Bookreviews CHEMICAL PATHOLOGY OF THE NERVOUS SYSTEM. Proceedings of the Third International Neurochemical Symposium, Strasbourg, 1958 (119 participants). Edited by Jordi Foich-Pi, Harvard Medical School, Boston, and McLean Hospit, 1, Waveriey, Mass. Oxford, 1961, Pergamon Press, 720 pages. Price $20. The
format of the sympositim, and, therefore, of the book, consists of groups of papers in areas of current research and clinical interest in the field of neurochemistry. The outstanding feature of the book, perhaps, is that each of these sections begins with a review of the area by a mature and sophisticated worker in the field, putting the following, frequently avant-garde and speculative research reports in perspective. The various areas covered include: inborn metabolic errors, including phenyiketonuia, the iipidoses, metachromatic dystrophies, Hartnup’s, and porphyria; nutritional metabolic disorders, emphasizing various B vitamins, proteins, and recent opinions concerning dietary lipid influences; the biochemistry of copper metabolism, including intake, binding, transport, storage, and influences on the central nervous system, with particular reference to Wilson’s disease; a large section which presents recent neuropathoiogic and histochemicai studies which have to do with various aspects of demyeiination, including basic studies on protein and lipid metabolism in tracts and peripheral nerves; fluid and electrolyte physiology, with reference to distribution and the blood-brain barrier; some chemical influences in central-nervous-system excitability which may play a role in the convulsive disorders, including acid-base changes, giutamic acid metabolism, ammonia and GABA; and five sections on hormones, enzymes, and the metabolism of proteins, amino-acids, amines, aromatic compounds, fluid and electrolytes, and other current byways in the general area of the biochemistry of mental disease. The contributors are among the world’s best known men studying chemical aspects of the nervous system, and the review articles which begin each section constitute in themselves as good a collection of reference sources as exists under one cover in this young and chaotic field. The kind and degree of solidity of data and conceptual framework, however, varies markedly from area to area, both as a function of the difficulty inherent in the area explored as well as the acceptable level of “proof” in the scientific climate in each field. For example, there is the work surrounding phenyiketonuria as represented by the reports of Armstrong and associates, and Knox versus Aitschuie’s report on glucose tolerance curves in schizophrenia. The former group represent orderly additions to a systematically growing chemical descriptive characterization of a definite entity; the latter group constitutes another unsystematic, poorly controlled “shotgun” attack on an experimental group as >-et not defined. The risk in putting both
of these types of research reports in the same volume is that the acceptance engendered by the first will transfer in the reader’s thinking to the second. However, if this is kept in mind, the unevenness serves as an accurate reflection of the status of neurochemistry today and becomes an interesting feature of this excellent book.
WILLIAM HARVEY LECTURES ON THE WHOLE OF ANATOMY. An annotated translation of Prelectiones Anatomiue Universulis. By C. D. O’Maiiey, Professor of Medical History, University of California at Los Angeles; F. N. L. Poynter, Head of Weiicome Historical Medical Library, London; and K. F. Russell, Associate Professor of Anatomy, University of Melbourne. Berkeley and Los Angeles, 1961, University of California Press, and London, 1961, Cambridge University Press, 239 pages, 5 iiiustrations. Price $8. In De Motu Cordis (1628), William Harvey wrote: “On several earlier occasions in my anatomical lectures I revealed my new concept of the heart’s movement and function and of the blood’s passage round the body. Having now, however, for more than nine years confirmed it in your presence . . . I have . . published it for ail to see.” The lectures to which he referred were his Lumleian lectures (1616-1618), under the auspices of the Royal College of Physicians; it is evident that the circulation was first considered in a iecture of 1618, rather than in 1616 as has been claimed. The Prelectiones are Harvey’s lecture notes, written in Latin with occasional English words and phrases interspersed. A facsimile publication of these notes, with a transcription by Edward Scott, of the British Museum (where the notes are deposited), was issued by the Royal College of Physicians in 1886. The present book is far more than this, and it will accomplish much not only in clarifying the background of De Motu Cordis ‘but also in supplying information about Harvey’s life and ways, as well as the treatment of anatomy in his time. It contains a 19-page Introduction by the translator-editors that supplies an eniightening setting for the Lectures. The Lectures themselves are presented in full, with continuity filled in by editorial insertions (in square brackets) and commentary in extensive footnotes. The iiiustrations are noteworthy: the Rolls Park portrait of Harvey (about 1622) in color; the nineteenth century reconstruction of the Royal College of Physicians building, where the Lectures were delivered; facsimile reproductions of three pages of the Lectures, including the title page--“1 begin with Jove, 0 Muses. ,411 things/are filled with Jove./ Lectures on the Whole of Anatomy/ b> me/ William Harvey/ Physician of London/ Professor of Anatomy/ and Surgery/ . .” LZn excerpt from the Introduction is quoted here for the reason that it contains the critical passages relating to the circulation:
“It is clear that when he came to write the notes, he had been making his experiments and observations on the heart and circulation for a long time. When talking of the systole and diastole of the heart, on folio 77v, he writes, ‘Having observed [the motion of the heart] for whole hours at a time, I was unable to discern [these things] easily by sight or touch, wherefore I propose that you ought to observe and note.’ Certainly he had already come to definite conclusions about the circulation, for on folio 79v he states dogmatically: ‘The heart having been extended and contracted, just as by a kind of force it propels from the right [ventricle] into the lungs, from the left into the aorta; wherefore [occurs] the pulse of the arteries . . .’ Again, on folio 78v, he says, ‘Hence the pulse of the artery [is] not from an innate faculty of the valves as according to Galen 13, but by the heart thrusting forth [as is indicated] by autopsy in the live and dead, by reason [and] by experiment with ligatures.’ His views on the origin of the heart beat are clearly set down on folio 77v: ‘The pulse begins at the auricles and progresses to the point, wherefore as if [there were] two wings WH. Nevertheless the heart beats when separated from the auricles and the auricles awaken the somnolent heart.’ These remarks could only follow prolonged observations on dissections of living animals. Finally, on folio 80” is the conclusive statement, ‘. . . wherefore the beat of the heart produces a perpetual circular motion of the blood’.” * This book is exactly what one would expect of the distinguished translator-editors. It is a scholarly and sensitive presentation of a phase of William Harvey’s work that had remained in undeserved obscurity until now.
PHYSIOLOGICAL AND PATHOLOGICAL AGING. By V. Korenchevsky, M.D.; edited by Geoffrey H. Bourne, D.&z., D.Phil., F.Z.S., Professor and Chairman of Anatomy, Emory University, Atlanta, Ga. New York, 1961, Hafner Publishing Company, 514 pages. Price $22.50. This monograph was written by Dr. V. Korenchevsky, who was born in Russia in 1880. He organized the Oxford Gerontological Unit in 1945, which he headed until he retired in 1952. He transferred this unit to St. Bartholomew’s Hospital in London, where he now concentrates on the medical literature concerned with aging. This book is a compendium of the author’s own experience and concepts and represents the fruits of his efforts. It is a summary of problems on aging and concerns a review of the literature, without, unfortunately, the author’s evaluation of the literature. It contains a summary of many papers from the Russian literature, an aspect that should be of interest to those who cannot read Russian. Again, however, the author fails to indicate his opinion of the importance or reliability of these reports. The monograph is divided into chapters which are concerned with each of the major systems or physiologic processes, e.g., aging of cells, con-
nective tissue, endocrine glands, heart, kidney, nervous system, and others. The chapter entitled “Causes of Aging” is limited to 2 pages, and is almost worthless. There are many interesting aspects of aging that could have beeu included in this chapter, such as data obtained in the fields of biology other than medicine, including genetics. Unfortunately, this book contains a mass of facts which are not presented critically or in an interesting fashion. The monograph is dull but may interest those who have read little on the subject of aging. It repeats a great deal of the material found in other monographs on aging, such as Cowdry’s book. Anyone interested in the aging process should at least glance over this book, but if he is already well informed, he will not find many exciting, stimulating, or new ideas here. It is well recognized that the aging process is poorly understood, but the great need is for concentrated, clear thinking on the subject, using the data already published only as a background.
CEREBRAL INFARCTION: THE ROLE OF STENOSIS OF THE EXTRACRAXIAL ARTERIES (Medical Research Council Special Report No. 300). By Peter 0. Yates and Edward C. Hutchinson, London, 1961, Her Majesty’s Stationery Office, 95 pages (British Information Service, New York, American agent). Price $2.65. Complete postmortem examination of the cerebrovascular tree from the aorta to the brain was done in 100 persons who died with clinically recognized cerebral ischemia in the Manchester Royal Infirmary during the years 1955 and 1956. Thirty-one persons who died from known cerebral hemorrhage during the same period were omitted, as were persons with cerebral infarction not associated with degenerative cerebrovascular disease. Patients with symptoms which were primarily psychiatric or with long histories of remitting illness tended to be excluded since they were not admitted to this hospital. Both carotid and both vertebral vessels were injected with a radiopaque gelatine mixture, and dissection of the vessels was carried out as indicated by radiographs. Cerebral infarction was found in 35 of the 100 subjects. Very few cases were due to local arterial occlusion with complete cessation of blood flow. In only 22 of the 3.5 subjects was there significant stenosis or occlusion of intracranial arteries, but 32 had significant stenosis of the extracranial portions of the cerebral arteries. Thus, in more than one third of the subjects who had cerebral infarction, neither occlusion nor significant stenosis of the intracranial cerebral arteries was found. Systemic factors, such as hypotension and anemia, were emphasized. Case summaries, autopsy findings, and maps of the vascular and cerebral lesions are provided on each patient with cerebral infarction. The authors conclude that cerebral infarction usually results from a combination of systemic disease and stenosis of extracranial arteries, in-