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Physiological Foundations of Neurology and Psychiatry

Author:

Ernst Gellhorn

Physiological Foundations of Neurology and Psychiatry
Physiological Foundations of Neurology and Psychiatry

Ernst Gellhorn, a former professor of neurophysiology at the University of Minnesota, was educated at the Universities of Berlin, Muenster, and Heidelberg. His books have been published in Germany, France, and the United States.

Physiological Foundations of Neurology and Psychiatry

Table of Contents
INTRODUCTION
Part I. Intrinsic and Extrinsic Factors Regulating
Neuronal Activity
Chapter 1. THE UNIT ANALYSIS OF NERVOUS ACTIVITY .. 11
Unit Activity in Reflexes, 12. Motor Discharges from the Respiratory Cen-
ter, 13. Discharges from the Motor Cortex, 15. The Regulation of Voluntary
Activity, 18. The Nature of the Central Excitatory Process, 20. The Func-
tions of the Sense Organs and the Adrian-Bronk Law (STRETCH RECEPTORS
AND THE EXCITATION OF SENSORY NERVES, VESTIBULAR AND ACOUSTIC RECEP-
TORS, THE ACTION OF CHEMORECEPTORS, OPTICAL RECEPTORS, CUTANEOUS RE-
CEPTORS, THE CONDUCTION OF EXCITATION FROM THE SENSE ORGANS TO THE
AFFERENT NERVE), 24. The Gradation of Autonomic Activity (HYPOTHALAM-
IC STIMULATION AND SYMPATHETIC ACTIVITY, NEURONAL EXCITABILITY AND
THE RATE OF SYMPATHETIC DISCHARGE), 32. Concluding Remarks, 36.
Chapter 2. THE INTERNAL ENVIRONMENT AND CENTRAL
NERVOUS ACTIVITY 38
Cortical Activity and the Oxygen Supply, 38. Variations in the Blood Sugar
Level, 44. The Interaction of Anoxia and the Blood Sugar, 45. Carbon Diox-
ide and the Electroencephalogram, 47. The Electroencephalogram, Water
Balance, and Cerebral Excitability, 48. The Action of Ions on Ganglion Cells,
49. Hormones and the Excitability of the Brain, 52. Concluding Remarks, 53.
Part II. Contributions to the Physiology and
Pathology of Movements
Chapter 3. THE MOTOR CORTEX AND THE PHYSIOLOGY
OF MOVEMENTS 57
Multiplicity of Representation of Movements in the Motor Cortex versus the
Mosaic Hypothesis, 58. Electromyography as an Indicator of Movements In-
ix
3
x Physiological Foundations of Neurology and Psychiatry
duced by Stimulation of the Motor Cortex, 63. General Characteristics of the
Effects of Electrical Stimulation of the Motor Cortex, 65. Multiple Repre-
sentation in Threshold Responses, 67. Patterns of Movements Resulting from
Stimulation of the Motor Cortex, 68. Proprioception and Cortically Induced
Movements, 70. Nociceptive Impulses and Cortically Induced Movements, 79.
Proprioception and Reflex Activity, 82. Nociceptive Impulses and Reflex Ac-
tivity, 86.
Chapter 4. VOLUNTARY MOVEMENTS, MOTOR CORTEX,
AND REFLEX ACTIVITY 89
Proprioception and Willed Movements, 89. Sensorimotor Integration in the
Visual Sphere, 92. The Unity of Sensation and Movement, 94. The Central
Position of the Spinal Cord, 96. The Interaction of Willed Movements with
Spinal Reflexes, 98. The Motor Cortex and the Variability of Movements, 99.
Levels of Integration in Willed Movements, 100.
Chapter 5. THE RESTITUTION OF MOVEMENTS AFTER
CENTRAL LESIONS 103
The Restitution of Muscle Function after Partial Denervation, 104. The Res-
titution of Motor Functions after Lesions in the Motor Area, 106. The Signif-
O
icance of Sensorimotor Disintegration, 109. The So-Called Plasticity of the
Central Nervous System (THE CROSSED PHRENIC PHENOMENON), 110. Learn-
ing and the Hierarchical Structure of Motor Functions, 113. Re-education
O
after Central Motor Lesions (RE-EDUCATION AND CHEMICAL TRANSMISSION,
RE-EDUCATION THROUGH PHYSIOLOGICAL FACILITATION), 115. Concluding
Remarks, 119.
Chapter 6. ELECTROMYOGRAPHY 121
Physiological Observations of Muscle Action, 121. Electromyography in Dis-
eases of the Central Nervous System (SPASTICITY, RIGIDITY, TREMOR, ATHE-
TOSIS, CEREBELLAR HYPOTONIA, FASCICULATION, POLIOMYELITIS, THE ELEC-
TROMYOGRAM AND MOTOR DEFICIT), 125. The Temporal Relations of Unit
Discharges, 130. The Electromyogram as an Indicator of Peripheral Nerve
Conduction in Man, 133. Electromyographic Studies of Nervous Discharges
in Ischemia and Hypocalcemia and Their Relation to Tetany, 134. Electro-
myographic Studies of the Function of the Neuromuscular Junction, 136.
Fibrillation, 138. Summary, 140.
Chapter 7. STUDIES ON EXPERIMENTAL CONVULSIONS 141
Acetylcholine and Cortical Activity, 142. Acetylcholine and Convulsive Ac-
tivity, 143. Anoxia and Convulsive Activity, 148. Anoxia and Electroshock,
150. Convulsions and Release from Cortical Inhibition, 152. Application to
Epilepsy, 155. The Brain Stem in Anoxic and Hypoglycemic Convulsions,
157. The Relation of Anoxic to Hypoglycemic Convulsions, 158. The Oxygen
Consumption of the Convulsive Neuron, 161. Temperature and Convulsions,
162. The Role of Afferent, Particularly Nociceptive, Impulses in the Precipi-
tation and Inhibition of Convulsions, 164. Further Studies on the Mechanism
Table of Contents xi
Involved in the Precipitation of Convulsions, 166. Convulsions and Sleep,
169. Proprioceptive Impulses and Convulsive Activity, 170. The Behavior of
the Motor Unit in Convulsions, 172. Carotid Sinus Reflexes and Convulsions,
172. Age and Convulsions, 174. Concluding Remarks, 177.
Part HI. The Physiological Basis of Consciousness
Chapter 8. AN APPROACH TO THE PROBLEM 181
Chapter 9. THE PHYSIOLOGY OF CONSCIOUSNESS 184
The Electroencephalogram in Sleep, 184. The Central Control of Sleep, 186.
The Role of the Diffuse Thalamic Systems, 193. The Arousal Reaction, 195.
Further Studies on the Arousal Reaction and Its Relation to the Activity of
Subcortical Structures, 197. Application to Problems of Epilepsy: The Hy-
pothalamus and the Spread of Convulsive Activity, 203.
Chapter 10. THE PATHOLOGY OF CONSCIOUSNESS 206
The Physiology of the Phantom Limb, 206. On the Difference between Sleep,
Anesthesia, and Experimental Coma, 211. A Tentative Summary, 213. Le-
sions in the Brain Stem and Coma, 217. Convulsive Activity and Conscious-
ness, 221. Consciousness and Its Dependence on Respiratory and Circula-
tory Functions, 224. Concluding Remarks, 225.
Part IV. Some Aspects of Autonomic Physiology
Chapter 11. NEUROHUMORS AND NEUROPHARMACOLO-
GY OF THE AUTONOMIC NERVOUS SYSTEM 231
The Older Work on Sympathin, 232. The Newer Work on Sympathin, 236.
The Nature of the Secreted Adrenalin, 241. The Nature of the Sympatheti-
co-Adrenal Discharge, 244. Acetylcholine and Parasympathetic Effectors,
248. Humoral Transmission through Autonomic Ganglia, 251. Is Acetylcho-
line Responsible for Nervous Conduction? 253. Acetylcholine and the Central
Nervous System, 254. The Action of Tetraethylammonium Chloride on the
Central Nervous System, 259. Sympathin, Tetraethylammonium Chloride,
and Hypertension, 264. The Supersensitivity of Denervated Structures, 266.
Chapter 12. THE EYE AS AN INDICATOR OF AUTONOMIC
ACTIVITY 269
Some Observations on the Innervation of the Iris, 269. The Blood Pressure
and the Pupil, 270. Pain and the Pupil, 271. The Pupil in Anoxia and As-
phyxia, 274. The Sensitized Pupil and Nictitating Membrane, 275. The Role,
of the Central Nervous System in Pupillary Dilatation and Contraction of
the Nictitating Membrane, 277. The Nature of Parasympathetically Induced
Pupillary Dilatation, 281. Pupillary Constriction, 282. Somato-Autonomic Inte-
grations of Ocular Reactions, 284. On the Pharmacology of the Eye, 285.
Concluding Remarks, 286.
xii Physiological Foundations of Neurology and Psychiatry
Part V. Integrations
Chapter 13. PRINCIPLES OF NEURO-ENDOCRINE ACTION 291
The Neural Control of Insulin Secretion, 292. The Adrenal Medulla, 294.
The Neural Factor in the Secretion of the Antidiuretic Hormone of the Pos-
terior Pituitary, 297. The Nervous Regulation of the Pressor Hormone of the
Neurohypophysis, 303. The Nervous Regulation of the Oxytocic Hormone,
304. The Nervous Regulation of the Gonadotrophic Hormones, 306. The Rela-
tion of the Sympathetico-Adrenal System to the Adrenal Cortex (THE ALAHM
REACTION, THE BIOCHEMICAL CHANGES OF THE ADRENAL CORTEX IN STRESS,
LYMPHOPENIA AND EOSINOPENIA AND STRESS, AGAIN THE ROLE OF SECRETED
ADRENALIN IN THE ACTIVATION OF THE ADRENAL CORTEX, SIGNIFICANCE FOR
NEUROPSYCHIATRY AND MEDICINE), 312. Can Thyroid Secretion Be Modified
by Neurogenic Discharges? 329. The Neural Control of the Secretion of the
Thyrotrophic Hormone, 330. Conclusions, 332.
Chapter 14. THE PHYSIOLOGICAL BASIS OF EMOTION ... 333
The Sympathetic Discharge in Emotion, 333. The Parasympathetic Discharge
in Emotion, 334. Autonomic Discharges in Human Emotion, 336. The Hypo-
thalamus and Autonomic Discharges in Emotion, 339. The Somatic Dis-
charge in Emotion, 344. Hypothalamic-Endocrine Relations in Emotion, 347.
The Hypothalamic-Cortical Discharge in Emotion, 350. The Influence of
the Cortex on the Hypothalamus, 352. Hypothalamic Lesions and Emo-
tion, 355. The Arousal of Emotion, 355. Concluding Remarks and Summary,
357.
Chapter 15. FACTORS INVOLVED IN CONDITIONING .... 361
General Characteristics of the Conditioned Reaction, 361. The Nervous
Structures Involved in the Conditioned Reflex, 364. The Nature of the Con-
ditioning Process, 368. Shock Therapy and Conditioning, 370. The Cortex
and Conditioning, 381. Hormones and Conditioning, 386. Concluding Re-
marks, 388.
Chapter 16. HOMEOSTASIS 389
Ontogenetic and Phylogenetic Aspects, 389. Homeostasis and the Endocrines,
390. The Role of the Sympathetico-Adrenal System, 392. The Significance of
Homeostasis for the Heart and Brain, 394. Homeostasis as an Organismic
Reaction, 396. Somato-Autonomic Integration of Cortical and Diencephalic
Origin in the Service of Homeostasis, 398. Subsidiary Mechanisms of Home-
ostasis, 399. The Suppressor Areas and the Homeostasis of Cortical Functions,
400. The Brain Stem and Cortical Homeostasis, 404. Brain Circulation and
Homeostasis, 407. The Homeostatic Action of Adrenalin on the Autonomic
Nervous System, 408. The Homeostatic Action of Adrenalin on the Somatic
Nervous System, 412. Shock and the Secretion of Adrenalin, 414. Conclud-
ing Remarks on the Homeostasis of the Internal Environment, 416.
Table of Contents xiii
Chapter 17. THE CONSTANCY OF THE EXTERNAL ENVI-
RONMENT 419
Visual Orientation Reactions, 419. Phenomena of Constancy, 421. The Role
of the Cortex in the Apparent Constancy of the External Environment, 424.
Part VI. Applications
Chapter 18. SCHIZOPHRENIA, THE AUTONOMIC NERVOUS
SYSTEM, AND SHOCK THERAPY 429
Autonomic Reactions in Schizophrenia, 429. The Endocrines and the Autono-
mic System in Schizophrenia, 433. Cortico-Hypothalamic Relations in Schizo-
phrenia, 434. Electroshock and Related Procedures, 438. Insulin Hypogly-
cemia, Sleep Treatment, and the Autonomic System, 442. Some Modifications
of Shock Therapy, 445. Concluding Remarks, 447.
Chapter 19. THE PHYSIOLOGICAL FOUNDATION OF CAR-
BON DIOXIDE THERAPY 450
The Action of Non-Narcotic Doses of Carbon Dioxide on the Somatic Ner-
vous System, 450. The Excitatory Effects of Carbon Dioxide, 452. The Effect
of High Concentrations of Carbon Dioxide, 456. The Physiological Basis of
Carbon Dioxide Therapy, 461.
Chapter 20. PHYSIOLOGICAL PRINCIPLES FOR THE THER-
APY OF PSYCHONEUROSES AND FUNCTIONAL PSY-
CHOSES 466
Autonomic Tests in Mental Disorders, 467. Experimental Analysis of Au-
tonomic Tests, 469. Summary and Application, 478.
BIBLIOGRAPHICAL INDEX OF AUTHORS 489
SUBJECT INDEX 545