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Nebraska Symposium on Motivation
PSYCHOSOMATICS discussed in relation to the world of science. His apprenticeship in medicine is described, and his renowned Religio Medici is scrutinized closely. If one wishes to learn about Browne's thoughts on a variety of subjects, I beHeve Religio Medici should be examined first and other writings approached afterwards. In this work one gains impressions of his beliefs and his personality. There are his views on religion and science, faith and prejudice, people and places, the apparent and the obscure. Some admirers actually regard the language and style of his treatise as beautiful, but I should forewarn those who chance it now that whether or not they share in this opinion, the reading of Religio Medici is not easy. In fact, for adequate understanding it must be read more than once. Time and patience are required. A good edition was published recently by the Cambridge University Press and a copy should be easy to acquire. 3 Professor Huntley has written a scholarly, attractive book that serves well to give readers a warm feeling for the man and his work. In addition to basic biographical data, this volume offers much in the way of specific medical background to satisfy the desires of physicians who may wish to focus especially on this aspect of Sir Thomas Browne. Those who want to concentrate largely on Browne's work as literary efforts should certainly find the examination by Huntley quite rewarding. From any vantage point, Huntley's book is meritorious, and the beginner and the advanced student of Browne will be rewarded amply for the time he gives it. REFERENCES
1. Osler, W.: Sir Thomas Browne, In Selected Writings of Sir William Osler. New York: Oxford University Press, 1951; also, Cushing, H.: The Life of Sir William Osler. New York: Oxford University Press, 1940. 2. Schneck, J. M.: A History of Psychiatry. Springfield, Ill.: Charles C Thomas, 1960; also Schneck, J. M.: Psychiatric Aspects of Sir Thomas Browne with a New Evaluation of His Work. Med. Hist., 5:157, 1961. 3. Browne, T.: Religio Medici. Cambridge: Cambridge University Press, 1955. JEROME M. SCHNECK, M.D.
THE IMPORTANCE OF BEING IMPERFECT. By fohn Robert Clarke. 216 pages. New York: David McKay Company, 1961. $3.95. Mr. Clarke, a teacher of literature at San Diego State College, has pinpointed one of the major difficulties that interferes with the pursuit of happiness. He divides perfectionists into two groups: "masters" and "understudies," and makes a valiant attempt to get the reader to search his soul and make the necessary changes. The author, in a spirited and witty challenge, indicates the value of recognition and acceptance of imperfection in ourselves and the disastrous results of the failure to do so. He defines the "masters" as those who say they are not perfect, but behave 122
as if they were; the "understudies" realize their imperfections, but are hopeful that they will become perfect. Either way they are doomed to dissatisfaction with life and their relationships with other persons. He offers the example of Socrates, who was set apart from others because he acknowledged his ignorance peacefully and began to ask questions. To Socrates, "Know thyseH," meant to know thy ignorance. The author adds that what is needed is our decision to take responsibility for ourselves with all of our flaws and failings. With full realization and awareness of the limitations of "do-it-yourseH" attempts to change human nature, this reviewer nevertheless believes that Mr. Clarke's contribution can be indeed helpful in revealing one of the major blind spots in the pursuit of a better life. W.D.
PSYCHOSOMATIC RESEARCH. By Roy R. Grinker, M.D. 221 pages. New York: Grove Press, 1961. $1.95. The author reviews the historical concepts of psychosomatic medicine, tracing its physiological roots to Pavlov and Cannon and its psychological ones to Freud. He evaluates current conceptual models (Dunbar, Franz Alexander, Szasz, Benedek, Harold Wolff, Ruesch, Halliday) pointing up both their values as well as limitations. Since theoretical formulations and operational methods are determined by the discipline in which each investigator is trained, the need for a "field" concept and multidisciplinary approach to research is constantly emphasized. The reader will find considerable information packed into this paperback edition, but little encouragement to treat the whole person. The author points up the inherent difficulties in treating "psychosomatic disease"; that the problem is as difficult, although not the same as with the schizophrenic. The need for new therapeutic techniques is emphasized. W.D.
NEBRASKA SYMPOSIUM ON MOTIVATION. Edited by Marshall R. Jones. 207 pages. Lincoln, Nebraska: University of Nebraska Press, 1961. $3.00. These papers are concerned with physiological aspects of motivational problems. Falk distinguishes between the homeostatic and nonhomeostatic components of thirst, hunger, and other drives to point out that, contrary to the view of many psychologists, there is still much to be learned about the biogenic drives; such knowledge he believes will lead to improved understanding about fundamental aspects of motivation. Teitelbaum reviews the research on the effects of damage to two areas on feeding and drinking behavior. He concentrates on the medial neural system which controls satiety and on the system in the lateral hypothalamus which controls feeding behavior, stressing the point that knowledge of the behavioral effects of damage to these areas has imVolume IV
BOOK REVIEWS portant implications for our understanding of normal hunger and thirst. He reports his own experiments indicating that in certain circumstances hyperphagia is caused by a defect in weight regulation mechanisms rather than by a defect in the regulation of food intake. Pfaffman reports considerable new material in the field of sensation; he discusses taste as a sensory mechanism and as a stimulus-response system and presents evidence to the effect that sensory stimuli are capable of motivating behavior directly. McKeachie presents the results of a long series of experiments designed to determine some of the factors which inhibit academic achievement at the college level, offering evidence in support of his hypothesis that teaching methods interact with student motives in influencing achievement. This little volume contains a great deal of thoughtprovoking new material, such as Falk's demonstration of a psychogenic hyperdipsia. Having read the book one may wonder, as does one of the contributors, David Birch, whether or not the concept of motivation is really a useful approach, or whether, for example, more attention should be given to the distinction between associative and nonassociative effects on behavior. ELIZABETH THOMA, PH.D.
REVIEW OF MODERN MEDICINE (Jan-June, 1962). 1027 pages. Minneapolis, Minn.: Modem Medicine, 1962. This book is a complete and panoramic view of current problems in medicine. Covering all the specialties, inclusive of general medicine, it offers the reader a concise, readable coverage and translation of current events. Of special interest to the readers of PSYCHOSOMATICS, are the editorials of Dr. Irvin H. Page. His sense of humor, equaled only by his academic and research achievements, makes these editorials very readable. His excursions into recent history, exploring some of the problems created by Nazi and Soviet psychology, prOVide a springboard for his philosophy of livinga remarkable balance of effervescent freedom combined with a preservation of the privilege to remain skeptical. Dr. Alvarez, Editor-Emeritus, always has interesting material to report. His choice of a splendid article by Dr. David Grob of Maimonides Hospital of Brooklyn on "Myasthenia Gravis," an evaluation of the psychic elements of bronchial asthma, and the importance of scotoma in the diagnosis of migraine, show the wide scope of medical coverage. The section on "Internal Medicine" contains abtracts of many pertinent articles. The most signiflcant ones deal with emotional factors in ulcerative colitis; the neurasthenic syndrome that may indicate hyperparathyroidism; the possibility of anoxia of the brain as a result of stenosis of the subclavian artery (when it is proximal to the origin of the vertebral artery); the possibility that emotional disturbances can cause aphthous ulcerations of the palate; the value of short term psychotherapeutic sessions by physicians with limited psychiatric training; the March-April, 1963
iatrogenic damage caused by overconcern with innocent cardiac murmurs-aIl of which again indicate that wide scope of this review of comprehensive medicine. The section on "Surgery", despite its quite understandable and predictable pre-occupation with problems of surgical technique, similarly offers much to the physician interested in comprehensive medicine. A few examples include the diagnosis of meralgia paresthetica, and its successful surgical treatment; the psychiatric symptoms so common to islet cell tumors of the pancreas; the surgical treatment of cerebrovascular insufficiency. In "Obstetrics", most interesting are the reports on the carpal tunnel syndrome as a cause of paresthesia of the hand; the value of psychotherapy in habitual abortion, and the use of magnesium sulfate in toxemia. The use of gynecologic surgery in intersexuality, surprisingly places more emphasis on the appearance of the external genitalia than on the psychosexual development of the individual; surely, this too must be considered in the determination of the eventual sex of the individual. "Pediatrics" considers, among other material, the diagnosis of neonatal kernicterus, the importance of hypernatremia as a cause of CNS symptoms, the need for awareness of parathion poisoning, the importance of herpes simplex meningoencephalitis, and the differential diagnosis of convulsive disorders. Included in geriatric problems is a significant study pointing to the high incidence of hypothyroidism and its normal confusion with signs of senility. "Neurology" considers studies on the incidence of epilepsy after head injury, the dangers of hypotensive anaesthesia, and the diagnosis and management of cerebrovascular occlusive disease. The section on "Psychiatry" is excellent. Abstracts deal with the resistance to pediatric psychotherapy, the fact that psychiatric patients can have somatic disease, an unusual discussion of the site of action of the tranquilizers, and a valuable contribution to the management of depression. This compendium of modem medicine is unquestionably the modem way to keep up with advances in all areas of medicine. W.D.
MEDICINE TODAY. By David Magerson. 110 pages. Baltimore: Penguin Books, 1961. $1.25. The author, a British physician writing under a pen-name, presents for lay readers a simple explanation of the more important "miracles" of modem medicine. Very properly, the book is divided into four chapters: Prevention, Diagnosis, Treatment and Prognosis (Things to Come). The subject matter ranges from antitoxins to space medicine and includes discussions of such varied developments as roentgenology, atomic medicine, antibiotics and heart surgery. The lay reader will get a good general view of the scope of today's medicine from this book. It is accurate and easy to read. The addition of a glossary would be helpful. LEONARD J. SCHIFF, M.D.
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1. Osler, W.: Sir Thomas Browne, In Selected Writings of Sir William Osler. New York: Oxford University Press, 1951; also, Cushing, H.: The Life of Sir William Osler. New York: Oxford University Press, 1940. 2. Schneck, J. M.: A History of Psychiatry. Springfield, Ill.: Charles C Thomas, 1960; also Schneck, J. M.: Psychiatric Aspects of Sir Thomas Browne with a New Evaluation of His Work. Med. Hist., 5:157, 1961. 3. Browne, T.: Religio Medici. Cambridge: Cambridge University Press, 1955. JEROME M. SCHNECK, M.D.
THE IMPORTANCE OF BEING IMPERFECT. By fohn Robert Clarke. 216 pages. New York: David McKay Company, 1961. $3.95. Mr. Clarke, a teacher of literature at San Diego State College, has pinpointed one of the major difficulties that interferes with the pursuit of happiness. He divides perfectionists into two groups: "masters" and "understudies," and makes a valiant attempt to get the reader to search his soul and make the necessary changes. The author, in a spirited and witty challenge, indicates the value of recognition and acceptance of imperfection in ourselves and the disastrous results of the failure to do so. He defines the "masters" as those who say they are not perfect, but behave 122
as if they were; the "understudies" realize their imperfections, but are hopeful that they will become perfect. Either way they are doomed to dissatisfaction with life and their relationships with other persons. He offers the example of Socrates, who was set apart from others because he acknowledged his ignorance peacefully and began to ask questions. To Socrates, "Know thyseH," meant to know thy ignorance. The author adds that what is needed is our decision to take responsibility for ourselves with all of our flaws and failings. With full realization and awareness of the limitations of "do-it-yourseH" attempts to change human nature, this reviewer nevertheless believes that Mr. Clarke's contribution can be indeed helpful in revealing one of the major blind spots in the pursuit of a better life. W.D.
PSYCHOSOMATIC RESEARCH. By Roy R. Grinker, M.D. 221 pages. New York: Grove Press, 1961. $1.95. The author reviews the historical concepts of psychosomatic medicine, tracing its physiological roots to Pavlov and Cannon and its psychological ones to Freud. He evaluates current conceptual models (Dunbar, Franz Alexander, Szasz, Benedek, Harold Wolff, Ruesch, Halliday) pointing up both their values as well as limitations. Since theoretical formulations and operational methods are determined by the discipline in which each investigator is trained, the need for a "field" concept and multidisciplinary approach to research is constantly emphasized. The reader will find considerable information packed into this paperback edition, but little encouragement to treat the whole person. The author points up the inherent difficulties in treating "psychosomatic disease"; that the problem is as difficult, although not the same as with the schizophrenic. The need for new therapeutic techniques is emphasized. W.D.
NEBRASKA SYMPOSIUM ON MOTIVATION. Edited by Marshall R. Jones. 207 pages. Lincoln, Nebraska: University of Nebraska Press, 1961. $3.00. These papers are concerned with physiological aspects of motivational problems. Falk distinguishes between the homeostatic and nonhomeostatic components of thirst, hunger, and other drives to point out that, contrary to the view of many psychologists, there is still much to be learned about the biogenic drives; such knowledge he believes will lead to improved understanding about fundamental aspects of motivation. Teitelbaum reviews the research on the effects of damage to two areas on feeding and drinking behavior. He concentrates on the medial neural system which controls satiety and on the system in the lateral hypothalamus which controls feeding behavior, stressing the point that knowledge of the behavioral effects of damage to these areas has imVolume IV
BOOK REVIEWS portant implications for our understanding of normal hunger and thirst. He reports his own experiments indicating that in certain circumstances hyperphagia is caused by a defect in weight regulation mechanisms rather than by a defect in the regulation of food intake. Pfaffman reports considerable new material in the field of sensation; he discusses taste as a sensory mechanism and as a stimulus-response system and presents evidence to the effect that sensory stimuli are capable of motivating behavior directly. McKeachie presents the results of a long series of experiments designed to determine some of the factors which inhibit academic achievement at the college level, offering evidence in support of his hypothesis that teaching methods interact with student motives in influencing achievement. This little volume contains a great deal of thoughtprovoking new material, such as Falk's demonstration of a psychogenic hyperdipsia. Having read the book one may wonder, as does one of the contributors, David Birch, whether or not the concept of motivation is really a useful approach, or whether, for example, more attention should be given to the distinction between associative and nonassociative effects on behavior. ELIZABETH THOMA, PH.D.
REVIEW OF MODERN MEDICINE (Jan-June, 1962). 1027 pages. Minneapolis, Minn.: Modem Medicine, 1962. This book is a complete and panoramic view of current problems in medicine. Covering all the specialties, inclusive of general medicine, it offers the reader a concise, readable coverage and translation of current events. Of special interest to the readers of PSYCHOSOMATICS, are the editorials of Dr. Irvin H. Page. His sense of humor, equaled only by his academic and research achievements, makes these editorials very readable. His excursions into recent history, exploring some of the problems created by Nazi and Soviet psychology, prOVide a springboard for his philosophy of livinga remarkable balance of effervescent freedom combined with a preservation of the privilege to remain skeptical. Dr. Alvarez, Editor-Emeritus, always has interesting material to report. His choice of a splendid article by Dr. David Grob of Maimonides Hospital of Brooklyn on "Myasthenia Gravis," an evaluation of the psychic elements of bronchial asthma, and the importance of scotoma in the diagnosis of migraine, show the wide scope of medical coverage. The section on "Internal Medicine" contains abtracts of many pertinent articles. The most signiflcant ones deal with emotional factors in ulcerative colitis; the neurasthenic syndrome that may indicate hyperparathyroidism; the possibility of anoxia of the brain as a result of stenosis of the subclavian artery (when it is proximal to the origin of the vertebral artery); the possibility that emotional disturbances can cause aphthous ulcerations of the palate; the value of short term psychotherapeutic sessions by physicians with limited psychiatric training; the March-April, 1963
iatrogenic damage caused by overconcern with innocent cardiac murmurs-aIl of which again indicate that wide scope of this review of comprehensive medicine. The section on "Surgery", despite its quite understandable and predictable pre-occupation with problems of surgical technique, similarly offers much to the physician interested in comprehensive medicine. A few examples include the diagnosis of meralgia paresthetica, and its successful surgical treatment; the psychiatric symptoms so common to islet cell tumors of the pancreas; the surgical treatment of cerebrovascular insufficiency. In "Obstetrics", most interesting are the reports on the carpal tunnel syndrome as a cause of paresthesia of the hand; the value of psychotherapy in habitual abortion, and the use of magnesium sulfate in toxemia. The use of gynecologic surgery in intersexuality, surprisingly places more emphasis on the appearance of the external genitalia than on the psychosexual development of the individual; surely, this too must be considered in the determination of the eventual sex of the individual. "Pediatrics" considers, among other material, the diagnosis of neonatal kernicterus, the importance of hypernatremia as a cause of CNS symptoms, the need for awareness of parathion poisoning, the importance of herpes simplex meningoencephalitis, and the differential diagnosis of convulsive disorders. Included in geriatric problems is a significant study pointing to the high incidence of hypothyroidism and its normal confusion with signs of senility. "Neurology" considers studies on the incidence of epilepsy after head injury, the dangers of hypotensive anaesthesia, and the diagnosis and management of cerebrovascular occlusive disease. The section on "Psychiatry" is excellent. Abstracts deal with the resistance to pediatric psychotherapy, the fact that psychiatric patients can have somatic disease, an unusual discussion of the site of action of the tranquilizers, and a valuable contribution to the management of depression. This compendium of modem medicine is unquestionably the modem way to keep up with advances in all areas of medicine. W.D.
MEDICINE TODAY. By David Magerson. 110 pages. Baltimore: Penguin Books, 1961. $1.25. The author, a British physician writing under a pen-name, presents for lay readers a simple explanation of the more important "miracles" of modem medicine. Very properly, the book is divided into four chapters: Prevention, Diagnosis, Treatment and Prognosis (Things to Come). The subject matter ranges from antitoxins to space medicine and includes discussions of such varied developments as roentgenology, atomic medicine, antibiotics and heart surgery. The lay reader will get a good general view of the scope of today's medicine from this book. It is accurate and easy to read. The addition of a glossary would be helpful. LEONARD J. SCHIFF, M.D.
123