按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
sponds in action as a whole and to but one stimulus at a time。 The integration of the individual as a whole occurs not alone in injury and fear； but also； though not so markedly； as a result of other phylogenetic associations； such as those of the chase and procreation。 When adequate stimuli are repeated with such rapidity that the new stimulus is received before the effect of the previous one has worn off； a higher maximum effect is produced than is possible under a single stimulus； however powerful。
Sexual receptors are implanted in the body by natural selection； and the adequate stimuli excite the nerve…muscular reactions of conjugation in a manner analogous to the action of the adequate stimuli of the nociceptors。 The specific response of either the sexual receptors or the nociceptors is at the expense of the total amount of nervous energy available at the moment。 Likewise in daily labor； which； in the language of evolution； is the chase； nervous energy is expended。 Under the dominance of fear or injury； however； the integration is most nearly absolute and probably every expenditure of nervous energy which is not required for efforts toward self…preservation is arrested； hence fear and injury drain the cup of energy to the dregs。 This is the potential difference between fear and desire； between injury and conjugation。
What is the practical application of this？ In operative surgery there is introduced a new principle； which removes from surgery much of the immediate risk from its trauma by establishing ANOCI…ASSOCIATION； it places certain of the phenomena of fear on a physical basis； it explains to us the physical basis for the impairment of the entire individual under worry or misfortune； it makes evident the physical results of the daily noci…associations experienced by the individual as a social unit。 On the other hand； it explains the power of therapeutic suggestion and of other influences which serve for the time to change the noci…integration； it shows the physical basis for the difference between hope and despair； it explains some of the phenomena of Graves' disease； of sexual neurasthenia； possibly of hay…fever and of the common cold。 The principle is probably equally applicable to the acute infections； in each of which chemical noci…association gives rise to many of the phenomena of the disease and it explains their cure by natural immunity and by vaccines。 This hypothesis should teach us to view our patients as a whole； and especially should it teach the surgeon gentleness。 It should teach us that there is something more in surgery than mechanics； and something more in medicine than physical diagnosis and drugs。
Conclusion
The brain…cells have existed for eons and； amid the vicissitudes of change； they have persisted with perhaps less alteration than has the crust of the earth。 Whether in man or in the lower animals； they are related to and obey the same general biologic laws； thus being bound to the entire past and performing their function in accordance with the law of phylogenetic association。
For so long a time have we directed our attention to tumors； infections； and injuries that we have not sufficiently considered the vital force itself。 We have viewed each anatomic and pathologic part as an entity and man as an isolated phenomenon in nature。 May we not find in the laws of adaptation under natural selection； and of phylogenetic association； the master key that will disclose to us the explanation of many pathologic phenomena as they have already explained many normal phenomena？
And may medicine not correlate the pathologic phenomena of the sick man with the forces of evolution； as the naturalists have correlated the phenomena of the sound man； and thus may not disease； as well as health； be given its evolutionary setting？
PHYLOGENETIC ASSOCIATION IN RELATION TO THE EMOTIONS＇*＇
＇*＇ Address before the American Philosophical Society； Philadelphia； April 22； 1911。
The surgeon is familiar with the manifestations of every variety of the human emotions in the various stations of life； from infancy to senility； in health and in disease。 Not only does he come into intimate contact with the emotions displayed by the victims of disease and of accidents； but he also observes those manifested by the relatives and friends of the families of his patients。 Moreover； he is unhappily forced to notice the emotional effect upon himself when he is waging an unequal battle against death the strain and worry at a crisis； when a life is in the balance and a single false move may be fatal； is an experience known only to the operating surgeon。
For the data for this paper； therefore； in which I shall for the most part limit my discussion to the strongest of all emotionsFEARI have drawn largely from my personal experience as a surgeon； as well as from an experimental research in which I have had the valuable assistance of my associates； Dr。 H。 G。 Sloan； Dr。 J。 B。 Austin； and Dr。 M。 L。 Menten。
I believe it can be shown that it is possible to elicit the emotion of fear only in those animals that utilize a motor mechanism in defense against danger or in escape from it。 For example； the defense of the skunk is a diabolic odor which repels its enemies； the skunk has no adequate equipment for defense or escape by muscular exertion； and the skunk therefore shows little or no fear。 Again； certain species of snakes are protected by venom； they possess no other means of defense nor have they adequate motor mechanisms for escape and they show no fear。 Because of their strength other animals； such as the lion； the grizzly bear； and the elephant； show but little fear （Fig。 6）。 Animals which have an armored protection； such as the turtle； show little fear。 It is； therefore； obvious that fear is not universal and that the emotion of fear is felt only by those animals whose self…preservation is dependent upon an uncertain adequacy of their power of muscular exertion either for defense or for flight （Fig。 7）。
What are the principal phenomena of fear？ They are palpitation of the heart； acceleration of the rate and alteration of the rhythm of the respiration； cold sweat； rise in body temperature； tremor； pallor； erection of the hair； suspension of the principal functions of digestion； muscular relaxation； and staring of the eyes （Fig。 12）。 The functions of the brain are wholly suspended except those which relate to the self…protective response against the feared object。 Neither the brain nor any other organ of the body can respond to any other lesser stimulus during the dominance of fear。
From these premises it would appear that under the influence of fear； most； perhaps all； of the organs of the body are divided sharply into two classes： First； those that are stimulated； and； second； those that are inhibited。 Those that are stimulated are the entire muscular system； the vasomotor and locomotor systems； the senses of perception； the respiration； the mechanism for erecting the hair； the sweat…glands； the thyroid gland； the adrenal gland （Cannon）； and the special senses。 On the other hand； all the digestive and procreative functions are inhibited。 What is the significance of this stimulation of