the origin and nature of emotions-第5部分

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mation；　_e。　g_。；　in　the　training　of　athletes；　the　rhythmic　discharge　of　muscular　energy　at　such　intervals　that　the　resting　stage　is　not　reached　before　a　new　exercise　is　given　results　in　a　gradual　ascent　in　efficiency　until　the　maximum　is　reached。　　This　is　summation；　and　summation　plays　a　large　role　in　the　development　of　both　normal　and　pathologic　phenomena。

We　have　now　pointed　out　the　manner　in　which　at　least　a　part　of　the　nervous　energy　of　man　may　be　discharged。　The　integrative　action　of　the　nervous　system　and　the　discharge　of　nervous　energy　by　phylogenetic　association　may　be　illustrated　by　their　analogy　to　the　action　of　an　electric　automobile。　The　electric　automobile　is　composed　of　four　principal　parts：　The　motor　and　the　wheels　（the　muscular　system　and　the　skeleton）；　the　cells　of　the　battery　containing　stored　electricity　（brain…cells；　nervous　energy）；　the　controller；　which　is　connected　with　the　cells　by　wiring　（the　receptors　and　the　nerve…fibers）；　and　an　accelerator　for　increasing　the　electric　discharge　（thyroid　gland？）。　The　machine　is　so　constructed　that　it　acts　as　a　whole　for　the　accomplishment　of　a　single　purpose。　When　the　controller　is　adjusted　for　going　ahead　（adequate　stimulus　of　a　receptor）；　then　the　conducting　paths　（the　final　common　path）　for　the　accomplishment　of　that　purpose　are　all　open　to　the　flow　of　the　current　from　the　battery；　and　the　vehicle　is　integrated　to　go　ahead。　It　spends　its　energy　to　that　end　and　is　closed　to　all　other　impulses。　When　the　controller　is　set　for　reverse；　by　this　adequate　stimulus　the　machine　is　integrated　to　back；　and　the　battery　is　closed　to　all　other　impulses。　　Whether　integrated　for　going　forward　or　backward；　if　the　battery　be　discharged　at　a　proper　rate　until　exhausted；　the　cells；　though　possessing　no　more　power　（fatigue）；　have　sustained　no　further　impairment　of　their　elements　than　that　of　normal　wear　and　tear。　　Furthermore；　they　may　be　restored　to　normal　activity　by　recharging　（rest）。　If　the　vehicle　be　placed　against　a　stone　wall；　and　the　controller　be　placed　at　high…speed　（trauma　and　fear）；　and　if　the　accelerator　be　used　as　well　（thyroid　secretion？）；　though　the　machine　will　not　move；　not　only　will　the　battery　soon　be　exhausted；　but　the　battery　elements　themselves　will　be　seriously　damaged　（exhaustionsurgical　shock）。

We　have　now　presented　some　evidence　that　nervous　energy　is　discharged　by　the　adequate　stimulation　of　one　or　more　of　the　various　receptors　that　have　been　developed　in　the　course　of　evolution。　In　response　to　an　adequate　stimulus；　the　nervous　system　is　integrated　for　a　specific　purpose　by　the　stimulated　receptor；　and　but　one　stimulus　at　a　time　has　possession　of　the　final　common　path　the　nerve　mechanisms　for　action。　　The　most　numerous　receptors　are　those　for　harmful　contact；　these　are　the　nociceptors。　The　effect　of　the　adequate　stimulus　of　a　nociceptor　is　like　that　of　pressing　an　electric　button　that　sets　great　machinery　in　motion。

With　this　conception；　the　human　body　may　be　likened　to　a　musical　instrumentan　organthe　keyboard　of　which　is　composed　of　the　various　receptors；　upon　which　environment　plays　the　many　tunes　of　life；　and　written　within　ourselves　in　symbolic　language　is　the　history　of　our　evolution。　　The　skin　may　be　the　〃Rosetta　Stone〃　which　furnishes　the　key。


Anoci…association


By　the　law　of　phylogenetic　association；　we　are　now　prepared　to　make　a　practical　application　of　the　principles　of　the　discharge　of　nervous　energy。　　In　the　case　of　a　surgical　operation；　if　fear　be　excluded　and　if　the　nerve…paths　between　the　field　of　operation　and　the　brain　be　blocked　with　cocain；＇*＇　no　discharge　of　energy　will　be　caused　by　the　operation；　hence　no　shock；　no　exhaustion；　can　result。　Under　such　conditions　the　nervous　system　is　protected　against　noci…association；　resulting　from　noci…perception　or　from　an　adequate　stimulation　of　nociceptors。　　The　state　of　the　patient　in　whom　all　noci…associations　are　excluded　can　be　described　only　by　coining　a　new　word。　　That　word　is　〃anoci…association〃　（Fig。　14）。


＇*＇　See　footnote；　page　4。@@@


The　difference　between　anesthesia　and　anoci…association　is　that；　although　_inhalation　anesthesia_　confers　the　beneficent　loss　of　consciousness　and　freedom　from　pain；　it　does　not　prevent　the　nerve　impulses　from　reaching　and　influencing　the　brain；　and　therefore　does　not　prevent　surgical　shock　nor　the　train　of　later　nervous　impairments　so　well　described　by　Mumford。　　_Anoci…association_　excludes　fear；　pain；　shock；　and　postoperative　neuroses。　　_Anoci…association_　is　accomplished　by　combining　the　special　management　of　patients　（applied　psychology）；　morphin；　inhalation　anesthesia；　and　local　anesthesia。

We　have　now　presented　in　summary　much　of　the　mass　of　experimental　and　clinical　evidence　we　have　accumulated　in　support　of　our　principal　theme；　which　is　that　the　discharge　of　nervous　energy　is　accomplished　in　accordance　with　the　law　of　phylogenetic　association。　If　this　point　seems　to　have　been　emphasized　unduly；　it　is　because　we　expect　to　rear　upon　this　foundation　a　clinical　structure。　How　does　this　hypothesis　apply　to　surgical　operations？


Prevention　of　Shock　by　the　Application　of　the　Principle　of　Anoci…association



Upon　this　hypothesis　a　new　principle　in　operative　surgery　is　founded；　_i。　e_。；　operation　during　the　state　of　_anoci…association_。　Assuming　that　no　unfavorable　effect　is　produced　by　the　anesthetic　and　that　there　is　no　hemorrhage；　the　cells　of　the　brain　cannot　be　exhausted　in　the　course　of　a　surgical　operation　except　by　fear　or　by　trauma；　or　by　both。　Fear　may　be　excluded　by　narcotics　and　special　management　until　the　patient　is　rendered　unconscious　by　inhalation　anesthesia。　Then　if；　in　addition　to　inhalation　anesthesia；　the　nerve…paths　between　the　brain　and　the　field　of　operation　are　blocked　with　cocain；＇*＇　the　patient　will　be　placed　in　the　beneficent　state　of　_anoci…association_；　and　at　the　completion　of　the　operation　will　be　as　free　from　shock　as　at　the　beginning。　　In　so…called　〃fair　risks〃　such　precautions　may　not　be　necessary；　but　in　cases　handicapped　by　infections；　by　anemia；　by　previous　shock；　and　by　Graves'　disease；　etc。；　anoci…association　may　become　vitally　important。


＇*＇　See　footnote；　page　4。@@@


Graves'　Disease


By　applying　the　principle　of　the　discharge　of　nervous　energy　by　phylogenetic　association；　and　by　making　the　additional　hypothesis　that　in　the　discharge　of　nervous　energy　the　thyroid　gland　is　stimulated　through　the　nervous　system；　we　can　explain　many　of　the　phenomena　of　Graves'　disease　and　may　possibly　discover　some　of　the　factors　which　explain　both　its　genesis　and　its　cure。

In　the　wild　state　of　animal　life　in　which　only　the　fittest　survive　in　the　struggle　for　existence；　every　point　of　advantage　has　its　value。　　An　animal　engaged　in　battle　or　in　a　desperate　effort　to　escape　will　be　able　to　give　a　better　account　of　itself　if　it　have　some　means　of　accelerating　the　discharge　of　energy　some　influence　like　that　of　pouring　oil　upon　the　kindling　fire。　There　is　evidence；　though　perhaps　it　is　not　conclusive；　that　such　an　influence　is　exerted　by　the　thyroid　gland。　In　myxedema；　a　condition　characterized　by　a　lack　of　thyroid　secretion；　there　is　dulness　of　the　reflexes　and　of　the　intellect；　a　lowered　muscular　power；　and　generally　a　sluggish　discharge　of　energy。　In　Graves'　disease　there　is　an　excessive　production　of　thyroid　secretion。　In　this　disease　the　reflexes　are　increased；　the　discharge　of　energy　is　greatly　facilitated；　and　metabolism　is　at　a　maximum。　The　same　phenomena　occur　also　after　the　administration　of　thyroid　extract　in　large　doses　to　normal　subjects。　　In　the　course　of　sexual　activities　there　is　an　increased　action　of　the　thyroid；　which　is　indicated　by　an　increase　in　its　size　and　vascularity。　That　in　fear　and　in　injury　the　thyroid；　in　cases　of　Graves'　disease；　is　probably　stimulated　to　increased　activity　is　indicated　by　the　increased　activity　of　the　thyroid　circulation；　by　an　increase　in　the　size　of　the　gland；　by　the　histologic　appearance　of　activity　in　the　nuclei　of　the　cells；　and　by　an　increase　of　the　toxic　symptoms。　Finally；　Asher　has　stated　that　electric　stimulation　of　the　nerve　supply　of　the　thyroid　causes　an　increased　secretion。　　The　origin　of　many　cases　of　Graves'　disease　is　closely　associated　with　some　of　the　causes　of　the　discharge　of　nervous　energy；　depressive　influences　especially；　such　as　nervous　shocks；　worry　and　nervous　strain；　disappointment　in　love；　business　reverses；　illness　and　death　of　relatives　and　friends。　The　association　of　thyroid　activity　with　procreation　is　well　known；　hence　the　coincidence　of　a　strain　of　overwork　or　of　fear　with　the　sexual　development　of　maturing　girls　is　obviously　favorable　to　the　incidence　of　Graves'　disease。　　The　presence　of　a　colloid　goiter　is　a　suitable　soil　for　the　development　of　Graves'　disease；　and　I　fully　recognize　also　the　evidence　that　infection　or　auto…intoxication　may　be　contributing　factors　and　must　be　assigned　their　role。

I　have　never　known　a　case　of　Graves'　disease　to　be　caused　by　success　or　happiness　alone；　or　by　hard　physical　labor　unattended　by　psychic　strain；　or　to　be　the　result　of　energy　voluntarily　discharged。　Some　cases　seem　to　have　had　their　origin　in　overdosage　with　thyroid　extract　in　too　vigorous　an　attempt　to　cure　a　colloid　goiter。　One　of　the　most　striking　characteristics　of　Graves'　disease　is　the　patient's　loss　of　control　and　his　increased　susceptibility　to　stimuli；　especially　to　trauma　and　to　fear　and　to　the　administration　of　thyroid　extract。　　It　has　been　shown　that　the　various　causes　of　the　discharge　of　nervous　energy　produce　alterations　in　the　nervous　system　and　probably　in　the　thyroid　gland。　　This　is　especially　true　of　the　fear　stimulus；　and　has　been　clearly　demonstrated　in　the　brains　of　rabbits　which　had　been　subjected　to　fear　alone　（Fig。　13）。　Of　special　interest　was　the　effect　of　daily　fright。　In　this　case　the　brain…cells　showed　a　distinct　change；　although　the　animal　had　been　subjected　to　no　fear　for　twenty…four　hours　before　it　was　killed　（Fig。　13　C。　Now；　a　great　distinction　between　man　and　the　lower　animals　is　the　greater　control　man　has　acquired　over　his　actions。　This　quality　of　control；　having　been　phylogenetically　most　recently　acquired；　is　the　most　vulnerable　to　various　NOCUOUS　influences。　The　result　of　a　constant　noci…integ