The Role of Neurology in the Study of the Nervous System
1. Introduction
“The Role of Neurology in the Study of the Nervous System” is an essay dealing with the neurological aspects of the nervous system, with the main focus being directed towards the autonomic and peripheral parts of the system where psychosomatic activities occur. As a continually advancing science, it is one that continues to reveal a greater understanding of the complexity of the nervous system. With new information obtained, it highlights the extensive connections to psychological processes and emotions. This essay aims to critically discuss the relevance of recent neurobiological research to the study of psychosomatic medicine, focusing primarily on neuroanatomical and neurochemical findings and their implications. It will aim to demonstrate that having a greater understanding of the structure and function of the nervous system can provide a bridge in linking basic biological processes to higher psychological function. In particular, it can aid the understanding of how certain internal physiological states and emotional conditions are translated into psychosomatic symptoms. Although neurology is technically defined as the medical science that deals with the nervous system and its disorders, its meaning has become interchangeable with “the study of the nervous system,” which is what the term represents in this essay. In commenting on the relationship between neurology and psychosomatic medicine, Eric Kandel points out: “To the extent that psychosomatic disorders reflect a somatic process initiated by an emotional condition, the conversion of the emotion into a somatic symptom must involve changes in the functional anatomy of the brain and a change in its chemical processing of information” (Kandel, 1997).
2. Understanding the Nervous System
The nervous system is perhaps the most complex and intriguing system in the human body. In the early days of its study, neurologists greatly benefited from philosophical studies and the myths of early medicine. Though these ways of thought did not give solid anatomical knowledge, the teachings of great philosophers such as Plato and Aristotle provided the basis of much of the modern jargon of neurology. The theory of the 4 humours proposed by Hippocrates also can be looked at from a neurological standpoint. Because the humours were thought to affect the temperament of individuals, this can easily be compared to the chemical imbalances in the brain which cause mental illnesses in modern medicine. Early anatomical researchers studied the nervous system through dissection and animal experimentation. Some more famous for their work on the nervous system are Herophilus and Erasistratus of Alexandria. They are recognized as early neuroscientists for their experiments on animals which led to significant knowledge on the somatosensory systems in the brain. At this time in Rome a man named Galen produced a great body of work which became the template for medical knowledge up until the Renaissance. Anatomists of the medieval Islamic world also made significant contributions to the field, and the reconstructions of the nervous system produced by Ibn al-Nafis and Vesalius would not be outdone until the 17th century.
3. Importance of Neurology in Medicine
This is evident by comparison of the neurological sciences core curriculum, which requires that all medical students receive some teaching of clinical neurology, with the typical exposure to basic or clinical neuroscience from other preclinical or paraclinical disciplines. In an attempt to accommodate the ever-increasing rate of new information and technology, the traditional methods in which clinical neurology is taught are beginning to change. The shift from a more apprentice-style approach being replaced by more formal teaching methods such as lectures and problem-based learning. The main aim is to produce a student who has a fundamental understanding of clinical neurology that can be put into practice irrespective of what area of medicine he ultimately enters. This is further supported by the contributions that clinical neurology has made to evidence-based medicine, with an emphasis on summarizing and critically appraising the current knowledge to make it more relevant to clinical practice and decision making. With two-thirds of all the information that we currently know about the biological basis of mental processes accrued in the last 50 years, and the new information that will arrive in the near future, it is no doubt that there will be an increasing need for the understanding of neurology in clinical practice.
Physiological studies have found relevance in many areas of contemporary medicine. A thorough understanding of the nervous system requires a comprehensive insight into the ways the nervous system can go wrong. This, in turn, requires an understanding of normal function. The logical step after understanding normal neural function would be to learn application to clinical practice. The final three steps – describing the neurological basis of psychological processes, understanding behavior, and examining the etiology and treatment of neurological disorders – explain the increasing relevance of neurology to clinical practice in medicine. With the advance in technology and our understanding of the nervous system, neurology has never had a more predominant influence on medicine.
4. Neurological Disorders and Diagnosis
There are various different ways and categories in which neurological disorders are classified to learn and understand the disorders. This can be done specifically by system, signs and symptoms, diseases, pathophysiology, diagnostic procedures, and treatments. This is very crucial for doctors, patients, and therapists to understand in order to help a patient manage or possibly recover from a neurological disorder. For doctors, the AANN (American Association of Neuroscience Nurses) has made a classification of neurologic problems. This classification is titled “The AANN (American Association of Neuroscience Nurses) a Patient Care Classifying Outcomes”. This classifies the disorders specifically into signs and symptoms, making it easier to understand for non-doctors. This is also important for doctors to understand because most people who have a disorder do not understand medical terminology. This is, of course, a step classification, with class 1 being the least severe and class 4 being the most severe. An example of a specific classification can be seen with the Glasgow Coma Scale for a head injury or the Rancho Los Amigos scale for a stroke.
Neurological disorders are diseases of the nervous system, which involve the brain, spinal cord, and nerves. The nervous system is divided into two parts: the central and peripheral nervous system. It is responsible for everything the body does, such as breathing, as well as enabling us to see, hear, move, and touch. The central nervous system is the control center for the body and includes the brain and the spinal cord. The peripheral nervous system includes all the nerves that lead to or from the central nervous system. Neural damage applies to the nervous system parts it disrupts, whether it is movement or thought. This is where a neurological disorder can affect a person. Since all human behaviors, physiological or anatomical, are controlled by the nervous system, any damage such as spinal cord injury or a disease state that affects the nervous system has the potential to cause devastating disability.
5. Advances in Neurology Research
In the early 20th century, the neurological examination was a central part of clinical medicine at a time when infectious diseases and a variety of strange nutritional/toxic states produced acute neurological syndromes. This pattern of practice is remembered in the dictum “acute neurology is general medicine,” which harks back to a time when the neurologist and the general physician were not so different. Since that time, general medicine has become less interested in acute syndromes with the rise of chronic degenerative diseases, and these are bread and butter to today’s neurologist. In our own time, the rise of molecular biology has made genetics and ultimately the genetic explanation and manipulation of cellular function the central paradigm of medical science, and ultimately the basic science of the neurologist. Measurable in many ways, neurology has become “more scientific,” but this process has had a devastating effect on general medicine and clinical neurology. In losing its acuteness and aetiologically varied pathology, the neurological examination has become a shadow of its former self, and there is a widespread feeling that this has led to a separation between neurology and the rest of clinical medicine, and between clinical and basic neurology. This feeling underlies skepticism about the future of neurology, reflected in uncertainty among medical students, the fall in neurology numbers, and complaints from neurologists themselves about the difficulty of career progression. Now is a good time both to look back at the causes and effects of previous research into the brain and nervous system, and to gather thoughts about future research directions.
It is logical to start with a comparison of then and now. In the early 20th century, the neurological examination was a central part of clinical medicine at a time when infectious diseases and a variety of strange nutritional/toxic states produced acute neurological syndromes. This pattern of practice is remembered in the dictum “acute neurology is general medicine,” which harks back to a time when the neurologist and the general physician were not so different. Since that time, general medicine has become less interested in acute syndromes with the rise of chronic degenerative diseases, and these are bread and butter to today’s neurologist. In our own time, the rise of molecular biology has made genetics and ultimately the genetic explanation and manipulation of cellular function the central paradigm of medical science, and ultimately the basic science of the neurologist. Measurable in many ways, neurology has become “more scientific,” but this process has had a devastating effect on general medicine and clinical neurology. In losing its acuteness and aetiologically varied pathology, the neurological examination has become a shadow of its former self, and there is a widespread feeling that this has led to a separation between neurology and the rest of clinical medicine, and between clinical and basic neurology. This feeling underlies skepticism about the future of neurology, reflected in uncertainty among medical students, the fall in neurology numbers, and complaints from neurologists themselves about the difficulty of career progression. Now is a good time both to look back at the causes and effects of previous research into the brain and nervous system, and to gather thoughts about future research directions.
In the past century, neurology has undergone several phases and the results have varied. Neurology, in the interwar period experienced a crisis of identity, a strong expansionist phase in the 1970s, and a healthy diversity in the 1990s. At each time, neurology was modified by the strong scientific and medical culture of the time, and the political forces that funded and supported that culture. In the 1990s, a time of crossdisciplinary research, it is interesting to look back at the close relationship with the rest of neuroscience and with clinical medicine, and to consider its future direction. This article is an attempt to do that.
