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Synesthesia: A union of the senses
118
Journal of the Neurological Sciences, 108 (1992) 118-119 © 1992 Elsevier Science Publishers B.V. All rights reserved 0022-510X/92/$05.00
B o o k reviews Post-Viral Fatigue Syndrome, by R a c h e l J e n k i n s a n d J a m e s M o w b r a y (eds.), 1991, J o h n W i l e y a n d Sons, C h i c h e s t e r , U . K . , 463 p a g e s , U S $60.00, I S B N 0-47192846-1 This volume on post-viral fatigue syndromes, edited by a psychiatrist and a neuroimmunologist, is a collaboration of approximately 35 contributors, most of whom are from the United Kingdom. The book is divided into 5 major sections dealing with definitions and epidemio l o ~ of the syndrome, host responses, clinical features, immune mechanisms and ideas for future research and treatment. The introduction discusses historical aspects of the disorder and gives an overview of the clinical presentation and nosology which aids in clarifying current concepts of the syndrome. The relationship of post-viral fatigue to depression and fibromyalgia is treated objectively. Data suggesting that symptoms result from persistent viral infection are presented in depth. General discussions of selected topics in virology and immunology provide basic background material for subsequent chapters. A glossary is also included. The text is quite readable and the chapters are well referenced. The multidisciplinary approach enables the reader to examine post-viral fatigue from various perspectives. However, the multiauthor format also lends itself to redundancy and contradictions. For instance, the differential diagnosis of chronic fatigue is discussed separately in several chapters and there is disagreement on the role of treatment with tricyclic antidepressants and physical therapy. Although this book may be too detailed for those with only a casual interest, it should prove useful reading for physicians who treat patients with this controversial disorder on a regular basis. DAVID S. LEFKOWITZ)MD Department of Neurology Bowman Gray School of Medicine Winston-Salem, NC, U.S.A.
Neurobehavioral Aspects of Cerebrovascular D&ease, by Bornstein, R.A. and Brown, G. (eds.), 1991, Oxford University Press, New York, NY, 367 pages, US $40.00 Even one who has devoted himself to the field of cerebral circulation and its diseases will find much of interest and of use in this 367 page volume. Authoritative chapters have been sequenced logically in order to cover the range of clinical effects of stroke on the human being. The chapters on clinical neuropsychology, recovery and treatment are particularly well done and there are some stand-outs, such as the chapter on anatomic imaging methods by Brown and Bornstein, that on the dementia syndrome of depression in patients with stroke by Starkstein, Bolla and Robinson and one on neuropsychological recovery after cerebral infarction by Meier and Strauman. The list of authors is outstanding and the price is not excessive. This book is recommended both for those already in the field, as well as for those learning it the first time. JAMESF. TOOLE, M.D. Editor, Journalof the Neurological Sciences BGSM Medical Center Winston-Salem, NC, U.S.A.
The Neuron Cell and Molecular Biology, by Levitan, I.B. and Kaczmarck, L.K. (eds.), 1991, Oxford University Press, Oxford, £18.95, ISBN 0-19-505832-1. The authors have produced an extremely well integrated, highly readable, soft cover volume which can introduce students of neuroscience into the field and graduates into a refresher and review on recent developments in a most readable and logical progression beginning with the cell, both neuron and gila, and progressing through the complexities of neural networks, it includes newer aspects of molecular biology, as well as theoretical considerations of behavior. The book is interspersed with wisdom, as well as with science and, as a typical example, the chapter "Neural Networks and Behavior" begins as follows: "As cells go, neurons are not loners. Every function of the nervous system, from regulation of autonomic activities such as heartbeat to the control of complex animal behaviors such as dating and mating, reflects the coordinated action of a network of interacting neurons. A major challenge of neurobiology is to understand the nature of the interactions and computations that neural networks carry out. In this chapter, we describe a number of simple neural networks whose biological role is known. These representative examples have been chosen to illustrate how specific cellular properties of different neurons in a network are essential to the function of the network as a whole". "The major lesson to be learned from such studies is that complex patterns of activity and relatively sophisticated computations can be carried out by networks of very simple units. For example, some networks can recognize patterns of inputs corresponding to letters of the alphabet. When stimuli in the shape of a letter "A" are applied to a two-dimensional array of input neurons, one set of output neurons will fire. A different set of output neurons fire when the shape "B" is applied. Other networks generate patterns of firing that very closely mimic pathological states such as epileptic seizures (Fig. 16-1c). Still other networks tackle mathematical problems, in all cases the responses of a network are in some way encoded in the pattern of activity of a set of output units. When the synaptic weights at individual connections are allowed to alter as a result of predetermined rules, ~he outputs of model networks may display features of learning". This book is a bargain at this price. ~AMESF. TOOLE, M.D. Editor, Journal of the Neurological Sciences,
BGSM Medical Center Winston-Salem, NC, U.S.A.
Synesthesia: A Union of The Senses, by R.E. Cytowic, Springer-Verlag, New York, 1989, pp. 354, US $75.00, ISBN: 0-387-96807-5 Synaesthetic phenomena have been reported, on and off, for hundreds of years. Francis Galton (who first used )he word "synaesthesia"), various romantic writers and musicians, those enterprising medical students Bleuler and Lehmann, psychologists intrigued with the subjective effects of Mescal and other hallucinogenic d~ugs, colour-hearing enthusiasts such as Rimington, Klein and Scriabin, were among the relatively few who wrote about them. But not since
119 Luria in 1968 has a neurologist or a psychiatrist made a serious effort to probe more deeply than mere descriptive reportage. Whether inborn or acquired, synaesthesia is truly intriguing, and, as Dr. C'~towic says, has interested the artist, then the philosopher and after that the psychologist " . . . but no one was very successful in making real sense of it and all camps ceased to be interested". Dr. Richard Cytowic was accidentally introduced to this neurological rarity when his bleeper went off while he was examining a patient, who was startled. She put her hands to her head and exclaimed "Oh those blinding red jaggers, turn that thing off[". Not long afterwards he happened to meet someone who, in response to tastes and smells, always perceived vivid geometric shapes and textures. On reporting these cases, other individuals endowed with one or other variety of synaesthesia came to his notice. He was able to carry out thorough neuropsychologieal investigation of some of them. Dr. Cytowic's aim has been to identify the nature of synaesthesia. In his own words, "I believe that the place to go fishing in the brain for an explanation is not at the top (in the neocortex where symbolic language resides) but close to the bottom of the pond, at an earlier stage of neural processing". In his fishing, the author cast his net widely, perhaps too far. He refers to alloaesthesia, palinopsia, number-forms, clairvoyance, pre-
cognitive dreaming, the "retinex" hypothesis of colour, phantom vision and "blindsight" among many other arcane topics. Dr. Cytowic concludes that we have not yet heard the final word on synaesthesia and that the neuro-anatomical locus lies in the left temporal lobe and limbic structures. I take issue with him on two points. Neurology was not an outgrowth of psychiatry but of general medicine. Secondly, in my personal experience of nearly three-quarters of a century at the National Hospital, Queen Square, aspects of higher nervous activity, including synaesthesia, have consistently been the subject of teaching at the bedside, on rounds and in the lecture theatre there. in his introduction, Dr. Cytowic made some stern statements about neurology. His remarks should not be brushed aside. If this carefully researched hook stimulates neurologists to direct their attention to higher nervous activity in general and synaesthesia in particular, this volume is a valuable catalyst. MACDONALD CR1TCHLEY Hughlings House Nether Stowey, Somerset TA5 1NL U.K.
Journal of the Neurological Sciences, 108 (1992) 118-119 © 1992 Elsevier Science Publishers B.V. All rights reserved 0022-510X/92/$05.00
B o o k reviews Post-Viral Fatigue Syndrome, by R a c h e l J e n k i n s a n d J a m e s M o w b r a y (eds.), 1991, J o h n W i l e y a n d Sons, C h i c h e s t e r , U . K . , 463 p a g e s , U S $60.00, I S B N 0-47192846-1 This volume on post-viral fatigue syndromes, edited by a psychiatrist and a neuroimmunologist, is a collaboration of approximately 35 contributors, most of whom are from the United Kingdom. The book is divided into 5 major sections dealing with definitions and epidemio l o ~ of the syndrome, host responses, clinical features, immune mechanisms and ideas for future research and treatment. The introduction discusses historical aspects of the disorder and gives an overview of the clinical presentation and nosology which aids in clarifying current concepts of the syndrome. The relationship of post-viral fatigue to depression and fibromyalgia is treated objectively. Data suggesting that symptoms result from persistent viral infection are presented in depth. General discussions of selected topics in virology and immunology provide basic background material for subsequent chapters. A glossary is also included. The text is quite readable and the chapters are well referenced. The multidisciplinary approach enables the reader to examine post-viral fatigue from various perspectives. However, the multiauthor format also lends itself to redundancy and contradictions. For instance, the differential diagnosis of chronic fatigue is discussed separately in several chapters and there is disagreement on the role of treatment with tricyclic antidepressants and physical therapy. Although this book may be too detailed for those with only a casual interest, it should prove useful reading for physicians who treat patients with this controversial disorder on a regular basis. DAVID S. LEFKOWITZ)MD Department of Neurology Bowman Gray School of Medicine Winston-Salem, NC, U.S.A.
Neurobehavioral Aspects of Cerebrovascular D&ease, by Bornstein, R.A. and Brown, G. (eds.), 1991, Oxford University Press, New York, NY, 367 pages, US $40.00 Even one who has devoted himself to the field of cerebral circulation and its diseases will find much of interest and of use in this 367 page volume. Authoritative chapters have been sequenced logically in order to cover the range of clinical effects of stroke on the human being. The chapters on clinical neuropsychology, recovery and treatment are particularly well done and there are some stand-outs, such as the chapter on anatomic imaging methods by Brown and Bornstein, that on the dementia syndrome of depression in patients with stroke by Starkstein, Bolla and Robinson and one on neuropsychological recovery after cerebral infarction by Meier and Strauman. The list of authors is outstanding and the price is not excessive. This book is recommended both for those already in the field, as well as for those learning it the first time. JAMESF. TOOLE, M.D. Editor, Journalof the Neurological Sciences BGSM Medical Center Winston-Salem, NC, U.S.A.
The Neuron Cell and Molecular Biology, by Levitan, I.B. and Kaczmarck, L.K. (eds.), 1991, Oxford University Press, Oxford, £18.95, ISBN 0-19-505832-1. The authors have produced an extremely well integrated, highly readable, soft cover volume which can introduce students of neuroscience into the field and graduates into a refresher and review on recent developments in a most readable and logical progression beginning with the cell, both neuron and gila, and progressing through the complexities of neural networks, it includes newer aspects of molecular biology, as well as theoretical considerations of behavior. The book is interspersed with wisdom, as well as with science and, as a typical example, the chapter "Neural Networks and Behavior" begins as follows: "As cells go, neurons are not loners. Every function of the nervous system, from regulation of autonomic activities such as heartbeat to the control of complex animal behaviors such as dating and mating, reflects the coordinated action of a network of interacting neurons. A major challenge of neurobiology is to understand the nature of the interactions and computations that neural networks carry out. In this chapter, we describe a number of simple neural networks whose biological role is known. These representative examples have been chosen to illustrate how specific cellular properties of different neurons in a network are essential to the function of the network as a whole". "The major lesson to be learned from such studies is that complex patterns of activity and relatively sophisticated computations can be carried out by networks of very simple units. For example, some networks can recognize patterns of inputs corresponding to letters of the alphabet. When stimuli in the shape of a letter "A" are applied to a two-dimensional array of input neurons, one set of output neurons will fire. A different set of output neurons fire when the shape "B" is applied. Other networks generate patterns of firing that very closely mimic pathological states such as epileptic seizures (Fig. 16-1c). Still other networks tackle mathematical problems, in all cases the responses of a network are in some way encoded in the pattern of activity of a set of output units. When the synaptic weights at individual connections are allowed to alter as a result of predetermined rules, ~he outputs of model networks may display features of learning". This book is a bargain at this price. ~AMESF. TOOLE, M.D. Editor, Journal of the Neurological Sciences,
BGSM Medical Center Winston-Salem, NC, U.S.A.
Synesthesia: A Union of The Senses, by R.E. Cytowic, Springer-Verlag, New York, 1989, pp. 354, US $75.00, ISBN: 0-387-96807-5 Synaesthetic phenomena have been reported, on and off, for hundreds of years. Francis Galton (who first used )he word "synaesthesia"), various romantic writers and musicians, those enterprising medical students Bleuler and Lehmann, psychologists intrigued with the subjective effects of Mescal and other hallucinogenic d~ugs, colour-hearing enthusiasts such as Rimington, Klein and Scriabin, were among the relatively few who wrote about them. But not since
119 Luria in 1968 has a neurologist or a psychiatrist made a serious effort to probe more deeply than mere descriptive reportage. Whether inborn or acquired, synaesthesia is truly intriguing, and, as Dr. C'~towic says, has interested the artist, then the philosopher and after that the psychologist " . . . but no one was very successful in making real sense of it and all camps ceased to be interested". Dr. Richard Cytowic was accidentally introduced to this neurological rarity when his bleeper went off while he was examining a patient, who was startled. She put her hands to her head and exclaimed "Oh those blinding red jaggers, turn that thing off[". Not long afterwards he happened to meet someone who, in response to tastes and smells, always perceived vivid geometric shapes and textures. On reporting these cases, other individuals endowed with one or other variety of synaesthesia came to his notice. He was able to carry out thorough neuropsychologieal investigation of some of them. Dr. Cytowic's aim has been to identify the nature of synaesthesia. In his own words, "I believe that the place to go fishing in the brain for an explanation is not at the top (in the neocortex where symbolic language resides) but close to the bottom of the pond, at an earlier stage of neural processing". In his fishing, the author cast his net widely, perhaps too far. He refers to alloaesthesia, palinopsia, number-forms, clairvoyance, pre-
cognitive dreaming, the "retinex" hypothesis of colour, phantom vision and "blindsight" among many other arcane topics. Dr. Cytowic concludes that we have not yet heard the final word on synaesthesia and that the neuro-anatomical locus lies in the left temporal lobe and limbic structures. I take issue with him on two points. Neurology was not an outgrowth of psychiatry but of general medicine. Secondly, in my personal experience of nearly three-quarters of a century at the National Hospital, Queen Square, aspects of higher nervous activity, including synaesthesia, have consistently been the subject of teaching at the bedside, on rounds and in the lecture theatre there. in his introduction, Dr. Cytowic made some stern statements about neurology. His remarks should not be brushed aside. If this carefully researched hook stimulates neurologists to direct their attention to higher nervous activity in general and synaesthesia in particular, this volume is a valuable catalyst. MACDONALD CR1TCHLEY Hughlings House Nether Stowey, Somerset TA5 1NL U.K.