Origin and Nature of Emotions Part 4

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 a.s.sociational lines?

Then, too, there may be chemical noci-a.s.sociations 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-a.s.sociation 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 princ.i.p.al points presented: In operations under inhalation anesthesia the nerve impulses from the trauma reach every part of the brain--the 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 a.s.sociation, may be prevented by the exclusion of the noci-a.s.sociation or by the administration of drugs like morphin and scopolamin, which so impair the a.s.sociational 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 a whole occurs not alone in injury and fear, but also, though not so markedly, as a result of other phylogenetic a.s.sociations, 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.

s.e.xual receptors are implanted in the body by natural selection, and the adequate stimuli excite the nerve-muscular reactions of conjugation in a manner a.n.a.logous to the action of the adequate stimuli of the nociceptors. The specific response of either the s.e.xual 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-a.s.sOCIATION; 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-a.s.sociations 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 s.e.xual 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-a.s.sociation 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 a.s.sociation.

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 ent.i.ty and man as an isolated phenomenon in nature.

May we not find in the laws of adaptation under natural selection, and of phylogenetic a.s.sociation, 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 a.s.sOCIATION 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 emotions--FEAR--I have drawn largely from my personal experience as a surgeon, as well as from an experimental research in which I have had the valuable a.s.sistance of my a.s.sociates, 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 princ.i.p.al 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 princ.i.p.al 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 cla.s.ses: 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 some and inhibition of other organs? As far as we know, the stimulated organs increase the efficiency of the animal for fight or for flight.

It is through skeletal muscles that the physical attack or escape is effected; these muscles alone energize the claws, the teeth, the hoofs, and the means for flight. The increased action of the muscles of the heart and the blood-vessels increases the efficiency of the circulation; the secretion of the adrenal gland causes a rise in the blood-pressure; the increased action of the thyroid gland causes an increased metabolic activity; there is evidence that glycogen is actively called out, this being the most immediately available substance for the production of energy; the increased activity of the respiration is needed to supply the greater need of oxygen and the elimination of the increased amount of waste products; the dilatation of the nostrils affords a freer intake of air; the increased activity of the sweat-glands is needed to regulate the temperature of the body which the increased metabolism causes to rise.

The activity of all the organs of perception--sight, hearing, smell-- is increased in order that the danger may be more accurately perceived.

It cannot be a mere coincidence that the organs and the tissues that are stimulated in the emotion of fear are precisely those that are actually utilized in a physical struggle for self-preservation.

Are any other organs stimulated by fear except those that can or that do a.s.sist in making a defensive struggle? I know of none.

On the other hand, if an animal could dispense with his bulky digestive organs, whose functions are suspended by fear, if he could, so to speak, clear his decks for battle, it would be to his advantage.

Although the marvelous versatility of natural selection apparently could devise no means of affording this advantage, it nevertheless shut off the nervous current and saved the vital force which is ordinarily consumed by these non-combatants in the performance of their functions.

Whatever may be the origin of fear, its phenomena are due to a stimulation of all the organs and tissues that add to the efficiency of the physical struggle for self-preservation and an inhibition of the func-

{ill.u.s.t. caption = FIG. 19--THE BROAD JUMP. Note the similarity of the expression to the facial expression of fear and of anger (Figs. 12 and 21). (Wm. J. Brownlow, drawn from photo.) tions of the leading organs that do not partic.i.p.ate in that struggle-- the non-combatants, so to speak. Fear arose from injury, and is one of the oldest and surely the strongest emotion.

By the slow process of vast empiricism nature has evolved the wonderful defensive motor me-chanism of many animals and of man.

The stimulation of this mechanism leading to a physical struggle is action, and the stimulation of this mechanism without action is emotion.

We may say, therefore, that fear is a PHYLOGENETIC FIGHT OR FLIGHT (Fig.

18). On this hypothesis all the organs and parts {ill.u.s.t. caption = FIG. 20.-FINISH OF RELAY RACE.

Compare the facial expression of the runners with those in Figs.

12, 19, 22. These pictures ill.u.s.trate the fact that the same mechanism is stimulated in emotion as in physical action.

(Photo by Underwood and Underwood, N. Y.)}

of the body are integrated, connected, or correlated for the self-preservation of the individual by the activity of his motor mechanism (Figs. 12, 19, and 20). We fear not in our hearts alone, not in our brains alone, not in our viscera alone--fear influences every organ and tissue; each organ or tissue is stimulated or inhibited according to its use or hindrance in the physical struggle for existence.

By thus concentrating all or most of the nerve force on the nerve-muscular mechanism for defense, a greater physical power is developed.

Hence it is that under the stimulus of fear animals are able to perform preternatural feats of strength. For the same reason, the exhaustion following fear will be increased as the powerful stimulus of fear drains the cup of nervous energy even though no visible action may result.

An animal under the stimulus of fear may be likened to an automobile with the clutch thrown out but whose engine is racing at full speed.

The gasoline is being consumed, the machinery is being worn, but the machine as a whole does not move, though the power of its engine may cause it to tremble.

When this conception is applied to the human beings of today, certain mysterious phenomena are at once elucidated. It must be borne in mind that man has not been presented with any new organs to meet the requirements of his present state of civilization; indeed, not only does he possess organs of the same type as those of his savage fellows, but of the same type also as those possessed by the lower animals even.

In fact, man has reached his present status of civilization with the primary equipment of brutish organs. Perhaps the most striking difference between man and animals lies in the greater control which man has gained over his primitive instinctive reactions.

As compared with the entire duration of organic evolution, man came down from his arboreal abode and a.s.sumed his new role of increased domination over the physical world but a moment ago.

And now, though sitting at his desk in command of the complicated machinery of civilization, when he fears a business catastrophe his fear is manifested in the terms of his ancestral physical battle in the struggle for existence. He cannot fear intellectually, he cannot fear dispa.s.sionately, he fears with all his organs, and the same organs are stimulated and inhibited as if, instead of it being a battle of credit, of position, or of honor, it were a physical battle with teeth and claws. Whether the cause of acute fear be moral, financial, social, or stage fright, the heart beats wildly, the respirations are accelerated, perspiration is increased, there are pallor, trembling, indigestion, dry mouth, etc.

The phenomena are those which accompany physical exertion in self-defense or escape. There is not one group of phenomena for the acute fear of the president of a bank in a financial crash and another for the hitherto trusted official who suddenly and unexpectedly faces the imminent probability of the penitentiary; or one for a patient who unexpectedly finds he has a cancer and another for the hunter when he shoots his first big game.

Nature has but one means of response to fear, and whatever its cause the phenomena are always the same--always physical.

If the stimulus of fear be repeated from day to day, whether in the case of a mother anxious on account of the illness of a child; a business man struggling against failure; a politician under contest for appointment; a broker in the daily hazard of his fortune; litigants in legal battle, or a jealous lover who fears a rival; the countless real as well as the baseless fears in daily life, in fact, all forms of fear, as it seems to me, express themselves in like terms of ancestral physical contests. On this law, fear dominates the various organs and parts of the body.

Anger and fear express opposite emotional states. Fear is the expression of a strong desire to escape from danger; anger, of a strong desire to attack physically and to vanquish opposition.

This hypothesis is strongly supported by the outward expressions of fear and of anger. When the business man is conducting a struggle for existence against his rivals, and when the contest is at its height, he may clench his fists, pound the table, perhaps show his teeth, and exhibit every expression of physical combat.

Fixing the jaw and showing the teeth in anger merely emphasize the remarkable tenacity of phylogeny. Although the development of the wonderful efficiency of the hands has led to a modification of the once powerful canines of our progenitors, the ancestral use of the teeth for attack and defense is attested in the display of anger.

In all stations of life differences of opinion may lead to argument and argument to physical combats, even to the point of killing.

The physical violence of the savage and of the brute still lies surprisingly near the surface (Fig. 21).