pathology for the physician

1
BOOK REVIEWS selected for detailed dissection. These were all treated by a "total push" program in which ECT, sub-insulin coma, individual analytic therapy, group therapy as well as environmental manipulation were often in- cluded. Many of these did not acquire maturity of personality nor insight, yet managed to function. The group included severe psychoneurotics, psycho- somatic disorders, personality problems as wt>I1 as psychotics. It is underscored that while "one-to-one" therapy, utilizing the methods pioneered by Freud, has been of tremendous value in understanding the human personality, such has been available to only a lim- ited group. There is a great need for techniques that can handle the ever increasing load of patients. Psychopharmacology plus emotional support through psychotherapy offers this wedge which is now cap- able of helping and caring for patients who would have been .. salvage. In striving for can' rather than cure, even the failures men- tioned above cannot be considered as hopeless. The author is to be congratulated for a well- written, compact text in which the present changes in psychiatric thinking are presl'ntl'd in a sobl'r, mature and soul-searching manner. Failures arl' ad- mitted; limitations are also underscored. Nevertheless, one is left with hope for the future rather than des- pair. \V.D. PARAPSYCHOLOGY: AN INSIDER'S VIEW OF ESP. ]. Gaither Pratt, 300 pages. New York: DouMecll/!1 & Company, 1964. $4.95. Parapsychology is exalted as a benign revolution ill th(' history of id('as. It is bestowed with the sollt'r (I.·!inition of the science of mind. :\Iind has an occult faculty for interacting with the outside world without the usc of Sl'nses, muscles or any otl1l'r bridging device. Such a mind's experiences falls in two rubrics: extrasensory' perception (ESP) or psychokinesis (PK). ESP is a special unconscious awarl'ness beyond the realm of sensory experience. PK is that aspect of the mind that exerts an in- /Iul'Ill'e over matter without limitation as to number, mass, shape or distance. TIm'!' kinds of ESP arc differentiated: telepathy (transfer of thought from one person to another), clairvoyance (identifying a physical object as in the naming of a card without knowing what it is) a"d precognition (anticipating a future event). The experimenters maintain they have demonstrated thl' major phenomena of ESP. However, sooner or later, their subjects lose their ability to score above chance. Success is attributed to motivation, factory conditions for the subject, special skills of experimenter and a mutual linking between subject and experimenter. Some animals were suspected of using ESP. The homing of pigeons, especially at great distances, still remains an enigma. Parapsy- chology is being investigated in England, Russia, Japan, India and Czechoslovakia as well as America's Duke University. This book is a pleasing, readable account of parapsychology both for recreational and informa- July-August, 1966 tional consumption. The author, the chief assistant to Dr. J. B. Rhine, presents a charming, personal autobiography and the travail of his professional development; he cites thrilling anecdotal accounts of ESP and recapitulates numerous scientific designs and safeguards. BENJAMIN KOTKov, Ph.D. PATHOLOGY FOR THE PHYSICIAN. William Boyd, M.D. Lea & Febiger, Philadelphia: 1965. This sl'venth edition of a classic is a most readable account and correlation of pathology with the symp- toms which characterize the disease during life. It is noteworthy that the picture of disease has, in re- cent years, changed considerably. Modern therapy has displaced some diseases from thl'ir former level of major importance. In other instances, chemo- therapy is held responsible for changes in morbid anatomy. In 20 chapters, the variolls organs and organ sys- tems arc surveyed; in each instance attempts are made to correlate pathology with biochemistry and physiology. In addition, the role of stress, where indicated, is not negated. Perhaps this latter state- ment is more understandable when the reader realizes that Dr. Boyd was a psychiatrist hefore he became a pathologist. Of particular interest to this reviewer is the realiza- tion that there are still many unsolved enigmas and dilemmas in organic medicine, and that this state of alfairs is not limited to psychiatry. For example, there is apparently still considerable controversy as to the rdationship of diet, particularly lipids, to arteriosclerosis. Another instance is that proof of the relationship of smoking to lung cancer is as yet ullsolved. An excellent account of the increasing importance of potassium is provided in the chapter on "Diseases of the Kidneys." It is noted that the most common cause of potassium depletion lies in the treatment of congestive heart failure through the repeated use of mercurial diuretics. The earliest symptoms in- clude pronounced weakness and lethargy. (Editor's Note: These symptoms may be too readily labeled as functional). Duodenal ulcer is described as the "wound stripe of civilization." The personality of the ulcer victim is dissected with equal accuracy as its morbid an- atomy. The same holds true for the author's de- scription of Ulcerative Colitis. The subject of stress in relation to pituitary and adrenal activation and its integration with Selye's General Adaptation Syndrome and Cannon's Emer- gency Emotions, are scrutinized in detail. The very fact that some diseases are now recognized to be due to adaptation to stress rather than focal infection in- dicate the psychosomatic nature of this text-book on "pathology." This book is recommended most highly. For the non-psychiatrist, it will help keep him abreast of recent advances in clinical medicine; for the psychia- trist it will not only provide a delightful change of pace but a reminder that he is primarily a physician. W.D. 265

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Page 1: Pathology for the Physician

BOOK REVIEWS

selected for detailed dissection. These were all treatedby a "total push" program in which ECT, sub-insulincoma, individual analytic therapy, group therapy aswell as environmental manipulation were often in­cluded. Many of these did not acquire maturityof personality nor insight, yet managed to function.The group included severe psychoneurotics, psycho­somatic disorders, personality problems as wt>I1 aspsychotics.

It is underscored that while "one-to-one" therapy,utilizing the methods pioneered by Freud, has beenof tremendous value in understanding the humanpersonality, such has been available to only a lim­ited group. There is a great need for techniquesthat can handle the ever increasing load of patients.Psychopharmacology plus emotional support throughpsychotherapy offers this wedge which is now cap­able of helping and caring for patients who would~ther~~ise have been ..beyo~.d salvage. In striving forcan' rather than cure, even the failures men­

tioned above cannot be considered as hopeless.The author is to be congratulated for a well­

written, compact text in which the present changesin psychiatric thinking are presl'ntl'd in a sobl'r,mature and soul-searching manner. Failures arl' ad­mitted; limitations are also underscored. Nevertheless,one is left with hope for the future rather than des­pair.

\V.D.

PARAPSYCHOLOGY: AN INSIDER'S VIEW OFESP. ]. Gaither Pratt, 300 pages. New York:DouMecll/!1 & Company, 1964. $4.95.

Parapsychology is exalted as a benign revolutionill th(' history of id('as. It is bestowed with thesollt'r (I.·!inition of the science of mind. :\Iind hasan occult faculty for interacting with the outsideworld without the usc of Sl'nses, muscles or anyotl1l'r bridging device. Such a mind's experiencesfalls in two rubrics: extrasensory' perception (ESP)or psychokinesis (PK). ESP is a special unconsciousawarl'ness beyond the realm of sensory experience.PK is that aspect of the mind that exerts an in­/Iul'Ill'e over matter without limitation as to number,mass, shape or distance.

TIm'!' kinds of ESP arc differentiated: telepathy(transfer of thought from one person to another),clairvoyance (identifying a physical object as in thenaming of a card without knowing what it is)a"d precognition (anticipating a future event).The experimenters maintain they have demonstratedthl' major phenomena of ESP. However, sooner orlater, their subjects lose their ability to score abovechance. Success is attributed to motivation, sati~­

factory conditions for the subject, special skills ofexperimenter and a mutual linking between subjectand experimenter. Some animals were suspected ofusing ESP. The homing of pigeons, especially atgreat distances, still remains an enigma. Parapsy­chology is being investigated in England, Russia,Japan, India and Czechoslovakia as well as America'sDuke University.

This book is a pleasing, readable account ofparapsychology both for recreational and informa-

July-August, 1966

tional consumption. The author, the chief assistantto Dr. J. B. Rhine, presents a charming, personalautobiography and the travail of his professionaldevelopment; he cites thrilling anecdotal accountsof ESP and recapitulates numerous scientific designsand safeguards.

BENJAMIN KOTKov, Ph.D.

PATHOLOGY FOR THE PHYSICIAN. WilliamBoyd, M.D. Lea & Febiger, Philadelphia: 1965.

This sl'venth edition of a classic is a most readableaccount and correlation of pathology with the symp­toms which characterize the disease during life. Itis noteworthy that the picture of disease has, in re­cent years, changed considerably. Modern therapyhas displaced some diseases from thl'ir former levelof major importance. In other instances, chemo­therapy is held responsible for changes in morbidanatomy.

In 20 chapters, the variolls organs and organ sys­tems arc surveyed; in each instance attempts aremade to correlate pathology with biochemistry andphysiology. In addition, the role of stress, whereindicated, is not negated. Perhaps this latter state­ment is more understandable when the reader realizesthat Dr. Boyd was a psychiatrist hefore he became apathologist.

Of particular interest to this reviewer is the realiza­tion that there are still many unsolved enigmas anddilemmas in organic medicine, and that this state ofalfairs is not limited to psychiatry. For example,there is apparently still considerable controversy asto the rdationship of diet, particularly lipids, toarteriosclerosis. Another instance is that proof ofthe relationship of smoking to lung cancer is as yetullsolved.

An excellent account of the increasing importanceof potassium is provided in the chapter on "Diseasesof the Kidneys." It is noted that the most commoncause of potassium depletion lies in the treatmentof congestive heart failure through the repeated useof mercurial diuretics. The earliest symptoms in­clude pronounced weakness and lethargy. (Editor'sNote: These symptoms may be too readily labeledas functional).

Duodenal ulcer is described as the "wound stripeof civilization." The personality of the ulcer victimis dissected with equal accuracy as its morbid an­atomy. The same holds true for the author's de­scription of Ulcerative Colitis.

The subject of stress in relation to pituitary andadrenal activation and its integration with Selye'sGeneral Adaptation Syndrome and Cannon's Emer­gency Emotions, are scrutinized in detail. The veryfact that some diseases are now recognized to be dueto adaptation to stress rather than focal infection in­dicate the psychosomatic nature of this text-bookon "pathology."

This book is recommended most highly. For thenon-psychiatrist, it will help keep him abreast ofrecent advances in clinical medicine; for the psychia­trist it will not only provide a delightful change ofpace but a reminder that he is primarily a physician.

W.D.

265