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organs, and the same organs are stimulated and the same organs are inhibited as if instead of its 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 is moral, financial, social, or stage fright, the heart beats wildly, the respirations are accelerated, perspiration is increased, there is a pallor, trembling, indigestion, dry mouth, etc. The phenomena are those of 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 naked 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 and whatever the cause the phenomena are always the same—always physical.

The stimulus of fear if repeated from day to day, whether it be 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 baseless fears in daily life—all forms of fear as it seems to me, express themselves in similar terms of ancestral physical contest and on this law dominate the various organs and parts of the body. Anger and fear express opposite states. Fear expresses the evidence of a strong desire to escape from danger; anger, a strong desire to attack physically and vanquish opposition. This hypothesis is strongly supported by the outward expression of fear and 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 he may exhibit every expression of physical combat. Fixing the jaw and showing the teeth in anger merely emphasizes 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 sta

tions of life differences of opinion may lead to argument and argument to physical combats, even to the point of killing. Physical violence of the savage and the brute still lies surprisingly near the surface.

There have now been presented some of the reasons based largely on gross animal behavior why fear is to be regarded as a


Fig. 3. The attitude and the facial expression represent anger, and the integration of the entire body for a strong aggressive action shows the extent to which the body of man has been evolved as a motor mechanism. From “Outing."

response to phylogenetic association of physical danger. I shall now present some additional evidence in support of this hypothesis from the clinical and the experimental side. Although there is not convincing proof yet there is evidence that the effect of the stimulus of fear upon the body without physical activity is more injurious than actual physical contest which results only in fatigue without gross physical injury. It is well known that the soldier lying under

fire waiting in vain for orders to charge suffers more than the soldier that flings himself into the fray; that a wild animal in an open chase against capture suffers less than when cowering in captivity. An unexpressed slumbering emotion is measurably relieved by action. It is probable that the various energizing substances needful in physical combat such as the secretion of the thyroid, the adrenals, etc., but which are not consumed in action may, if frequently repeated, cause physical injury to the body. That the brain is definitely influenced, even damaged by fear has been proved by the following experiments:

Rabbits were frightened by a dog but not injured, and not chased. After various periods of time the animals were killed and their brain cells compared with the normal. Widespread changes were seen. The principal clinical phenomena expressed by the rabbit were rapid heart, accelerated respiration, prostration, tremors, and a rise in temperature.

The dog showed similar phenomena-excepting instead of muscular relaxation as in the rabbit the dog showed aggressive muscular action. Both the dog and the rabbit were exhausted and although the dog exerted himself actively and the rabbit remained physically passive, the rabbit was much more exhausted.

Further observations were made upon the brain of a fox chased for two hours by members of a hunt club, then finally overtaken by the hounds and killed. The brain cells of this fox as compared with those of a normal fox showed extensive physical changes in most of the cells.

The next line of evidence is offered with some reservation but it has seemed to me to be more than mere idle speculation. It relates to the phenomena of one of the most interesting diseases in the entire category of human ailments—I refer to exophthalmic goiter or Graves' Disease-a disease primarily involving the emotions. This disease is frequently the direct sequence of severe mental shocks or a long and intensely worrying strain. The following case is typical. A broker was in his usual health up to the panic of 1907. During this panic his fortune and that of others was for almost a year in jeopardy, failure finally occurring. During this

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heavy strain he became increasingly more nervous, and imperceptibly there appeared a pulsating enlargement of the thyroid gland, an increased prominence of the eyes, marked increase in perspiration, even profuse sweating, palpitation of the heart, increased respiration with frequent sighing, increase in blood pressure; there was tremor of many muscles, rapid loss of weight and strength, frequent gastro-intestinal disturbances, loss of normal control of his emotions, and marked impairment of his mental faculties. He was as completely broken in health as in fortune. These phenomena

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Fig. 4. This picture is taken from Darwin's “ Expression of the Emotior.s

in Man and Animals " and expresses horror and agony.

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resembled closely those of fear and followed in the wake of strain due to fear.

In young women exopthalmic goiter often follows in the wake of a disappointment in love; in women, too, it frequently follows in the wake of an illness of a child or parent in which the double strain of

worry and of constant care is present. Since such strains usually fall heaviest upon woman, they are the most frequent victims. Now, whatever the exciting cause of exophthalmic goiter, whether unusual business worry, disappointment in love, a tragedy, or the illness of a loved one, the symptoms are alike and closely resemble the phenomena of one of the great primitive emotions. How could disappointment in love play a role in the causation of Graves' Disease? If the hypothesis presented for the explana

tion of the genesis and the phenomena of fear is correct then it would hold for the emotion of love. If fear is a phylogenetic physical defense or escape but without resulting in muscular action then love is a phylogenetic conjugation without physical action. The quickened pulse, the leaping heart, the accelerated respiration, the sighing, the glowing eye, the crimson cheek, and many other phenomena are merely phylogenetic recapitulations of ancestral acts.

The thyroid gland is believed to participate in such physical activities. Hence, it could well follow that the disappointed maiden who is intensely integrated for a youth will at every thought of him be subjected by phylogenetic association to a specific stimulation analogous to that which attended the ancestral consummation. Moreover, a happy marriage has many times been followed by a cure of the exophthalmic goiter which appeared in the wake of such an experience. The victims of Graves' Disease present a counterpart of emotional exhaustion. The emotions in Graves' Disease are abnormally acute as illustrated by personal observation of death of a subject of this disease from fear alone. Whatever the exciting cause of this disease the symptoms of Graves' Disease are the same; just as in fear the phenomena are the same whatever the exciting

In Graves' Disease as illustrated by the photographs the resemblance is close to that of fear. The following phenomena fear and Graves' Disease have in common: increased heart beat, increased respiration, rising temperature, muscular tremors, protruding eyes, loss in weight; Cannon has found an increased amount of adrenalin in the blood in fear and Frankel in Graves' Disease; increased blood pressure; muscular weakness; digestive disturbances; impaired nervous control; hypersusceptibility to stimuli; in protracted intense fear the brain cells show marked physical changes; in Graves' Disease analogous changes are seen. In Graves' Disease there seems to be a composite picture of an intense expression of the great primitive emotions. If Graves' Disease is a disease of the great primitive emotions or rather of the whole motor mechanism how is the constant flow of stimulation of this complicated mechanism supplied ? It would seem that at some period



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