Autonomic Imbalance and the Hypthalamus

Autonomic Imbalance and the Hypthalamus: Implications for Physiology, Medicine, Psychology, and Neuropsychiatry

Ernst Gellhorn
Copyright Date: 1957
Edition: NED - New edition
Pages: 320
https://www.jstor.org/stable/10.5749/j.cttttm9s
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  • Book Info
    Autonomic Imbalance and the Hypthalamus
    Book Description:

    Autonomic Imbalance and the Hypothalamus was first published in 1957. Fundamental alterations in the reactivity of autonomically innervated structures frequently have been observed in physiological tests as well as under clinical conditions. However, the mechanism of these alterations and the changes in the reactivity of the central structures of the autonomic nervous system that are their most frequent site of action had not been subjected to systematic, experimental analysis until Dr. Gellhorn launched the investigations he reports in this volume. The influence of the sino-aortic reflexes on the hypothalamus and the cortex is analyzed experimentally, and new data on the relation of the hypothalamus to vascular, respiratory, and visceral functions are presented. On the basis of his physiological work Dr. Gellhorn shows how clinically applicable methods for the diagnosis of parasympathetic and sympathetic disorders at the hypothalamic level may be devised. He shows the significance of his observations for an understanding of the physiology of the emotions and suggests clinical applications to such problems as hypertension, central autonomic disorders, and functional psychoses. The influence of age on parasympathetic and sympathetic excitability is shown on control subjects and on neuropsychiatric patients, and significant differences between these two groups at similar age levels are disclosed. For the convenience of the clinical reader the experimental results are summarized in a special section before the clinical applications are discussed.

    eISBN: 978-0-8166-6254-8
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. PREFACE
    (pp. vii-x)
    E. Gellhorn
  3. Table of Contents
    (pp. xi-2)
  4. INTRODUCTION
    (pp. 3-6)

    IT IS a long-established fact based on experiments on various nerve-muscle preparations that a given stimulus acting on an autonomically innervated organ produces diametrically opposed effects on this organ in different physiological states. Thus, stimulation of the hypogastric nerve elicits a relaxation of the virginal uterus but a contraction of the pregnant uterus of the cat (49), and the smooth muscles of the gastrointestinal tract react to various stimuli differently in different states of tone.

    Without adding further examples, it may be said that fundamental alterations and even a reversal in the responsiveness of autonomically innervated structures have frequently been...

  5. Part I. Experimental Investigations

    • CHAPTER 1 PHYSIOLOGICAL LAWS CONCERNING AUTONOMIC IMBALANCE
      (pp. 9-76)

      ALTHOUGH the importance of summation phenomena has been greatly stressed by Sherrington (280) for the somatic nervous system, there exists no systematic work showing their significance for sympathetic and parasympathetic functions although Bronket al. (31, 33) have clearly demonstrated them for autonomic ganglia. For this reason, and as a basis for an understanding of the more complex problems involved in the study of the dynamics of autonomic imbalance, this problem was investigated. Examples will be given showing summation* between (a) two stimuli applied to central autonomic structures (hypothalamus); (b) one central (hypothalamic) stimulus and one peripheral stimulus which elicits...

    • CHAPTER 2 HYPOTHALAMIC EXCITABILITY, PHASIC AUTONOMIC REFLEXES, AND TONIC AUTONOMIC FUNCTIONS
      (pp. 77-118)

      ONE goal of this work, it was pointed out in the Preface, was to understand certain clinical observations on the action of mecholyl in patients with neuropsychiatric disorders. The experimental work, to be discussed in this chapter, seems to the writer to prove his original contention that the mecholyl test, other conditions being equal, reflects the state of excitability of the sympathetic division of the hypothalamus. These observations are a challenge to establish methods by which also the state of the parasympathetic division of the hypothalamus may be determined. Such an investigation is important, since an insight into the state...

    • CHAPTER 3 THE RELATION OF HYPOTHALAMIC EXCITATION TO NEUROGENIC AND HORMONAL (ADRENOMEDULLARY) DISCHARGES. A Contribution to the Study of Homeostasis
      (pp. 119-139)

      IT IS generally accepted that appropriate excitation of the centers of the autonomic system leads to a sympathetico-adrenal discharge. This discharge occurs in emotional excitement and in conditions in which the internal environment has been changed (for instance in cold, anoxia, and hypoglycemia), and it contributes to the restitution of the physiological state of the organism. The sympathetic discharges are easily recognized by the increase of the blood pressure and heart rate, the inhibition of the gastrointestinal tract, the contraction of the nictitating membrane, the dilatation of the pupils, and piloerection, to mention only a few symptoms. The secretion of...

    • CHAPTER 4 THE TONE OF THE SKELETAL MUSCLES IN ITS RELATION TO THE EXCITABILITY OF THE HYPOTHALAMUS AND THE EMOTIONS
      (pp. 140-146)

      THE studies of the last few decades have furnished many examples of the interrelation between the autonomic and somatic nervous systems. For the present discussion, which is concerned with the tone and activity of the striated muscles, the observations showing that the excitation of autonomic centers is associated with significant changes of the skeletal muscles are of importance. They are based on three sets of experiments:

      1. Variations in the pressure of the carotid sinus caused marked changes in behavior and in muscle tone. When the pressure was raised, the unanesthetized animals became quiet, reacted less to environmental stimuli, and had...

    • CHAPTER 5 ON THE RELATION OF THE HYPOTHALAMUS TO THE VISCERA
      (pp. 147-157)

      THE tuning concept which played a central role in our investigations was derived from experiments involving the circulatory system. Thus it was shown that a reduction in the baroreceptor reflexes by an experimentally induced fall of the blood pressure (and thereby of the sinoaortic pressure) led to a sympathetic tuning, that is, to an increased sympathetic responsiveness to the stimulation of the posterior hypothalamus or the sciatic nerve. Similar effects of sympathetic tuning were produced by direct stimulation of the posterior hypothalamus or the sciatic nerve. The blood pressure and heart rate increased and in this condition the response of...

    • CHAPTER 6 RESPIRATORY REFLEXES AND THE HYPOTHALAMUS
      (pp. 158-164)

      A LARGE part of this monograph has been devoted to a study of vascular reactions in their dependence on the anterior and posterior divisions of the hypothalamus. In view of the fact that vascular and respiratory functions are intimately interrelated, it seems to be advisable to subject respiratory reflexes to a similar investigation. Such an investigation should have two goals: (a) to determine whether the principles underlying hypothalamic control of vascular relations are applicable to the area of respiratory reflexes; (b) to investigate the possibility of using respiratory functions as indicators of the state of the hypothalamus.

      That respiration is...

    • CHAPTER 7 THE HYPOTHALAMIC-CORTICAL DISCHARGE AND ITS RELATION TO THE STATE OF THE HYPOTHALAMIC BALANCE
      (pp. 165-200)

      IF IT is correct, as Sherrington (280) argued convincingly, that to investigate the integrative action is one of the chief tasks of a physiology of the central nervous system, it follows that no physiological investigation of central nervous functions should be limited by artificial anatomical boundaries. Particularly is this true of the study of autonomic functions. An understanding of the role of the autonomic nervous system in the organism is unthinkable without considering its intimate relation to the endocrine system (87, 94, 141). But it is necessary to go even further. Langley (208) thought of the autonomic nervous system as...

    • CHAPTER 8 EXPERIMENTS ON THE ACTION OF DRUGS ON THE HYPOTHALAMIC-CORTICAL SYSTEM
      (pp. 201-214)

      THE experiments discussed in the preceding chapters have shown that fundamental alterations in the reactivity of the hypothalamus are easily produced by physiological means and have far-reaching effects on the cerebral cortex. These studies were supplemented by some pharmacological observations. Although a complete survey of the action of drugs on the hypothalamus is beyond the scope of this book, some experiments are reported which show, at least in principle, how hypothalamic imbalances may be eliminated. The literature of the last years seems to indicate that science and industry will devote a great deal of effort to psychopharmacology and closely allied...

  6. Part II. Review of Results and Clinical Application

    • CHAPTER 9 THE EXPERIMENTAL FOUNDATION AND THE CLINICAL APPLICATION OF THE CONCEPT OF PARASYMPATHETIC AND SYMPATHETIC TUNING OF THE AUTONOMIC NERVOUS SYSTEM
      (pp. 217-224)

      IN CONTRAST to the somatic nervous system the autonomic system shows a rather irregular behavior under a variety of conditions. Even in the simple nerve-muscle preparation the effect of the stimulation of a nerve is variable inasmuch as it depends on the state of the muscle. Vagal stimulation leads to an increase in the tone and contraction of the stomach if the state of activity of this organ is low, but to an opposite effect if the spontaneous activity is considerable. Other factors may likewise alter the reactivity of an autonomically innervated organ to nervous stimulation. Thus, the response of...

    • CHAPTER 10 THE EXPERIMENTAL FOUNDATION AND THE CLINICAL APPLICATION OF THE MEASUREMENT OF HYPOTHALAMIC IMBALANCE IN THE INTACT ORGANISM
      (pp. 225-238)

      THE experimental work discussed in the preceding section showed that through reflexes the autonomic balance can be shifted either to the sympathetic or the parasympathetic side and that these alterations are associated with characteristic changes in the responsiveness of the autonomic system. It was also mentioned that stimuli acting directly on autonomic central structures change the state of autonomic tuning in the same manner as previously described for reflex stimuli. Thus a state of sympathetic tuning results either from hypotension or from mild stimulation of the posterior (sympathetic) hypothalamus. In either case the central sympathetic discharges are increased: in the...

    • CHAPTER 11 THE HYPOTHALAMIC-CORTICAL SYSTEM IN HYPOTHALAMIC IMBALANCE. REVIEW AND CLINICAL APPLICATION
      (pp. 239-242)

      THE investigations discussed thus far have been concerned with the measurement of autonomic reactivity in states of autonomic and, specifically, of hypothalamic imbalance and with the influence of this imbalance on the sympathetic and parasympathetic “downward” discharge. The last decade has shown that, in addition, the hypothalamus exerts a profound influence on the cerebral cortex as a whole. We have to sketch, therefore, the nature and significance of this “upward” discharge, both in general and in conditions of altered hypothalamic excitability in particular.

      If the posterior hypothalamus is stimulated electrically, a rage reaction is elicited which is characterized not only...

    • CHAPTER 12 THE PHYSIOLOGY OF FEAR AND ANGER
      (pp. 243-251)

      FUNKENSTEIN (78) published a challenging paper entitled “The Physiology of Fear and Anger” in theScientific American. Although he had originally divided the reactions of his patients to mecholyl into seven groups, he confines himself in this paper to two groups only — according to our investigations distinguishable as sympathetic hyporeactors and hyperreactors respectively. Psychologically the hyporeactors were frightened and depressed, whereas the hyperreactors were “angry at other people.” Funkenstein performed the mecholyl test also on students under conditions of emotional stress. In agreement with his observations on psychotic patients, he found that the hyporeactors felt depressed and were anxious...

    • CHAPTER 13 THE ROLE OF THE HYPOTHALAMUS IN HOMEOSTASIS
      (pp. 252-258)

      IT IS one of Cannon’s great merits to have reintroduced and elaborated Bernard’s concept of the constancy of the internal milieu and to have shown the fundamental importance of the autonomic nervous system in homeostasis (38). The new data on autonomic functions presented in this book made it necessary to reconsider the role of homeostasis in physiological and pathological conditions and to apply this concept specifically to the state of autonomic imbalance of the hypothalamus.

      It was shown earlier that the rise of the blood pressure resulting from an injection of adrenaline or noradrenaline led to a reduction in the...

  7. SUMMARY AND CONCLUSIONS
    (pp. 261-274)

    ONE of the chief problems dealt with in this book, experimentally and clinically, is how hypothalamic functions and the state of hypothalamic balance can be evaluated in the intact organism by methods applicable to the human patient. Before this problem could be attacked, it was necessary to investigate the laws of interaction of two stimuli acting on either the parasympathetic or the sympathetic nervous system under a variety of conditions.

    The blood pressure, the heart rate, and the contraction of the normal and denervated nictitating membrane served as indicators of autonomic reactivity in most of the experiments. In a smaller...

  8. EPILOGUE
    (pp. 277-282)

    AFTER the facts and their interpretation have been presented and an attempt has been made to show the significance of the experimental work on which this monograph is based, several questions of fundamental interest require a brief discussion. They are relegated to this last section and thereby separated from the experimental and critical parts because a somewhat personal attitude appears to be unavoidable. Whereas I have striven to report the experimental data objectively and to draw only such conclusions as appear warranted by the facts, I feel that some larger questions cannot be handled in this way.

    One of these...

  9. BIBLIOGRAPHY
    (pp. 285-297)
  10. INDEX
    (pp. 298-300)