Critchley M, Critchley EA John Hughlings Jackson: Father of English Neurology Oxford, Oxford University Press, 1998, 240 pages h/b. Price £39.50. ISBN 0-19-512339-5 With the passing of time, John Hughlings Jackson becomes an ever more inaccessible figure. Even at Queen Square, where folk memories tend to be especially durable, the senior neurologists trained by somebody who was trained by somebody who remembered Jackson's ward rounds have all long since retired, and with them has gone any sense of the personality of the ‘father of English neurology’. In 2000, 165 years after Jackson was born, all we have left to fall back on is his corpus of rather difficult, often frankly impenetrable, writing. Macdonald Critchley's new memoir, co-written with his wife Eileen and published shortly after his death in 1997, sets out to review Hughlings Jackson's achievements, and in doing so to show why he is so important a figure in the history of neurology. We can expect an account by Critchley to be authoritative, because his teachers knew Jackson, and he tells us in his introduction that much of the narrative is a distillation of their memories. Critchley's remark ‘in my 97 years I have never known any other neurologist to arouse such deep affection’ promises an exceptional character. The early chapters of historical background, largely the fruits of painstaking research by Eileen Critchley, are of limited interest. There is rather too much unsifted detail, and because Victorians tended to use and re-use the same Christian names in successive generations, it is difficult to keep track of the line of immediate JHJ forebears. The chapter on his maternal ancestors is particularly overburdened with irrelevant minutiae. However, the account of Jackson's training at York Medical School and his early years as a junior doctor is interesting. By the early 1860s, Jackson was an established physician and writer on neurological topics, and a review of his work published over 40 years comprises the meat of this book. Jackson's style was difficult to follow, even for his contemporaries: the frequent use of parentheses and subordinate clauses, woven on a background of unfamiliar philosophical argument, caused many to give up the struggle. Indeed, had it not been for neurologists such as William Broadbent, Henry Head, Francis Walshe (and, with this book, Macdonald Critchley), his work would have largely been lost. Critchley shows us that Hughlings Jackson's lasting contribution to neurology was to have offered an integrated view of the nervous system, based on his own meticulous clinical observations of cases, many with post-mortem confirmation. His interests in neurology were wide, ranging as they did from epilepsy and aphasia to the cerebellum, mental diseases and hemiplegia. For Jackson, the interest lay not so much in descriptive clinicopathological correlation, but in what a given patient's impairment could tell him about normal function. His research on the aphasias showed the value of this approach, as Critchley traces Jackson's thinking from the early realisation that speech is not a simple phenomenon, to the complex arguments on the acquisition of language and the relationship between speech and thought that were to have such an influence on the work of Freud. Following through these pages, one comes to appreciate why Arnold Pick described Hughlings Jackson as ‘the deepest thinker in neuropathology of the last century’. There are glimpses of the man, too. A kind man, with a sense of humour, often abstracted. Asked for his view on a subject not immediately occupying his thoughts, a typical reply would be ‘I forget now, but you will find my opinion in The Medical Times for last October’. A delightful neuropathological story, which smacks of the urban myth, is that of an absent minded Jackson pulling a handkerchief from his pocket to blow his nose at a dinner party, and in doing so letting fall on to the table a ‘sizeable portion’ of brain tissue. What comes over in such anecdotes is the immense affection in which Jackson was held by both his contemporaries and his juniors; Critchley's personal achievement is to make one wish that one could have known him too. I really enjoyed this book: it wasn't always easy, but given the subject, that was not unexpected. It was, though, well worth the effort.