In civil life, the complex of symptoms Beard jumbled together as neurasthenia, when a.s.sociated with a loss of self-control, so that the sufferer is incapacitated for the duties of everyday life, has become the popular "nervous breakdown." A sanitarium appears to be one of the necessary components of the condition. It is the last act, the climax of "nerves."

During the War of 1914-1918, thousands of cases of functional disorders of the nervous came to be grouped under "Sh.e.l.l Shock."

The psychic phenomena in the wake of concussion of the brain due to explosives suggested the term, and its application to affections of self-control, or dissociations of the personality, with paralysis, blindness, speechlessness, loss of hearing and so on. The War neurosis (including those arising in home service) is still a topical subject because thousands of mentally disabled soldiers are alive.

In view of what has been said concerning the endocrine mechanism of the instincts and the vegetative apparatus, it could be predicted that a number of these nerve casualties of peace and war would be caused by an upset of the equilibrium between the glands of internal secretion.

A study of war neuroses by the great Italian student of the endocrines, Pende, confirms this a.s.sumption. As emphasized, the internal secretions are like tuning keys, and tighten or loosen the strings of the organism-instrument, the nerves. War for the soldier, or the civilian combatant as well, sets the strings vibrating, and with them the glands controlled by them. Excessive stimulation or depression of an endocrine will disturb the whole chain of hormones, and the vegetative system, and their echoes in the psyche. The nervous disorders of war that have been lumped as sh.e.l.l shock or war shock may be looked upon as uncompensated; airings of the endocrine vegetative mechanism, as dislocations of parts and processes that are reflected outwardly as ailment or disease.

AN ENDOCRINE NEUROSIS

An exquisite example of an endocrine neurosis, that is a disorder of nerves and brain dependent upon an upset of the equilibrium between the internal secretions due to a trying experience, was furnished recently by the reactions of three naval officers lost in the snow wilds of Canada through a balloon adventure. The cases aroused a good deal of interest at the time, and the details were reported by the newspapers as if they were the episodes of a serial mystery story.

The three officers started out late one fine evening from Rockaway Air Station in a balloon for a practice trip. Atmospheric conditions suddenly changed, they became lost in the clouds, and finally landed somewhere in the Canadian wilderness. The commander of the balloon crew, Lieut. A., 23 years old, was the youngest of the three; the oldest, Lieut. B., being 45, and the third man in the thirties, Lieut.

C.

According to the testimony given at the Court of Inquiry held afterwards, two hours after they abandoned the balloon and started struggling through the snow, B. became tired and complained of his fatigue. B.'s fatigue increased, and two days later became so great that the party had to stop for an hour and build a fire in order to permit him to rest. However, an hour proved too little: and in another half hour he was falling and fainting.

Letters written by C. to his wife and gotten hold of by reporters declared that B. at this juncture pa.s.sed into a semi-sane state, in which he accused himself of a number of sins, and volunteered to commit suicide, so that the others would not be burdened by his weakness. Also, that they might use his body to fortify themselves. A.

discussed with C. the advisability of taking B.'s knife away from him. Living on their carrier pigeons, they continued on, moved by a desperate hope of finding someone. B. had several fainting spells after drinking water traced by moose tracks.

Luck favored them, and they encountered an Indian who guided them to a place called Moose Factory. Here they wrote the letters home which reached their wives and the daily press before they themselves returned to civilization. A great hue and cry was raised by the newspapers about their plight. Newspaper correspondents vied with each other for the honor of being the first to meet them and get their story.

They arrived at a collection of houses named Mattice. A. and C.

proceeded ahead and found instructions for them not to talk. C. went back to B., who was in a shack with the correspondents full of the story of the letters. B. became enraged and struck C. who retained his self-control.

Differences were patched up, and the three returned together to New York. There the medical examination of the three showed that the four days in the wilderness had left its deepest effects upon the physique and mind of B. In a few days he developed an attack of tonsillitis, with fever, and a mental disturbance described by the medical officer as exhaustion psychosis. He believed this condition to be the result of severe exhaustion, prolonged anxiety, worry, and extreme exposure.

Extreme restlessness and irritability, confusion of thought and an undefined perplexity, all the prominent symptoms of exhaustion psychosis, making him hyperactive and inclined to acts of violence, were in evidence.

The physique, character and reactions of Lieut. B. are what interest us in the case. The pictures of him published, and the structure of his skull, face and teeth, his hair and other physical traits point to his being an adrenal-centered type, of the unstable variety, so far as his internal secretion make-up is concerned. As we shall see in the next chapter on the different kinds of endocrine personalities, the unstable adrenocentric (convenient name for the cla.s.s) is characterized by rapid exhaustibility because under conditions of stress and strain, the reserve of the gland is consumed. The adrenal glands, we noted in a preceding chapter, are concerned with the maintenance of muscle and nerve tone in emergencies. They are the glands which, during crises especially, control the production and supply of energy to the various organs and tissues called upon to function to the utmost in emergencies. When the adrenals fail, as they do readily in these labile adrenocentrics, it is as if the adrenals were cut out of the body. And it has been repeatedly shown that extirpation of the adrenals is immediately followed by degeneration and breakdown of the brain cells.

These facts explain the reactions of Lieut. B. The acute call upon his adrenals made by his dangerous situation probably soon exhausted them of their content of reserve secretions. Overwhelming fatigue with loss of muscle tone followed. The changes in the brain caused him to talk as he did in the wilderness. Returned to safety, the news that his reputation was under fire because of C.'s letter brought out another adrenal characteristic: the excessive instinct of pugnacity, easily stimulated, with its emotion of anger and the tendency to violence.

What is spoken of as a quick temper is an adrenocentric trait.

Returned to New York, an infection, tonsillitis, attacked him.

Infections in adrenocentrics use up the content of the adrenals as rapidly as physical exhaustion or emotion. So the tonsillitis, which in another type of individual would have been combatted continuously by the adrenals and so pa.s.sed by as a mere sore throat, presented him with a high temperature, and the brain disturbance described by the medical officer as exhaustion-psychosis, with again a tendency to violence. In short, the history of his adventure is the history of his adrenals under stress and strain. It ill.u.s.trates the mechanism of a typical endocrine neurosis.

THE UNCONSCIOUS AND THE VISCERA

In the chapter on the glands of internal secretion as an interlocking directorate, certain generalities were stated as the laws of the government of the organism's life by them in a.s.sociation with the vegetative apparatus. It was put forward as a fundamental revision of the theory, hitherto accepted, of the limitation of mind to the brain cells. We think and feel not alone with the brain, but with our muscles, our viscera, our vegetative nerves, and last but not least our endocrine organs. In short, we think and feel with each and every part of ourselves.

Among these pristine factors determining the content of consciousness, the endocrines are most important, because they alone to start with, of all the other factors, are different in each and every individual.

They are what render him unique at birth, even though he looks the counterpart of millions of other babies born at the same time. They const.i.tute his inner destiny. As he grows, the external factors, social experiences, climate, accidents, and disease modify and condition the reactions and complexity of the endocrine system. As these modifications and a.s.sociations are of the greatest import for the final elaboration of the personality, composing as they do the elements of the unconscious which confers the unique stamp of normal, abnormal, supernormal, or subnormal, it is worth while now to review the most general of the determining laws. Man is an energy phenomenon, both conscious and unconscious, with the energy emanating from the endocrine-vegetative mechanisms. So it becomes possible for us, by their aid, to a.n.a.lyze the conscious, the subconscious and the unconscious with the terms long current in the a.n.a.lyses of physics.

1. Man is an energy machine which, though it is constantly losing energy as a whole; consists of parts constantly acc.u.mulating energy (as a result of inherent chemical reactions accelerated by the absorption of food). This process of local acc.u.mulation of energy a.s.sociated with general loss of energy may be observed even in the ameba, in the form of stored reserve food material. Evolution created a system of organs, the viscera, as specialists in energy conservation, utilization or transformation.

For intercommunication and interaction between the viscera two systems were elaborated: a younger system of direct contacts, the nerves, and nerve cells, through which influences could be conducted for the stimulation, acceleration, r.e.t.a.r.dation or inhibition of an energy process in them; and the older, the endocrine gland a.s.sociation, for the production of chemical substances to act as messengers to be sent from one viscus to another, and also to the nerves, through the blood or lymph which bathe all the cells. They could affect only one or certain organs, because by selection only the chosen organ or organs knew the code, as it were. The chemical system is much the older system, and preceded the nerve system by aeons of time. The whole system, viscera, visceral nerves and the endocrines gradually united into a complete autonomous organism within the organism, and as such functions as the vegetative apparatus.

EVOLUTION OF THE ENDOCRINES

2. In the course of evolution, variations occurred in all three components of the apparatus, the viscera, the nerves, and the endocrines. Now variations in the viscera and the nerves are essentially grossly physical and quant.i.tative. That is, there may be a bigger stomach or a smaller stomach, larger nerve fibres or smaller.

And as Life always has worked with a large margin of safety, and always played for safety first as regards quant.i.ty, these variations have not become of much significance for the history and destiny of the animal.

But variations among the endocrines made a tremendous difference. To have very much thyroid and very little pituitary, much adrenal and not enough parathyroid meant a great deal to the Organism as a whole, as well as to the vegetative apparatus. For states of tension and relaxation, activity and inactivity in the nerves and viscera would be determined by these variations in the ratio between the variants. The vegetative apparatus in its virginity, say in the new-born infant, may be said to have its development primarily determined by the reaction potentials of the endocrine part of it, that is the latent power of each gland to secrete at a minimum or a maximum, and the balance between them.

EDUCATION OF THE VEGETATIVE SYSTEM

3. Training or education involves, beside other effects, a training of the endocrines, and hence of the entire vegetative apparatus, to respond in a particular way to a particular stimulus. Experience is like the introduction of new push-b.u.t.tons, levers, and wheels into the mechanism. All learning which calls out or arrests the functioning of an instinct, must, from what we have learned of the chemical dynamics of instincts as reactions between hormones, nerves and viscera, affect the vegetative system. When there is a conflict between two or more instincts, between pressures of energy flowing in different directions, there may be compromise and normality, or a grinding of the gears and abnormality.

Where does the brain come in, in all this? As the servant of the vegetative apparatus. To call it the master tissue is manifestly absurd, when it can only be the diplomatic const.i.tutional monarch of the system. It can, in fact, act only as the great central station for a.s.sociative memory, as only one of the factors implicated in education.

The most powerful educative agents of the vegetative apparatus of a human being are the other humans around him. And they comprise the most powerful of the external effectors of education, for better, for worse. The training and education of the endocrine-vegetative system is the basis of all social rules (Habit, Custom, Convention, Law, Conscience). An unresolved discord, a continued conflict among the parts of the vegetative system, in spite of such education, is the foundation of the unhappiness of the acute or chronic misfits and maladjusted, the neurotic and the psychotic.

THE PHYSICAL BASIS OF THE UNCONSCIOUS

4. Another vastly important law that governs the content of the conscious and the unconscious, and resultant behaviour is the fact that the nerves and nerve cells of the vegetative apparatus, the nerves leading to the viscera and the endocrine glands, like the solar plexus, are affected by stimuli of lower value than those which arouse the brain cells. In the metaphorical language of the old psychology, the threshold value, that is the strength or loudness of stimulus sufficient to make itself felt or heard, is less for the vegetative apparatus than for the brain. So we begin to glimpse why an emotion seems to be experienced before the visceral changes that really preceded it, but pressed their way into consciousness later. This gives us a clue to the unconscious as the more sensitive and deeper part of the mind.

More than that, it supplies us with a physical basis for the unconscious which will explain much of the observed laws of its workings. It provides a reason for the apparent swiftness, spontaneity, and unreasonableness of what is called intuition. And it may show us a source for a good deal of the material of dreams and dream states.

We have said that we think and we remember, not alone with the brain, but with the muscles, the viscera and the endocrines. So do we forget not alone with the brain, but with the muscles, the viscera, the endocrines and their nerves. The utmost importance of muscle att.i.tudes in remembering has been established in the experimental laboratory.

It is one of the great services Freud rendered to psychology (and one, by the way, largely responsible for the acceptance of his doctrines by the disinterested intelligence) that he showed that a species of forgetting is nothing casual, but active and purposeful, a manifestation of the life of the unconscious. However, though his description of the process was correct, he left it to occur in a vacuum. As a matter of fact this forgetting consists in the inhibition of a.s.sociative memory by a process in the vegetative apparatus, so as to maintain the equilibrium within itself which is reflected in consciousness as comfort.

The unconscious, in short, consists of the buried a.s.sociations among the parts of the vegetative apparatus and the brain cells. We seem to be much nearer to grasping the nature of the unconscious, when we look upon it as a historical continuum, a compound or emulsion of different and various states of intravisceral pressure and tone, in the vegetative apparatus, dependent upon the balance between the endocrines, as well as upon past experiences of the viscera in the way of stimulation or depression. We forget that which is held down, literally, in the vegetative apparatus. This explanation of forgetting tells, too, why the forgotten (stored in the sub-brain, the endocrine-vegetative system) continually projects itself into and interferes with the regular flow of consciousness, e.g., in slips of the tongue, mistakes of spelling, and so on: because the energy bottled in the vegetative system tends to erupt into the consciousness into which it would ordinarily flow.

In the evolution of the mind, there have been elaborated devices to protect it against the vegetative apparatus. Consciousness, or awareness, must be accepted as a fundamental, primal fact, like protoplasm. Consciousness and protoplasm may be the complementary sides of the same coin. Whatever the truth, the fact stands out that the oldest, deepest, most potent consciousness is that of the traditionally despised lowest organs, the vegetative organs, the heart and lungs, stomach and intestines, the kidneys and the liver, and so on, their nerves, e.g., the solar plexus, and the glands of internal secretion. They invented and elaborated muscle, bone and brain to carry out their will. Evolution has been in the direction of a greater perfection of the methods of carrying out their will. Their consciousness, working upon the growing and multiplying brain cells, has created what we call self-conscious mind.

Mind, reacting upon its creator, has, in a sense, come to dominate them, because it has become the meeting ground of all the energy-influences seething and bubbling in the organism, and so developed into the organ of handling them as a whole, their Integrating-Executive. But just the same and all the time, the underlying consciousness of the viscera and their accessories stand as the powers behind the throne, but as what we have now learned to speak of, in relation to the Mind, as the Unconscious.

PSYCHOPATHOLOGY OF EVERYDAY LIFE

To sum up these relations of the viscera, the endocrines, the unconscious and the mind, it may be stated as a far-reaching generality for the understanding of human life: that character and conduct are expressions of the streams of energy arising in the vegetative apparatus, primarily endocrine determined at birth, and secondarily experience determined after the organism has learned to react as a whole, as consciousness. The result of such a reaction as a whole tends to balance the disturbance of energy, so as to maintain or restore the equilibrium, or sense of harmony and comfort, when consciousness again disappears. This law is an attempt at synthesis of the labors of the psycha.n.a.lysts, the behaviourists, and the students of the internal secretions (Freud, Jung, Adler, Sherrington, Watson, Von Bechterew, Kempf, Crile, Cannon, Cushing, Fraenkel are the great names of the movement). Most of the details, and all of the quant.i.tative applications of the law still remain to be worked out. But a statement like the following of Cushing, the eminent surgeon-student of the endocrines, that "it is quite probable that the psychopathology of everyday life hinges largely upon the effect of ductless gland discharges upon the nervous system," shows which way the wind is blowing.

In the face of these conceptions the position of the psycha.n.a.lyst as a practical therapeutist becomes clearer, and the causes of his failure when he fails. In the first place, he deals with psychic results as processes, and ignores the physiology of their production. Since a true cure of the neurosis, what he is after, is impossible without a removal of the cause, a disturbance in the vegetative apparatus, he cannot succeed where an automatic adjustment among the viscera does not follow his probings and ferretings of the unconscious. In the second place, he disregards the existence of a soil for the planting of the malign complexes in the individual in whom they grow and flourish. That soil is composed in part of the endocrine relations within the vegetative apparatus. And as we can often attack that soil more effectively and radically from the endocrine end than from the experience end (e.g., repressed episodes) we may transform the soil and make it barren rock for morbid complexes, at any rate. The concept of the endocrine-vegetative apparatus as the determinant of normal and abnormal behaviour, emotional reactions and disturbances of power should in time cause even the most fanatic of the psycha.n.a.lysts to recognize the functional basis of the mental acrostics they are so fond of dissecting.

NATURAL ABILITY

Another achievement of the psycha.n.a.lysts is the recognition of the influence of organic and functional inferiorities of the individual upon the history of his personality. Gross organ inferiorities are those which are definite handicaps in the struggle for success in society, such as heart disease. Such handicaps, however, are limited to relatively few of a population. The raison d'etre of the greater number of minor mental inefficiencies the psycha.n.a.lyst puts down to handicaps in the unconscious. Again he mistakes figurative imagery for explanations. The conception of endocrine diversity in the make-up supplies us with the rationale of the vast majority of organic and functional defects and inferiorities, in short, subnormalities of any group, large or small.

Moreover, how would the psycha.n.a.lyst explain the occurrence and influence of organic and functional _superiorities_ and their tremendous influence upon the individual and society? We live in a generation which has acquired a flair for the pathologic. Undoubtedly it is a soul-sick generation, and its interest in sickness of the mind is only natural. Just the same, whatever advances, improvements, progress, have been made (and certainly a number of the changes in his environment, external and internal, must be admitted to be changes for the better) have been made, not by natural disability, but by natural ability. What is the physiology of natural ability?

The finest study of natural ability that has as yet been composed is Francis Galton's on Hereditary Genius. It also remains the best study of the natural conditions of success. He showed that of the type of man he cla.s.sed as "ill.u.s.trious" there occurred about one in a million, and of the type "eminent" about two hundred and fifty in a million.

Of the qualities which determine natural ability of this kind, he selected inherent capacity, zeal, and perseverance as the three prerequisites. And he states that "If a man is gifted with vast intellectual ability, eagerness to work, and power of working, I cannot comprehend how such a man should be suppressed." "Such men (those who have gained great reputations) biographies show to be haunted and driven by an incessant, instinctive craving for intellectual work." "They ... work ... to satisfy a natural craving for brain work." "It is very unlikely that any conjunction of circ.u.mstances should supply a stimulus to brain work commensurate with what these men carry in their own const.i.tutions."

What is this inherent craving for brain work? What is this zeal? And what is power of endurance and perseverance, the quality of stamina?

How are they to be interpreted in terms of the internal secretions?

In view of what has been said of the ante-pituitary as the gland of intellectuality, studies of intellectually gifted people having shown well functioning large pituitaries, and of mental defectives in a certain number of cases a small limited pituitary, it is justifiable to regard the factor of inherent capacity as a function of the ante-pituitary. The factor of zeal or enthusiasm points to the thyroid. Markedly enthusiastic types are thyroid dominant types. Vigor as a third factor, the ability to stand stress and strain of continued effort is dependent upon good adrenal and interst.i.tial cell function.

So we may say that craving and capacity for brain work plus ardor plus perseverance in its pursuit, the triplicate of natural ability, are the reflections in conduct and character of balanced and sufficient ante-pituitary, thyroid, and adrenal-interst.i.tial contributions in the chemical formula of the personality. In the chapter on historic personages a.n.a.lyzed from the endocrine viewpoint, we shall see that some of the most eminent and ill.u.s.trious people of history have been pituitary-centered.

MENTAL DEFICIENCY