The unknown source of John Hughlings Jackson's early interest in aphasia and epilepsy

The National Hospital for Paralysis and Epilepsy in London (founded 1859) was the scene of great discoveries in the new specialty of neurology, carried out in great part by John Hughlings Jackson (1834-1911). The clinicians Jonathan Hutchinson and Charles Edward Brown-Sequard are typically identified as Jackson's mentors. This paper discusses the previously neglected role of Jabez Spence Ramskill (1824-1897), founding physician of the National Hospital. Ramskill appears to have been significant in providing the opportunity and context that led Jackson to develop his theories concerning higher cerebral function disorders. As assistant physician to Ramskill at the National Hospital, Jackson was provided with a vast caseload of epileptic, hemiplegic, and aphasic patients. Ramskill and Jackson both published papers on aphasia in the London Hospital Reports in 1864. Consideration of the similarities and differences between these 2 papers highlight significant issues in the clinical and theoretical development of understanding language organization in the brain. The early writings of Jackson and case notes of Ramskill document a close link between the 2 and indicate the debt that Jackson had to Ramskill for providing him with the opportunities to develop his original ideas on epilepsy and aphasia.