The Applied Anatomy of the Nervous System—Being a study of this portion of the human body from a standpoint of its general interest and practical utility. Designed for use as a text-book and as a work of reference. By Ambrose L. Ranney, A.M., M.D. Second edition, revised and enlarged. 8vo. Profusely illustrated. Cloth, $5.00; sheep, $6.00.

A second edition of this work has just been issued and, as the author says, has been enlarged. It contains 791 pages including the index; and is divided into four main parts, the first part treating of the brain; 2d, the cranial nerves; 3d, the spinal cord; 4th, the spinal nerves.

It is very difficult to give a review of a work like this, which treats so largely of the anatomy of the nervous system; and which is the most difficult part of anatomy, and a great deal of which is not positively settled, but is under sharp discussion by those who pay special attention to the subject.

The work is a more or less successful compilation, which is prepared with the idea of its being used as a text-book. Its size indicates that it contains an enormous quantity of material on the gross and fine anatomy, but excursions are also made into the domain of medicine to illustrate the application of the anatomical knowledge to the explanation of symptoms in disease; and quite frequently physiology and pathology are dealt with.

As a text-book the work appears to me a great deal too large; and the treatment of the subjects too diffuse; and often not clear; this is especially so in the anatomical part. Cerebral anatomy is one of those subjects of which it is very difficult to treat in a clear and comprehensive manner so that others can understand it; and for this reason a text-book should be small and contain only such anatomy as is clearly made out and can be made practical use of as applied anatomy. The finer anatomy and the study of the course of fibres, etc., should be taken up as a special work, and studied with patience on specimens, sections, etc.

A great many digressions into physiological questions might have been left out, and some other subjects properly belonging to general medicine, which the student could best study in some of the recent works on diseases of the nervous system, or at the clinics. As an illustration of what is meant, take, for instance, a consideration of the tendon reflex on page 576, and the short imperfect sketch on page 621, on progressive muscular atrophy, when on the next page is a figure of a man, forty-five years old, with progressive muscular atrophy, from Freidreich’s work; a case which, by the way, is probably not a case of chronic myelitis of the anterior horns, but one of the cystrophies. The subject of progressive muscular atrophies is now undergoing close study, and a large number of cases are not dependent upon lesions of the anterior horns, but are due to changes in the muscles themselves. The work of Freidreich, Erb, Lichtheim, Ladaur, Charcot, Landonzy and Dejeuni, and many others, have placed the subject in a different light from that in which it was viewed some ten years ago.

Subjects like these can be found more satisfactorily treated in other works, and are altogether out of place in a book like this and only adds to its bulk.

The descriptions are often such as to confuse and mislead a student; for instance, take the opening chapter on the brain, where the author says: “In man and the vertebrates, the cerebro and spinal axis may be divided into three separate portions, each perfectly independent of one another and yet very intimately connected.”

Now this division is quite artificial, and is only for purposes of description, and these parts are not perfectly independent of one another.

Again, he says: “The nervous system of all animals may be subdivided into two distinct histologic elements, nerve cells and nerve fibres.” What has become of the neuroglia and neuroglia cells; are they not important histologic elements in the nervous system of all animals? Without this supporting framework what would become of the nerve tubes and ganglion cells? And in many of the diseases of the central nervous system this neuroglia takes on a very active condition, as is seen in such a disease as disseminated cerebro and spinal sclerosis.

On page 45, in speaking of the study of sections of the cortex, the author says: “By a judicious employment of gradually increasing powers in the microscopic objectives used, the general arrangement of the elements may be first mastered, and later on the minute details of each of the component parts may be studied.”

This sounds like a most formidable and delicate task in the judicious employment of objectives in increasing powers in the study of these sections. No one should attempt to study the histology of the nervous system without previously knowing something about the use of the microscope and having some practical knowledge of general histology and pathology; to such a person the study of sections does not depend upon the judicious employment of gradually increasing powers in the microscope objectives; if he use a No. 2 and a No. 7 of Verick, or some objective of about the same magnifying power, it is then simply a question of studying the specimens with those powers and learning to see and understand what he sees; there is no mystery about it.

I will refer to one other paragraph on page 56, where it is stated:

“The central gray matter of the spinal cord. This has no connection with the higher senses. It is capable in itself of the simplest kind of reflex acts by means of the spinal nerves. These can be produced at the will of the experimenter, in the beheaded frog, when an irritation of the skin by an acid, etc., is created; and Robin has satisfactorily performed the same experiment upon a beheaded criminal. We have reason to believe that the spinal cord can be slowly and in a purely automatic way taught to perform certain series of muscular movements (as in playing scales upon a musical instrument, for example,) without any intervention of the higher ganglia.”

This is physiology. Is it true that the central gray matter of the spinal cord has no connection with the higher senses? The complicated movements which are performed by a person playing on a musical instrument, like the piano, for instance, are more than a simple reflex action of the spinal cord; and we do not believe that the spinal cord can be taught to perform such movements without the intervention of the higher ganglia. When one is learning to play the piano or other musical instrument, the higher centres are constantly in action, guiding and regulating the muscular contractions which go to make up the act of playing; after constant repetition under the guidance of the higher centres, the spinal cord and lower centres, as it were, learn and retain the combinations necessary to the performance of the act, all that is necessary is to start the particular combination, and the spinal cord will carry it on automatically.

The spinal cord cannot be taught to perform such complicated acts without the intervention and guidance of the higher centres to begin with.

Dr. Ranney has done a great deal of work in the preparation of this volume, and deserves much credit for his endeavors to collect this somewhat scattered material.

The work has numerous illustrations and diagrams, most of them exceedingly good, but we observe among them some of the worthless and often fanciful illustrations from Luys’, which are reproduced here.