John Hughlings Jackson: Father of English Neurology (review)

Macdonald Critchley and Eileen A. Critchley. John Hughlings Jackson: Father of English Neurology. New York: Oxford University Press, 1998. xi + 228 pp. Ill. $55.00.

John Hughlings Jackson (1834-1911) is usually accorded the status of the doyen of British neurology; he thus occupies a position comparable to that of Jean-Martin Charcot in France and Wilhelm Erb in Germany among the founding figures of the discipline. It may therefore seem surprising that there has been no scholarly biography of so imposing a figure. This omission is, in part, explained by the state of the record: Jackson ordered that his personal papers, including his voluminous casebooks, be destroyed after his death--an instruction that was, alas, observed, leaving a dearth of archival material for the historian. Furthermore, Jackson never published a monograph; his numerous writings are scattered throughout a multitude of journals, although some have been gathered together in more accessible form.

The current volume is clearly a labor of love. The principal author was himself a distinguished London neurologist who saw a direct line of descent between Jackson and himself. Eileen Critchley supplemented her husband's professional expertise and intimate knowledge of the Jacksonian tradition in British neurology with painstaking genealogical studies to establish their subject's family background. The resulting work is perhaps best viewed as a primary source for those interested in assessing the part that Jackson's writing and personal influence have played in the construction of neurologists' sense of identity. A recurrent theme within this book, and in the literature surrounding Jackson more generally, is that it is impossible to separate the man from the work.

One of the most valuable aspects of the volume is the compilation of the reminiscences, tributes, and evaluations produced by neurologists since Jackson's death. These show how, by ascribing a particular personality to this father figure, neurology strove to establish its own identity. The construction of Jackson's "genius" is especially intriguing. The obscurity of his style and his failure to attain immediate recognition for his ideas were translated into virtues: Jackson's mind possessed a profundity that militated against the spurious clarity displayed by some of his professional contemporaries. He arrived at his results, moreover, through meticulous clinical observation coupled with spectacular feats of theoretical generalization. All this was achieved with little in the way of technological support, though Jackson was an early proponent of the ophthalmoscope. He thus epitomized an era of unmediated intellectual achievement. One detects a note of nostalgia for this style of neurology in the remarks of later twentieth-century practitioners, who worked in an environment where diagnosis was increasingly mechanized and where the clinician was more a technician than a philosopher.

This book also contains a fair amount of incidental material about some of Jackson's contemporaries; this hardly amounts, however, to an adequate account of his professional and wider intellectual setting. There is an unfortunate antiquarian flavor to some passages: most readers could dispense, for instance, with the extended discussion of the hyphenation of Jackson's name. This is, nonetheless, a valuable volume that should encourage further study of the Jacksonian legacy. The title itself bears some scrutiny. The paternal role ascribed to Jackson is a commonplace--but what are we to make of the fact that he is identified as the father specifically of English neurology?

L. S. Jacyna
Wellcome Institute for the History of Medicine
London

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