The history of a catatonic dog

This article is a condensed life-history of a dog (“V3”) born and reared in the Pavlovian Laboratory and studied until his death in 1961. A detailed study was made of his pathologic development, his relations to people, and the effects of drugs. Measurements recorded were heart rate, blood pressure, respiration, 24-hour activity, sexual reflexes, general behavior. Although early experiments were done chiefly for recording and were not considered noxious or traumatic, this dog’s general development and symptoms seem to have been “constitutionally” rather than environmentally determined. His external behavior was strikingly similar to that of a catatonic patient-flexibilitas cerea, general immobility. Of particular interest was the “Effect of Person”: in the presence of all humans who confronted him he showed catatonic postures, cardiovascular disorders (tachycardia up to 200 beats/min., bradycardia to 12 beats/min., drop of blood pressure from 150 to 75 mm Hg, arrest of heart-beat for as long as 8 seconds), moribund poses. His response to drugs illustrated the specificity to a definite “constitutional type”: sexual activity markedly increased by alcohol and rarely present except after administration of alcohol; no improvement after administration of tranquilizers, except alcohol and meprobamate, which made him act like a normal dog in behavior and in relations to people. His symptoms and reactions to both people and drugs were generally opposite to those of another dog, “Nick”, studied over his life span: Nick showed excessive activity in physiologic systems; hyperactivity (running); generally, improvement through “Effect of Person”; sexual inhibition with alcohol. Observations of the two dogs suggest that symptoms as well as reactions to drugs are the result of the “type” rather than the procedure used, that perhaps psychopathologic symptoms are due more to inborn constitution than to “conflict” (“collision”) between excitation and inhibition, and that neurotic or psychotic symptoms may not interfere with longevity-Nick lived to be 14 years old and died fighting; V3, who also spent most of his life in the laboratory, died at the age of 14.     

Pavlov’s “higher nervous activity”

The term higher nervous activity was introduced by Pavlov about 1909 to replace what he previously called “psychical” or “mental.” In Russia “higher nervous activity” is now used for what we often designate as psychophysiological or psychosomatic. “Higher nervous activity” was not a synonym in Pavlov’s use for psychical or mental; it indicates what physiology can deal with and measure as opposed to our subjective feelings and representations. The philosophical differences underlying Pavlov’s concepts, as well as the philosophical basis for distinguishing between what we measure physically and the subjective correlates, are discussed.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.