the origin and nature of emotions-第7部分

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ny　other　pathologic　phenomena　may　be　explained　in　a　similar　manner。　Thus　we　can　understand　the　variations　in　the　gastric　analyses　in　a　timid　patient　alarmed　over　his　condition　and　afraid　of　the　hospital。　He　is　integrated　by　fear；　and　as　fear　takes　precedence　over　all　other　impulses；　no　organ　functionates　normally。　　For　the　same　reason；　one　sees　animals　in　captivity　pine　away　under　the　dominance　of　fear。　The　exposure　of　a　sensitive　brain　to　the　naked　possibility　of　death　from　a　surgical　operation　may　be　compared　to　uncovering　a　photographic　plate　in　the　bright　sunlight　to　inspect　it　before　putting　it　in　the　camera。　This　principle　explains；　too；　the　physical　influence　of　the　physician　or　surgeon；　who；　by　his　PERSONALITY；　inspires；　like　a　Kocher；　absolute　confidence　in　his　patient。　　The　brain；　through　its　power　of　phylogenetic　association；　controls　many　processes　that　have　wholly　escaped　from　the　notice　of　the　〃practical　man。〃　　It　is　in　accordance　with　the　law　of　association　that　a　flower；　a　word；　a　touch；　a　cool　breeze；　or　even　the　thought　of　a　fishing　rod　or　of　a　gun；　is　helpful。　On　the　contrary；　all　suggestions　of　despair　or　misfortune　a　corrugated　brow；　the　gloomy　silence　of　despair；　or　a　doubtful　word　are　equally　depressing。　　In　like　manner；　one　could　add　many　illustrations　of　the　symbolism　that　governs　our　daily　lives。　Thus　we　see　that　through　the　laws　of　inheritance　and　noci…association；　we　are　able　to　read　a　new　meaning　into　the　clinical　phenomena　of　various　diseases。


Observations　on　Patients　whose　Associational　Centers　are　Dulled；　and　on　Diseases　and　Injuries　of　Regions　not　Endowed　with　Nociceptors


Reversing　the　order　of　our　reasoning；　let　us　now　glance　at　the　patient　who　is　unconscious　and　who；　therefore；　has　lost　much　of　the　power　of　association。　　His　mouth　is　usually　dry；　the　digestive　processes　are　at　a　low　ebb；　the　aroma　of　food　causes　no　secretion　of　saliva；　tickling　the　nose　causes　no　sneezing；　he　catches　no　cold。　The　laryngeal　reflex　is　lost　and　food　may　be　quietly　inhaled；　the　entire　process　of　metabolism　is　low。　　The　contrast　between　a　man　whose　associational　centers　are　keen　and　a　man　in　whom　these　centers　are　dulled　or　lost　is　the　contrast　between　life　and　death。

In　accordance　with　the　law　of　adaptation　through　natural　selection；　phylogeny；　and　association；　one　would　expect　no　pain　in　abscess　of　the　brain；　in　abscess　of　the　liver；　in　pylephlebitis；　in　infection　of　the　hepatic　vessels；　in　endocarditis。　This　law　explains　why　there　are　no　nociceptors　for　cancer；　while　there　are　active　nociceptors　for　the　acute　infections。　It　is　because　nature　has　no　helpful　response　to　offer　against　cancer；　while　in　certain　of　the　acute　pyogenic　infections　the　nociceptors　force　the　beneficent　physiologic　rest。

Could　we　dispossess　ourselves　of　the　shackles　of　psychology；　forget　its　confusing　nomenclature；　and　view　the　human　brain；　as　Sherrington　has　said；　〃as　the　organ　of；　and　for　the　adaptation　of　nervous　reaction；〃　many　clinical　phenomena　would　appear　in　a　clearer　light。


Natural　Selection　and　Chemical　Noci…association　in　the　Infections


Thus　far　we　have　considered　the　behavior　of　the　individual　as　a　whole　in　his　response　to　a　certain　type　of　noci…influences。　We　have　been　voicing　our　argument　in　terms　of　physical　escape　from　GROSS　physical　dangers；　or　of　grappling　with　GROSS　NERVE…MUSCULAR　enemies　of　the　same　or　of　other　species。　　To　explain　these　phenomena　we　have　invoked　the　aid　of　the　laws　of　natural　selection　and　phylogenetic　association。　If　our　conclusions　be　correct；　then　it　should　follow　that　in　the　same　laws　we　may　find　the　explanation　of　immunity；　which；　of　course；　means　a　defensive　response　to　our　MICROSCOPIC　enemies。　　There　should　be　no　more　difficulty　in　evolving　an　efficient　army　of　phagocytes　by　natural　selection；　or　in　developing　specific　chemical　reactions　against　_*microscopic　enemies_；　than　there　was　in　evolving　the　various　nociceptors　for　our　nerve…muscular　defense　against　our　_*gross　enemies_。　That　immunity　is　a　chemical　reaction　is　no　argument　against　the　application　of　the　law　of　natural　selection　or　of　association。　What　essential　difference　is　there　between　the　chemical　defense　of　the　skunk　against　its　NERVE…MUSCULAR　enemies　and　its　chemical　defense　（immunity）　against　its　MICROSCOPIC　ENEMIES？

The　administration　of　vaccines　becomes　the　adequate　stimulus　which　awakens　phylogenetic　association　of　a　chemical　nature　as　a　result　of　which　immune　bodies　are　produced。

In　discussing　this　subject　I　will　raise　only　the　question　whether　or　not　the　specific　character　of　the　inaugural　symptoms　of　some　infectious　diseases　may　be　due　to　phylogenetic　association。　These　inaugural　symptoms　are　measurably　a　recapitulation　of　the　leading　phenomena　of　the　disease　in　its　completed　clinical　picture。　Thus；　the　furious　initiative　symptoms　of　pneumonia；　of　peritonitis；　or　erysipelas；　of　the　exanthemata；　are　exaggerations　of　phenomena　which　are　analogous　to　the　phenomena　accompanying　physical　injury　and　fear　of　physical　violence。　　Just　as　the　acute　phenomena　of　fear；　or　those　which　accompany　the　adequate　stimulation　of　nociceptors；　are　recapitulations　of　phylogenetic　struggles；　so　may　the　inaugural　symptoms　of　an　infection　be　a　similar　phylogenetic　recapitulation　of　the　course　of　the　disease。　　A　certain　amount　of　negative　evidence　is　supplied　by　a　comparison　of　the　response　to　a　dose　of　toxins　with　the　response　to　a　dose　of　a　standard　drug。　No　drug　in　therapeutic　dosage　except　the　iodin　compounds　causes　a　febrile　response；　no　drug　causes　a　chill；　on　the　other　hand；　all　specific　toxins　cause　febrile　responses　and　many　cause　chills。　If　a　species　of　animal　had　been　poisoned　by　a　drug　during　vast　periods　of　time；　and　if　natural　selection　had　successfully　established　a　self…defensive　response；　then　the　administration　of　that　drug　would　cause　a　noci…association　（chemical）；　and　a　specific　reaction　analogous　to　that　following　the　administration　of　Coley's　toxins　might　be　expected。　Bacterial　noci…association　probably　operates　through　the　same　law　as　that　through　which　physical　noci…association　operates。　Natural　selection　is　impartial；　however。　　It　must　be　supposed　that　it　acts　impartially　upon　the　microscopic　invader　and　upon　the　host。　On　this　ground　one　must　infer　that；　in　accordance　with　the　same　law　of　natural　selection；　the　bacteria　of　acute　infections　have　met　by　natural　selection　each　advance　in　the　struggle　of　the　host　for　immunity。　　Hence　the　fast　and　furious　struggle　between　man　and　his　microscopic　enemies　merely　indicates　to　what　extent　natural　selection　has　developed　the　ATTACK　and　the　DEFENSE　respectively。　This　struggle　is　analogous　to　the　quick　and　decisive　battles　of　the　carnivora　when　fighting　among　themselves　or　when　contending　against　their　ancient　enemies。　　But　when　phylogenetically　strange　animals　meet　each　other；　they　do　not　understand　how　to　conduct　a　fight：　natural　selection　has　not　had　the　opportunity　of　teaching　them。　The　acute　infections　have　the　characteristics　of　being　ancient　enemies。　On　this　hypothesis　one　can　understand　the　high　mortality　of　measles　when　it　is　introduced　into　a　new　country。　　By　natural　selection；　measles　has　become　a　powerful　enemy　of　the　human　race；　and　a　race　to　which　this　infection　is　newly　introduced　has　not　had　the　advantage　of　building　up　a　defense　against　it　by　the　law　of　natural　selection。　May　not　the　phenomena　of　anaphylaxis　be　studied　on　associational　lines？　Then；　too；　there　may　be　chemical　noci…associations　with　enemies　now　extinct；　which；　like　the　ticklish　points；　may　still　be　active　on　adequate　stimulation。　　This　brief　reference　to　the　possible　relation　of　the　phenomena　of　the　acute　infections　to　the　laws　of　natural　selection　and　of　specific　chemical　noci…association　has　been　made　as　a　suggestion。　　Since　the　doctrine　of　evolution　explains　all　or　nothing；　I　have　included　many　phenomena　to　see　how　reasonable　or　unreasonable　such　an　explanation　might　be。


Recapitulation


The　following　are　the　principal　points　presented：　　In　operations　under　inhalation　anesthesia　the　nerve　impulses　from　the　trauma　reach　every　part　of　the　brainthe　cerebrum　that　is　apparently　anesthetized　as　well　as　the　medulla　that　is　known　to　remain　awake　the　proof　being　the　PHYSIOLOGIC　exhaustion　of　and　the　PATHOLOGIC　change　in　the　nerve…cells。　Under　ether　anesthesia　the　damage　to　the　nerve…cells　is　at　least　four　times　greater　than　under　nitrous　oxid。　　Inhalation　anesthesia　is；　therefore；　but　a　veneer　a　mask　that　〃covers　the　deep　suffering　of　the　patient。〃　　The　cause　of　the　exhaustion　of　the　brain　is　the　discharge　of　nervous　energy　in　a　futile　effort　to　energize　the　paralyzed　muscles　in　an　attempt　to　escape　from　the　injury　just　as　if　no　anesthetic　had　been　given。　The　exhaustion　is；　therefore；　of　the　same　nature　as　that　from　overexertion；　but　if　the　nerve…paths　connecting　the　field　of　operation　and　the　brain　be　blocked；　then　there　is　no　discharge　of　nervous　energy　from　the　trauma；　and　consequently　there　is　no　exhaustion；　however　severe　or　prolonged　the　operation　may　be。

Fear　is　a　factor　in　many　injuries　and　operations。　　The　phenomena　of　fear　probably　are　exhibited　only　by　animals　whose　natural　defense　is　nerve…muscular。　The　skunk；　the　porcupine；　the　turtle；　have　little　or　no　fear。　　Fear　is　born　of　the　innumerable　injuries　which　have　been　inflicted　in　the　course　of　evolution。　　Fear；　like　trauma；　may　cause　physiologic　exhaustion　of　and　morphologic　changes　in　the　brain…cells。　The　representation　of　injury；　which　is　fear；　being　elicited　by　phylogenetic　association；　may　be　prevented　by　the　exclusion　of　the　noci…association　or　by　the　administration　of　drugs　like　morphin　and　scopolamin；　which　so　impair　the　associational　function　of　the　brain…cells　that　immunity　to　fear　is　established。　Animals　whose　natural　defense　is　in　muscular　exertion；　among　which　is　man；　may　have　their　dischargeable　nervous　energy　exhausted　by　fear　alone；　or　by　trauma　alone；　but　most　effectively　by　the　combination　of　both。　What　is　the　mechanism　of　this　discharge　of　energy？　　It　is　the　adequate　stimulation　of　the　nociceptors　and　the　physiologic　response　for　the　purpose　of　self…preservation。　According　to　Sherrington；　the　nervous　system　responds　in　action　as　a　whole　and　to　but　one　stimulus　at　a　time。　The　integration　of　the　individual　as