Microbiology
Modern Neurology comprises tributes on his retirement from no fewer than 59 of his colleagues and pupils, and represents a fair conspectus of the present state of the discipline, though one that cannot be regarded as entirely reassuring for its future.
Abstract
Born in New Zealand and trained as a neurologist at the National Hospital, Queen Square, Derek Denny-Brown occupied the senior Harvard chair of neurology at the Boston City Hospital from 1939 to 1967. Splendidly produced, Modern Neurology comprises tributes on his retirement from no fewer than 59 of his colleagues and pupils. It begins with a comparative account of the brains of a variety of birds by Stanley Cobb, and ends with a neurosurgeon's observations on bedsores by Donald Munro. The 45 other papers contain something for everybody. Not unexpectedly in view of Dr. DennyBrown's own interests, iatrogenic disorders of the cat and monkey are formidably represented in this diverse anthology. However, there is also much to interest the neurological physician, as well as the man to whom the patient is first and foremost a convenient subject for neurophysiological observation. The clinician will enjoy Maurice Victor's succinct and convincing account of Bostonian alcoholic epilepsy; Charles Aring's gentle scepticism about the value of surgery for aneurysms; Joseph Foley's account of trigger factors in focal cerebral ischaemia; the veteran Graeme Robertson's elegantly documented case of imperception and disorientation; and of course that irrepressible old trouper Sir Francis Walshe's sparkling jeu d'esprit on memory traces. In other words, Modern Neurology will be read with relish by every neurologist. It probably represents a fair conspectus of the present state of the discipline, though one that cannot be regarded as entirely reassuring for its future. The book contains a good deal of science, mostly morphological, and a good deal of clinical information, mostly anecdotal. But there is little clinical science in the modern sense, and it is not a book to be recommended to the director of a grantgiving body in the confident hope that he would be inspired to put his money into a dynamic -and exciting field of medicine. He might even give it to psychiatry. The papers reveal a traditional preoccupation with the site of the lesion and the mechanism of symptoms, but for the most part little interest in disease or its natural history. Treatment rates no more than a passing nod, and aetiology as opposed to pathogenesis not even that. The neurologists social function and his place in the medical team depend on his special skills in the management of the commoner neurological illnesses, but such banal problems receive little attention here. Multiple sclerosis goes as unnoticed in the index as in 612 pages of text, Parkinsonism receives no more than cursory mention, and except for two esoteric papers neither epilepsy nor head injury makes an appearance. We are left with an uneasy suspicion that the neurology of our generation may be epitomized by the neurologists of the next as "beta minus, could do better."