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Adrenaline and the Inner World

An Introduction to Scientific Integrative Medicine

David S. Goldstein, M.D., Ph.D.

Publication Year: 2006

This accessible work is the first in more than seventy-five years to discuss the many roles of adrenaline in regulating the "inner world" of the body. David S. Goldstein, an international authority and award-winning teacher, introduces new concepts concerning the nature of stress and distress across the body's regulatory systems. Discussing how the body's stress systems are coordinated, and how stress, by means of adrenaline, may affect the development, manifestations, and outcomes of chronic diseases, Goldstein challenges researchers and clinicians to use scientific integrative medicine to develop new ways to treat, prevent, and palliate disease. Goldstein explains why a former attorney general with Parkinson disease has a tendency to faint, why young astronauts in excellent physical shape cannot stand up when reexposed to Earth's gravity, why professional football players can collapse and die of heat shock during summer training camp, and why baseball players spit so much. Adrenaline and the Inner World is designed to supplement academic coursework in psychology, psychiatry, endocrinology, cardiology, complementary and alternative medicine, physiology, and biochemistry. It includes an extensive glossary.

Published by: The Johns Hopkins University Press

Title Page, Copyright Page

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pp. vii-viii

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pp. ix-xiv

This book tells a life story, but it isn’t a biography. It paints a family portrait, but not of a human family. Instead, this book depicts the world’s most famous hormone, adrenaline, and its chemical family, the catecholamines (pronounced cat-a-COLA-means, or, if you are British, cat-a-coal-AYmeans). They are part of you. They have kept you alive and are keeping ...

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1 The Inner World

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pp. 1-29

Inside you is an inner world, full of comings and goings and the beautiful paradox of seeming constancy despite continuous change.We are born, we develop and mature, we reproduce, we live out our lives, we get old, we get sick, and we die, yet for most of our existence we believe in our essential ...

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2 The “Automatic Nervous System”

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pp. 30-56

Some bodily activities, like standing up and moving legs to walk across a room, are voluntary, conscious, and observable from the outside. Others, like digesting, sweating, and tightening blood vessels, are unconscious, involuntary, and automatic, and they may or may not be observable from the outside. The brain uses different parts of the nervous system to regulate ...

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3 The Arbiters of the Inner World

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pp. 57-105

So much of the workings inside the body reflect the dynamic equilibria of production, release, recycling, and breakdown of catecholamines; so many researchers have spent so much of their careers learning about catecholamine systems and their intricacies; so much of importance to medicine and physiology is known about these systems; and so much of the history ...

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4 The Rest of the Cast

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pp. 106-120

The brain has at its disposal many effectors to control the inner world, in addition to the components of the autonomic nervous system described classically by Langley and Cannon. These other effectors operate according to the same principles as those that apply to the traditional components of the autonomic nervous system. ...

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5 Stress as a Scientific Idea

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pp. 121-140

The scientific integrative medicine approach can help understand how genetic changes already present at birth lead to degenerative diseases decades later, at the other side of life. This chapter develops a theory about this linkage; the starting point is stress as a scientific idea. ...

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6 Distress

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pp. 141-163

The occurrence of stress does not require consciousness. Selye would have agreed with this assertion, because he claimed that stress reactions can occur in anesthetized animals, in lower animals without nervous systems or undergoing mechanical damage to denervated limbs, and even in cells cultured outside the body. In contrast, distress does require consciousness, because ...

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7 Stress in Evolutionary Perspective

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pp. 164-180

Science depends on measurement. Measurement is the key link in the circular chain of the scientific method. The chain consists of observation, induction of an explanatory concept, derivation of a testable hypothesis, prediction, experimental design, measurement, data analysis, and inference, which enlighten further observation. Hopefully, accumulating experimental ...

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8 Dysautonomias

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pp. 181-206

In dysautonomias, altered activity of one or more components of the autonomic nervous system adversely affects health. Dysautonomias can manifest as occasional episodes or chronic, persistent neurodegeneration. They occur in all age groups, from inherited genetic diseases in children to functional disorders in adults to autonomic failure in the elderly. Some entail ...

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9 Tests for Dysautonomias

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pp. 207-223

There are four types of tests to diagnose dysautonomias: physiological, neuropharmacological, neurochemical, and neuroimaging. Physiological tests involve measurements of a body function in response to a manipulation such as standing, tilt-table testing, or a change in room temperature. Neuropharmacological tests involve giving a drug and measuring its immediate effects. ...

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10 Treatments for Dysautonomias

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pp. 224-234

Successful treatment of dysautonomias requires an individualized program, which can change over time. Because the underlying disease mechanisms often are not understood well, treatment is likely to involve some trial and error. ...

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11 Drugs and the Family

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pp. 235-246

All three members of the adrenaline family are powerful drugs. Adrenaline itself is the most potent. In current algorithms of the American Heart Association for Advanced Cardiac Life Support (ACLS), adrenaline is the drug of first choice for sudden death from asystole, when the heart goes “flatline.” No other drug has such an ability to restore the electrical activity of ...

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12 The Future Scientific Integrative Medicine

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pp. 247-270

In this book you have learned a lexicon for the political science of the inner world. You have come across many new words and phrases—effectors, homeostats, allostatic load, monitored variable, dysautonomias—and new perspectives about old ones—negative feedback, the autonomic nervous system, stress, distress, fight-or-flight, and, of course, adrenaline. I have used ...


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pp. 271-291


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pp. 293-294


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pp. 295-309

E-ISBN-13: 9780801888823
E-ISBN-10: 0801888824
Print-ISBN-13: 9780801882890
Print-ISBN-10: 0801882893

Page Count: 328
Illustrations: 49 illustrations
Publication Year: 2006

Research Areas


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Subject Headings

  • Adrenaline -- Physiological effect.
  • Stress (Physiology).
  • Autonomic nervous system.
  • Integrative medicine.
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