Plucking the fruit of memory and running the risk of spoiling its bloom
Memory is a strange phenomenon with which we all have to cope. It involves two processes: the first is the learning of new skills, new behaviour patterns or pieces of information; later comes the recall or re-expression of the skill or information, a process known as retrieval. Memory has different aspects known as sensory memory, working memory and long-term
memory. Short-term memory, which is essentially sensory, is lost unless
it is transferred into the long-term bank. But, once transferred, it
may be difficult to erase, even when we would much rather forget its
origin for our own peace of mind.
Joseph Conrad in 1924 commented: “In plucking the fruit of memory,
one runs the risk of spoiling its bloom.” Macbeth complained: “Canst
thou not minister to a mind diseased, Pluck from the memory a rooted
sorrow?” And Thomas De Quincey, in his ‘Confessions of an
Opium-eater’ (1822), lamented: “It is notorious that the
memory strengthens as you lay burdens upon it, and becomes trustworthy
as you trust it.” And although environment has scant effect upon
the power of remembering, mood at the time of initial stimulus is an
important factor in aiding or diminishing it. Thus, recollection of a
sensation may be a two-edged process, for good or ill.
In the New England Journal of Medicine for 17 February is a review article
on memory dysfunction, a phenomenon encountered in clinical medicine
as a feature of many pathological processes. These include neurodegenerative
diseases, strokes, tumours, trauma to the head, hypoxia, malnutrition,
attention-deficit disorder, depression and drug reactions, as well as
the normal ageing process.
Four memory systems of clinical significance are usually distinguished:
episodic memory, semantic memory, procedural memory, and working memory.
The first of these refers to the recall of personal experiences and depends
on activity in the medial temporal lobes of the brain. Recent events
are most susceptible, remote events most resistant. The left lobes are
most active when words are being learnt, the right lobes where vision
is concerned.
Semantic memory refers to the general store of conceptual and factual
knowledge of the individual. Alzheimer’s disease is the commonest
factor disrupting this. Semantic memory disorder is suspected when a
person finds difficulty in recalling a name previously known.
Procedural memory is concerned with the learning of behavioural and cognitive
skills which are used automatically and unconsciously. The most common
disorder affecting it is Parkinson’s disease and it is to be suspected
when previously learnt skills have been lost or there is serious impairment
of new learning ability.
Working memory, involving the ability to maintain and manipulate knowledge
temporarily for an immediate purpose, depends on a network of cortical
and subcortical impulses varying with the task. This may be impaired
in several conditions such as Alzheimer’s Parkinson’s and
Huntingdon’s diseases.
Memory cannot be regarded as a simple concept, but it is regulated by
a host of separate distinct neurological systems, of which several may
be impaired in neurodegenerative disorders.
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