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The development of neurology as an independent discipline in the mid-19th century was considerably influenced by the almost simultaneous foundation of the Charcot School at the Salpetriere Hospital in Paris and the National Hospital for the Paralysed and Epileptic and it's School at Queen Square in London in the 1860's. We have reviewed the early interactions between Charcot's school and the leading neurologists at the National Hospital and also discussed their neurological antecedents and subsequent links up to the outbreak of World War 1 in 1914. Earlier interactions involved Trousseau and Duchenne in France and Graves, Todd, Laycock and Allbutt in Britain. The French Brown–Sequard was one of the first two physicians appointed to the National Hospital. Charcot was a frequent visitor to Britain culminating in his influential role in the 1881 International Medical Congress in London. He first suggested the terms “Parkinson's Disease” and “Jacksonian Epilepsy”. He attracted numerous British visitors to Paris and his studies of hysteria were influenced by Laycock, Todd and Russell Reynolds. Hughlings Jackson drew upon the anatomical studies of Gratiolet in his interactions with Broca and Charcot which influenced French views on aphasia , epilepsy and cortical localisation. Ball, an Englishman, was the first Professor of mental and brain diseases in Paris in 1877. Bruce in Edinburgh and Kinnier Wilson in London both maintained frequent contacts with Paris, where the latter first presented his studies of hepatolenticular degeneration in 1912. The Entente Cordiale of 1904 led to further interactions with the leading role of the French and British physicians Raymond and Duckworth. Two outstanding British women, Elizabeth Garrett and Blanche Edwards, qualified in Medicine in Paris with neurological interests. Our review emphasises the constructive influence of the French and British Schools on each other and thus on the development of neurology. The French influence was primarily the establishment of the anatomo-clinical method and the use of photographic illustrations in publications. The British School influence was its Clinical Assessment Skills and scientific studies of newly recognised diseases and concepts and its early development of neurosurgery .

The report shows that V.A. Karlov proved at the current level of knowledge the correctness of the ideas of the great English neurologist John Hughlings Jackson, author of works on localization of the projection motor centers of the cerebral cortex, on aphasia, and others.

Heinrich Hoffmann (1809–1894) is the author of Der Struwwelpeter (Shaggy Peter, 1845), a famous collection of moralistic tales for children. He was a psychiatrist who founded the mental asylum in Frankfurt am Mein. In 1859, Hoffmann published a book on “Observations on mental disorders and epilepsy”, following the classification system proposed by Wilhelm Griesinger (1817–1868). Herein, Hoffmann explores, among others, the influence of lunar phases, seasonality, and circadian rhythm on seizure frequency, topics that continue to be object of investigation. In his monograph, Hoffmann refers to some patients with seizure semiology showing a somatotopic distribution and spreading to different body regions. Although devoid of physiopathological or anatomo-clinical interpretation, these observations precede by almost ten years the first description of the march of seizure activity from an initial focus made by John Hughlings Jackson (1835–1911). Consistently with the main topic of his book, Hofmann discusses in detail the association between altered mental states and epileptic seizures, reporting the first case of forced normalization, a phenomenon later described by the Swiss neuropsychiatrist Hans Heinrich Landolt (1917–1971) in 1953.

Jules Baillarger was one of the foremost figures of nineteenth-century neurobiology. He is remembered today for his discovery that the human cerebral cortex is composed of six intercalated layers. Even today, two horizontal fiber bundles within cortical layers IV and V are referred to as the outer and inner bands of Baillarger. It is a measure of the importance of Baillarger's discovery that his findings were elaborated upon with advances in microscopy and the development of methods for staining neurons and myelin by, notably, Theodor Meynert and Santiago Ramon y Cajal. Furthermore, Baillarger's observation that there are variations in the thickness of one or another of the six cortical layers in different cortical regions, and the discovery of giant pyramidal motor neurons in layer V of the precentral gyrus, ultimately led to the

We review interactions between British and French Neurologists from the birth of this discipline in the 1860s to the early 20th century. First connections include Robert Bentley Todd and Thomas Clifford Albutt in England and Armand Trousseau and Guillaume Benjamin Amand Duchenne in France. During the 1860–80 years, Jean-Martin Charcot in Paris created the Salpetriere school of neurology. In London, the National Hospital for the Paralysed and Epileptic was founded in Queen's Square in 1860 with Charles Brown-Sequard as a first physician. Hughlings Jackson (1862), Russell Reynolds (1863), later William Gowers (1873) and David Ferrier (1880), all influenced French Neurology. Charcot investigated paralysis agitans and named it Parkinson's disease. He emphasized the contribution of Jackson to aphasia and epilepsy. Charcot travelled frequently to Great-Britain, especially to the annual meetings of the British Medical Association. He and other French physicians interacted with British colleagues at the International Congress in London in 1881. In the late 19th century, a number of articles were published by Charcot and other French authors in Brain, and by British neurologists in Nouvelle Iconographie de la Salpetriere and Revue Neurologique. Brown-Sequard and Charcot became corresponding members of the Royal Society of Medicine in 1887, as later did Jules Dejerine, Joseph Grasset and Theodule Ribot. The creation in 1999 of the Societe de Neurologie de Paris included among the foreign corresponding members Jackson and Ferrier. Dejerine, Fulgence Raymond and Pierre Marie developed Charcot's work and received in Paris foreign neurologists, among which Samuel Alexander Kinnier Wilson who spent one year in Paris in 1903 with Pierre Marie. He returned to Queen Square and King's College Hospital and remained in contact with French neurology. Wilson presented in Paris in 1912 a new disease he called progressive lenticular degeneration with cirrhosis of the liver (Wilson's disease). During the early 20th century, Anglo-French connections were emphasized in international congresses, notably in 1900 in Paris and in 1913 in London, where Joseph Babinski made his lecture on the cerebellar syndrome. In 1914, the Societe de Neurologie de Paris elected 10 new foreign corresponding members from Great Britain. Since then, Anglo-French links have continued with other young promising neurologists travelling from France to the United Kingdom and vice-versa.

‘The anatomical basis of prosopagnosia’1 is a concept that has intrigued neurologists and neuropsychologists since the first descriptions of prosopagnosia in the 19th century by Quaglino and subsequently by the giants of early neurology Hughlings Jackson and Charcot.2 3 The JNNP has a long history of publishing manuscripts discussing this phenomenon that have included case reports by illustrious authors such as Elizabeth Warrington4 and also historical notes2 detailing Lewis Carroll’s humpty dumpty in Through the looking-glass, and what Alice found there (1872), as an early report of prosopagnosia. John Meadows in his comprehensive review published in 19741 has been cited more than 400 times, which speaks to the enduring interest in this disorder. The review provides an in-depth discussion of aspects of prosopagnosia that continue to intrigue researchers and clinicians. It is fascinating to re-read this paper written 45 years ago and realise that many of the issues raised are still relevant and that (correct) anatomical conclusions could be reached based on such primitive data. The original data on prosopagnosia were based on acute insults to the brain for example, stroke and tumours, but more recent research building on these original observations has led to a body of research examining progressive forms of prosopagnosia in neurodegeneration and to the discovery of congenital prosopagnosia. The anatomical basis of prosopagnosia Authors: J. C. Meadows Year published: 1974 Number of times cited: 433 Prosopagnosia is a rare condition defined as the specific inability to recognise familiar faces even those of highly familiar people such as family members. Meadows in his 1974 paper1 discusses key issues including the exact definition of prosopagnosia, the …

The Jacksonian theory of hierarchical control has had a clear impact on the development of modern neuroscience. Hughlings Jackson's concepts of hierarchical control pertained to the structural organization of the central nervous system rather than to cognitive constructs. Perseverations occupy a special place within the rich phenomenologic domain of cognitive pathology associated with frontal lobe damage. In cases with massive frontal lobe lesions, however, task demands may be minimal and still precipitate perseveration and perseverative responses may be observed even in the execution of simple motor tasks. An extensive literature leads to the conclusion that massive, focal prefrontal damage almost invariably implies the presence of perseveration characterized by horizontal and vertical pervasiveness. Cognitive involution due to diffuse disease in humans can be viewed as dominated by frontal lobe dysfunction. An illustration of double dissociation principles appears to be provided by applications of both structural and functional brain-imaging techniques in investigations of the schizophrenic syndrome.

John Hughlings Jackson, the 19th-century British neurologist, first described what are today called Jacksonian seizures. He is generally associated with somatotopy, the idea that neighboring brain regions control neighboring body parts, as later represented pictorially in Wilder Penfield’s “homunculus,” or little man in the brain. Jackson’s own views, however, were quite different, though this is seldom appreciated. In an 1870 article, Jackson advanced the hypotheses that each region of the cerebrum controls movements of multiple body parts, but to different degrees, and that the “march” of movements that typically occurs during Jacksonian seizures is caused by the downstream connections of the overactive neurons at the seizure focus, rather than a somatotopic organization of the cerebrum. Jackson’s hypotheses, which were based almost entirely on his careful observations of movements during seizures, are well within the range of current hypotheses about how the frontal lobe is organized to control movements and thus deserve renewed attention.

Throughout his medical career, Robert Dunn (1799-1877) published a number of clinical cases with postmortem reports involving acquired language disorders, with the first noted in 1842. He developed a physiologically informed approach to psychological function during the 1850s along with a group of notable colleagues Benjamin Collins Brodie, Henry Holland, Thomas Laycock, John Daniel Morell, and Daniel Noble. He was also active in ethnographic research on human origins and racial diversity. As such, Dunn represents an interesting player in the developing fields of neurology, psychology, and anthropology in England in the latter part of the nineteenth century. These various strands converged at the meeting of the British Association of the Advancement of Science in 1868, where Dunn shared the program of lectures on the cutting-edge topic of aphasia with Paul Broca (1824-1880) and John Hughlings Jackson (1835-1911). Dunn's ideas developed over a longer time frame than his younger colleagues and as such represent a unique blending of concepts from the earlier work of Franz Josef Gall (1758-1828) and Jean-Baptiste Bouillaud (1798-1881) to the perspectives on language organization in the brain developed after 1861.

The seventeenth and eighteenth centuries saw the birth of the terms ‘neurology’ and ‘psychiatry’, the two components of the word ‘neuropsychiatry’. Despite the excess of a too literal approach to brain-behaviour relationships, Gall and Spurzheim’s phrenology should be recognised for mounting formal opposition to the mind-brain dualism that still prevailed in the first part of the nineteenth century and for establishing a (proto)scientific foundation for considering the brain as the organ of behaviour. The second half of the nineteenth century was dominated by Charcot’s school in France, whereas in Germany Griesinger expanded his predecessors’ work on the cerebral localisation of mental diseases and their symptoms. The first part of the twentieth century saw the development of Freud’s influential theories, which progressively shifted the focus of psychiatry from the brain to the unconscious. However the neuropsychiatric approach to brain-behaviour correlations did not disappear, thanks to the approach endorsed by Hughlings Jackson, von Economo, and Goldstein, among others.

John Hughlings Jackson was associated with the London Hospital as a Lecturer and Physician for nearly 40 years while also on the staff at The National Hospital, Queen Square. His experience at the two hospitals was complementary; sometimes, a patient would be exchanged between the two hospitals. At the London Hospital, he was especially revered by students, colleagues and even by the House Governor, for his knowledge and his contributions to neurology. His ideas helped to resolve the chaotic contemporary understanding of neurological phenomena into a coherent whole, determining the direction of future neurological research in the following century. His life and work was supported and strengthened by the help and friendship of his colleagues at the London Hospital, especially Sir Jonathan Hutchinson.

The earliest known description of a case of apraxia is attributed to Hughlings Jackson (1861), although he did not give a specific name to the disorder. The term “apraxia”, from the Greek apraksia (απραξiα – “inaction”) was first used in the modern era by Steinthal to describe deficits in planning and execution of motor actions due to neurological injury. However, it was the German neurologist Hugo Karl Liepmann who established the conceptual foundations of apraxia in its various forms of [...]

The purpose of this study was to present the evolution of views on epilepsy as a disease and symptom during the 19th and the 20th century. A thorough study of texts, medical books, and reports along with a review of the available literature in PubMed was undertaken. The 19th century is marked by the works of the French medical school and of John Hughlings Jackson who set the research on epilepsy on a solid scientific basis. During the 20th century, the invention of EEG, the advance in neurosurgery, the discovery of antiepileptic drugs, and the delineation of underlying pathophysiological mechanisms, were the most significant advances in the field of research in epilepsy. Among the most prestigious physicians connected with epilepsy one can pinpoint the work of Henry Gastaut, Wilder Penfield, and Herbert Jasper. The most recent advances in the field of epilepsy include the development of advanced imaging techniques, the development of microsurgery, and the research on the connection between genetic factors and epileptic seizures.

Exotic experiences such as the sensing of another consciousness or the detachment of consciousness from the body are occasionally reported by individuals with partial seizures from a temporal lobe focus. The experiences display the characteristics of Hughlings Jackson's “parasitic consciousness”. We have hypothesized that these experiences are encouraged by slight discrepancies in hemispheric activity that can be simulated by application of weak, physiologically-patterned magnetic fields across the cerebral hemispheres. Electroencephalographic and Low Resolution Electromagnetic Tomography (sLORETA) data revealed altered activity bands within specific regions within the cerebral cortices during these experiences. The clear changes in power of brain activity were discerned after consistent durations of exposure to specifically patterned weak magnetic fields. Millisecond range point durations were required. The technology may be useful to explore the subjective components associated with complex partial seizures.

The year 2011 marked the centenary of the death of one of the founders of British neurology, John Hughlings-Jackson (1835-1911). By common consent he was a great clinician. But he was more. He endeavored to use clinical observations to throw light on one of the great problems of the modern world, the problem of mind. Hughlings-Jackson's daily contact with mentalities warped by neurological disease caused him to ponder deeply the nature of the mind-brain relationship, nowadays often known simply as the "hard problem. " In particular, he saw the danger of conflating mind and brain, a danger that has grown greater with the spectacular growth of neuroscientific knowledge during the last century. Although Hughlings-Jackson's neuroscientific thought is long outdated, his philosophic endeavors remain highly instructive. © 2012 by The Johns Hopkins University Press.

‘ Henry Head was the outstanding clinical neuroscientist of his generation and prominent in the arts and literary society of Edwardian London ’ When the Medical Committee met on 4 February 1896 to consider the appointment of a new member of the consultant staff at Queen Square, Henry Head was placed third of five candidates. Sir William Gowers (1845–1915) explained that “everyone recognises his great ability… [but] whenever I spoke to Head (or rather he spoke to me) I always felt that I knew nothing… and was only too glad to escape”. Thus, having worked at the National Hospital intermittently since 1881, a patronising attitude to senior colleagues left Head, the outstanding original thinker in neurology of his generation, outside the self-styled ‘temple of neurology’. In ‘Henry Head, herpes zoster, and the graphic development of his scheme of the dermatomes in man’1 , Dr GD Schott, formerly consultant neurologist at Queen Square, writes about the archive of images that Head produced depicting the dermatomes of man. Head’s work leaned much on mapping the sensory and cutaneous features of herpes zoster.2 3 He told (Sir) Charles Sherrington (1857–1952) that, based on personal experience, the English language lacked words adequately describing the exquisite unpleasantness of herpes zoster and referred pain. Head blossomed under the influence of (Sir) Michael Foster (1836–1907), JN (John) Langley (1852–1925) and Walter Gaskell (1847–1914) at Trinity College, Cambridge; Julius Bernstein (1839–1917) in Berlin; Ewald Hering (1834–1918) in Prague with whom he worked during a 2-year interval in the Cambridge Natural Sciences Tripos; and (John) Hughlings Jackson (1835–1911), his predecessor at the London Hospital where Head was appointed to the consultant staff in 1896. He earned his living through private practice and legal work while also serving the needs of the poor in the east end of London. …

Some scepticism has been voiced over whether the work of John Hughlings Jackson possesses any significant philosophical orientation. This article argues that Hughlings Jackson was acquainted with the work of a wide range of philosophers. In particular, certain aspects of the writings of John Stuart Mill are reflected in Hughlings Jackson's own work. From early in his career, Hughlings Jackson adopted a critical stance in his neurological papers, seeking to expose shortcomings in the conventional practices of his peers and urging greater methodological rigour and sophistication in order to advance their science. This critical and 'procedurist' bias endows Hughlings Jackson's writings with a characteristically modern character.

John Hughlings Jackson was a pioneer in neurology who thought deeply about the structure of the brain and how that manifested itself in the various syndromes that he saw in the clinic. He enunciated a theory of the evolution and dissolution of neural function based on the idea that basic sensorimotor processes become embedded in networks of connections that relate them in successively more complex ways to allow for performance of more and more nuanced and adaptive functions. Hughlings Jackson noted the curious link between human thought, action and speech. He further recognized that disinhibition or release from control and direction marked neurological damage. His integrative framework remains deeply relevant to the plethora of results being produced by the careful and diverse experimentation currently undertaken with the aid of brain imaging techniques of which he could only dream. In celebration of the memory of John Hughlings Jackson, we revisit his concept of neural evolution and development, which led to what eventually became a leading model of brain organization, whereby a new order of behavioural control—the conscious mind—is created out of simpler elements, in a manner similar to Herbert Spencer’s evolutionary theory. By this Hughlings Jackson did not mean anything dualistic but merely that the highest layer of evolution of nervous arrangements was ‘highly complicated’ and that dissolution of that higher level leaves ‘a lower consciousness and a shallower nervous system’. * Abbreviation : BA : Brodmann area

Epilepsy is one of the few neurological disorders to be recognized in Antiquity. The etiology of epilepsy has evolved from affliction of evil spirits and bad omens to an organic disease of the brain. Geographically separate cultures have recognized the diverse symptomatology of epilepsy from vigorous convulsions to spontaneous localized jerking since times immemorial. Similarly, the diagnostic procedures and treatment options have varied in different milieus. In this review we have followed the course of history chronologically from Babylonians to Hughlings Jackson, mapping the conceptual development of epilepsy and the origin of some of the positive and negative attitudes inherited into today's epileptology. Original writings, such as Hughlings Jackson's letters, and English translations of early Latin work, where available, were used as primary sources of information. Where primary sources were not accessible, we consulted research articles, books, and commentaries by eminent historians and epileptologists.

The theories of John Hughlings Jackson (1835–1911) on brain structure and function will be discussed in the light of earlier theories of the frontal lobes that influenced him. These included the works of Charles Darwin (1809–1882) and Herbert Spencer (1820–1903). Hughlings Jackson's Four Principles of Nervous Action were: – evolution of nervous functions; – hierarchy of those functions; – negative and positive symptoms of dissolution; – local and uniform dissolution. Important principles were the hierarchical organisation of the central nervous system, with interactions between levels. The highest level was the prefrontal cortex . His ideas were better applied to the motor than the sensory system . Further he was concerned with movements rather than muscles. Of considerable significance were ideas of inhibition and release, and that clinical signs of neurological injury involved both processes simultaneously. This led to concepts of positive and negative symptoms, which he opined were present in every case; lesions could never localise a function, but only degrade a system, and the clinical effects were a reflection of the continued level of activity of parts of the brain spared by the lesion. His interests in philosophy led him to state there was no physiology of the mind any more than there was a psychology of the nervous system; he advocated the Doctrine of Concomitance and parallelism of mental and neural states. Hughlings Jackson disagreed with the cerebral laterality ideas of Pierre Paul Broca (1824–1880). He was impressed by the work of the French anatomist and zoologist Luis Pierre Gratiolet (1815–1865) and advocated an important role for the right hemisphere in language. For Hughlings Jackson mentation was a “dual process, played out between the two hemispheres of the brain”. Finally, in the presentation there will be a brief note on the relationship between Jean-Martin Charcot (1825–1893) and Hughlings Jackson [1] , [2] , [3] .

In the 1850s Delasiauve and Russell Reynolds independently introduced the idea that the previously more inclusive concept of "epilepsy" should be restricted to that of an idiopathic disease manifesting epileptic seizures not caused by detectable brain pathology. This idea was rather widely accepted, though with some modification, over much of the next century. However there was increasing opposition to the idea from those, including John Hughlings Jackson, who perceived that all epileptic seizures must be symptoms of underlying brain disease. With increasing identification of structural brain pathology in what had been regarded as instances of idiopathic epilepsy, the latter view has increasingly prevailed.

This is the conclusion of a two-part translation of José Maria López Piñero’s book John Hughlings Jackson (1835—1911), Evolucionismo y Neurología (Madrid: Editorial Moneda, 1973). Part 1 was published in History of Psychiatry 21 (1): 85—95.

After returning to Spain from a research period in London on a Wellcome Trust scholarship, José Maria López Piñero1 published in 1973 a short book entitled John Hughlings Jackson (1835—1911), Evolucionismo y Neurología (Madrid, Editorial Moneda). Written from the perspective of the classical German medical historiography that the author had imbibed from Werner Leibbrand and Annemarie Wettley, this work truly added to Jacksonian scholarship. Neither hagiographic nor nitpicking, it offered a sober assessment of the contribution of the great Yorkshireman and it was soon to become a minor classic among connoisseurs. Although important additions to Jacksonian scholarship have appeared since 1973,2 López Piñero’s book has retained its relevance. It will be published in History of Psychiatry in two parts.3

A lightening, or clearing, of the mental state in the hours or days before death, particularly in those delirious, is occasionally noted by those caring for the dying. Similar phenomena have been described in the natural world and in classical literature. This brief period of lucidity is generally followed by a rapid terminal decline. The author reports on his experience with six cases illustrating this phenomenon. The increasing use of palliative sedation may diminish the possibility of lightening up before death occurring. The theoretical concepts of Hughlings Jackson may provide an explanation for this phenomenon.

John Hughlings Jackson articulated a neurologic method of systematically evaluating the anatomy, physiology, and pathology of every patient with neurologic disease. He used this mode of analysis to develop a theory of the physiology of epilepsy. We examined an example of his method in a newly discovered, unpublished manuscript containing his suggestions for the treatment of epilepsy based on his physiologic ideas. He had his private papers destroyed at the time of his death, but the Rockefeller Library of the University College London Institute of Neurology, Queen Square, contains a collection of his papers probably saved from destruction by his collaborator James Taylor. Among these articles is an 1899 memorandum, labeled "For Private Circulation" and entitled "A Suggestion for the Treatment of Epilepsy." In it, Hughlings Jackson claimed that focal discharging lesions cause both focal and generalized epilepsy, and that the cells in the lesion discharge their energy more easily than normal tissue. Citing microscopic evidence that such lesions are congested and inflamed, and that tuberculin destroys such tissue in the lung, he reasoned that destroying these unstable neurons with tuberculin would improve epilepsy. In this private manuscript, Hughlings Jackson uses an unusually detailed analysis of the pathology, anatomy, and physiology of epilepsy to predict a scientific approach to its treatment.

Although many individuals contributed to the development of the science of cerebral localization, its conceptual framework is the work of a single man--John Hughlings Jackson (1835-1911), a Victorian physician practicing in London. Hughlings Jackson's formulation of a neurological science consisted of an axiomatic basis, an experimental methodology, and a clinical neurophysiology. His axiom--that the brain is an exclusively sensorimotor machine--separated neurology from psychiatry and established a rigorous and sophisticated structure for the brain and mind. Hughlings Jackson's experimental method utilized the focal lesion as a probe of brain function and created an evolutionary structure of somatotopic representation to explain clinical neurophysiology. His scientific theory of cerebral localization can be described as a weighted ordinal representation. Hughlings Jackson's theory of weighted ordinal representation forms the scientific basis for modern neurology. Though this science is utilized daily by every neurologist and forms the basis of neuroscience, the consequences of Hughlings Jackson's ideas are still not generally appreciated. For example, they imply the intrinsic inconsistency of some modern fields of neuroscience and neurology. Thus, "cognitive imaging" and the "neurology of art"--two topics of modern interest--are fundamentally oxymoronic according to the science of cerebral localization. Neuroscientists, therefore, still have much to learn from John Hughlings Jackson.

We must remember that many doctrines were stated years ago in principle which were then novel and much disputed, hut are now so generally accepted that we are in danger of ceasing to think of the very early propounders of those doctrines

Summary: Aim: To trace the concept that the cerebral cortex is the site of epileptogenesis before Hughlings Jackson published the idea in 1870 in the paper “A study of convulsions” which marks the beginning of modern epileptology. Method: Perusal of 19th century English language medical literature. Result: The existence of cortical epileptogenesis was postulated by Richard Bright in 1831 and 1836, touched on by Robert Bentley Todd in 1849, and rediscovered independently by Samuel Wilks in 1866. Wilks's idea probably became known to both John Thompson Dickson and John Hughlings Jackson and was then developed further, particularly by Jackson. Conclusion: The thought of Samuel Wilks probably played a more important role in the origins of modern epileptology than has sometimes been appreciated.