the origin and nature of emotions-第29节

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in　severe　cases　there　is　daily　fever。　In　fact；　in　Graves'　disease　we　find　displayed　to　an　extraordinary　degree　an　exaggeration　of　the　whole　action　of　the　kinetic　mechanism。

We　have　stated　that　in　acute　Graves'　disease　there　is　a　tendency　to　the　production　of　spontaneous　fever；　and　that　there　is　a　magnified　diurnal　variation　in　temperature　which　is　due　to　an　increased　output　of　energy　in　even　the　normal　reaction　producing　consciousness。　　In　Graves'　disease　there　is；　therefore；　a　state　of　intensified　consciousness；　which　is　associated　with　low　brain　thresholds　to　all　stimuliboth　to　stimuli　that　cause　muscular　action　and　to　stimuli　that　cause　fever。　　The　intensity　of　the　kinetic　discharge　is　seen　in　the　constant　fine　tremor。　It　is　evident　that　the　thresholds　of　the　brain　have　been　sensitized。　In　this　hypersensitization　we　find　the　following　strong　evidence　as　to　the　identity　of　the　various　mechanisms　for　the　production　of　fever。　In　the　state　of　superlative　sensitization　which　is　seen　in　Graves'　disease　we　find　that　the　stimuli　that　produce　muscular　movement；　the　stimuli　that　produce　emotional　phenomena；　and　the　stimuli　that　produce　fever　are　as　nearly　as　can　be　ascertained　equally　effective。　Clinical　evidence　regarding　this　point　is　abundant；　for　in　patients　with　Graves'　disease　we　find　that　the　three　types　of　conversion　of　energy　resulting　from　emotional　stimulation；　from　infection　stimulation；　and　from　nociceptor　stimulation　（pain）；　are；　as　nearly　as　can　be　judged；　equally　exaggerated。　In　the　acute　cases　of　Graves'　disease　the　explosive　conversion　of　latent　energy　into　heat　and　motion　is　unexcelled　by　any　other　known　normal　or　pathologic　phenomenon。　　Excessive　thyroid　secretion；　as　in　thyrotoxicosis　from　functioning　adenomata；　and　excessive　thyroid　feeding；　cause　all　the　phenomena　of　Graves'　disease　except　the　exophthalmos　and　the　emotional　facies　（Figs。　15　and　23）。　The　ligation　of　arteries；　the　division　of　its　nerve　supply；　or　the　excision　of　part　of　the　gland；　may　reverse　the　foregoing　picture　and　restore　the　normal　condition。　　The　patient　notes　the　effect　on　the　second　day　and　often　within　a　week　is　relatively　quiescent。　On　the　contrary；　if　there　is　thyroid　deficiency　there　results　the　opposite　state；　a　reptilian　sluggishness。

At　will；　then；　through　diminished；　normal；　or　excessive　administration　of　thyroid　secretion；　we　may　produce　an　adynamic；　a　normal；　or　an　excessively　dynamic　state。　　By　the　thyroid　influence；　the　brain　thresholds　are　lowered　and　life　becomes　exquisite；　without　its　influence　the　brain　becomes　a　globe　of　relatively　inert　substance。　　Excessive　doses　of　iodin　alone　cause　most　of　the　symptoms　of　Graves'　disease。　　As　we　have　stated；　the　active　constituent　of　the　thyroid　is　iodin　in　a　special　protein　combination　which　is　stored　in　the　colloidal　spaces。　Hence　one　would　not　expect　to　find　changes　in　the　cells　of　the　thyroid　gland　as　a　result　of　increased　activity　unless　it　be　prolonged。

We　have　thus　far　considered　the　normal　roles　played　by　the　brain；　the　adrenals　the　liver；　the　muscles；　and　the　thyroid　in　transforming　latent　into　kinetic　energy　in　the　form　of　heat　and　motion　as　an　adaptive　response　to　environmental　stimuli。

The　argument　may　be　strengthened；　however；　by　the　discussion　of　the　effect　of　the　impairment　of　any　of　these　links　in　the　kinetic　chain　upon　the　conversion　of　latent　into　kinetic　energy。


Effect　Upon　the　Output　of　Energy　of　Impaired　or　Lost　Function　of　Each　of　the　Several　Links　in　the　Kinetic　Chain

（1）　_The　Brain_。In　cerebral　softening　we　may　find　all　the　organs　of　the　body　comparatively　healthy　excepting　the　brain。　As　the　brain　is　physically　impaired　it　cannot　normally　stimulate　other　organs　to　the　conversion　of　latent　energy　into　heat　or　into　motion；　but；　on　the　contrary；　in　these　cases　we　find　feeble　muscular　and　intellectual　power。　　I　believe　also　that　in　patients　with　cerebral　softening；　infections　such　as　pneumonia　show　a　lower　temperature　range　than　in　patients　whose　brains　are　normal。

（2）　_The　Adrenals_。In　such　destructive　lesions　of　the　adrenals　as　Addison's　disease　one　of　the　cardinal　symptoms　is　a　subnormal　temperature　and　impaired　muscular　power。　　Animals　upon　whom　double　adrenalectomy　has　been　performed　show　a　striking　fall　in　temperature；　muscular　weakness；after　adrenalectomy　the　animal　may　not　be　able　to　stand　even；and　progressive　chromatolysis。

（3）　_The　Liver_。When　the　function　of　the　liver　is　impaired　by　tumors；　cirrhosis；　or　degeneration　of　the　liver　itself；　then　the　entire　energy　of　the　body　is　correspondingly　diminished。　This　diminution　of　energy　is　evidenced　by　muscular　and　mental　weakness；　by　diminished　response　and　by　gradual　loss　of　efficiency　which　finally　reaches　the　state　of　asthenia。

（4）　_The　Muscles_。It　has　been　observed　clinically　that　if　the　muscles　are　impaired　by　long　disuse；　or　by　a　disease　such　as　myasthenia　gravis；　then　the　range　of　production　of　both　heat　and　motion　is　below　normal。　This　is　in　agreement　with　the　experimental　findings　that　anesthetics；　curare；　or　any　break　in　the　muscle…brain　connection　causes　diminished　muscular　and　heat　production。

（5）　_The　Thyroid_。In　myxedema　one　of　the　cardinal　symptoms　is　a　persistently　subnormal　temperature　and；　though　prone　to　infection；　subjects　of　myxedema　show　but　feeble　febrile　response　and　readily　succumb。　　This　clinical　observation　is　strikingly　confirmed　by　laboratory　observations；　normal　rabbits　subjected　to　fear　showed　a　rise　in　temperature　of　from　one　to　three　degrees；　while　two　rabbits　whose　thyroids　had　been　previously　removed　and　who　had　then　been　subjected　to　fright　showed　much　less　febrile　response。　Myxedema　subjects　show　a　loss　of　physical　and　mental　energy　which　is　proportional　to　the　lack　of　thyroid。　　Deficiency　in　any　of　the　organs　of　the　kinetic　chain　causes　alike　loss　of　heat；　loss　of　muscular　and　emotional　action；　of　mental　power；　and　of　the　power　of　combating　infectionsthe　negative　evidence　thus　strongly　supports　the　positive。　　By　accumulating　all　the　evidence　we　believe　we　are　justified　in　associating　the　brain；　the　adrenals；　the　thyroid；　the　muscles；　and　the　liver　as　vital　links　in　the　kinetic　chain。　Other　organs　play　a　role　undoubtedly；　though　a　minor　one。


Studies　in　Hydrogen　Ion　Concentration　in　Activation　of　the　Kinetic　System

Having　established　the　identity　of　some；　at　least；　of　the　organs　which　constitute　the　kinetic　chain；　we　endeavored　to　secure　still　further　evidence　regarding　the　energy…transforming　function　of　these　organs　by　making　studies　of　the　H…ion　concentration　of　the　blood；　as　one　would　expect；　_prima　facie_；　that　the　normal　reaction　would　be　altered　by　kinetic　activation。＇*＇


＇*＇　The　H…ion　observations　were　made　in　my　laboratory　by　Dr。　M。　L。　Menten。


H…ion　concentration　tests　were　made　after　the　application　of　the　adequate　stimuli　by　which　the　function　of　the　kinetic　organs　had　been　determined；　and　we　studied　also　the　effect　upon　the　acidity　of　the　blood　of　strychnin　convulsions　after　destruction　of　the　medulla；　of　deep　narcotization　with　morphin　before　anesthesia；　of　deep　narcotization　with　morphin　after　the　H…ion　concentration　had　already　been　increased　by　fear；　by　anger；　by　exertion；　by　injury　under　anesthesia；　or　by　anesthesia　alone。

The　complete　data　of　these　experiments　will　be　later　reported　in　a　monograph；　here　it　is　sufficient　to　state　that　anger；　fear；　injury；　muscular　exertion；　inhalation　anesthesia；　strychnin；　alcohol；　in　fact；　all　the　stimuli　which　we　had　already　found　to　produce　histologic　changes　in　the　brain；　the　adrenals；　and　the　liver…excepting　bacterial　toxinscaused　increased　H…ion　concentration。　Of　striking　significance　is　the　fact　that　morphin　alone　caused　no　change　in　the　H…ion　concentration；　while　if　administered　before　the　application　of　a　stimulus　which　by　itself　produced　increased　H…ion　concentration；　the　action　of　that　stimulus　was　neutralized　or　postponed。　　If；　however；　morphin　was　administered　after　increased　acidity　had　been　produced　by　any　stimulus；　or　by　inhalation　anesthesia；　then　the　time　required　for　the　restoration　of　the　normal　alkalinity　was　much　prolonged；　and　in　some　instances　the　power　of　acid　neutralization　was　permanently　lost。

After　excision　of　the　liver；　the　normal　H…ion　concentration　was　maintained　for　periods　varying　from　one　to　several　hours；　after　which　the　concentration　（acidity）　began　to　increase　as　the　vitality　of　the　animal　began　to　decline；　the　concentration　（acidity）　increasing　rapidly　until　death。　　After　excision　of　the　adrenals　the　blood　remained　normal　for　from　four　to　six　hours；　when　the　H…ion　concentration　increased　rather　suddenly；　the　increase　being　synchronous　with　the　incidence　of　the　phenomena　which　immediately　preceded　death。

In　none　of　these　cases　was　it　determined　whether　the　increased　H…ion　concentration　was　due　to　other　causes　of　death　or　whether　death　was　due　to　the　increased　acidity。

It　is　also　significant　that　after　the　application　of　each　of　the　adequate　stimuli　which　increased　the　H…ion　concentration　of　the　blood　in　other　parts　of　the　body　the　blood　from　the　adrenal　vein　showed　a　slight　diminution　in　acidity；　as；　in　most　instances；　did　the　blood　from　the　hepatic　vein　also。

In　fact；　the　H…ion　concentration　of　the　blood　in　the　adrenal　vein　was　less　tha