Diseases of the Nervous System
- Author:
Walshe, O.B.E., M.D., D.Sc., F.R.C.P. E. and S. Livingstone, Edinburgh. Price 12s. 6d. net, postage 8d.
As this book is designed for Practitioners and Students it is permissible that it should be reviewed by one who is not a neurological specialist. And no comment or criticism will be made on the neurological statements that it contains. The method of presentation, however, is important and the author in his preface describes the task that he has undertaken as follows: “To deal only with what is possible in general practice in the matter of diagnostic methods and of treatment, to strip the subject of unnecessary complexities and to confine myself to what I have seen and believe to be true.”
The book is divided into two parts. The first of 40 pages covers the General Principles of Neurological Diagnosis and is probably the most valuable section. The second part of the book is a Descriptive Account of the More Common Diseases of the Nervous System and occupies some 230 pages. But this includes a chapter of 20 pages on the Psychoneuroses which the author concedes are Diseases of the Personality and so not of the Nervous System. There are nine figures of which two are photographs, an X-ray of bilateral cervical ribs and a picture of the palmar aspect of a hand in a similar case. The presentation is clear, concise and dog- matic. The chapters are easy to read and to understand and throughout bear the imprint of the author’s attitude towards the problems of medicine. Description and diagnosis are given more prominence than treatment. Not that the author is averse to treatment but management and nursing of neurological cases rank first with him and he is desperately anxious to save the chronic sufferer from exploitation by charlatans both within and without the medical profession. Physiotherapy and especi- ally electrical forms of treatment are regarded with suspicion and one feels that the author may have been unfortunate in his choice of collabora- tors in these respects.
Dr Walshe’s views on psychotherapy are well known to his medical colleagues and are stated again here with his usual frankness. Psycho- genic factors in illness are very important an” must be recognized as such. But because their occurrence is largely due to inborn tendencies not too much must be expected in the way amelioration, except in the case of ” traumatic neuroses ” which will tend to get well once matters of law and compensation are decided- Dr Walshe emphasizes the importance of the part the general practitioner should play in the treatment of psychoneurotic cases and believes that a careful history, an intelligent under- standing of the situation and a thorough explanation of the position are all that |s required in the vast majority of cases. It lS only in the severer forms of anxiety and 111 patients with marked obsessional symptom* that the attentions of the psychotherapist w” be called for.
The psychological aspects of migraine’ writer’s cramp and enuresis are dismissed as no proven. The medical treatment of the latter lS still in the author’s hands mainly a matter of belladonna. And anyhow there is consolation in the fact that it is rare for the condition to continue after the age of twelve. But psycho- logical questions are only of secondary interest to neurologists who are not usually influenced W researches into psychopathology. The main object of this book, an up-to-date comprehensive survey of the common diseases of the Nervous System, seems excellently served. H.C.S.
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