Cerebral Localization in the Nineteenth Century — The Birth of a Science and its Modern Consequences

Abstract

Although many individuals contributed to the development of the science of cerebral localization, its conceptual framework is the work of a single man—John Hughlings Jackson (1835–1911), a Victorian physician practicing in London. Hughlings Jackson's formulation of a neurological science consisted of an axiomatic basis, an experimental methodology, and a clinical neurophysiology. His axiom—that the brain is an exclusively sensorimotor machine—separated neurology from psychiatry and established a rigorous and sophisticated structure for the brain and mind. Hughlings Jackson's experimental method utilized the focal lesion as a probe of brain function and created an evolutionary structure of somatotopic representation to explain clinical neurophysiology. His scientific theory of cerebral localization can be described as a weighted ordinal representation. Hughlings Jackson's theory of weighted ordinal representation forms the scientific basis for modern neurology. Though this science is utilized daily by every neurologist and forms the basis of neuroscience, the consequences of Hughlings Jackson's ideas are still not generally appreciated. For example, they imply the intrinsic inconsistency of some modern fields of neuroscience and neurology. Thus, “cognitive imaging” and the “neurology of art”—two topics of modern interest—are fundamentally oxymoronic according to the science of cerebral localization. Neuroscientists, therefore, still have much to learn from John Hughlings Jackson.