Physiological Foundations of Neurology and Psychiatry

Physiological Foundations of Neurology and Psychiatry

Ernst Gellhorn
Copyright Date: 1953
Edition: NED - New edition
Pages: 570
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    Physiological Foundations of Neurology and Psychiatry
    Book Description:

    Physiological Foundations of Neurology and Psychiatry was first published in 1953. The findings of Dr. Gellhorn’s extensive and significant research on the physiology of the central nervous system form the basis of the discussion in this volume. Reference is frequently made to the applicability of this laboratory experience to clinical as well as other fields. An attempt has been made to integrate the clinical and experimental literature with the discussion, to give an up-to-date picture of the problems involved and to indicate the possibilities for future investigation. Topics of interest to physiologists, endocrinologists, internists, neurologists and neurosurgeons, psychiatrists, and clinical psychologists are discussed. An important aspect of the author’s work concerned certain recent tests which show an altered reactivity of autonomic centers in the psychotic condition. His interpretation of the significance of these tests for a physiologically oriented therapy of functional psychoses is published here for the first time. The physiological effects actually produced in the central nervous system by “shock” treatment and carbon dioxide therapy are analyzed. Other sections give consideration to some of the principal working mechanisms of the neuron, to the factors determining movements and convulsions, to the pathophysiology of cortical lesions, to some aspects of autonomic physiology, and to the problem of consciousness. An important section deals with integrative functions of the nervous system - those involved in emotion, the conditioning process as the basis of behavior, and homeostasis.

    eISBN: 978-0-8166-6255-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-viii)
  2. Table of Contents
    (pp. ix-2)
  3. Introduction
    (pp. 3-8)

    Expounding the physiological foundations of neurology and psychiatry is perhaps more difficult than the application of physiology to any other branch of clinical medicine. In no other area of study are the phylogenetic differences between man and the readily available laboratory animals so profound. The very limited use of anthropoid apes has been confined almost exclusively to explorations of the motor cortex and to behavioral studies. Although the monkey has served for experimental work more extensively, particularly in the last decade, there are still many physiological problems which have thus far been attacked only in the cat, dog, or even...

  4. PART I Intrinsic and Extrinsic Factors Regulating Neuronal Activity
    • 1 The Unit Analysis of Nervous Activity
      (pp. 11-37)

      Physiological investigations in general are based on two procedures, analysis and synthesis. In the former an attempt is made to determine the activity of the individual cell or even parts of the cell in various physiological processes, whereas the object of research in the latter is to understand the interaction of the cells in a particular organ and, still more important, the integration of the functions of the various organs. Applied to the nervous system, the goal of analysis is the knowledge of the intimate function of the neurons, while synthesis is more concerned with complex patterns of activity, the...

    • 2 The Internal Environment and Central Nervous Activity
      (pp. 38-54)

      The changes produced in sensory and motor neurons by physiological stimuli have been analyzed in the preceding chapter on the basis of action potentials which indicate that the gradation of activity is achieved in the same manner in the somatic and in the visceral nervous system. This work must be supplemented by the study of neurons under the influence of chemical factors. Any nervous function at spinal or supraspinal levels can be investigated for this purpose; but the great responsiveness of the cortex to such changes, related to its high metabolic rate, and the importance of this structure for problems...

  5. PART II Contributors to the Physiology and Pathology of Movements
    • 3 The Motor Cortex and the Physiology of Movements
      (pp. 57-88)

      In order to understand the foundations of neurology, a thorough discussion of the physiological basis of movements and their coordination is necessary. The study of movements, more than that of any other cerebral function, reveals the general principles which regulate the activity of the central nervous system as a whole and permits one to gain some insight into sensorimotor integration. Since Jackson's highest level of integration (730) is outside the reach of the experimental physiologist, the investigation of the cortical contribution to this function is mainly confined to the study of the motor cortex. However, our chief interest does not...

    • 4 Voluntary Movements, Motor Cortex, and Reflex Activity
      (pp. 89-102)

      On the basis of the data presented in the preceding chapter it seem appropriate to compare voluntary movements with those elicited reflexly or by stimulation of the motor cortex and to evaluate their interrelation.

      Proprioception is obviously of great importance for all movements no matter whether they are simple reflexes studied in the spinal animal or highly complex and skilled movements executed through will power. The experiments showing that proprioceptive impulses modify in a similar manner reflexes and cortically induced movements suggest the spinal cord as an important site of proprioceptive facilitation and inhibition. The study of movements after deafferentation...

    • 5 The Restitution of Movements after Central Lesions
      (pp. 103-120)

      The restitution of movements following lesions in various parts of the central nervous system is of theoretical interest because the function of structures such as the motor cortex can be properly evaluated only if the results of stimulationandablation are taken into account. In addition the functional recovery from cortical motor lesions is obviously of great practical import from the point of view of prognosis and therapy. That the axon outside the central nervous system has considerable recuperative powers not only in laboratory animals but also in man is attested by the restoration of motor and sensory functions after...

    • 6 Electromyography
      (pp. 121-140)

      To ascertain the degree and the temporal relations of activity in individual muscles in reflexes and willed movements is of greatest importance for an understanding of central nervous functions in physiology and pathology. In animal experimentation the performed work or the developed tension gives a direct measure of muscle function, but these data cannot be obtained without sectioning of the muscle tendon and fixation of the limb. These procedures introduce unphysiological conditions and are not applicable to man. It is, however, possible to measure muscle activity through a recording of action potentials either through surface electrodes or through the insertion...

    • 7 Studies on Experimental Convulsions
      (pp. 141-178)

      Although action potentials of the brain were already described in 1875,* it may be said that the modern period of electrophysiological research was inaugurated by Berger’s discovery (87) that even with the skull intact, action potentials of the brain can be recorded. The confirmation of this work by Adrian and Matthews and their interpretation of the alpha potentials as synchronous discharges of neurons of the occipital lobes (16) greatly furthered the development of this new field. The knowledge of clinical neurology, particularly as relates to epilepsy, has been increased by the electroencephalographic work of Berger and his followers in the...

  6. PART III The Physiological Basis of Consciousness
    • 8 An Approach to the Problem
      (pp. 181-183)

      These three quotations — from a poet, from a philosopher, and from a neurologist — remarking how closely interwoven are mind and body, raise the question whether it is possible to lay the groundwork for a physiological interpretation of mental processes. Attempts in this direction have been made not infrequently in the past. Verworn (1187) hypothesized that memory and the growth of the neuron are related, E. Hering (626) dealt in a famous oration with memory as a characteristic of living systems, and von Kries (805), the author of the duplicity theory odf vision, spoke on one occasion on the material basis...

    • 9 The Physiology of Consciousness
      (pp. 184-205)

      The state of consciousness in which a person is aware of himself and his environment depends on the complexity of the nervous organization. Its range varies between different individuals, the intelligent and the stupid, the newborn and the adult. There are also different levels of consciousness in the same person depending on the degree of his alertness. Electroencephalography has confirmed and expanded these common experiences. With the eyes closed a person may show welldeveloped alpha potentials of a frequency of 8 to 12 per second and an amplitude of about 50 microvolts; when he is in a state of greater...

    • 10 The Pathology of Consciousness
      (pp. 206-228)

      One of the conclusions reached from the experimental work described in the preceding chapter, namely, that characteristic differences in arousal value exist between various sensory modalities and that arousal reactions are related to the phenomenon of consciousness, is supported by clinical experiences of an entirely different kind — the study of the factors which determine the appearance of a phantom limb in patients with an amputated extremity. Such an investigation illuminates solely one sector of the problem of consciousness — the role of afferent impulses — but it supplements the work on experimental animals in which the state of awareness can only be...

  7. PART IV Some Aspects of Autonomic Physiology
    • 11 Neurohumors and Neuropharmacology of the Autonomic Nervous System
      (pp. 231-268)

      Some aspects of the role of electrical potentials in excitability, conduction, and synaptic transmission have been discussed earlier. Important as this work is, it gives only an incomplete picture of the basic physiological characteristics of the neuron. It is supplemented by another wide field of neurophysiological research, the study of neurohumors, which, at least in part, deals with fundamental intraspinal and intracerebral processes and seems to have great potentialities for neurology and clinical medicine. A discussion of this work and some related questions concerning the action of certain drugs on the central nervous system has therefore been chosen as the...

    • 12 The Eye as an Indicator of Autonomic Activity
      (pp. 269-288)

      Since it is not possible within the framework of this book to treat the autonomic nervous system systematically, an attempt will be made to illustrate on a single organ some of the principles which guide its activity. The eye has been chosen because of its obvious significance for clinical neurology and the importance which reactions on autonomic ocular indicators have played in the development of the physiology of the involuntary nervous system.

      It is well established that stimulation of the oculomotor nerve causes constriction of the pupil whereas stimulation of the superior cervical sympathetic trunk induces dilatation. Moreover sectioning of...

  8. PART V Integrations
    • 13 Principles of Neuro-Endocrine Action
      (pp. 291-332)

      The integration of the functions of the various organs in the body during rest and activity and under conditions of changes in the external and internal environment is accomplished through the functions of the nervous system and the endocrines. These mechanisms are likewise at work under pathological conditions. Thus tissue damage results in adjustment reactions consisting of nervous discharges and quantitatively altered internal secretions. Even the gross anatomical changes in various organs, particularly the adrenal cortex and the lymphatic tissue, as seen in Selye’s alarm reaction (1104), are the result of neuro-endocrine activity. For a better understanding of the behavior...

    • 14 The Physiological Basis of Emotion
      (pp. 333-360)

      If a physiologist discusses the problem of emotion today, he will quite naturally take as his point of departure the ideas which Walter B. Cannon (190–192) developed a number of years ago. In attempting to refute the James-Lange theory, Cannon reached the conclusion that in emotion it is the thalamus which is excited through afferent stimuli. These impulses appear to be relayed to other parts of the diencephalon and result in a “downward discharge” activating viscera and skeletal muscle. In addition they elicit an “upward discharge” constituting the equivalent of the “feeling tone” of the emotion. Cannon further assumed...

    • 15 Factors Involved in Conditioning
      (pp. 361-388)

      In a book dealing with the medical aspect of neurophysiology it appears necessary to discuss at least some phases of the basic physiology of conditioning, since these processes undoubtedly furnish patterns according to which individual reactions are acquired. Any reflex elicited in the normal or anesthetized organism or in an animal in which the brain has been removed is characteristic of the species. It is not always the same since it may undergo quantitative changes as the result of antecedent stimuli. Even qualitative changes occur: stimulation of a nerve of the left leg will induce, instead of the typical extension,...

    • 16 Homeostasis
      (pp. 389-418)

      The concept of homeostasis is so widely used in physiology and medicine that a detailed explanation of the meaning of the term is hardly necessary. Suffice it to say that it was one of Claude Bernard’s major achievements to recognize that the composition of the blood and tissue fluids is kept within narrow limits. This relative constancy of the “internal environment” is called homeostasis (Cannon, 191a, 194).

      There are marked differences in the degree to which homeostasis has been developed in various organisms. One could speak of phylogenetic and ontogenetic development of homeostatic functions. In certain invertebrates which inhabit the...

    • 17 The Constancy of the External Environment
      (pp. 419-426)

      In the preceding pages the evidence for the existence of homeostasis and the mechanisms contributing to it have been reviewed, and their value for the survival of the organism and for the development of the brain has been emphasized. But it may be said that the survival of an organism in general and of the most complex species, man, in particular, depends not only on relative constancy in the internal milieu but also on a similar constancy in the external environment, since the latter is the basis of orientation and purposeful action. No attempt will be made to discuss this...

  9. PART VI Applications
    • 18 Schizophrenia, the Autonomic Nervous System, and Shock Therapy
      (pp. 429-449)

      Basing his conclusions on a study of the clinico-experimental literature and on experiments concerning the physiological mechanisms involved in various forms of shock therapy, the writer emphasized in 1938 (441, 442) the autonomic disturbances in schizophrenes and the compensatory action of shock therapy. Analyses of the blood of excited psychotics for insulin gave further evidence for an imbalance of autonomic centers. The studies on alterations in conditioned reactions reported earlier have explained, at least in principle, how insulin coma and convulsions induced for therapeutic purposes may alter behavior. The thesis presented in this chapter is not different from that presented...

    • 19 The Physiological Foundation of Carbon Dioxide Therapy
      (pp. 450-465)

      It was shown in the preceding chapter that through a study of the physiological mechanisms involved in the shock therapy of mental diseases some light is thrown on the nature of the disease process and a new approach to therapeutic problems appears to be possible based not on empirical data but on physiological principles. In 1929 Loevenhart and his associates (853) made some interesting observations on establishing contact with catatonics under the influence of high concentrations of carbon dioxide. This study has been resumed by Meduna (923), who reports favorable effects from carbon dioxide therapy in psychoneurotics. These clinical observations...

    • 20 Physiological Principles for the Therapy of Psychoneuroses and Functional Psychoses
      (pp. 466-486)

      In the last two chapters an attempt has been made to relate mental disease to a dysfunction of the autonomic nervous system. The reactivity of the sympathetic centers has been found to be subnormal in schizophrenes, and the therapeutic effect of so-called shock therapy has been interpreted as being due to the prolonged excitatory action of these procedures on central sympathetic structures, particularly on the hypothalamus. This interpretation is supported by observations showing increased sympathetic responsiveness with clinical improvement. Such observations were made not only by Hill (650) in an important study which has been discussed earlier but also in...

  10. Bibliographical Index of Authors
    (pp. 489-544)
  11. Subject Index
    (pp. 545-556)