Zadok Paper S100 Winter 1999
The Nature of Humans-Mind and Brain; Body, Soul and Spirit
by Alan Gijspers

Scientific views of humanity

Modern science arose out of the very basic descriptive science of anatomy. Rembrandt's dramatic "The anatomy Lesson of Dr Tulp" well illustrates the demonstrative and descriptive nature of this science (and reminds us that all science is not mathematical!). Anatomists demonstrated what was actually there. Later function was inferred from structure, and experimental physiology arose to determine the workings of the human machine. So the heart was seen as a pump, the kidneys as filters, the bowels as organs of digestion and absorption. Was the heart nothing but a pump, the kidneys nothing but filters and the human nothing but a biological machine?

The rise of modern science should not obscure the more ancient descriptive science of clinical syndromes which goes back to Hippocrates. Thomas Sydenham's description of gout is still quoted in modern medical textbooks. This taxonomy of conditions is one of the "Stamp collecting" sciences referred to by Rutherford's famous phrase, "There are two forms of science: physics and stamp collecting." However inexact and imprecise, this form of science is of necessity the basis of clinical medicine.

Interestingly, Malcolm Jeeves12 points out that the brain was not always regarded as the organ of thinking and behaviour. The science of neurology or the study of the brain developed out of the study of diseases in the brain, comparing what was found at post-mortem with the disorders of function observed while the person was still alive. Thus Broca described defects of language fluency which are related to a particular lesion in the frontal part of the dominant hemisphere and later Wernicke described a defect of understanding speech related to a different part of the same hemisphere. Subsequent lesions were also described. Most recently PET (positron emission tomography) scanning, a dynamic form of study of brain function, has identified activation of different speech areas with different linguistic activities. (More accurate understanding of how lesions produce disorders of function under controlled conditions can occur with animal studies, where more localised lesions can be carefully made and studied.)

From this beginning, modern neurology has greatly increased our understanding of brain function. Thus physiologic neurology has studied the electrical transmission of impulses along nerves and their junctions with other nerves and muscles. It has mapped the location of these transmitters in the brain and discovered links between neurotransmitters and the endocrine (hormonal) systems. The loss of proper endocrine function can have a profound effect on the effectiveness of the person and on how they feel and even how they perceive their relationship with others, including God.

There are many ways neurological structure and activity can be measured. These include the EEG (electro-encephalogram) which measures brain waves and has a role in diagnosing different forms of epilepsy. More recently CT (computerised tomography) and MRI (magnetic resonance imaging) have helped to define structural lesions and PET scanning has helped to describe brain function.

In the last 50 years, many drugs affecting the nervous system have been discovered. Thus severe mental diseases such as mania, schizophrenia and depression are less of a scourge than they once were. Drugs which alter behaviour (either for the better or the worse) raise ethical questions not yet fully answered. For example, if a drug has altered that person's behaviour, does that diminish that person's responsibility for that behaviour?

Neurosurgery has undergone a similar revolution to pharmaceutics. More accurate surgery and the ablation of over-active areas especially in the basal ganglia has led to better control of Parkinson's disease. Further, there is some success with the transplantation of foetal cells into the basal ganglia to provide the missing dopa.

Thus we acknowledge that for a number of neurological diseases, loss of structure means loss of function. If that loss is predominantly in motor areas then there will be loss of muscle power, of muscle control. If it is in speech areas, there is loss of language ability, in the memory areas there is loss of memory and if it is in the frontal areas there is loss of social control. These are diseases over which patients have no control. Some neurologist would then identify brain areas for emotions, morals and so on. Some even have posited a centre for spirituality! Are all behavioural problems diseases of the brain? Is there a structural correlate for all mind problems? So far the evidence is inconclusive, but the evidence would tend to suggest that there is a tightening link between the mind and the brain.13

To: Psychology and psychiatry

Alan J. Gijsbers MBBS FRACP DTM&H PGDip Epi, is Specialist Physician at Turning Point Drug and Alcohol Centre and at the Department of Drug and Alcohol Studies St Vincent's Hospital. He is a Visiting Physician at the Epworth Hospital, a Senior Lecturer in Clinical Medicine at the Department of Psychological Medicine Monash University and Senior Fellow at St Vincent's Hospital Clinical School, University of Melbourne. He also contributes to a Dual Diagnosis Clinic at the St John of God and St Vincent's Collaborating Centre consulting on people with both Drug and Alcohol and Psychiatric Disorders. He is a fellow ISCAST and editor of their national bulletin. He also somehow manages to be a husband to his wife, Lois, and a father to three children.