A valuable addition to the Monographs on Nervous and Mental Disease is the recent contribution by Dr. Higier. As Dr. Higier observes in his introduction, the vegetative nervous system has received but scant attention from physicians. The translation of "Vegetative Neurology" by Dr. Walter Max Kraus of New York fills a gap left by the textbooks on clinical medicine. Although it is obviously out of the question for the clinician to devote much time to the comparative anatomy and embryology either

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... of the vegetative or the cerebrospinal nervous system, the anatomy and physiology, as well as the pathology and pharmacology of the vegetative nervous system should have fully as much attention given to them as is directed to the anatomy, physiology, etc., of the central nervous system. Dr. Higier's summary of the latest researches in vegetative anatomy, physiology, and pathology demonstrates the importance of involuntary mechanisms of the lower neurons for the maintenance of normal physiologic equilibrium. In the light of vegetative neurology, abnormal function may often be traced to derangement of the sympa¬ thetic or of the autonomie systems, or of ductless glands, the secretions of which influence these systems. How much influence such derangements may exert on the development of mental disorders is as yet uncertain, since in the psychoses and psychoneuroses there is set going a vicious cycle involving the cerebral cortex and the spinal and vegetative neurons, the initiation of which is difficult to ascertain. In any event, vegetative pathology appears to be of no little importance to the neurologist and the psychiatrist, as well as to the internist. After a brief summary of the gross and microscopic anatomy, of the histology and embryology of the vegetative nervous system, there follows a chapter of twenty-eight pages on the physiology of the vegetative system that gives the reader access to the most recent conclusions and opinions on auto¬ nomie and sympathetic innervation. Under pharmacology and pharmacodynamics of the vegetative nervous system, the action of drugs (muscarin, pilocarpin, physostigmin, picrotoxin, atropin) and of internal secretions (epi¬ nephrin, iodothyrin, hypophysin) is discussed in relation to the sympathetic and autonomie systems.. The physiologic action of atropin, epinephrin, pilo¬ carpin, and ergotoxin on smooth muscle is summarized by Meyer and Gottlieb's chart, which, however, is not very recent (1911). The pathology of the vegetative system and the clinical signs and symp¬ toms of vegetative disturbances are discussed in comprehensive fashion. The author supports the theory of the Vienna school that hypertonus of the sym¬ pathetic (sympatheticotonia) and of the autonomie (vagetonia) produces dis¬ tinct types of neuroses capable of clinical differentiation. Loss of that physio¬ logic which results from the reciprocal innervation of smooth muscle is the outcome of overstimulation of the autonomies or of the sympathetics as the case may be. The rôle of the ductless glands in overstimulation of either Downloaded From: http://archneurpsyc.jamanetwork.com/ by a University of Manitoba User on 06/21/2015