Commonwealth Fund Publications – serie

In this report on one of the first continuing care departments in the country, Dr. Harold Willard describes how he set up and directed a program in Thayer Hospital, Waterville, Maine, to provide the personnel and services necessary for improved care of patients with chronic illnesses. The community hospital, he maintains, must be the center for developing methods for health maintenance and care of the chronically ill. Two chapters by Dr. Stanislav Kasl provide a theoretical background for continuing care and discuss the importance of information from the behavioral sciences in the development and operation of continuing care programs.

This journey to the beginnings of the physician’s art brings to life the civilizations of the ancient world—Egypt of the Pharaohs, Greece at the time of Hippocrates, Rome under the Caesars, the India of Ashoka, and China as Mencius knew it. Probing the documents and artifacts of the ancient world with a scientist’s mind and a detective’s eye, Guido Majno pieces together the difficulties people faced in the effort to survive their injuries, as well as the odd, chilling, or inspiring ways in which they rose to the challenge. In asking whether the early healers might have benefited their patients, or only hastened their trip to the grave, Dr. Majno uncovered surprising answers by testing ancient prescriptions in a modern laboratory.Illustrated with hundreds of photographs, many in full color, and climaxing ten years of work, The Healing Hand is a spectacular recreation of man’s attempts to conquer pain and disease.

On Development is, as John Tyler Bonner says, “a book on ideas,” the ideas at stake in the contest to unravel the mechanisms of life. This fluent discussion of developmental biology synthesizes decades of intensive progress in specialized areas of the science: from the dramatic deciphering of the genetic code to detailed analyses of animal behavior patterns. Placing these discoveries in an evolutionary context, Bonner explores the continuities and the transitoriness of individual lives and individual forms.He begins by discussing the ubiquity among organisms of developmental cycles and their universal properties, including senescence and death. He argues that the life cycle itself is an object of natural selection and shows how, in any species, it reflects the evolutionary tradeoff between energy requirements of the individual and reproductive efficiency of the species. Although nucleic acids are thought to be the ultimate and fundamental source of genetic regulation, Bonner points out that a massive amount of information required for normal development is not directly controlled by nuclear DNA during the life cycle. Each life cycle is governed by some immediate instructions from the genes and by many gene-initiated instructions that were given in previous life cycles and have accumulated in various parts of the fertilized egg. All of these instructions taken together govern the development of a new organism.Acknowledging the great value of reductionist theories in biology, Bonner constructs his synthetic view of development without resorting to vitalist concepts or to hand-waving explanations. He draws examples and evidence from more than half a century of biological research, from sources as diverse as Spemann and Spiegelman. Certain organisms, such as the cellular slime molds, upon which Bonner himself has conducted a number of original experiments, and the social insects provide crucial examples of dramatic evolutionary increments in biological complexity and offer insight into the control mechanisms that make such advances possible.

The search for effective immunization against pneumonia was a principal avenue of investigation before the advent of The search for effective immunization against pneumonia was a principal avenue of investigation before the advent of antibiotics made such an effort appear unnecessary. Recently, however, the limitations of antibiotic therapy have become increasingly evident, and interest has been renewed in many of the threads of research which have all but lain dormant since the 1930s. In 1978, a pneumococcal vaccine was licensed by the F.D.A., merely as evidence of a renaissance in pneumococcal research which is now taking place. We are pleased to be reissuing two classic volumes which provide a unique repository of data amassed prior to the time when penicillin precluded further exhaustive observation of the unmodified infection.Heffron’s Pneumonia is a compilation and analysis of all aspects of pneumococcal disease, including the distribution of pneumococcal types, the pathology of pneumonia, its epidemiology, symptoms, signs, complications, diagnosis, prognosis, and immunology. With a complete cross-reference index and an extensive bibliography, Heffron’s book is still the definitive work on pneumococcal infections.White’s Biology of Pneumococcus contains the wealth of information acquired in the first six decades following the discovery of the pneumococcus. With a bibliography drawing together some 1593 papers, White’s volume is of unquestionable significance as a historical record and the basis for further study.

Waiting lists in psychiatric clinics and increasing numbers of patients in long-term psychotherapy have highlighted the need for shorter methods of treatment. Existing forms of short-term psychotherapy tend to be vague and uncertain, lacking as they do a clearly formulated rationale and methodology.The bold and challenging technique for brief psychotherapy designed around the factor of time itself, which James Mann introduces here, is a method he hopes will revolutionize current practice. The significance of time in human life is examined in terms of the development of time sense as well as its unconscious meaning and the ways these are experienced in both the categorical and existential senses. The author shows how the interplay between the regressive pressures of the child’s sense of infinite time and the adult reality of categorical time determine the patient’s unconscious expectations of psychotherapy.