Weir Mitchell's observations on sensory localization and their influence on Jacksonian neurology

Background: John Hughlings Jackson (1835-1911) in London was critical in advancing the concept of cerebral localization. Hughlings Jackson, however, did not work in a vacuum. Silas Weir Mitchell (1829-1914), in Philadelphia, published several clinical observations related to localization. Objective: To examine Weir Mitchell's clinical observations on sensory localization, to determine whether they influenced Jacksonian neurology, and to elucidate the private relationship between the two men. Methods: The authors reviewed published (fictional and scientific writings of Weir Mitchell and scientific writings of Hughlings Jackson) and archival sources (Weir Mitchell's unpublished autobiography and Hughlings Jackson's unpublished correspondence with Weir Mitchell). Results: In the 1860s, Weir Mitchell, through his work on phantom limb syndrome and other nerve injuries, made oblique references to the central representation of body parts, specifically with regard to sensation. Hughlings Jackson had an interest in somatotopic representation in the nervous system and repeatedly cited Weir Mitchell's work in support of his ideas. The two shared several patients, met at least once in London, and carried on a friendly correspondence. Conclusions: Weir Mitchell's observations on sensory localization were well known to Hughlings Jackson, who cited them in seminal articles on cortical localization. Their correspondence provides an example of trans-Atlantic scientific and clinical communication at the time that neurology emerged as a distinct clinical discipline.