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George York, David Steinberg. London: The Wellcome Trust Centre for the History of Medicine, 2006, £35.00, pp 139. ISBN 0 95484 1 9 1
The name Hughlings Jackson still has considerable currency with neurologists of all interests, but his name is also widely known within psychiatry. This may be because he was perhaps one of the first neuropsychiatrists, someone who tried to understand the development of symptoms following cerebral lesions, but the symptoms also included abnormal mental states.
This little book gives a very succinct account of his life, but also of his neurological model. It is one of the clearer descriptions of Hughlings Jackson's principles this reviewer has read, and they only take up the first 30 pages of the text. Following that there is a catalogue of all of the known writings of Hughlings Jackson from 1861 through to 1909, and then appendices of some published work, essentially pamphlets, some of which were circulated privately, and also unpublished documents which reside in the Rockefeller Medical Library of the National Hospital for Neurology and Neurosurgery.
This is a most useful and nicely produced book for anybody who would like an introduction to Hughlings Jackson's works, but is essential for Jacksonian Scholars.
This reviewer would merely cavil with the failure in the discussion of Hughlings Jackson's work to appreciate his interest in mental phenomena, with overemphasis on a view that Hughlings Jackson only considered the nervous system as a sensory–motor machine. Although it is known that Jackson favoured a psychophysical parallelism (the doctrine of concomitance) and avoided metaphysical explanations for scientific phenomena, rejecting unconscious mental states, his interest in psychiatry was considerable. This was stimulated by Daniel Hake Tuke and Thomas Laycock, and when he was at the National Hospital he visited the Bethlem Hospital and did ward rounds with Thomas Savage. Furthermore, he closely collaborated with James Crichton Browne at the West Riding Lunatic Asylum.
An outline of his thinking, still so important for neurology and psychiatry, can be gleaned from this useful book. As his obituarist Golla remarked “(Hughlings Jackson's) fundamental conception of the real significance of symptoms as the evidence of release of control is never lost sight of, and provides the clue to much that has been hopelessly entangled by the irrational attribution of positive symptoms to nervous matter that has undergone destruction”.