Overstressing their point

Mind, Immunity and Health: The Science of Psychoneuroimmunologyby P. Evans, F. Hucklebridge and A. ClowFree Association Books, 2000. £16.95 (x + 185 pages) ISBN 1 85343 487 6It is immediately apparent from the opening chapter that Mind, Immunity and Health will not be a dry text, nor a hodgepodge of voices collated together to cover a field. Before one comes to the end of the first page, the reader is served this wonderful sentence to highlight the importance of interdisciplinary research: ‘Rather our point is that, whatever walls some scientists may throw up around their focus of interest, nature certainly does not recognize them.’An analogy to natural and artificial boundaries around countries follows that gives a sample of a recurring vehicle used throughout the book for making the science not only understandable to the introductory reader, but also relevant to their day-to-day experiences. Brief references to historical figures (Henry James, Walter Cannon, Hans Selye), literary examples (roots of words; quotes from Shakespeare) and some almost philosophical musings (is consciousness necessary to experience an emotion?) make this book highly readable.The initial progression of chapters from introduction, to a very basic review of immunology, to a survey of the channels of communication between nervous and immune systems, is logical and easy to follow, aided by clear and simple diagrams. The deep suspicion that many scientists have for the term ‘stress’ is acknowledged, and refreshingly brought back to the biological basis of the hormonal and neuronal stress response. But the flow of chapters then swerves away from basic biology and mechanisms of neural-immune communications – an area of some of the greatest advances in this field over the past decade.The next series of chapters focus first on methodology in human studies, then stress, depression, conditioning, cerebral lateralization and immune function, before ending with a chapter titled ‘PNI [psychoneuroimmunology] and Health’.The authors’ bias is boldly underlined by this choice of topics and the devoting of full chapters to such areas as lateralization while at the same time condensing all research on the bi-directional neural–immune communication into a single chapter. This organization gives the novice student the impression that PNI is the study of the effect of stress on immune responses, rather than the study of the role of neural factors in susceptibility, resistance and course of immune disease. Although the authors clearly state that their focus is on human rather than animal studies, this bias seems to have constrained them to give rather short shrift to the wealth of advances in basic neurobiology and immunology that have in recent years so much enhanced the design and credibility of human studies. By, almost as an afterthought, glossing over animal work that originally proved the cause and effect relationship between stress responsiveness and susceptibility and resistance to a variety of inflammatory diseases, the authors underplay a very important aspect of this emerging science. Without such animal studies, human studies showing the relationship between blunted neuroendocrine stress responses and allergic asthma and dermatitis could, as the authors point out, be considered association rather than cause and effect. In this regard, the authors also omit more recent data supporting this association in other human illnesses.The overall organization of the book, its depth and topic selection, are in stark contrast to other introductory texts in the field, such as Stress, Immune Function, and Health: The Connection 1xRabin, B.S. See all References1, a comprehensive yet basic and very readable text that does cover all these areas of PNI in a balanced and clear introductory style. In this regard, although Mind, Immunity and Health is overall palatable and generally accurate, it cannot be considered a comprehensive introductory text. It is a book, written in a singular voice pertaining both to writing style and particular focus, that will give the starting student a taste of some highlights of the field of PNI.