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S M Janković

Publications and source records attributed to S M Janković.

At least 19 recordsLinked to original sources

Service quality in public and private pharmacies in the city of Kragujevac, fr Yugoslavia.

AIM: To compare the service quality in public and private pharmacies in the city of Kragujevac by measuring patient care and health facility indicators. METHODS: The patient care indicators and health facility indicators, established by the World Health Organization in 1995, were measured prospectively in 7 public and 7 private pharmacies in Kragujevac, Yugoslavia, during November and December 1999. A sample of 100 patient-visits was analyzed in each pharmacy. RESULTS: Our study showed that the average drug dispensing time ranged from 20.5 to 48.2 seconds, being significantly longer in private (21.1-48.2 s) than in public pharmacies (20.5-33.7 s) (F=13.12, p<0.001). The percentage of actually dispensed drugs ranged from 29% to 63%, and no significant difference was found between public and private pharmacies. Patients' knowledge of a correct dosage ranged from 30% to 74% and the availability of key drugs ranged from 67% to 93% with no significant difference between public and private pharmacies. There was serious negligence in labeling the dispensed drugs in both public and private pharmacies: not a single drug package was labeled according to the World Health Organization recommendations. Key drugs were highly available in both public and private pharmacies. CONCLUSION: The average drug dispensing time was too short for a proper interaction between a pharmacist and a patient in both public and private pharmacies. The results of our study suggest that there was no real difference in the service quality between the public and the private pharmacies.

Croatia↗

Relaxant effect of oxytocin on isolated human oviduct.

AIM: Oxytocin produces concentration-dependent relaxation of isolated isthmus and ampulla of human oviduct precontracted by histamine. The aim of our study was to investigate whether this oxytocin effect was specific and by which receptors it was mediated. METHODS: We investigated effects of oxytocin and its antagonists on isolated isthmus and ampulla of the uterine tubes from 20 women who underwent surgery for uterine fibroids. Selective vasopressin and oxytocin antagonists were used to treat isolated preparations of the tubes. RESULTS: In a concentration-dependent manner, oxytocin enhanced spontaneous relaxation of both isthmus (EC50=1.23+/-0.03 x 10(-7) mol/L) and ampulla (EC50=1.04+/-0.26 x 10(-7) mol/L) precontracted by histamine. Neither predominantly selective vasopressin V1 receptor antagonist, [beta-mercapto-beta,beta-cyclopentamethylene-propionyl1,0-metyr2,arg8]-vasopressin (1.0 x 10(-9)-1.0 x 10(-7) mol/L), nor predominantly selective vasopressin V2 antagonist, [1-(beta-mercapto-beta,beta-cyclopentamethylene-propionic acid), 2-D-isoleucine, 4-D-isoleucine]-arginine-vasopressin (1.0 x 10(-9)-1.0 x 10(-7) mol/L) affected significantly the relaxation of isolated ampulla and isthmus produced by oxytocin. On the other hand, [Deamino-Cys1,D-Tyr (Et)2, Thr4, Orn8]-oxytocin, a selective blocker of oxytocin receptors, produced in a concentration-dependent manner (6.7 x 10(-9) mol/L, 2.0 x 10(-8) mol/L, and 6.7 x 10(-7) mol/L) significant shifts of the concentration-response curves of relaxation for oxytocin to the right in isolated preparations of both the ampulla and the isthmus. The values of pA2 for [Deamino-Cys1,D-Tyr (Et)2, Thr4, Orn8]-oxytocin calculated from constrained Schilds plot were 8.08+/-1.53 for ampulla and 7.94+/-0.67 for isthmus. CONCLUSION: Oxytocin relaxes smooth muscles in human oviduct through a specific effect on oxytocin receptors.

Fallopian Tubes↗

Effects of nicotine, dimethylphenylpiperazinium and tetramethylammonium on smooth muscles from feline and human gastric corpus.

Both excitatory and inhibitory intrinsic neurons could be found within the gastric wall, both of them receiving innervation from vagal fibres and being sensitive to nicotine. The effects of three nicotine receptor agonists, nicotine, tetramethylammonium (TMA) and 1,1-dimethyl-4-phenylpiperazinium (DMPP), on contractile activity of preparations isolated from feline and human gastric corpus wall were investigated. While DMPP (3.5x10(-8) to 5.9x10(-4)m) did not affect either spontaneous contractions or basal tension of isolated preparations from both species, TMA produced concentration-dependent tonic contractions of both circular and longitudinal isolated preparations from human (3.66x10(-5) to 5.10x10(-3)m) and feline (6. 1x10(-7) to 2.1x10(-3)m) stomach. On the other hand, nicotine (4. 1x10(-8) to 7.0x10(-4)m) produced concentration-dependent relaxation of only circular isolated preparations from feline gastric corpus. The effect of nicotine was sensitive to mecamylamine, and not to pancuronium, while the effect of TMA was sensitive to both mecamylamine and pancuronium. Although in our experiments DMPP had no effect, its excitatory action on gastric intrinsic neurons through the hexamethonium-insensitive pathway had already been described. The results of our study suggest that two different types of ganglion nicotine receptor exist together within the wall of feline stomach: (1) type N(N1)which is involved in relaxation and is sensitive only to nicotine and mecamylamine, and not to DMPP, TMA and pancuronium; (2) and type N(N2)which is involved in contraction of gastric muscle and sensitive to DMPP, TMA, mecamylamine and pancuronium, and not to nicotine.

Adult↗

The effects of excitatory amino acids on isolated gut segments of the rat.

Glutamate and aspartate are excitatory neurotransmitters in both central and peripheral nervous systems, acting on ionotropic and metabotropic receptors. In our study we have examined the effects of glutamate, aspartate, N-methyl-d-aspartate (NMDA), kainic acid and (+/-)-1-aminocyclopentane-cis-1,3-dicarboxylic acid (ACPD) on tone and spontaneous activity of isolated rat gastric fundus, jejunum, ileum, ascending colon and rectum. Both glutamate and aspartate produced concentration-dependent tonic contractions of rat fundus and rectum; the other gut segments used in the study were not responsive. While only NMDA and kainic acid produced concentration-dependent tonic contractions of isolated rat gastric fundus, all three type-selective agonists of glutamate receptors (NMDA, kainic acid and ACPD) produced tonic contractions of isolated rat rectum. The results of our study suggest that glutamate and aspartate in rat gastric fundus activate excitatory intrinsic neurons through only ionotropic receptors (NMDA and non-NMDA receptors), while the same action in rat rectum is mediated through both ionotropic and metabotropic receptors.

Animals↗

Schild's equation and the best estimate of pA2 value and dissociation constant of an antagonist.

Calculation of the pA2 value and dissociation constants for an antagonist from the effects observed on isolated smooth muscles can be done in two ways: using Schild's plot procedure or Schild's equation. In our study we used the effects of muscarinic antagonists observed in experiments on isolated human and feline stomach and rat gastric fundus. Only the estimates of pA2 values and dissociation constants made using the Schild's equation on the basis of the lowest antagonist concentrations were not significantly different from the values calculated using the Schild's plot procedure. This suggest that, when it is impractical to perform the full Schild's plot procedure, the best estimate of pA2 values and dissociation constants can be done with the lowest antagonist concentration that significantly inhibits the effects of an agonist on an isolated smooth muscle preparation.

Animals↗

Different roles of histamine receptor subtypes in ampullar & isthmic segments of human fallopian tube.

We have studied the influence of both menstrual cycle phase and subtype-selective histamine antagonists on the contractions produced by histamine isolated in human fallopian tubes. Histamine produced tonic contractions of the isolated preparations of both the ampullar and isthmic segments of the human fallopian tube were analyzed. The effects of both histamine and its antagonists were not dependent on the phase of the menstrual cycle. The isolated preparations of the ampullar segment from post menopausal patients were not responsive on histamine. When responding, the ampullar segments were slightly more sensitive to histamine than the isthmic segments. All three subtype selective histamine antagonists (pyrilamine, cimetidine and thioperamide) produced strong inhibition of histamine evoked contractions of the ampullar segment. On the other hand, only pyrilamine strongly inhibited histamine evoked contractions of the isthmic segment. The results of our study suggest that only H1 receptors were responsible for the histamine contractile effect on the isthmic segment and that all three subtypes of histamine receptors were involved in the effect of histamine on the ampullar segment of human fallopian tube.

Adult↗

Risk factors for Graves' disease.

A case-control study of 100 newly diagnosed patients with Graves' disease and the same numbers of controls matched with respect to sex, age (+/- 2 years) and type of residence (rural-urban) was carried out. According to the matched analysis (McNemar's test and 6 test) seventeen variables recognized as risk factors were included into the model of multivariate conditional logistic regression. The following factors were significantly associated with the occurrence of Graves' disease: change in time spent on work-much overtime work, second job, much less work than usual (RR = 6.62; CI = 2.08-21.01), lack of readiness of relatives and friends to help the subjected (RR = 1.48; 95% CI = 1.14-1.93), increased arguments with spouse (RR = 14.12; 95% CI = 1.63-121.87), unemployment for at least one month (RR = 9.80; 95% CI = 1.13-85.02), and family history of Graves disease in the first degree of relation (RR = 7.20; 95% CI = 0.85-60.70).

Adult↗

Pharmacologic characterization of muscarine receptor subtypes in rat gastric fundus mediating contractile responses.

The role of four muscarinic receptor subtypes M1, M2, M3 and M4 which have been characterized pharmacologically was examined in motility control of isolated rat gastric fundus. Acetylcholine produced concentration-dependent tonic contraction of isolated rat fundus (EC50 = 9.64 +/- 0.14 x 10(-8)M). These contractions were concentration-dependently antagonized by atropine (KB = 2.45 x 10(-11)M), M1 selective blockers telenzepine (KB = 6.64 x 10(-11)M) and pirenzepine (KB = 2.3 x 10(-8)M), and hexocyclium (KB = 2.82 x 10(-10)M). M3-selective blocker p-fluoro-hexahydro-sila-difenidol (pFHHSiD) was a less potent antagonist (KB = 2.3 x 10(-8)M), while M2 and M4-selective methoctramine produced only weak blockade of tonic contractions caused by acetylcholine (KB = 4.68 x 10(-6)M). These results suggest that only M1 and M3 muscarinic receptors have functional roles in motility control of rat gastric fundus, M1 receptors being more important.

Acetylcholine↗

Stressful life events in the pathogenesis of Graves' disease.

A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age ( +/- 2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95%CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a co-worker (McNemar = 4.50; RR = 3.50; 95%CI = 1.10-11.08; p = 0.031). change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95%CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95%CI = 1.82-66.44; p = 0.006), increased arguments with fiancé/fiancée or a steady date (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95%CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95%CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.

Adult↗

Spasmogenic action of beta-lactam antibiotics on the gastrointestinal tract of experimental animals.

We have investigated the effects of beta-lactam antibiotics on isolated preparations of rat fundus, ileum, and the body of feline stomach. Isotonic changes of isolated preparations were recorded. Benzylpenicillin (EC50 = 1.31 +/- 0.13 x 10(-5) M), ampicillin (EC50 = 2.16 +/- 0.15 x 10(-5) M), cefotaxime (EC50 = 1.33 +/- 0.15 x 10(-5) M), ceftriaxone (EC50 = 4.39 +/- 0.13 x 10(-5) M) and ceftazidime (EC50 = 1.42 +/- 0.01 x 10(-3) M) produced concentration-dependent tonic contractions of rat fundus. Rat ileum and feline stomach did not respond on these substances. Lidocaine (2.3 x 10(-5) M) and physostigmine (1.0 x 10(-8) M) significantly potentiated contractions produced by benzylpenicillin. On the other hand, methysergide (1.4 x 10(-7) M) and atropine (9.6 x 10(-9) M) significantly blocked tonic contractions produced by benzylpenicillin. Effects of beta-lactam antibiotics on smooth muscle isolated preparations were tissue and species dependent, indicating selectivity of their action.

Animals↗

[Dopamine receptor subtypes].

Dopamine is a neurotransmitter in both central and peripheral nervous system. In the central nervous system dopamine is involved in regulation of: movements, emotional processing of sensory input, appetite, vomiting and secretion of anterior pituitary hormones. The most important peripheral effect of dopamine is control of splanchnic and renal blood flows. There are five subtypes of dopamine receptors. D1 receptors are responsible for majority of peripheral dopamine effects; in the brain they modulate activity of limbic system. Symptoms of schizophrenia are produced by increased activation of D2 and D4 receptors. On the other hand, Parkinson's syndrome could be induced by D2 receptors blockade. D3 receptors decrease craving in drug-dependent laboratory animals. Although D5 receptors were found in many brain regions and in peripheral blood lymphocytes, their functions remain unknown. Linking dopamine receptor subtypes with actual effects of dopamine will enable more selective therapy of disorders caused by malfunction of this important system.

Animals↗

[Neurohumoral regulation of Fallopian tube motility].

Motility of Fallopian tubes is essential for transport of ova from peritoneal cavity uterus. Numerous substances were found to affect motility of the tubes. Catecholamines cause both relaxation and contraction isolated Fallopian tubes; it depends on type of receptor they bind for. Acetylcholine, neurotensin and oxytocin stimulate motility of the tubes, while gamma-aminobutyric acid, vasoactive intestinal peptide and substance P have an inhibitory role. Numerous cytokines and their receptors were found in human oviducts; their effects on motility remain to be established. The whole sequence of events in regulation of oviducts motility is still unknown so further investigation in the field is required.

Fallopian Tubes↗

Comparison of two approaches to amitriptyline dose individualisation.

Individualisation of an amitriptyline dose regimen offers substantial advantages over non-individualised treatment. In our study, we have compared both clinical effects, adverse effects and plasma steady-state concentrations of amitriptyline in 15 patients with major depressive disorder divided in three groups; (i) patients in group A were taking non-individualised doses of amitriptyline; (ii) patients in group B were taking doses of amitriptyline individualised by modified Bayesian method; and (3) patients in group C were taking doses of amitriptyline individualised by the multiple point method. The treatment course was 8 weeks long, in the setting of a psychiatric clinic. The patients in group A were taking significantly higher doses throughout the treatment course; the initial doses for the patients in group B were higher than doses for the patients in group C, but after corrections based on measured steady-state plasma concentrations they became similar. While Hamilton score descended uniformly in all three groups, both adverse effects and steady-state plasma concentrations of amitriptyline were higher in non-individualised group during the whole treatment course. The results of our study suggest that the multiple points method is the most precise, but tedious and not practical. The modified Bayesian method with correction based on first measured plasma steady-state concentration of amitriptyline offers similar therapeutic outcome and adverse effects score combined with low cost and being easy-to-use.

Adult↗

Sensitization of rat gastrointestinal tract to acetylcholine and histamine produced by X-radiation.

Abdominal x-radiation produces both acute and chronic disturbances of gastrointestinal motility. Anaesthetized Albino-Oxford rats received one-session x-radiation (absorbed dose 10 Gy) of whole abdomen. Two hours after irradiation the rats were sacrificed and segments of their gastrointestinal tract (gastric fundus, jejunum, ileum and ascending colon, were mounted in isolated organ bath. Acetylcholine and 5-hydroxytryptamine produced tonic contractions of all gut segments, while histamine did so only with gastric fundus. While contractile effect of 5-hydroxytryptamine was not affected by x-radiation, the responses of all gut segments on acetylcholine were potentiated and shifted towards lower concentrations. After x-radiation histamine produced concentration-dependent tonic contraction of previously unresponsive jejunum and ascending colon. The results of our study suggest that x-radiation produces acute sensitization of rat gastrointestinal tract to acetylcholine and histamine.

Acetylcholine↗

[Epilepsy, eponyms and patron saints (history of Western civilization)].

From a historic point of view, epilepsy and its eponyms were in an ontogenetic symbiosis throughout their history. Epilepsy is a disease with a history of eponyms presenting the frame of mind of both streetwise as well as skilled "authors" about its origin and nature. From ancient times the names for epilepsy, archetypal Hippocratic disease, just as rich in number as varied in their implication, reflected the local folkways of thinking. In this article we briefly presented more than 50 eponyms and patrons of epilepsy. As the source of information we used both the apocryphal, canonical and hagiographic as well as heretic literature, legends and iconography from the Middle Ages of domestic and foreign origin. Pre- and post-Hippocratic era, apart from stemming from the oldest written medical sources, point to the position that the disease had organic origin located in the brain. The period of Rome adopted the attitudes set by Galen which remained en vogue throughout the emerging Middle Ages and Renaissance. These eras generated new eponyms which reflected a downfall in the manor, stating that the disease is the consequence of supernatural forces. In the "Age of darkness" eponyms for epilepsy reflected more the relation of men to the Nature than to the disease or a sick man; this is evidenced through the generation of number of patrons for the disease. The most famous patron of patients with epilepsy was St. Valentine (after conversion from pagandom he died in Rome as a martyr, c. 270). He was allotted a patronage either due to the phonic resemblance of his name with the (past participle of the) verb "fallen"-as Martin Luther claimed, or due to a cure of epilepsy of the son of a Roman rhetor who built for him a chapel in which he continued to cure the sick. The emergence of a flamboyant personality of Paracelsus on the historic scene of the XVI century represents a less successful attempt to revoke the way of thinking set by the old Greek doctors; however, it brought about the precipitous decay of attitudes that started with Romans and inaugurated the way of thinking characteristic of Renaissance and the ages thereafter. Serbian literature of the Middle Age was strongly impacted by influences that fanned from Italy (Salerno) and south France (Montpellier), reflecting the attitudes of medical schools and universities prevailing at that time Europe. The name [symbol: see text] from Hilandar Medical Codex No 517 (XV-XVI century) is obviously taken from Byzantine medicine, which was founded on the works of Hippocrates, Galen and Dioscurides. It came down to us through the Serbian folk Byzantine codices named "latrosophia of Hilandar", preserved mostly from the author Michail Pselos (XI century). On the other hand, the name [symbol: see text] or morbus magnus, reflects its Roman origin. The name [symbol: see text] meaning fainting, loss of consciousness or syncope, stems from the same source. The name [symbol: see text] designated epileptic disease in Serbian monks, monasteries probably being the only niche where epileptics could find refuge. Children's epilepsy or convulsions are expressed as [symbol: see text] No mention is found of epileptic status except for the notion [symbol: see text] meaning "to be without consciousness for a longer period of time'; it does not, however, refer directly to epilepsy or convulsions. It is worthy noting that already in the XIV century Serbs had their medical literature translated to their own language, and were the only one of all Slavic peoples that did so. Nevertheless, both apocryphal and canonical, as well as consecrated medicine were based on magic, astrology and occultism. The magic formulas used in Middle Age Serbia for the cure of epileptics as well as sick in general, were basically irrational; still, as a trace of its descension they contained unintelligible words of the eastern origin (Greek, Persian or Jewish). (ABSTRACT TRUNCATED)

Epilepsy↗

[Eponyms and epilepsy (history of Eastern civilizations)].

The history of eponyms for epilepsy in the lands of the Eastern globe present the portrait of the attitudes of both the laymen and skilled people towards the disease and patient, as well as to the Nature itself. As opposed to the West which during the Middle ages changed its concepts of epilepsy as the organic brain disease for the sublime 'alchemic' position, the people of the East were more prone to consider from the beginning of their civilization till the XIX century that epilepsy is the consequence of the evanescent spiritual and extracorporal forces which by themselves were out of their reach. As compared to the western civilization, the historical resources are, often as a consequence of a linguistic barriers, more scarce-as consequently is the number of eponyms, but are nevertheless picturesque. The medical science from Babylonian period presumed that epileptic manifestations are the consequence of the demonic or ill spiritual actions. There existed an attitude that at the beginning of an epileptic attack the patient was possessed by a demon (the Akkadic, i.e., Babylonian verb "sibtu" denoting epilepsy, had the meaning "to seize" or "to be obsessed"); at the end of the clonic phase the demon departed from the body. Different demons were responsible for different forms of epilepsy such as nocturnal and children epilepsy, absence epilepsy and pure convulsions, simple and complex automatisms, and gelastic epilepsy. Thus, the doctors from the period of Babylon aside from making primordial classification of epilepsies, knew about their clinical picture (prodromal symptoms and aura, Jackson's epilepsy. Todd's paralysis), postictal phenomena and intericatl emotional instability; provocative factors were also known (sleep deprivation, emotions, as well as alcohol, albeit in a negative sense-as a cure for epilepsy). There is no doubt than in the period of Babylon the clinical picture of serial fits and its progress to status epilepticus were clearly recognized and considered as life threatening events. Persian history of epilepsy, except from the 6th century Zoroastrian "Avesta" document, lacks the written or spoken medical heritage untill the 7th century A.D. and the Arabic conquest of the entire Moslem world. On the other hand, Islamic medicine should be freed from the simple prejudice that the Moslem authors were only the translators of Greek medicine; contrary to such a view, their work contains a high degree of individuality. Although Mohammed introduced a lot of novelty into medicine, Khoran and the Sayings do not explicitly refer to epilepsy. Of importance is to notice that Moslem medicine did not have demons in the "repertoire" of direct causes of epilepsy. The causes and the cures of epilepsy were more magic-mystical and occult in nature, which is reminiscent of the European, as well as Serbian Middle age attitudes. Avicenna recognized difference between children and adult epilepsy. He considered insomnia and afternoon siesta as well as intensive sounds and light to be a provocative factors, whereby we see that at least empirically he knew of sleep (deprivation), startle and reflex epilepsy. The XIII century invasion of Mongols brought about the recession in Moslem Medicine; it recovered only in the XVIII century under the strong influence of European medicine handed over to us through Jewish doctors of various nationalities. The story of the China history of epilepsy has its debut approximately in the 8th century B. C. Medical texts from this period name epilepsy "Dian" and "Xian" which meant "the falling sickness" and "convulsions", respectively. Chinese medical terminology often interchangeably used the words "mania", "madness" and "psychosis" for "epilepsy" which, aside from a prominent language barrier, brings additional confusion. Although Chinese documents gave the first description of the grand mal epileptic attack already in the 8th century B. C. (ABSTRACT TRUNCATED)

China↗

[Treatment of spasms of visceral smooth muscles].

A lot of pathophysiological factors can cause increased activation of smooth muscle contractile mechanisms resulting in long-lasting contractions-spasms. They significantly increase the intercellular concentration of calcium ions and/or increase the affinity of thin contractile filaments for them. The most frequently used drugs in the therapy of visceral smooth muscle spasms are substances that relax smooth muscles (with antimuscarinic activity/atropine-like/or with non-specific activity/papaverine-like direct spasmolytics) and analgesics (opioids or nonsteroid antiinflammatory drugs-NSAID). In the treatment of biliary and renal colics NSAIDs for parenteral use were equally or more efficient than spasmolytics or opioid analgesics. Organic nitrates relax smooth muscles efficiently, but this effect is short-lasting due to their rapid liver metabolism. Experiences with other drugs that could be useful in spastic visceral conditions are still scarce (calcium channel blockers, botulinum toxin, metoclopramide etc). Due to diversity of mechanisms of action of spasmogenic factors, further investigations are directed to discovery of more efficient and more selective drugs than these currently used.

Aged↗

[Dr. John Hughlings Jackson].

The great English neurologist, Dr. John Hughlings Jackson was born in Providence Green, Yorkshire, north England, in 1835. He spent his apprenticeship in the city of York, continued his medical education at St. Bartholomew's hospital in London, and qualified in medicine in 1856. After working in the city of York, he studied in London and in 1860 graduated at St. Andrews university in Scotland. He died in London in 1911, famous and celebrated by his colleagues as the "father of British neurology". Jackson was a prolific writer, witty and ingenious person, but also solitary and absent minded, with a lat of "tiny peculiarities of a genius". At first he was committed to become a philosopher but was persuaded by Jonathan Hutchinson, one of his rare friends, to enter medicine. His "Selected Writings" were first published in 1931 and reprinted recently, in 1996, by Arts & Boeve. Jackson, unlike William Richard Gowers, wrote his articles in a style which was not palatable to his contemporary colleagues. This could be the reason that his medical work was not widely known and would have remained in shadow had it not been rediscovered mostly by German neurologists, who preceded their English colleagues and collected the fame. Jackson gave the first classification of epileptic seizures acceptable, to a degree, even today. It was twofold: the first, taxonomic, which corresponds to contemporary classification of seizures, he compared to the attitude of a gardener who classifies flowers according to their beauty, height or color, and was aware of its purely phenotypic, descriptive and utilitarian character; the second was scientific, physiologic and it would correspond nowadays to the current concept of syndromic classification. Jackson was aware that this 'scientific classification' was to await for the future time, when the knowledge of the real nature of epilepsy became fundamentally broadened. On the other hand, he thought that all the epilepsies were partial becoming generalized only secondarily. Partial epilepsies were the starting point in his work. He realized that epileptic attacks are not different types of epilepsies with different pathophysiological mechanisms, but that they differ in respect to the focus of origin; he stressed their gray matter (cortical) arigin with the cause located as the rule "on the side of the brain, opposite to the body convulsed". Jackson's ideas on epileptogenesis and the localization of epileptogenic processes represent his fundamental contribution to the understanding of their pathophysiology. His most philosophical contribution to neurology was the concept of the evolution and dissolution of the nervous system, which was the consequence of his ideas on its organization. Symptoms observed after the lesion of a certain part of the brain are not the consequence of its function; they are the result of the function of the remaining non-lesioned regions which are in a certain way freed from the adjacent or a higher control. This concept of interpretation af the symptoms of the nervous diseases remains applicable even today. Jackson was the first to stress the importance of ophthalmoscopy in neurology in all cases of neurologic disease, especially in cases of optic neuritis (papilloedema) which may be present even if the patient did not notice the minimized visual acuity. The way of thinking that Jackson introduced in medicine and neurology may be his most precious legacy to the generations that followed.

History, 19th Century↗