Bob Maynard
Department of Health London, UK

https://doi.org/10.36866/pn.97.36

The first article in this short series (PN94, Spring 2014, p. 9) started with the remarks: ‘The age of great textbooks of physiology seems to have passed. Those splendid thousand page volumes that used to inform and perhaps intimidate, have – like battleships – disappeared. But actually, we can still learn a lot from these books. In this article, I am discussing just a few of the ‘greats’ from 40 years ago.’ In that article, I revisited Ruch and Patton’s Physiology and Biophysics. Now I turn to three more examples of Great Textbooks.

General Physiology
Hugh Davson

Hugh Davson (1909–1996) probably knew as much as any one person could know about general physiology or biophysics. His General Physiology appeared as a single volume in 1951 and in its final two-volume form in 1970. By then, it had become a standard work and few professional physiologists lacked a copy. It is an extraordinary book. Davson’s approach to physiology and his unusually fluent prose style are well shown in the preface to the first edition. He points out that advances in general physiology depended on the recruiting of scientists trained in non-biological subjects (his own training was in chemistry) and noted the difficulties under which those trained only in the biological sciences must labour. His honesty is transparent. How many authors would thank their employers, in his case the Medical Research Council, for having ‘…silently acquiesced in the theft of so many hours, devoted to this book, which might perhaps have been better employed in original research…’?

How did he write such a book? By spending thousands and eventually tens of thousands of hours, reading and summarising the results of original papers in the library of the Royal Society of Medicine. His approach was straightforward: he read only original papers (he deliberately eschewed reviews and monographs); he collated the results and sources onto filing cards and typed up his findings in the evenings. He set out to read everything relevant to his subject and although he described his approach as ‘haphazard’, it seems unlikely that any physiologist has ever read more. In addition to this almost unimaginable labour, he ran an excellent research group, established and maintained his position as a leading authority on the physiology of the eye and cerebrospinal fluid and as the doyen of membrane physiology. The range of subjects covered in depth in his book is most impressive. From the mechanics of flagella, DNA, the molecular biology of connective tissue, diffusion processes, electrophysiology, photosynthesis, the gut, the kidney, cardiac muscle – the list is endless. And all in faultless, flowing English.

Davson’s General Physiology was a unique book. It contains much information of classical importance and anybody who thinks he or she has a new idea in membrane physiology would be well advised to read Davson before applying for a grant. But more valuable perhaps than the scientific information is the opportunity to meet Davson. Nobody will write, and certainly nobody will be paid whilst writing this sort of book again.

Principles of Human Physiology
Ernest Starling

According to Sir Charles Lovatt Evans, Starling dictated much of the first edition of Principles of Human Physiology (PHP). Perhaps the text might have been shortened, but as it stands, it links us immediately with Starling: brilliant, impatient and busy. Starling’s pupil Charles Lovatt Evans took over after Starling’s death in 1927 and the book changed. More details, references and historical introductions to sections were added. Lovatt Evans wrote (not edited) all the editions up to the 12th in 1956, and then handed over to Hugh Davson and Grace Eggleton who, as editors and contributors, produced two more – the last appearing in 1968. Again, the book changed. No longer a single author work, it now comprised a series of eight ‘books’ or monographs, each contributed by an expert. It is the final, 14th edition which is considered here.

Even in 1968, PHP looked more like a reference book than a textbook for students. E M Killick, in reviewing the 12th edition, commented that the book had ‘one great defect as a textbook, namely, that medical students find it extremely difficult to read.’ A damning comment, but softened by her praise for the work as a reference book for teachers of physiology.

The 14th edition contains contributions of outstanding quality. M de Burgh Daly’s 500 or so pages on blood, the circulatory and respiratory systems (with contributions by Davson), and D H Smyth’s account of the gut are excellent pieces of work. Davson contributed extensively: 558 pages on the CNS and special senses in addition to the Introduction and sections on tissue fluids and the CSF. Davson told me that he had written the section on the CNS after having been let down by a distinguished neuro-physiologist. Although the CNS was not Davson’s special area of interest, he excelled in a fluent and exhaustive style, dealing with the anatomy as well as the physiology.

Rushton’s chapter, ‘Nerve Fibres’, is still worth reading today. He wrote in a classical style introducing striking analogies ‘Like ships anchored to their buoys, the K+ ions cannot drift away but all swing on their moorings in one direction with the set of the tide.’

But as sales dropped, Davson deplored the decision to drop the book and responded in style with a new book that he wrote with Malcolm Segal: An Introduction to Physiology. This ran to five volumes, the first two providing an admirable introduction to the subject, the latter three providing more detail along the lines of PHP. Volume 3 is devoted to the control of the major systems. Davson’s preface, in which he distinguishes sharply between an Introduction and a Synopsis, is worth reading. But even at five volumes the book remained incomplete and no further editions have appeared.

Principles of Human Physiology was a great reference book. In its time, there was hardly a fact likely to be needed by a student of physiology that could not be found between its covers. It remains a splendid account of classical physiology and contains valuable information.

Medical Physiology
Vernon B Mountcastle

‘Mountcastle’, as the book was usually known, was the largest of the great textbooks of physiology of the 1970s period. Two large volumes, 1858 pages plus an index – a long book – Medical Physiology, like the other books considered in this series, had a long history. It appeared in 1918 and was edited for many years by Philip Bard from Johns Hopkins University. The 14th and final edition appeared in 1980: 1999 pages plus 72 pages of index. One volume was devoted to the nervous system (and muscle); the other to the remainder of the subject. Rather confusingly, the order of the volumes was reversed between the 12th and 14th editions.

The approach taken by all contributors involved a great deal of detail. Illustrations were adequate but not prolific and the impression received by the beginner was one of long passages of rather solid text. This was off-putting to some; to others the depth of treatment was rewarding and the standard of the work was clearly a long way beyond that of ‘ordinary’ textbooks of medical physiology.

The series of chapters, which seemed to be particularly good were those on sensation contributed by Mountcastle himself. His work on the organisation of the cerebral cortex in columns of neurones was well known of course and his expertise glowed in these chapters. But not all the CNS chapters were up to date, indeed several had not been revised at all from the earlier edition of the book.

‘Mountcastle’ was the largest textbook of physiology available in the 1960s. It provided a detailed account of those aspects of physiology useful to medical students and to doctors. But it was long! It lacked the punch of Ruch and Patton’s Physiology and Biophysics and the 1980 edition was the last. Students no longer read such long books: the loss is theirs.

References

Ruch TC & Patton HD (1965). Physiology and biophysics, 19th edn. W B Saunders.

Davson HA (1970). Textbook of General Physiology, 4th edn, two volumes. J & A Churchill.

Starling EH (1912). Principles of Human Physiology, 1st edn.

Starling EH (1968). Principles of Human Physiology, ed. Davson H and Eggleton G, 14th edn, 1668 pages. J & A Churchill, London.

Mountcastle VB (ed) (1968). Medical Physiology. 12th edn. CV Mosby Company, Saint Louis.

Killick EM (1957). Experimental Physiology 42, 145.