the origin and nature of emotions-第30节

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hepatic　vein　also。

In　fact；　the　H…ion　concentration　of　the　blood　in　the　adrenal　vein　was　less　than　in　the　blood　of　any　other　part　of　the　circulation。


Kinetic　Diseases

If　our　conclusions　are　sound；　then　in　the　kinetic　system　we　find　an　explanation　of　many　diseases；　and　having　found　the　explanation；　we　may　find　new　methods　of　combating　them。

When　the　kinetic　system　is　driven　at　an　overwhelming　rate　of　speed；　as　by　severe　physical　injury；　by　intense　emotional　excitation；　by　perforation　of　the　intestines；　by　the　pointing　of　an　abscess　into　new　territory；　by　the　sudden　onset　of　an　infectious　disease；　by　an　overdose　of　strychnin；　by　a　Marathon　race；　by　a　grilling　fight；　by　foreign　proteins；　by　anaphylaxis；the　result　of　these　acute　overwhelming　activations　of　the　kinetic　system　is　clinically　designated　shock；　and　according　to　the　cause　is　called　traumatic　shock；　toxic　shock；　anaphylactic　shock；　drug　shock；　etc。

The　essential　pathology　of　shock　is　identical　whatever　the　cause。　If；　however；　instead　of　an　intense　overwhelming　activation；　the　kinetic　system　is　continuously　or　intermittently　overstimulated　through　a　considerable　period　of　time；　as　long　as　each　of　the　links　in　the　kinetic　chain　takes　the　strain　equally　the　result　will　be　excessive　energy　conversion；　excessive　work　done；　but　usually；　under　stress；　some　one　link　in　the　chain　is　unable　to　take　the　strain　and　then　the　evenly　balanced　work　of　the　several　organs　of　the　kinetic　system　is　disturbed。　　If　the　brain　cannot　endure　the　strain；　then　neurasthenia；　nerve　exhaustion；　or　even　insanity　follows。　If　the　thyroid　cannot　endure　the　strain；　it　undergoes　hyperplasia；　which　in　turn　may　result　in　a　colloid　goiter　or　in　exophthalmic　goiter。　If　the　adrenals　cannot　endure　the　strain；　cardiovascular　disease　may　develop。　　If　the　liver　cannot　take　the　strain；　then　death　from　acute　acidosis　may　follow；　or　if　the　neutralizing　effect　of　the　liver　is　only　partially　lost；　then　the　acidity　may　cause　Bright's　disease。　Overactivation　of　the　kinetic　system　may　cause　glycosuria　and　diabetes。

Identical　physical　and　functional　changes　in　the　organs　of　the　kinetic　system　may　result　from　intense　continued　stimulation　from　any　of　the　following　causes：　　Excessive　physical　labor；　athletic　exercise；　worry　or　anxiety；　intestinal　autointoxication；　chronic　infections；　such　as　oral　sepsis；　tonsillitis；　and　adenoids；　chronic　appendicitis；　chronic　cholecystitis；　colitis；　and　skin　infections；　the　excessive　intake　of　protein　food　（foreign　protein　reaction）；　emotional　strain；　pregnancy；　stress　of　business　or　professional　life　all　of　which　are　known　to　be　activators　of　the　kinetic　system。

From　the　foregoing　statements　we　are　able　to　understand　the　muscular　weakness　following　fever；　we　can　understand　why　the　senile　have　neither　muscular　power　nor　strong　febrile　reaction；　why　long…continued　infections　produce　pathologic　changes　in　the　organs　constituting　the　kinetic　chain；　why　the　same　pathologic　changes　result　from　various　forms　of　activation　of　the　kinetic　system。　In　this　hypothesis　we　find　a　reason　why　cardiovascular　disease　may　be　caused　by　chronic　infection；　by　auto…intoxication；　by　overwork；　or　by　emotional　excitation。　　We　now　see　that　the　reason　why　we　find　so　much　difficulty　in　differentiating　the　numerous　acute　infections　from　each　other　is　because　they　play　upon　the　same　kinetic　chain。　Our　postulate　harmonizes　the　pathologic　democracy　of　the　kinetic　organs；　for　it　explains　not　only　why；　in　many　diseases；　the　pathologic　changes　in　these　organs　are　identical；　but　why　the　same　changes　are　seen　as　the　result　of　emotional　strain　and　overwork。　We　can　thus　understand　how　either　emotional　strain　or　acute　or　chronic　infection　may　cause　either　exophthalmic　goiter　or　cardiovascular　disease；　how　chronic　intestinal　stasis　with　the　resultant　absorption　of　toxins　may　cause　cardiovascular　disease；　neurasthenia；　or　goiter。　Here　is　found　an　explanation　of　the　phenomena　of　shock；　whether　the　shock　be　the　result　of　toxins；　of　infection；　of　foreign　proteins；　of　anaphylaxis；　of　psychic　stimuli；　or　of　a　surgical　operation　with　its　combination　of　both　psychic　and　traumatic　elements。

This　conception　of　the　kinetic　system　has　stood　a　crucial　test　by　making　possible　the　shockless　operation。　　It　has　offered　a　plausible　explanation　of　the　cause　and　the　treatment　of　Graves'　disease。　　Will　the　kinetic　theory　stand　also　the　clinical　test　of　controlling　that　protean　disease　bred　in　the　midst　of　the　stress　of　our　present…day　life？　Present…day　life；　in　which　one　must　ever　have　one　hand　on　the　sword　and　the　other　on　the　throttle；　is　a　constant　stimulus　of　the　kinetic　system。　The　force　of　these　kinetic　stimuli　may　be　lessened　at　the　cerebral　link　by　intelligent　controla　protective　control　is　empirically　attained　by　many　of　the　most　successful　men。　　The　force　of　the　kinetic　stimuli　may　be　broken　at　the　thyroid　link　by　dividing　the　nerve　supply；　reducing　the　blood　supply；　or　by　partial　excision；　or　if　the　adrenals　feel　the　strain；　the　stimulating　force　may　be　broken　by　dividing　their　nerve　supply；　reducing　the　blood　supply；　or　by　partial　excision。　No　theory　is　worth　more　than　its　yield　in　practice；　but　already　we　have　the　shockless　operation；　the　surgical　treatment　of　Graves'　disease；　and　the　control　of　shock　and　of　the　acute　infections　by　overwhelming　morphinization　（Figs。　62；　72；　and　73）。


Conclusions

To　become　adapted　to　their　environment　animals　are　transformers　of　energy。　This　adaptation　to　environment　is　made　by　means　of　a　system　of　organs　evolved　for　the　purpose　of　converting　potential　energy　into　heat　and　motion。　　The　principal　organs　and　tissues　of　this　system　are　the　brain；　the　adrenals；　the　thyroid；　the　muscles；　and　the　liver。　Each　is　a　vital　link；　each　plays　its　particular　role；　and　one　cannot　compensate　for　the　other。　　A　change　in　any　link　of　the　kinetic　chain　modifies　proportionately　the　entire　kinetic　system　which　is　no　stronger　than　its　weakest　link。

In　this　conception　we　find　a　possible　explanation　of　many　diseases　one　which　may　point　the　way　to　new　and　more　effective　therapeutic　measures　than　those　now　at　our　command。



ALKALESCENCE；　ACIDITY；　ANESTHESIAA　THEORY　OF　ANESTHESIA＇*＇


＇*＇　Paper　delivered　before　the　Virginia　Medical　Association；　Washington；　D。　C。；　October　29；　1914。


Alkalis　and　bases　compose　the　greater　part　of　the　food　of　man　and　animals；　the　blood　in　both　man　and　animals　under　normal　conditions　being　slightly　alkaline　or　rather　potentially　alkaline；　that　is；　although　in　circulating　blood　the　concentration　of　the　OH…ions　upon　which　the　degree　of　alkalinity　dependsis　but　little　more　than　in　distilled　water；　yet　blood　has　the　power　of　neutralizing　a　considerable　amount　of　acid　（Starling；　Wells）。　At　the　time　of　death；　whatever　its　cause；　the　concentration　of　H…ions　in　the　blood　increases；　the　concentration　of　H…ions　being　a　measure　of　acidity；that　is；　the　potential　or　actual　alkalinity　decreases　and　the　blood　becomes　actually　neutral　or　acid。

To　determine　what　conditions　tend　to　diminish　the　normal　alkalinity　of　the　blood；　many　observations　were　made　for　me　in　my　laboratory　by　Dr。　M。　L。　Menten　to　determine　by　electric　measurements　the　H…ion　concentration　of　the　blood　under　certain　pathologic　and　physiologic　conditions。

As　a　result　of　these　researches　we　are　able　to　state　that　the　H…ion　concentration　of　the　bloodits　acidityis　increased　by　excessive　muscular　activity；　excessive　emotional　excitation；　surgical　shock；　in　the　late　stages　of　infection；　by　asphyxia；　by　strychnin　convulsions；　by　inhalation　anesthetics；　after　excision　of　the　pancreas；　and　in　the　late　stages　of　life　after　excision　of　the　liver　and　excision　of　the　adrenals。　Morphin　and　decapitation　cause　no　change　in　the　H…ion　concentration。　Ether；　nitrous　oxid；　and　alcohol　produce　an　increased　acidity　of　the　blood　which　is　proportional　to　the　depth　of　anesthesia。

Many　of　the　cases　studied　were　near　death；　as　would　be　expected；　since　it　is　well　known　that　a　certain　degree　of　acidity　is　incompatible　with　life。

Since　alkalis　and　bases　preponderate　in　ingested　food；　since　alkalinity　of　the　blood　is　diminished　by　bodily　activity；　and　since　at　the　point　of　death　the　blood　is　always　acid；　we　may　infer　that　some　mechanism　or　mechanisms　of　the　body　were　evolved　for　the　purpose　of　changing　bases　into　acids　that　thus　energy　might　be　liberated。

These　observations　lead　naturally　to　the　question；　May　not　acidity　of　itself　be　the　actual　final　cause　of　death？　We　believe　that　it　may　be　so　from　the　facts　that（1）　The　intravenous　injection　of　certain　acids　causes　death　quickly；　but　that　convulsions　do　not　occur；　since　the　voluntary　muscles　lose　their　power　of　contraction；　and　（2）　the　intravenous　injection　of　acids　causes　extensive　histologic　changes　in　the　brain；　the　adrenals；　and　the　liver　which　resemble　the　changes　invariably　caused　by　activation　of　the　kinetic　system　（Figs。　74　and　75）。　In　view　of　these　facts　may　we　not　find　that　anesthesia　and　many　instances　of　unconsciousness　are　merely　phenomena　of　acidity？

As　has　been　stated　already；　we　have　found　that　the　H…ion　concentration　of　the　bloodits　acidityis　increased　by　alcohol；　by　ether；　and　by　nitrous　oxid。　　In　addition　our　tests　have　shown　that　under　ether　the　increase　of　the　H…