Authors: Andrew J. Larner1, Sarah Cooper2, Max Cooper3
Affiliations:
1 Honorary Senior Research Fellow, Department of Translational Neuroscience & Stroke, Institute of Neurology, University College London, London, United Kingdom
2 Department of Neurology, Royal Sussex County Hospital, Brighton, UK
3 Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
Abstract: The results of randomised controlled clinical trials form the basis for the modern treatment of epileptic seizures. Elements of clinical trial design may sometimes be discerned in the therapeutic experiments of earlier generations. We review an investigation published in 1875 in which some features typical of a cross-over clinical trial were adopted. This trial of farinaceous versus nitrogenous diet in the control of epileptic seizures was explicitly based on the pathophysiological speculations of John Hughlings Jackson and was conducted by John Merson at the West Riding Asylum in Wakefield, West Yorkshire, England. This article examines the context, the setting, the investigator, the trial, and its aftermath.
Keywords: clinical trials; cross-over; diet; history of neuroscience; Hughlings Jackson, John; Merson, John
Published in: The Charcot Journal, 2026, Volume 2, Issue 1, Pages 4-13.
Download PDF: 2026_V2_I1_Larner
How to cite this article: Larner AJ, Cooper S, Cooper M. Testing Hughlings Jackson’s proposed dietary treatment of epilepsy: John Merson’s cross-over trial of 1875. The Charcot Journal. 2026;1(1):4-13.