Hughlings Jackson, John

(1835-1911) English physician who pioneered the development of neurology as a medical specialty during the reign of Queen Victoria. John Hughlings Jackson has been called the “father of English neurology.” Jackson made a number of scientific discoveries in several areas of higher nervous activity and language, and contributed greatly to the study of various types of epilepsy.

Hughlings Jackson observed his wife’s epileptic seizures. He noted that all of her seizures followed the same pattern. They would start at one of her hands, move to her wrist, then her shoulder, then her face. They would finally affect the leg on the same side of her body, then stop. He went on to describe this form of epilepsy associated with localized convulsive seizures, now known as Jacksonian epilepsy or Jacksonian seizures.

Hughlings Jackson believed that seizures were electrical discharges within the brain. The discharges started at one point and radiated out from that point. This suggested to him that the brain was divided into different sections, and that each section controlled the motor function (or movement) of a different part of the body. And since the pattern never varied, the way the brain is organized must also be set.

Jackson’s research on epilepsy stretched across a broad spectrum and included uncinate attacks, intellectual aurae, and many other manifestations, which are now collectively covered by the term temporal lobe epilepsy. Jackson described a classic case of temporal-lobe epilepsy in the case of “Dr. Z.” Dr. Z.’s disease eventually destroyed his career and ended in his death.

Hughlings Jackson was among the first to recognize the pattern of disease of the cerebellum. His research was not limited to epilepsy, and encompassed studies in aphasia and neuro-ophthalmology. He devised a hierarchy of the nervous system with positive and negative manifestations of neurological activity. His work was based on a detailed, insightful evaluation of the clinical symptoms of diseases of the brain, coupled with meticulous, repeated studies of their phenomena. Jackson’s observations of localized brain lesions led to the first cases of neurosurgical ablation of brain tumors. Much of his original work still forms the foundation of contemporary understanding of the loss of language caused by stroke and other diseases.