December 2S, 191 1] 



NATURE 



273 



knot gratuitously tied in the tangled skein of physical 

 and psychical phenomena," and while the author 

 "would deprecate the assumption that the psyche has 

 mixed, in any way, as an integral factor in the 

 machinery of the building processes of the forms of 

 life, or in their daily workings as intricate mechan- 

 isms," yet he believes that the psyche has been able 

 to exert an influence on the working by either delaying 

 or hastening it. In this the psyche is like Driesch's 

 " Entelechy," which punctuates the transformations of 

 energy within the body. 



THE SENSIBILITY OF THE ALIMENTARY 

 CANAL. 

 The Goulstonian Lectures on the Sensibility of the 

 Alimentary Canal. Delivered at the Royal College 

 of Physicians on March 14, 16, and 21, igii. By 

 Dr. Arthur F. Hertz. Pp. v + 8o. (London : Henry 

 Frowde and Hodder and Stoughton, 19 ii.) Price 

 55. net. 



THE lectureship which was founded by the late 

 Dr. Goulston is annually awarded to one of the 

 newly elected fellows of the Royal College of 

 Physicians, and so forms a channel by means of 

 which a junior member of the medical profession may 

 make what has often proved to be the first of a valu- 

 able series of additions to physiological and patho- 

 logical progress. Dr. Hertz, however, to whom the 

 honour was awarded this year, is already well known 

 to his medical brethren, and has published many 

 papers on various subjects, as well as a book on 

 constipation. It is to him and his colleagues at 

 Guy's Hospital that we owe the work by means of 

 which the X-ray method has been rendered an aid in 

 medical, as it had been previously shown to be in 

 surgical, cases, and during recent months allusions 

 have been made in these columns to the value of 

 such research in elucidating the disorders of the 

 alimentary canal. 



In the present volume, in which Dr. Hertz re- 

 publishes his lectures, he has, however, struck a new 

 note, and deals with the sensations arising from this 

 part of the body. 



The martyr to dyspepsia needs no reminding how 

 insistent such sensations may be. The man in per- 

 fect health, however, is scarcely cognisant of the 

 existence of his internal organs. In pre-anacsthetic 

 days, surgeons discovered that the majority of the 

 internal structures of the body are insensitive to 

 touch ; they can be handled, and even cut or burnt 

 without causing any sensations. Dr. Hertz not only 

 confirms this by his careful experimental and clinical 

 observations, but has further shown that the alimen- 

 tary canal is, with the exception of the oesophagus 

 and the anal canal, also insensitive to sensations of 

 heat and cold. Contact with alcohol, however, applied 

 to any part gives rise to a subjective sensation of 

 warmth. 



But, as already suggested in the mention of the 

 dyspeptic, pain is experienced; this sensation, which 

 is probably the most primitive of the senses, as it is 

 so important for protective purposes in the struggle 

 for existence can be elicited, but its only cause is 

 NO. 2200, VOL. 88] 



tension or stretching, which in a milder degree is 

 also the cause of the sensation of fulness. If disease 

 spreads to, or the tension is exerted on, peritoneal 

 structures, the pain may become excruciating. This 

 sensibility varies in different people, and is most 

 marked in those with an irritable nervous system, as 

 in neurasthenia, hj^pochondriasis, and anaemia. But 

 when visceral pain or discomfort is present, all 

 people are alike in their inability to localise it accu- 

 rately. It is then that the so-called "referred pains" 

 come to the assistance of the physician. By this one 

 means that areas of skin and subjacent muscle related 

 to the same spinal segments that govern the viscera, 

 are the seat of discomfort, pain, and even of tender- 

 ness. This aspect of the subject has been taken up 

 especially by Dr. Henry Head, and it is quite pos- 

 sible to localise an internal disorder by a study of 

 the referred pain. The painful, tender patch may not 

 always be in the immediate vicinity of the affected 

 organ, for in growth the skin area, and the in- 

 ternal viscus which send their messages to the same 

 segment of the spinal cord may become widely 

 separated ; for instance, the association of liver trouble 

 and shoulder pain is familiar even to the non-medical 

 reader. 



The alimentary canal, though destitute of any true 

 tactile sense, is endowed with certain sensations pecu- 

 liar to itself, namely, hunger and thirst. These two 

 sensations do not run quite on all fours with each 

 other, and of them Dr. Hertz refers to hunger only. 

 This consists not only in a general sensation of malaise, 

 but a local sense of abdominal emptiness. Dr. Hertz 

 believes that the latter is produced by the motor 

 activity of the stomach and intestines during fasting ; 

 and this affects consciousness partly because the action 

 is excessive, and partly because the central nervous 

 system is over-excitable in this condition. 



The brochure of which we have attempted this brief 

 and imperfect summary will amply repay careful 

 perusal, and hearty congratulations are due to its 

 author, not only for his accurate and well-devised 

 experimental work and observations, but also for the 

 lucid and interesting way in which he has presented 

 them. W. D. H. 



A NEW PRIMER OF PSYCHOLOGY. 

 The Essentials of Psychology. By Prof. W. B. Pills- 

 burv. Pp. xi + 362. (New York: The Macmillan 

 Co.; London: Macmillan and Co., Ltd., 191 1.) 

 Price 55. 6d. net. 



THE task of writing a good elementary text-book 

 on any science is notoriously arduous, and this 

 is especially the case with so difficult a subject as 

 that of psychology. The ideal writer of such a book 

 would be one whose power of taking a broad and 

 unbiassed view of his subject was guaranteed by a 

 thoroughly sound previous training in mathematics, 

 physiology, and philosophy (metaphysics, logic, ethics, 

 &c.), every one of which sciences is absolutely essential 

 to a competent knowledge of psychology in its full 

 extent at the present day. A writer falling short of this 

 ideal is likely to betray the fact by an im. \. mu'ss, more 

 or less pronounced, in his treatment ul dilti-ront parts 



