Grey matter, with added colour

April 17, 2008

M. W. Brown on an engagingly vivid look at the brain and the neuroanatomists who mapped it

Across the centuries, anatomists have sought recognition and hoped for medical and scientific immortality through the naming of body parts. The German anatomist Johann Gottfried Zinn (17-59) who discovered the ciliary zonules (very tiny elastic suspensory ligaments attaching to the lens of the eye) probably had such a hope. It is less likely that he expected a book to be named after his discovery.

In reality, anatomists such as Zinn have probably been remembered more in abhorrence or despair by generations of trainee medics required to remember lists of these obscure appellations. Now, even the more common of such names are starting to fade into obscurity as less anatomy is taught and such eponymous titles are rejected in favour of more descriptive terms; so Zinn's is an unusual modern renaissance.

The success and joy of David Bainbridge's book is to make such unusual names a spur to interest. His explanations also benefit from his knowledge of development and his ability to make cross-species comparisons. Neuroanatomy is commonly feared by medical students because of its complexity and huge new vocabulary. When I first studied the neuroanatomy of the hindbrain's brain stem - a small part of the brain essential to our remaining alive - my student colleague memorably said to me, "Who designed this? It could never work."

This book does an excellent job of introducing the layout of the brain in an easily digestible form through describing the history of its discovery while celebrating quirkiness in its nomenclature and the eccentricities of early anatomists.

For instance, Bainbridge points out that the ancient Egyptians referred to the brain as "skull offal", while for the Greeks it was "marrow" - a term still used today as "medulla" (which means marrow) for part of the brain stem. Franz de la Boe, aka Sylvius, who gave his name to both an aqueduct and a fissure in the brain, was better known for introducing a diuretic to treat kidney disease, though his cure, gin, is now commonly taken for other reasons.

Santiago Ramon y Cajal is perhaps the greatest neuroanatomist. He advanced the subject by making meticulous drawings based on his observations of nerve cells viewed under the microscope, yet as a boy he had nearly blown himself up and scarred his eye.

Bainbridge has an accessible style and a vivid turn of phrase. For example: "Much of the apparent disorder of the hindbrain results from the way that the cumbersome central processing centers of hearing and balance have to be crammed in. Of course it is appropriate that the medulla is full to the gunnels with cochlear and vestibular nuclei ... because these centers are probably the reason the hindbrain exists." And: "Memory, fright, emotion, motivation ... They now have a degree of definition and a sense of location that we could not have imagined a century ago. Are we edging closer to allocating every conceivable function of the mind to a specific patch of pale brown blancmange?" While this as a goal would be contentious for many neuroscientists, the enjoyable phraseology is accessible to all: "'Area 51' is not only a legendary secretive military area in New Mexico, it is also the periamygdaloid cortex, next to the fear (and paranoia?) inducing amygdala (almond)."

I found Bainbridge's attempt to deal with consciousness less successful. There are anatomical comments that could be made, for instance, about the necessity of structures in the brain stem for the level of consciousness (determining whether you are awake, asleep or comatose), while the cerebral cortex is necessary for the content of consciousness (determining whether you see or are blind, for example), and the cerebellum is not necessary at all. So neuroanatomy still has some role to play in revealing the underlying neural organisation necessary for our sense of awareness.

This book is enjoyable to read and provides an excellent contribution to making some of the apparently bizarre structure and functioning of the brain accessible to the lay reader. All neuroscientists should also welcome it: as a teacher of neuroanatomy for many years I certainly read it with pleasure.

Beyond the Zonules of Zinn: A Fantastic Journey Through Your Brain

By David Bainbridge
Harvard University Press
ISBN 9780674026100
Published 28 February 2008

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