Book Reviews

As originally printed in The Physiologist, 
February 2001, Volume 44, Number 1 
Page 50

Sound

Physiological Medicine: A Clinical Approach to Basic Medical Physiology.

Atlas of Functional Neuroanatomy

Sound
Patricia Kruth and Henry Stobart
New York: Cambridge University Press, 2000, 235 pp., illus., index, $34.95.
ISBN: 0-521-57209-6

    The psychophysicist Hermann Helmholtz began his classic On The Sensations of Tone with a lofty goal in mind: to finally bridge the gap between the science of physical and physiological acoustics and the philosophy of music and aesthetics. Helmholtz was well aware of the difficulties of this task: “The horizons of physics, philosophy, and art have of late been too widely separated, and, as a consequence, the language, the methods, and the aims of any one of these studies present a certain amount of difficulty for the student of any other of them.” Although the collection of essays in Sound was not intended to resolve these timeless difficulties, it nonetheless provides a wonderful glimpse of the world of sound from a variety of perspectives. 
The nine essays were presented by biologists, musicians, physicists, acousticians, and historians at the renowned “Darwin College Lectures,” a series of public seminars organized by Darwin College in Cambridge. The book tackles both silence (Philip Peek) and vocal communication (Peter Slater on birdsong and Peter Ladefoged on speech). It touches upon the physical properties of sound (Charles Taylor) and its perception (Jonathan Ashmore). The collection then turns to the theme of music, exploring musical evolution (Christopher Page and Brian Ferneyhough), cultural variation in music (Steven Feld)), and even the marriage of sound and image in film (Michel Chion). With such a breadth of topics, the book provides an informative, accessible, and engaging perspective on the variety of approaches to the study of sound and the various ways sound pervades our life and the lives of those in other cultures. 
    If there is one underlying theme to emerge from this apparent smorgasbord of chapters, it would undoubtedly be that the quality and meaning of sound is in the ear of the beholder—be it bird or human, African or European, Medieval or Modern. Philip Peek’s chapter on silence, for example, provides a fascinating look at how different cultures appreciate the absence of sound. Throughout Africa, speechlessness is commonly understood to convey respect, discretion, knowledge and peace. The silence of an elder, for example, can effectively hush all social inferiors to effectively end proceedings. A person’s silence is also indicative of good composure and prudence. Conversely, in loquacious Western societies, talk is good and speechlessness can lead to the dreadful awkward silence. A defendant’s silence is often considered an admission of guilt, and the most talkative among us are considered the socially dominant individuals.
    Another notable contribution is Christopher Page’s “Ancestral Voices,” which elegantly tackles the history of music and the evolution of musical instruments, specifically, the psaltery into the piano. One important myth, which the author debunks, is the notion that music has somehow progressively improved over the centuries. Page examines the historical context in which medieval music, in particular, was created and the ways in which musical qualities were valued then devalued. This ebb and flow shows that while music has certainly evolved, it has not been a progression to some idealized form. In this sense, the evolution of music is like the evolution of organic life-non-teleological. The appealing qualities of music are shaped by the culture and instruments of the time. The psaltery, for example, was made to accommodate longer strings for deeper pitches by sacrificing other sound qualities and became the harpsichord. The harpsichord naturally transmuted into the piano, as we know it today. This shift in the size of this particular instrument reflects a cultural shift in the Early to Modern transition when there was much exploration of the lower pitches in music. 
    Though not catastrophic, there are some weak moments in the book. Jonathan Ashmore’s chapter entitled “Hearing” is really about just one part of the ear—the cochlea. The chapter suggests that we know nothing about the central auditory system or, at the behavioral level, how we perceive different sounds and how we locate them. However, modern neuroscience has shown that there are spectacular neural specializations for speech and music perception in humans, and for communication systems in other animals (e.g. birdsong). Charles Taylor’s chapter on “The Physics of Sound” is a nice overall review of different ways musical instruments produce sound, but he constantly refers to auditory demonstrations that presumably occurred during his lecture. As such, many readers will feel disconnected throughout much of the chapter. The editors could have made this chapter read more smoothly with some supplement to the text, perhaps a compact disc with demonstrations and examples from each of the chapters. Another minor annoyance is the lack of a bibliography. There were many points in the book where I would have liked to pursue a particularly interesting issue brought up by the author but could not do so because of the lack of references. 
    Despite its minor problems, Sound is a well-written, illuminating collection that Helmholtz himself would have applauded. This volume will be music to the ears of acoustic scientists searching for a broad, yet enlightening glimpse of the domain of sound. 
Asif A. Ghazanfar 
Harvard University 

Physiological Medicine: A Clinical Approach to Basic Medical Physiology 
Vishwanath R. Lingappa and Krista Farey. New York: McGraw-Hill, 2000, 1088 pp., illus., index, $39.95.
ISBN: 0-07-038128-3

    Physiological medicine, a clinical approach to basic medical physiology is a valuable text for clinicians who completed their medical training, for residents in clinical specialties and for medical students especially as a complementary text, and for trainees in other health-related fields. The book is well written with excellent diagrams of key physiological mechanisms that are then linked with various aspects of clinical medicine. The bibliography is relatively up-to-date. The field of physiological medicine rapidly changes with new advances in understanding of pathophysiology of disease. Yet, in most chapters, the information appears to be up-to-date, probably more so than in traditional, larger clinical textbooks. The scope of the material covered in the 20 chapters and 905 pages is necessarily superficial as compared to textbooks that deal with specific organ systems, such as digestive diseases, cardiology, neurophysiology and neurology, etc. The 20 chapters include: Principles of Physiology and Medical Knowledge; Molecular Foundations of Physiology; Command and Control of Organ Systems; Liver Physiology; Gastrointestinal Physiology; Physiology of the Endocrine Pancreas and Fuel Homeostasis; The Cardiovascular System; Respiratory Physiology; Renal Physiology; Fluid, Electrolyte, Acid-Base, and Blood Pressure Regulation; Physiology of the Hypothalamus and Pituitary; Physiology of the Thyroid Gland; Adrenal Physiology; Calcium and Mineral Metabolism; Physiology of the Male Reproductive System; Physiology of the Female Reproductive System; Physiology of Pregnancy, the Neonate, and Growth; Physiology of the Nervous System; Introduction to Host Defense; and Organ System Integration.
    On the other hand, the book provides a more integrated view of pathophysiology of disease than would be available in a specialty textbook. 
    There are a few areas that would have enhanced the value of the book. Specifically, it is difficult to follow the different sections related to energy metabolism without having to read through chapters on the liver, digestive organs, pancreas and insulin. It would have been useful to include a better description of nutrients such as fat, carbohydrate, protein, etc. and their sources in the diet and then trace specific nutrients from digestion through their metabolism and then provide some description of the diseases specifically related to the various dietary sources and their metabolism. 
    There is a relative absence of a discussion of physiology of energy expenditure, how we measure “energy balance.” The topic is covered to a limited degree in the section on obesity. The chapter on female sex hormones would have been enhanced by a better discussion of hormonal changes at the menopause and a better description of post-menopausal physiological changes and their associated diseases. There is, however, a good description in the book of bone pathophysiology and the risk of osteoporosis. There is relatively little information in the book on the physiological changes associated with aging. A separate chapter on the physiology of aging would be useful given that the major burden of disease in the population occurs among older individuals. The book also would have benefited from some discussion of genetic variation in physiological responses and how they relate to “disease susceptibility.” In summary, physiologic medicine is an extremely ambitious, well-written text. This book will be useful, as noted, for a medical students as well as for clinicians in practice and may be especially valuable as a text in courses for other health-related disciplines such as trainees in epidemiology, genetics, environmental health sciences, for graduate students in other basic sciences of medicine and health other than physiology. This obviously cannot replace textbooks which specifically focus on one or two organ systems or on specific pathophysiological processes, i.e., calcium, metabolism, cardiovascular disease, atherosclerosis, etc. 
Lewis H. Kuller
University of Pittsburgh

Atlas of Functional Neuroanatomy
Walter J. Hendelman
Boca Raton, FL: CRC, 2000, 258 pg., illus., index, $39.95.
ISBN: 0-8493-1177-2.

    For the visually minded student of the neurosciences and medicine, this monograph should offer a useful introduction. Consonant with the current educational trends, it attempts to eliminate the details of neuroanatomy and to focus on what the author, an experienced teacher of the subject, considers the essentials.
    The substantive material is divided into three parts: the first is an orientation and description of the main parts of the spinal cord and brain; the second is an illustrative guide through the relations of certain ones of these parts in the sensory and motor systems; the third is a regrouping of the structures put to service in clinical neurology. Naturally, one can find some degree of overlap and inconsistency in the separation of the three sections.
    The anatomical displays combine photographs of the spinal cord and brain with caricatures of the more important of these structure and with CT and MRI scans. This component of the monograph is commendable. The functional aspects of neuroanatomy and the systems which they form suffer from a paucity of detail. The glossary at the end should be useful.
    If this atlas were to serve as an orientation to neurological medicine, it would need the elaboration of an experienced instructor. For the prospective neuroscientist, it should be more valuable. 
Raymond D. Adams
Massachusetts General Hospital

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