This revised edition of Oliver Sacks's book is considerably expanded with additional case histories, new findings and practical information on treatment. In a new chapter, illustrated with startling colour paintings by migraine patients, Dr Sacks discusses similiarities among the visual hallucinations, or auras, that often precede a migraine and those that are induced by hallucinogenic drugs or deliria. Drawing on recent advances in chaos theory and neural stimulation, he describes these "hallucinatory constants" and what they reveal about the working of the brain. This is a comprehensive view of one of mankind's complex disorders.

2008-07-10 Freudian trousers

Fascinating that Sacks should interpret headache, albeit its extreme form "migraine" in Freudian terms. At every turn Sacks fails to appreciate the charlatanism, self-promotion and downright lack of scientific method that lies at the heart of Freud's ideas whilst either implicitly or explicitly using them to interpret symptomatology. In modern neuroscience migraine aura and the fortification patterns can be understood as the brain abhorring a vacuum and sensory deprivation, filling the brain with random geometric shapes that adorn neolithic caves the world over. For Sacks the reality of the meaningless of these patterns and indeed the meaningless suffering migraine inflicts is absent. Instead these are deep seated primitive outbursts of repressed emotion that can only gain sense in the crazy mixed up world of Freud where even a ladder acquires priapic significance. Nor does Sacks appear as the sympathetic physician:

"This old description brings out the true depressive quality- the sense of hopelessness and permanence of misery- a reaction which is celarly far in excess of a realistic response to a short lived benign attack of which the patient has had innumerable experiences" (pg 26)

An engaging read, if only to see how much Freud pulls at the hem of Sacks's trousers so that every step is taken with the weight of the past and the plodding ridiculousness of pseudo-religious thought.