George Washington Crile

“ 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. ”

“ I have found that if an intelligent patient who is suffering from fear can be made to see so plainly as to become firmly convinced that his brain, his various organs, indeed his whole being, could be physically damaged by fear, that this same instinct of self-preservation will, to the extent of his conviction, banish fear. ”

“ 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? ”

“ 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 assumed 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. ”

“ In other words, sights, sounds, and odors are symbols which awaken phylogenetic association. If a species has become adapted to make a specific response to a certain object, then that response will occur automatically in an individual of that species when he hears, sees, or smells that object. Suppose, for example, that the shadow of a hawk were to fall simultaneously on the eyes of a bird, a rabbit, a cow, and a boy. That shadow would at once activate the rabbit and the bird to an endeavor to escape, each in a specific manner according to its phylogenetic adaptation ”

“ Each system transforms such amounts of potential into kinetic energy as are required to perform its specific work; but no one of them transforms latent into kinetic energy for the purposes of escaping, fighting, pursuing, nor for combating infection. The stomach, the kidneys, the lungs, the heart strike no physical blow-their role is to do certain work to the end that the blow may be struck by another system evolved for that purpose. I propose to offer evidence that there is in the body a system evolved primarily for the transformation of latent energy into motion and into heat. ”

“ 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. ”

“ In some animals the protection from too rough contact with surroundings was secured by the development of an outside armor; in others noxious secretions served the purposes of defense, but such devices as these were not suitable for the higher animals nor for the diverse and important functions of the human race. The safety of the higher animals and of man had to be preserved by some mechanism by means of which they could become adapted to a much wider and more complex environment, the dominance over which alone gives them their right to be called "superior beings." ”

“ What attribute, after all, has man which in its ultimate analysis is not possessed by the lowest animals or by the vegetable creation, even? From the ameba, on through all the stages of animal existence, every action is but a response to an adequate stimulus; and as a result of adequate stimuli each step has been taken toward the higher and more intricate mechanisms which play the higher and more intricate parts in the great scheme of nature. ”

“ On the hypothesis that it is good for the individual who is acutely stricken by a disease or who is poisoned by autointoxication to rest and fast, and that the muscular system obeys the imperial command of pain, and in view of the fact that the brain is not only in constant touch with the conditions of every part of the body but that it is also the controlling organ of the body, one would expect that in these diseases the major pain whose purpose it is to govern general muscular action would be located in the head and there we find it. ”

“ The exposure of a sensitive brain to the naked possibility of death from a surgical operation may be compared to uncovering a photographic plate in the bright sunlight to inspect it before putting it in the camera. This principle explains, too, the physical influence of the physician or surgeon, who, by his PERSONALITY, inspires, like a Kocher, absolute confidence in his patient. The brain, through its power of phylogenetic association, controls many processes that have wholly escaped from the notice of the "practical man." ”

“ It is idle to consider any experimental research into the cause of phenomena that have developed by natural selection during millions of years. Nature herself has made the experiments on a world-wide scale and the data are before us for interpretation. Darwin could do no more than to collect all available facts and then to frame the hypothesis by which the facts were best harmonized. Sherrington, that masterly physiologist, in his volume entitled "The Integrative Action of the Nervous System," shows clearly how the central nervous system was built up in the process of evolution. ”

“ 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. ”

“ 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. ”

“ When one reflects on the vast amount of evidence as to the origin and the purpose of pain, he is forced to conclude that pain is a phenomenon of motor stimulation, and that its principal role is the protection of the individual against the gross and the microscopic enemies in his environment. The benefits of pain are especially manifested in the urgent muscular actions by means of which the body moves away from physical injury ”

“ Since all normal life depends upon the response of the brain to the daily stimuli, we should expect in health, as well as in disease, to find modifications of the functions and the physical state of the component parts of this central battery— the brain-cells. Although we must believe, then, that every reaction to stimuli, however slight, produces a corresponding change in the brain-cells, yet there are certain normal, that is, non-diseased, conditions which produce especially striking changes. ”

“ In children almost any unexpected phenomenon, such as a sudden "booing" from behind a door, is attended by laughter, and in like manner the kinetic reaction produced by the innumerable threats of danger which are suddenly averted, a breach of the conventions, a sudden relief from acute nervous tension; a surprise—indeed, any excitant to which there is no predetermined method of giving a physical response— may be neutralized by the excitation of the mechanism of laughter. ”

“ If death occurs, the stimulus to motor acts is suddenly withdrawn and she then cries aloud, and performs many motor acts as a result of the intense stimulation to motor activity which is no longer needed in the physical care of her child. With this clue we can find the explanation of many phenomena. We can understand why laughter and crying are so frequently interchangeable; why they often blend and why either gives a sense of relief; we can understand why either laughter or crying can come only when the issue that causes the integration is determined ”

“ We postulate that the pain is associated with the discharge of energy from the brain-cells. If this be true, then if every nociceptor in the body were equally stimulated in such a manner that all the stimuli should reach the brain-cells simultaneously, then the cells would find themselves in equilibrium and no motor act would be performed. But if all the pain nerve ceptors but one were equally stimulated, and this one more strongly stimulated than the rest, then this one would gain possession of the final common path—would cause a muscular action and the sensation of pain. ”

“ My thesis to-night, however, will go beyond this common agreement, for I shall maintain, not that man is in *large measure the product of his environment, but that environment has been the actual CREATOR of man; that the old division between body, soul, and spirit is non-existent; that man is a unified mechanism responding in every part to the adequate stimuli given it from without by the environment of the present and from within by the environment of the past, the record of which is stored in part in cells throughout the mechanism, but especially in its central battery—the brain. ”

“ The great impulse to a deeper and keener study of man's relation, not only to man, but to the whole animal creation, which was given by Darwin, has opened the way to the study of man on a different basis. Psychologists, physicians, and priests are now joining hands as never before in the great world-wide movement for the betterment of man. The new science of sociology is combining the functions of all three, for priest, physician, and psychologist have come to see that man is in large measure the product of his environment. ”

“ Bacteriologists have taught us that bacteria grow best at the normal temperature of the body, hence fever must interfere with bacterial growth. With each rise of one degree centigrade the chemical activity of the body is increased 10 per cent. In acute infections there is aversion to food and frequently there is vomiting. In fever, then, we have diminished intake of energy, but an increased output of energy—hence the available potential energy in the body is rapidly consumed. This may be an adaptation for the purpose of breaking up the foreign protein molecules composing the bacteria. ”