.
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.
Jackson was the first to place the site of epilepsy in the cerebral cortex; and from his careful analysis of the localized type of epilepsy, with its “march” of events, as he put it, he deduced that in this case it was limited to a certain area of one cerebral hemisphere. This focal fit, or convulsion beginning unilaterally, had been described earlier by L. F. Bravais and by others, but its significance had remained unknown; it is therefore appropriately termed “Jacksonian epilepsy.”
Each local epileptic manifestation received Jackson’s attention; and he is also well known for the first adequate account of the uncinate fit, which involves a “dreamy state,” a hallucination of smell or taste, and involuntary chewing or tasting. The loss of consciousness associated with the major (grand mal) and the minor (petit mal) varieties of epilepsy also intrigued him; he was able to demonstrate that it was due to a widespread of the discharge. Concerning the etiology of epilepsy, he often found no pathological change and suggested a nutritional disturbance of brain cells, which may well be the explanation in certain cases. Jackson’s interest in epilepsy led him to several important discoveries in neurophysiology, the most significant being cortical localization and speech function.
One of Jackson’s most outstanding contributions to the neurosciences was his contention that function is localized to areas of the cerebral cortex. This he deduced from his studies on focal epilepsy and from philosophical considerations, here clearly being influenced by Herbert Spencer and supplementing the work of Broca. By 1870 he was certain of his contention, and it was in the same year that Fritsch and Hitzig showed experimentally that electrical stimulation of the cortex produced contralateral limb movement. Others quickly verified this; but the most important confirmatory study was that of Ferrier, whose aim was to test Jackson’s suggestion fully.
The various motor defects manifested by neurological disease provided Jackson with further data to expand his basic concepts of nervous system activity. The focal motor epileptiform attack, the multifarious phenomenon of hemiplegia, and the complex, involuntary movements of chorea were each employed to contribute in particular to his ideas on the functioning of the cerebral cortex and the cerebellum. He considered that the latter controlled continuous (tonic) movements, whereas the cerebrum controlled changing (clonic) movements, and thereby formulated the modern doctrine of the tonic nature of the cerebellar activity. In addition, Jackson envisaged functional localization in the cerebellum, which has been demonstrated only very recently. His so-called “cerebellar attacks,” occurring with tumors of the cerebellum, were of brainstem origin.
Jackson had no religious convictions and denied the existence of life after death.
Views
Jackson carried out no experiments and rarely employed the microscope; but he was acutely aware of their importance and was widely read in the literature. He was devoted to clinical observation, to the analysis of facts, and to philosophic reasoning.
In early life Jackson was influenced by four men: Thomas Laycock, who introduced him to the Paris school of clinicopathologic correlation and to clinical neurology; Jonathan Hutchinson, who imbued him with the Hunterian tradition of scrupulous observation and biological and pathophysiologic principles; Charles Brown-Séquard, who also influenced him to devote his attention to the nervous system; and Herbert Spencer, whose positivistic evolutionary theory led Jackson to certain basic neurological doctrines.
Before Jackson’s time it was thought that epileptic phenomena originated in the medulla oblongata, and it was his work more than anyone else’s that initiated progress toward the present concept. He considered each attack to be an experimental situation from which, by close observation and deduction, he could add to the knowledge of the functioning of the normal brain. At a physiological level he considered a convulsion to be a symptom, not a disease per se: “an occasional, an excessive and a disorderly discharge of nerve tissue on muscle.” The word “discharge” was an inspired forecast of electrical phenomena.
He applied the data of abnormal functioning to the elucidation of the normal action of the nervous system. He was less concerned with the etiology of disease and its cataloging than with the interpretation of disorders in terms of physiology. Jackson always wished to know how a symptom could reveal the normal function and how knowledge of disease could illuminate the normal dynamic properties of the nervous system.
Jackson believed in neither precise cortical mosaics nor diffuse representation; but in the case of the representation of movements, he postulated a motor area and worked out the cortical pattern accepted today, noting its gradations and overlapping. His views were not widely accepted at the time but are nearer to modern beliefs than are those of his contemporaries.
Jackson’s study of epileptics whose attacks involved a disturbance of speech allowed him to investigate the physiology of speech, particularly its central mechanisms. Unlike his contemporaries, who were seeking precise cerebral centers for the various manifestations of speech function, Jackson preferred to elucidate its physiological basis. He concluded that there were two components of speech. First was intellectual or “propositioning” speech, the unit of which is the proposition with precise word order, and not the word, although a single word may have a propositional value if, when it is uttered, other words are understood. Second was emotional speech, which expresses feelings but has no propositional value. As Walshe has pointed out, this simple analysis may be nearer the truth than many modern approaches. Jackson’s suggestion concerning the respective roles of the two cerebral hemispheres in the production and control of speech is no longer acceptable.
Quotations:
"I should be misunderstood if I were supposed to underrate the physiological study of disease of the nervous system. Indeed, I think that to neglect it shows want of education, but to neglect the clinical shows want of experience and sagacity. Never forget that we may run the risk of being over-educated and yet under-cultivated."
"The study of the causes of things must be preceded by the study of things caused."
"For in disease the most voluntary or most special movements, faculties, etc, suffer first and most, that is in an order the exact opposite of evolution. Therefore, I call this the principle of Dissolution."
"It has been said that he who was the first to abuse his fellow-man instead of knocking out his brains without a word, laid thereby the basis of civilisation."
Membership
Jackson was appointed Fellow of the Royal Society in 1878, and in 1885 was the first president of the Neurological Society, later absorbed by the Royal Society of Medicine. 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.
Royal Society
,
England
1878 - 1911
Neurological Society
,
England
1885 - 1911
National Society for Epilepsy
,
England
1892 - 1911
Personality
Jackson was an intensely shy, modest, and obsessional man who disliked most social activities. He was gentle, ever-courteous, and had a subtle, if somewhat hidden, sense of humor. He never exhibited excesses of passion, and his intellectual honesty allowed him always ready to acknowledge the efforts of others.
Much has been written on the fertility of Jackson’s genius, which basically depended upon his ability to diverge and converge. Like his contemporary Charles Darwin, he had the keenest powers of observation and at the same time an ability to manipulate philosophical concepts, together with the comprehensiveness of view. He could, on the one hand, give laborious attention to the minutest local clinical neurological detail, which he analyzed with infinite care, and on the other he could synthesize and propound wide generalizations and fundamental doctrines involving the whole nervous system. His writings are usually considered difficult to read because of an involved and tedious style, dictated by his obsessive need to qualify and document statements and to repeat himself.
Physical Characteristics:
Jackson suffered from migraines and a chronic form of vertigo.
Connections
Jackson married his cousin Elizabeth Dade Jackson in 1865; they had no children, and she died of a cerebrovascular disorder in 1876.