Adrenaline
2013; Elsevier BV; Volume: 1; Linguagem: Inglês
10.1016/s2213-8587(13)70023-8
ISSN2213-8595
Autores Tópico(s)Adrenal Hormones and Disorders
ResumoAdrenaline begins with an elegant couplet of questionable relevance: “A little learning is a dangerous thing; drink deep, or taste not the Pierian Spring” (Alexander Pope). It is not an accusation that one could make of the author, Brian Hoffman, Professor of Medicine at Harvard Medical School, Boston, MA, USA. But he wears his learning lightly, and briskly outlines his purpose. “Adrenaline has enormous cultural significance as a molecule associated with medically important stress and with excitement, anger and terror”, he explains. “Adrenaline flows in an adventurer ascending a sheer cliff or in a young violinist debuting at Carnegie Hall. A shot of adrenaline empowers superhuman feats in emergencies. On the other hand, an adrenaline surge during a bitter argument may precipitate a heart attack or scare us to death.” Hoffman's slender but detailed history of adrenaline, which he regards as the first discovered hormone, despite secretin's pretensions to the title, begins, as medical biographies invariably do, in classical antiquity. But this is a rare subject on which the Greeks and Romans stand silent. Herophilus (335–280 BC), the father of anatomy, did not mark the adrenal glands, nor did Galen of Pergamon (circa 129–210). They go unmentioned in Andreas Vesalius' (1514–64) opus of the human body, De humani corporis fabrica. It was Bartholomaeus Eustachius (circa 1500–74) who eventually described them. “I consider it indicated to say something of the glands, diligently overlooked by other anatomists”, he wrote waspishly. Soon enough, the same glands were identified in fish and mammals. “The widespread existence of the adrenals in many species spoke to their importance”, declares Hoffman, “but only in the softest whisper”. The author's studious research takes us next to eighteenth century France and to a competition hosted by Bordeaux's Academy of Sciences, which asked “what is the use of the adrenal glands?”, but found no satisfactory answer. The competition's adjudicator, incidentally, was Charles de Montesquieu (1689–1755). Hoffman points out, with solemn exactitude, that Montesquieu “took an early interest in biology before becoming a great political essayist”, which makes the great man's life sound like a question in Trivial Pursuit. Our author does have a dry sense of humour, and it is disappointing that he gives it free rein so infrequently; for the most part Adrenaline is a strikingly earnest endeavour. Witness the critique of Bob Dylan's The Lonesome Death of Hattie Carroll, early in the book, which gently upbraids Dylan for ignoring the fact that “adrenaline and the closely related substance noradrenaline almost certainly played a significant role in her death, a consequence of the actions of the sympathetic nervous system”, all of which may well be true, but it is difficult to write a protest song about the iniquities of the sympathetic nervous system. The chapter “A Country Doctor's Remarkable Discovery” recounts the experiments of English physiologist George Oliver (1841–1915). His work, measuring the effects of extracts from the adrenal glands on blood pressure, along with Edward Schäfer (1850–1935), who came up with the term “endocrine”, was of crucial importance in advancing our understanding of adrenaline. An entertaining aside with slightly wistful undertones, “View Through a Retrospectoscope” applies today's exacting safety standards to Oliver's era. “Oliver did not have to obtain informed consent from volunteers, nor did he have to deal with government agencies concerned with safe manufacturing practices for experimental substances”, writes Hoffman, sounding for all the world like a man whose experiences with government agencies have seldom quickened him with joy. “On the other hand”, he adds judiciously, “in his day, investigators felt a duty to test new chemicals on themselves first, an activity not generally acceptable now”. Oliver's might have been a simpler time, but it had its own complications. This book is predominantly a tale of the twentieth century. Adrenaline was first named in a scientific journal in 1901; 100 years later, musicians were using β-receptor antagonists to quash performance nerves. The chapter and subchapter headings—”Molecular Basis for the Activation of Glycogen Phosphorylase”; “The Perils of an Insufficient Sympathetic Nervous System”—testify that this is not really a book for the layman, and there are hints that Adrenaline may have started life as a series of lectures. Still, the biochemistry is explained with clarity and Hoffman is a convivial enough host. The text is studded with lively anecdotes, including the amusing story of how the author managed to escape from an enraged motorist. “A stocky man leaped out of the car and started towards me on foot; he called out once, ‘you're going down’. Somewhat alarmed, I balanced precariously on my bicycle, feet clipped into the pedals.” The terrified academic managed to take refuge in a refreshment tent. Not built for fighting, then, but at least in Adrenaline he makes wrestling with ideas look easy.
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