John Hughlings Jackson
John Jackson was born a farmer’s son at Providence Green, Hammerton, Yorkshire, England on 4 April 1835. The matronymic Hughlings, from his mother Sara Hughlings, became attached to the Jackson family name. His elementary education was poor. In 1865 he qualified for medicine at York, where he came under the influence of the neurologist Thomas Laycock, who considered the brain as subject to the laws of reflex action. Highly impressed by the writings of the philosopher and early evolutions Herbert Spencer (1820-1903), Jackson gave serious consideration to the thought of abandoning medicine in favor of philosophy. When Jackson had come to London in 1895, Jonathan Hutchinson (1828-1913) persuaded him to pursue his medical career. With the help of Hutchinson, Jackson started in London as a medical journalist and thus became acquainted with the chief London hospitals. In 1862 he became assistant physician to the National Hospital, Queen Square, where Jackson’s interest in neurology was encouraged above all by Edouard Brown-Sequard (1817-1984). In 1864 he was appointed to the staff of the London Hospital. In 1867 he joined the staff of the National Hospital, at that time named Hospital for the Epileptic and Paralysed, where he worked as a staff member up to 1896, and as a consultant from 1896 to 1906. More than 300 papers from his hand, written in a meticulous but difficulty readable style with many footnotes, were mainly published in medical journals of limited circulation at first. In 1878 he joined J.C. Bucknill, J. Crichton-Brown, and D. Ferrier as founder and editor of the famous journal Brain. About 1865 he married his cousin Elisabeth Jackson, who suffered from what we now call Jacksonian epilepsy and who died childless eleven years later. Jackson was a modest, even shy man of big stature, restless, who abhorred sports or even walking, suffered from migraine, vertigo, and progressive hearing deficiency. The reading of novels and even of penny thrillers was his only hobby. The “father of British neurology” died of pneumonia on October 7, 1911. (see McHenry, 1969; 1956 and Lennox, 1970 for appraisals of his life and work.)
In 1864 Jackson published his first papers on loss of speech and on defects of expression, in 1894 his last, with a total number of 28. The theme of loss of speech is seldom discussed separately, but almost always in connection with other neurological phenomena as hemiplegia and epileptic seizures.
In these papers it is clear from the beginning that Jackson, unlike his contemporaries, is critical about localization of the “faculty of speech” in a circumscribed part of the brain. In 1866 he expressed his disagreement with Broca with a gentle introduction: “I must here say that I believe less in some of the views propounded by Broca than I did, although I think the scientific world is under vast obligation to him for giving precision to an important inquiry”, but then he states: “I think, then, that the so-called ‘faculty’ of language has no existence”. The medieval doctrine of he faculties and its transformation by Franz-Joseph Gall into the doctrine of speech center in the brain were not accepted by Jackson. In Jackson’s interpretation the nervous system is an organ of movements, even for the most voluntary and complex movements serving in speech. In his paper “On the nature of the duality of the brain” (1874) he states: “to locate the damage which destroys speech and to locate speech are two different things”. In 1868 Broca presented his views in a meeting of the British Association at Norwich. Jackson contributed to the discussion and from the abstract “Observations on the physiology of language” (1868) it is clear that Jackson opposed Broca. On that occasion Jackson stressed his opinion that destructive lesions never cause positive effects, but only negative ones, and that any positive symptoms are the consequences of the released activity of lower centers. In every cause of affection of speech there exists, according to Jackson, a negative and a positive condition. The patient may be not able to speak, to write, or to read, and expression by signs may be impaired: this is the negative condition. At the same time the patient may be able to write his signature, to swear or utter other emotional expressions: this is the positive condition (Head, 1926). In other words, Jackson applied his ideas on evolution and dissolution of the nervous system also on affections of speech.
Jaskson makes a distinction between voluntary and involuntary language. he acknowledges his indebtedness to the ideas of Jules Baillarger (1809-1890).In the book De l’aphasie au point de vue psychologique (1865) Baillarger distinguished between “aphasie simple” and “aphasie avec perversion de la faculte du language”, an automatic-voluntary dissociation being possible in the former and usually present in thelatter. Bailarger considered the automatic-voluntary dissociation essential for the classification of aphasia. Jackson called this the “Baillarger principle”. From 1874 Jackson expressed his views based on the Baillarger principle. The right half of the brain, he says, is the half for the automatic use of words, the left is the half for both the automatic and the voluntary use. The left is the leading half.
On the expressive side of language Jackson interprets loss of speech as loss of symbols. On the receptive side of language loss of perception (imperception) means loss of images. Speech and perception cooperate intimately in mentation. In the process leading to the speech there is a double revival of words. Nervous arrangements for words used in speech lie chiefly in the left half of the brain, and nervous arrangements for words used in understanding speech lie in the right half also. In the case of perception there is a vivid image; in the case of thinking of an object in its absence (ideation) the image is faint. In a similar way, in internal speech there is fanit excitation of the same sensorimotor processed which for eternal speech need to be strongly excited.
In “The Founders on Neurology” William Lennox ended his biography of Jackson as follows: ‘Father of British neurology’, he appears to us as having been foremost on the brilliant staff that made ‘Queen Square’ a center of world neurology.