Abstract

This article examines some of the published references to John Hughlings Jackson as the “father of English neurology”, the “father of British neurology”, or even the “father of neurology”. These publications show that, rather than being a retrospective, posthumous signifier, this terminology in fact dates from Jackson’s own lifetime.

Introduction

Neurology first began to emerge as an independent medical discipline in the 1860s and 1870s, as some clinical practitioners were able to devote most or even all of their time to patients with diseases afflicting the nervous system. One amongst these clinicians was John Hughlings Jackson (1835–1911). It is now perhaps a commonplace, indeed almost reflexive cliché, to refer to Jackson as the “father of English neurology”, or the wider claim of the “father of British neurology”, or even the ultimate “father of neurology”. But what were the origins of this terminology? This article examines some of the published examples of this wording (no claim for a comprehensive study is made), moving sequentially backwards in time, as per the unscrolling of a family tree.

1998: The Critchleys

Contemporary neurologists might be of the view that Jackson’s status as the “father of English neurology” stems, at least in part, from the biography written by Macdonald Critchley (1900–1997) and his wife Eileen, first published in 1998, of which this was the subtitle [1]. Almost at the outset they stated of Jackson that “this man of genius became widely known as the Father of English neurology” (1998:1) but offered no analysis of the origin of the phrase. Earlier usages are, however, to be found.

1961: Wetherill

Wetherill’s account of the York Medical School [2], where Jackson had some of his medical training in the early 1850s and where he came under the influence of Thomas Laycock, noted that Jackson “has been called ‘The Father of English Neurology’” (1961:266) but gave no reference(s).

1960: Macdonald Critchley

In an account of Jackson and the early years of the National Hospital at Queen Square [3], Macdonald Critchley characterised Jackson as “the father of British neurology” (1960:617).

1939: Purves-Stewart

In the memoir of his life and career as a neurologist [4], Sir James Purves-Stewart (1869–1949) designated Jackson as the “father of modern English neurology” (1939:41). Much of Purves-Stewart’s working life was spent in London, certainly from around 1896 onwards, affording him some direct contact with Jackson (unlike Critchley), indeed they were co-authors of a paper [5], although their contributions appeared separately.

1935: Foster Kennedy

Robert Foster Kennedy (1884–1952), of eponymous fame, had apparently encountered Jackson at Queen Square when a very young man (according to the Critchleys, 1998:193). In a brief article written to commemorate the 100th anniversary of Jackson’s birth [6], Foster Kennedy said of Jackson that he “might be called the Father of Neurology” (1935:480). Foster Kennedy’s much broader claim was later transcribed by the Critchleys (1998:194), without comment, although they cited neither Purves-Stewart nor Wetherill.

1911: Risien Russell

Amongst the many obituaries and appreciations written at the time of Jackson’s death in October 1911, the contribution of James Samuel Risien Russell (1863–1939) noted: “Dr. Jackson has been fitly described as the ‘father of English neurology.’ No father has been more loved, and no father has ever set his sons a better example of how best to live their lives” [7].

1907: The unveiling of Jackson’s marble bust at Queen Square

Jackson officially retired from his work at the National Hospital, Queen Square in 1906, an occasion subsequently marked the following year by the unveiling of a bust of Jackson at the hospital. The event was described in the pages of the British Medical Journal:

In order to commemorate his long association with, and the valuable services which he has rendered to, the National Hospital for the Paralysed and Epileptic, Queen Square, Bloomsbury, the medical and surgical staff have placed a marble bust of Dr. Hughlings Jackson, M.D., F.R.S., the “Father” of British neurology, in the hall of that institution. At the presentation Sir William Gowers, the Senior Physician, on behalf of the subscribers, handed over the bust in a few well-chosen and appreciative remarks [8].

This was the occasion on which Gowers reportedly stated: “Let us look upon this bust and then turn to the living counterpart – our master!” [9,10]. To my knowledge, there is no evidence that Gowers used the wording of “father of British neurology”.

1896: The Hughlings Jackson Lectureship

Evidently then, the “father” terminology existed in Jackson’s own lifetime. Indeed, it had been used some years before his retirement. In 1896, a proposal was made to the Neurological Society of London, apparently by Dr Walter Colman (1864–1934), another of Jackson’s junior collaborators:

At a meeting of the Neurological Society held at the National Hospital, Queen Square, on Thursday, November 5th, it was announced by the President, Dr. Alexander Hill, that the Council had unanimously decided to found a Hughlings Jackson Lectureship, and he was happy to say he believed that the whole medical profession would welcome this and the further announcement that Dr. Hughlings Jackson had kindly consented to give the first lecture.

This announcement in the British Medical Journal continued:

It was believed that to succeed, as lecturer, the father of English neurology will be an incentive to all distinguished workers in this science, whether at home or abroad [11].

Of note, the Lancet item on the foundation of this eponymous lectureship [12] did not describe Jackson as the “father of English neurology”.

Discussion

The purpose of this article is not to express any particular opinion on the desirability or otherwise of nominating a paternity for the discipline of neurology (or indeed of any “-ology”; ditto maternity), other than to observe that it would seem implausible that a solitary individual could initiate a whole sphere of intellectual inquiry, the emergence of which may seem more likely to be a consequence of distributed, collaborative effort. Rather, the purpose of this article has been merely to attempt a preliminary tracing of the historical record of this paternalistic trope for Jackson. It does not purport to be a systematic study of the literature, merely a brief narrative of examples. Of note, other individuals have on occasion been similarly labelled: both Thomas Willis (1621–1675) and Jean-Martin Charcot (1825–1893) have been designated as “the father of neurology” [13,14]. In similar vein, Frederick Batten (1865–1918) has been called the “father of paediatric neurology” [15], and Jun Kimura (1935–2022) the “father of electrodiagnostic neurology” [16].

As shown here, application of the epithet to Jackson was not a retrospective, posthumous signifier but was established in his own lifetime. (It may be an interesting diversion to ponder on whether or not Jackson himself was aware of this label, and if so what his reactions to it might have been.) If the 1896 item was the original usage, its appearance in the British Medical Journal may be significant: it may prompt the speculation that it originated with Ernest Hart (1835–1898), the journal’s editor since 1866. As Greenblatt has argued, “there must have been mutual respect and ready communication between Jackson and Hart”, elsewhere describing Hart as “a Jackson aficionado” [17]. Hart published many of Jackson’s lectures in the British Medical Journal, and Jackson also contributed to the early issues of the London Medical Record, another journal edited by Hart [18].

Whatever its exact origin, the terminology is indicative of the respect and esteem in which Jackson was held, and the significance attached to his labours by contemporaries. This work was almost exclusively clinical, as manifested in his many lectures and journal publications. Unlike Gowers, Jackson wrote no textbook. At the administrative level, he may have been the moving spirit in the inauguration of the Neurological Society of London (1885–6) and was its first President (1886), but he was not a committee man. Nor was he an experimentalist although certainly sympathetic to the application of physiological principles to clinical medicine: “The physiological part of our clinical work is not sufficiently methodical; we have medical knowledge, and we have separately physiological knowledge, but our medical knowledge is not sufficiently physiological” [19]. To extend the parental metaphor, this was a sound principle with which to guide the development of his putative offspring.

References

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  6. Kennedy F. John Hughlings Jackson. Bull N Y Acad Med 1935; 11 (8): 479-480. https://doi.org/10.1097/00005053-193512000-00002
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  12. Anon. Lancet 1896; 2 (3820): 1402 (14th November).
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  14. Kumar DR, Aslinia F, Yale SH, Mazza JJ. Jean-Martin Charcot: the father of neurology. Clin Med Res 2011; 9 (1): 46-49. https://doi.org/10.3121/cmr.2009.883
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