the liver and the brain

Iain Macmillan iain.macmillan at health.wa.gov.au
Fri Sep 3 10:01:26 EST 2004


Matthew Kirkcaldie <m.kirkcaldie at removethis.unsw.edu.au> wrote in message news:<m.kirkcaldie-FC9A38.12461403092004 at tomahawk.comms.unsw.edu.au>...
> In article <363d693e.0409021806.4347802e at posting.google.com>,
>  rscanlon at nycap.rr.com (ray scanlon) wrote:
> 
> > I know that it is difficult for a man, who has spent his lifetime cataloguing
> > trees, to listen when he is told that he is surrounded by a forest.
> > Nevertheless, that's the way it is.
> > 
> > You must try.
> 
> What a pompous, patronising attitude.  I hope you enjoy your insular 
> world of self-importance - it's clear you are incapable of learning, 
> since you already have all the answers.  It's a pity that people who've 
> spent their lives studying these things seriously don't agree with you, 
> but clearly you're more comfortable with your smug generalisations than 
> the hard light of real-world phenomena and evidence.
> 
> Please don't bore us with your posturing, we've seen it all before.  If 
> you're willing to discuss something seriously, please do so.
> 
>       MK.

Apologies for a lurker (a biological psychiatrist)posting to this
erudite discussion. The original post referred to the brain and the
liver. I thought it might be useful to contrast the brain with the
heart.

The human heart was long regarded as the seat of all sorts of mystical
and or magical forces, until a chap called William Harvey worked out
that it is, in fact, a pump. Since then, over the past three hundred
and odd years, the mechanism of the heart's pump action has been
worked out - how the complex interlinked muscle fibres contract, how
the timing of these contractions is regulated, and, most importantly
for therapeutics, how these effects can be modified by drugs etc.

I think it's reasonable to say that the heart as an organ is pretty
well understood, despite its being essentially a vast, intricate
network of cells which would be pointless to map exactly.

My thoughts are that the brain is a squishy organ, pretty similar in
size to the heart, with wiring, support structures and areas whose
individual function is pretty well understood - visual pathways etc.
Bits of brain develop with time and experience, bits seem to stop
working (eg DLPFC in depression, Drevets et al. Nature) and other bits
seem to depend critically for their function on vascular factors,
which appear to be of great importance in the development of at least
some brain diseases.

A patient with heart failure in 1610 might have cough, chest pain and
swollen ankles. Eminent physicians of the time might see chest pain as
important, and treat with aspirin, cough as important and treat with
opiates, or swollen ankles as important and treat with leeches - all
of which treatments would be likely to produce benefits, but not with
the mechanisms or for the reasons the treating physicians would give.

My hope is that the equivalent conceptual leap for the brain that
Harvey made for the heart is near, and that the lag in translating it
into a clear understanding of how the brain "works" is less than the
three hundred years it took for Harvey's work to be translated into
precise understanding.

Thanks,

Iain

who has only posted previously in response to florid psychopathology



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