John Hughlings Jackson - Science and Research

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. His name is attached eponymously to the characteristic "march" of symptoms in focal motor seizures and to the so-called "dreamy state" of psychomotor seizures of temporal lobe origin. 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.

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. 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, 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 ‘negativesymptoms (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. The ‘positive-negative’ distinction he took from Sir John Reynolds.

Continental psychiatrists and psychologists (e.g. Ribot, Janet, Freud, Ey) have been more influenced by Jackson’s theoretical ideas than their British counterparts. During the 1980s, the ‘positive-negative’ distinction was temporarily fashionable in relation to the symptoms of schizophrenia.

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 He also delivered the 1872 Hunterian Oration to the Hunterian Society.

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