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Book Forum: Minds Behind the Brain   |    
Minds Behind the Brain: A History of the Pioneers and Their Discoveries
ANDRÉS MARTIN, M.D.; JOSÉ G. MERINO, M.D., M.PHIL.
Am J Psychiatry 2000;157:2072-2073. doi:10.1176/appi.ajp.157.12.2072
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By Stanley Finger, Ph.D. New York, Oxford University Press, 2000, 347 pp., $35.00.

Scientists write history for heuristic and didactic purposes—to give their professional and lay peers a greater understanding of new discoveries in the light of past achievements and to teach and inspire today’s researchers and students. By writing a biographical history of the individuals who studied the brain, Stanley Finger has set out to explore the inner workings of a scientific elite. He focuses on which personal factors and universal traits made for their scientific greatness and how their political, religious, and intellectual milieu shaped their ideas and concepts. With a vivid style that through the frequent use of anecdote makes the titans of the past seem more human and their milestones more memorable, Minds Behind the Brain achieves these objectives well.

Minds Behind the Brain distills more than 5,000 years of brain science into the lives and crowning achievements of 15 select individuals, whose life and work are discussed in detail. This remarkably long journey into brain history takes the reader from pharaonic trepanation to the isolation of nerve growth factor during the second half of the twentieth century. Along the way, certain "stops" seem especially relevant to the development of psychiatry as a discipline. Localization of mental function in the brain may seem self-evident or tautological to us, but it was a prescient and revolutionary notion in Hippocrates’ time—thinking inside of the box being the challenge of his day.

In the wake of Andreas Vesalius’s dissections and observational anatomy, René Descartes emerges as a pivotal figure whose demarcation between the material brain and the ethereal mind set the stage for a dualism that has continued to dog much of our field’s history. Medicine’s historical struggle to reconcile the two effectively may be seen as having been variously played out in other and parallel dualisms, such as the ones between psychiatry and neurology, or between dynamic and biological psychiatry.

Luigi Galvani’s work was one of the last nails in the coffin of the humoral theories that had permeated much of the earlier physiological conceptualizations of neural function, and one that importantly advanced the field by making physiological experimentation more accessible. In concert with Santiago Ramón y Cajal’s identification of the neuron as the functional unit of the nervous system, such advances set the scientific infrastructure necessary for an understanding of electric and chemical communication between neural cells. Otto Loewi’s subsequent work on neurotransmission has had a deep impact on contemporary psychiatry and its reliance on models of mental illness based on states of chemical deficiency or excess.

The critiques that can be leveled at Minds Behind the Brain are in part a testimony to the readability and thought-provoking nature of this highly engaging book. Some are centered on Finger’s approach to the past and his view of the history of cerebral discovery as an uninterrupted line leading to the present situation. Although the individuals included in this book were chosen because of the impact of their ideas and not for being "on target when seen through today’s eyes," a self-referential framework is evident throughout much of the book. The past is valued largely as a function of the present, and earlier achievements are examined under the light of later discoveries. For example, Galen’s anatomy is described as being well ahead of his physiology because his anatomical observations were empirical but his physiological conclusions were based on "speculation." In reality, Galen’s anatomy and physiology are interrelated and cannot be analyzed separately: they are a reflection of his beliefs and the philosophy of his time. Although it may be tempting to view Descartes’s localization of the soul in the pineal gland or Golgi’s neural sincicium as scientific errors from our modern perspective, the value of these concepts must be analyzed from the perspective of their peers to fully understand their impact.

Psychiatrists in general, and clinicians in particular, may finish reading Minds Behind the Brain with a sense of having been left out of the brain race. Other than passing references to Pinel’s breaking of the chains at the Salpêtrière or to Crichton-Browne and his circle at the West Riding Asylum, psychiatrists are absent from the book. Moreover, neuroscientists doing basic research are disproportionately featured, with Charcot and Broca the only clinicians to get chapters of their own. Although the concept of psychiatry and neurology as separate disciplines is a recent one, psychiatrists may be left rooting for the inclusion of Alzheimer or Wernicke (both identified primarily as psychiatrists), or of Werner-Jaurregg, who, until Eric Kandel, was the only psychiatrist to win a Nobel prize.

Five thousand years of history are sure to leave disgruntled guests out in the cold without an invitation ("How could he have forgotten Luria?" is one of many rumblings around the dinner table). Yet it is to Stanley Finger’s credit that one finishes reading Minds Behind the Brain eager to explore further the history of neuroscience: perhaps to read Cajal’s Advice for a Young Investigator(1), or to go looking for that misplaced invitation of Luria’s. Most of all, one is left full of wonder: what will the next 5,000 years bring? We eagerly look toward a great future in brain science, chock-full now with awe for its past.

Cajal SR: Advice for a Young Investigator. Translated by Swanson N, Swanson LW. Cambridge, Mass, MIT Press, 1999
 
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References

Cajal SR: Advice for a Young Investigator. Translated by Swanson N, Swanson LW. Cambridge, Mass, MIT Press, 1999
 
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