Customer Reviews

Adrenaline and the Inner World: An Introduction to Scientific Integrative Medicine

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This remarkable book is both accessible to the layman, and should be required reading for physicians. It delivers so much more than what the title promises, in that it is really a philosophical treatise on how medicine should work, based on an insightful appraisal of how the body and the mind maintain "homeostasis", or steady-state operation. For anyone who has questioned the fairly narrow focus on adrenal steroids that occupies clinical endocrinology, it is a revelation to see how crucial the other adrenal hormones, especially adrenaline, are to the harmony of both the body and the mind. Dr. Goldstein teaches that control of basic body functions as well as some aspects of mental states is accomplished by dynamic, complex, interdependent feedback loops that often cross any putative body/mind boundary. He delineates the key control systems, explaining along the way how they can affect multiple biological variables, influence mood and behavior, and interact with each other. Dr. Goldstein gives a wonderful historical perspective, teaching that human understanding (and sometimes tragic misunderstanding) of all of this has evolved over thousands of years, and that the way this understanding evolved impacts patient care today. In an era when practitioners too often resort to diagnoses of convenience in order to dismiss patients whose complaints are complex, an honest reading of this book by physicians should provide scientific support in finding better ways to help. For the patient with a disability such as autonomic failure this book could be like food to a starving man, holding out hope that a careful analysis of the dynamic response of these control systems could yield at least an insight into the cause of the disability, if not also an effective treatment. Using extremely engaging and entertaining writing, fascinating references to the Bible, biographies of historical figures in medicine, and clever but simple analogies Dr. Goldstein makes the complex immediately intuitive. But, what is truly amazing is the economy with which he disposes of certain philosophical mistakes that even now distort patient care, especially the notion of body-mind duality championed by Descartes. He does a superb job of arguing against the still widely accepted idea that the mind and the body are somehow separate, only connected by a one-way street where affectations of the mind cause physical illness, while the reverse is rarely the case. In fact, as a philosophical treatise on medicine the book really packs a punch in terms of the sheer territory that it so accurately covers. For such a readable book, this is a real accomplishment.
For anyone interested in how the body controls its basic functions, what can and does go wrong, a solid introduction to the idea of feedback loops, and the definition and medical implications of stress, this book really stands alone. As a vision for how medicine should be it shines a bright light in corners where much ignorance still lurks

There is a dearth of material for the serious reader on the autonomic nervous system. It seems that either there is a one-page article on the rudiments, or some incredibly specialized and narrow research articles.

It was in that context that I ordered this book. As a nurse and therapist interested in the body-mind-heart connection, I was encouraged by the word integrative in the title. I had hoped that the role of emotions, human relations, social pressures etc... would be discussed. Instead, the book seems to be a reductionistic, allopathic physicians guess at 'integration' The author seems to guess that a few limited anecdotes from common real life situations (like panic attacks) would make clinical medicine more human. Hmmmm. Given how little else there is out there, you might see for yourself.

Update 2011: The dearth is less! See The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation (Norton Series on Interpersonal Neurobiology)

'Adrenaline and the Inner World' is one of those rare scholarly works that is accessible to the lay person. Dr. Goldstein's discussion of the members of the adrenaline family reads like a fascinating college lecture by a polymath professor who continuously digresses into wonderful little asides. What would otherwise be a dry recitation of chemical interactions is enriched with tidbits from medical and Hebrew history, philosophy and personal observation. I purchased this book because I met Dr. Goldstein while I was participating in a Clinical Study at NIH. I was taken with his self deprecating humor and willingness to answer questions from someone with little background knowledge. What makes this book worth reading is the illustration of difficult concepts wtih observations from many different fields. The book's conclusion, however, seems incomplete. The narrative seems to end mid-thought, as though the author was distracted by some new and startling observation that demanded his attention. One hopes it will produce a sequel, and we'll be able to hear the rest of the story.

ADRENALINE AND THE INNER WORLD: AN INTRODUCTION TO SCIENTIFIC INTEGRATIVE MEDICINE represents the first attempt in nearly seventy years to discuss the roles of adrenaline in regulating the body, and it comes from an international authority and teacher on the topics who uses his insights to address issues of stress and body regulation. College-level health collections, in particular, will find quite accessible his discussion of how to use scientific integrative medicine to develop new ways to treat and prevent disease. From weight loss and gain to adrenaline's affects on various body systems, this is the only book you'll need to thoroughly understand the topic and its related health issues.

Diane C. Donovan, Editor
California Bookwatch