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Progress in the medical sciences usually is first recorded in the journals. This has been true of progress in visceral or vegetative neurology. Pottenger has gathered together the results of this progress, so far as they relate to the phenomena of disease as manifested through the vegetative nervous system, and presented them in a systematic way in his book. He presents the subject in three parts.
Part I discusses “The Relationship Between the Vegetative Nervous System and the Symptoms of Visceral Disease.” The introduction to this section is very interesting and contains the author's speculations on a number of related topics. His principal thesis as set forth here is “there is a patient who has the disease, as well as the disease which has the patient,” and he speaks for this viewpoint which needs emphasis now because the growth of medical specialism and especially the laboratory of clinical pathology has tended to obscure the individual. Clinical observation he rates as worthy of consideration as laboratory findings and the superior man in the medicine of the future will be the one who is able to bring together all these special developments, “the internist who appreciates the unity of medicine” (p. 1).
This section is taken up largely with a discussion of the vegetative nervous system reflexes, both as they are manifested through the sympathetics and the parasympathetics. “Thus we may expect two sets of symptoms to be set up reflexly whenever an important internal organ is involved in a severe inflammatory process: (1) a group through the sympathetics which express themselves as motor, sensory and trophic reflexes in the skin, subcutaneous tissues and muscles, (2) a group through the parasympathetics which express themselves for the most part as motor, sensory, secretory and probably later as trophic reflexes in other viscera (p. 92). The nature of these reflexes is discussed, their mechanisms, and the location of symptoms produced in relation to the vertebrate so