the origin and nature of emotions-第24节

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We　know　that　a　deficiency　or　lack　of　thyroid　secretion　will　inhibit　sexual　emotion　and　conception；　will　produce　stupidity　and　inertia；　will　diminish　vitality。　　On　the　other　hand；　excessive　thyroid　secretion　drives　the　entire　mechanism　at　top　speed；　the　emotions　are　intensified；　the　skin　becomes　soft　and　moist；　the　eyes　are　brilliant　and　staring；　the　limbs　tremble；　the　heart　pounds　loudly　and　its　pulsations　often　are　visible；　the　respiration　is　rapid；　the　stimulation　of　the　fear　mechanism　causes　the　eyes　to　protrude　（Fig。　16）；　the　temperature　mounts　at　every　slight　provoca…tion　and　may　reach　the　incredible　height　of　110'0　even。　　In　time；　the　entire　organism　is　destroyed　literally　consumedby　the　concentration　of　dynamic　energy。　It　is　interesting　to　note　that　in　these　patients　emotion　gains　complete　possession　of　the　final　common　path；　they　are　wild　and　delirious　but　they　never　have　pain。

All　the　diseases　caused　by　excessive　motor　activity　may　be　called　kinetic　diseases。　　Against　the　conditions　in　life　which　produce　them　man　reacts　in　various　ways。　　He　intro…


｛illust。　caption　=　FIG。　　51。CROSS…COUNTRY　RACE。　　Winner　of　six…mile　cross…country　race　showing　typical　expression　of　exhaustion。　（Copyright　by　Underwood　and　Underwood；　N。　Y。）　duces　restful　variety　into　his　life　by　hunting　and　fishing；　by　playing　golf　and　tennis；　by　horseback　riding；　by　cultivating　hobbies　which　effectually。　turn　the　current　of　his　thoughts｛illust。　caption　=　FIG。　　52。｛A　B　and　C｝　from　the　consuming　stress　and　strain　of　his　business　or　professional　life。　　These　diversions　are　all　rational　attempts　to　relieve　tension　by　self…preservative　reactions。　For　the　same　reason　man　attempts　to　relieve　the　strain　of　contention　with　his　fellow…man　by　unions；　trusts；　corporations。　In　spite　of　all　efforts；　however；　many　constitutions　are　still　broken　daily　in　the　fierce　conflicts　of　competition。　We　know　how　often　the　overdriven　individual　endeavors　to　minimize　the　activities　of　his　motor　mechanism　by　the　use　of　agents　which　diminish　brain　activity；　such　as　alcohol；　tobacco；　and　various　narcotics。　Occasionally　also；　some　person；　who　can　find　no　respite　from　his　own　relentless　energies；　seeks　relief　in　oblivion　by　suicide。

Most　fortunately；　two　fundamental　instinctsself…preservation　and　the　propagation　of　the　speciesact　powerfully　to　prevent　this　last　fatal　result；　and　instead　the　harassed　individual　seeks　from　others　the　aid　which　is　lacking　within　himself。　He　may　turn　to　the　priest　who　seeks　and　often　secures　the　final　common　path　for　faith　in　an　over…ruling　Providence；　a　faith　which　in　many　incontrovertible　instances　has　proved　sufficient　in　very　truth　to　move　mountains　of　lesser　stimuli；　or　he　turns　to　a　physician；　who　too　often　treats　the　final　outcome　of　the　hyperactivity　only。　The　physician　who　accepts　the　theory　of　the　kinetic　diseases；　however；　will　not　only　repair　as　far　as　he　may　the　lesions　caused　by　the　disordered　and　forced　activities；　but　will；　by　compelling　and　forceful　suggestion；　secure　the　final　common　path　for　right　conduct；　that　is；　for　a　self…　and　species…preservative　course　of　action　as　opposed　to　wrong　conduct…a　self…　and　species…destructive　course　of　action。

By　forcefully　imparting　to　his　patient　the　knowledge　of　the　far…reaching　effects　of　protracted　emotional　strain；　of　overwork；　and　of　worry；　the　physician　will　automatically　raise　his　threshold　to　the　damaging　activating　stimuli　which　have　produced　the　evil　results。　Even　though　some　parts　of　his　organism　may　have　been　permanently　disabled；　a　patient　thus　protected　may　yet　rise　to　a　plane　of　poise　and　efficiency　far　above　that　of　his　uncontrolled　fellows。

In　extreme　cases　it　does　not　seem　unreasonable　to　believe　that　the　uncontrolled　patient　might　be　rescued　by　the　same　principle　which　has　proved　effective　in　saving　patients　from　the　emotional　and　traumatic　strain　of　surgical　operationsthe　principle　of　anoci…association。　That　is；　by　disconnecting　one　or　more　of　the　activating　organs　from　the　brain；　the　motor　mechanism　might　be　saved　from　its　self…destruction。

Under　this　hypothesis；　that　man　in　disease；　as　in　health；　is　the　product　of　his　phylogeny　as　well　as　of　ontogeny；　the　sphere　of　the　physician's　activities　takes　on　new　aspects　of　far…reaching　and　inspiring　significance。　　Prognosis　will　become　definite　in　proportion　to　the　physician's　knowledge　not　only　of　the　ontogenetic　history　of　the　individual　patient；　but　also　of　the　phylogenetic　history　of　the　race。　As　that　knowledge　increases；　as　he　appreciates　more　and　more　keenly　the　significance　of　environment　in　its　effect　upon　individual　development；　in　so　far　will　the　physician　be　in　a　position　to　contribute　mightily　to　the　welfare　of　the　race。



THE　KINETIC　SYSTEM＇*＇


＇*＇　Address　delivered　before　the　New　York　State　Medical　Society；　April　28；　1914；　to　which　has　been　added　a　further　note　regarding　studies　of　hydrogen　ion　concentration　in　the　blood。


In　this　paper　I　formulate　a　theory　which　I　hope　will　harmonize　a　large　number　of　clinical　and　experimental　data；　supply　an　interpretation　of　certain　diseases；　and　show　by　what　means　many　diverse　causes　produce　the　same　end　effects。

Even　should　the　theory　prove　ultimately　to　be　true；　it　will　in　the　mean　time　doubtless　be　subjected　to　many　alterations。　　The　specialized　laboratory　worker　will；　at　first；　fail　to　see　the　broader　clinical　view；　and　the　trained　clinician　may　hesitate　to　accept　the　laboratory　findings。　Our　viewpoint　has　been　gained　from　a　consideration　of　both　lines　of　evidence　on　rather　a　large　scale。

The　responsibility　for　the　kinetic　theory　is　assumed　by　myself；　while　the　responsibility　for　the　experimental　data　is　shared　fully　by　my　associates；　Dr。　J。　B。　Austin；　Dr。　F。　W。　Hitchings；　Dr。　H。　G。　Sloan；　and　Dr。　M。　L。　Menten。＇t＇


＇t＇　From　H。　K。　Cushing　Laboratory　of　Experimental　Medicine；　Western　Reserve　University；　Cleveland。


Introduction

The　self…preservation　of　man　and　kindred　animals　is　effected　through　mechanisms　which　transform　latent　energy　into　kinetic　energy　to　accomplish　adaptive　ends。　　Man　appropriates　from　environment　the　energy　he　requires　in　the　form　of　crude　food　which　is　refined　by　the　digestive　system；　oxygen　is　taken　to　the　blood　and　carbon　dioxid　is　taken　from　the　blood　by　the　respiratory　system；　to　and　from　the　myriads　of　working　cells　of　the　body；　food　and　oxygen　and　waste　are　carried　by　the　circulatory　system；　the　body　is　cleared　of　waste　by　the　urinary　system；　procreation　is　accomplished　through　the　genital　system；　but　none　of　these　systems　was　evolved　primarily　for　the　purpose　of　transforming　potential　energy　into　kinetic　energy　for　specific　ends。　　Each　system　transforms　such　amounts　of　potential　into　kinetic　energy　as　are　required　to　perform　its　specific　work；　but　no　one　of　them　transforms　latent　into　kinetic　energy　for　the　purposes　of　escaping；　fighting；　pursuing；　nor　for　combating　infection。　The　stomach；　the　kidneys；　the　lungs；　the　heart　strike　no　physical　blow…their　role　is　to　do　certain　work　to　the　end　that　the　blow　may　be　struck　by　another　system　evolved　for　that　purpose。　　I　propose　to　offer　evidence　that　there　is　in　the　body　a　system　evolved　primarily　for　the　transformation　of　latent　energy　into　motion　and　into　heat。　This　system　I　propose　to　designate　〃The　Kinetic　System。〃

The　kinetic　system　does　not　directly　circulate　the　blood；　nor　does　it　exchange　oxygen　and　carbon　dioxid；　nor　does　it　perform　the　functions　of　digestion；　urinary　elimination；　and　procreation；　but　though　the　kinetic　system　does　not　directly　perform　these　functions；　it　does　play　indirectly　an　important　role　in　each；　just　as　the　kinetic　system　itself　is　aided　indirectly　by　the　other　systems。

The　principal　organs　which　comprise　the　kinetic　system　are　the　brain；　the　thyroid；　the　adrenals；　the　liver；　and　the　muscles。　The　brain　is　the　great　central　battery　which　drives　the　body；　the　thyroid　governs　the　conditions　favoring　tissue　oxidation；　the　adrenals　govern　immediate　oxidation　processes；　the　liver　fabricates　and　stores　glycogen；　and　the　muscles　are　the　great　converters　of　latent　energy　into　heat　and　motion。

Adrenalin　alone；　thyroid　extract　alone；　brain　activity　alone；　and　muscular　activity　alone　are　capable　of　causing　the　body　temperature　to　rise　above　the　normal。　　The　functional　activity　of　no　other　gland　of　the　body　alone；　and　the　secretion　of　no　other　gland　alone；　can　cause　a　comparable　rise　in　body　temperaturethat　is；　neither　increased　functional　activity　nor　any　active　principle　derived　from　the　kidney；　the　liver；　the　stomach；　the　pancreas；　the　hypophysis；　the　parathyroids；　the　spleen；　the　intestines；　the　thymus；　the　lymphatic　glands；　or　the　bones　can；　_per　se_；　cause　a　rise　in　the　general　body　temperature　comparable　to　the　rise　that　may　be　caused　by　the　activity　of　the　brain　or　the　muscles；　or　by　the　injection　of　adrenalin　or　thyroid　extract。　　Then；　too；　when　the　brain；　the　thyroid；　the　adrenals；　the　liver；　or　the　muscles　are　eliminated；　the　power　of　the　body　to　convert　latent　into　kinetic　energy　is　impaired　or　lost。　I　shall　offer　evidence　tending　to　show　that　an　excess　of　either　internal　or　external　environmental　stimuli　may　modify　one　or　more　organs　of　the　kinetic　system；　and　that　this　modification　may　cause　certain　diseases。　　For　example；　alteratio