We may therefore visualize a mechanism of fear. An instant excess of adrenalin occurs in the blood of, say, a cat when it is alarmed by the sight of a dog. In that cat, at the image of its hereditary enemy, certain brain cells vibrate. A nerve tract, in use as the line for that particular message in a hundred thousand generations of cats, whirrs its yell to the medulla of the adrenal gland. Through the tiny, solitary veins of the glands, an infinitesimal quantity of the reserve adrenalin responds. And with what an effect! The blood, that primary medium of life, the precious fluid that is everything, must all, or nearly all, be sent to the firing line, the battle trenches, the brain and muscles, now or never. So the blood is drafted from the non-essential industries—from the skin where it serves normally to regulate the heat of the body—from the digestive organs, the stomach and intestine, which must forsooth stop now, since if the organism will die, their last effort of digestion has been done—from the liver and spleen, great chemical factories in normal times, but now of no moment. Besides, should they be wounded, it is better they should be bloodless, and so run the least chance of bleeding to death, or getting infected, for the more tissue there is around, the greater the danger of infection. So, like the skin, the liver which usually holds in its great lakes and vessels about a quarter of all the blood in the body, is almost drained and blanched. At the same time, its great storehouses of sugar open their sluices and pour into the blood, increasing its sugar content by about a third because the combustion of sugar is the easiest way of getting energy free in the cells, sugar being the most quickly burned up of all the foods, and so the great food of the muscles and the heart. The poisons of fatigue, acid products of the contraction of muscles, are antagonized and neutralized by substances formed in the course of the oxidation of the sugar. Adrenalin, too, is directly fatigue antagonist. It causes the blood to clot faster than under ordinary circumstances. It erects the hair of the animal, and dilates the pupils of the eyes. There is an increase of the apparent size, all of which are to intimidate the enemy, like an Indian's painting of his face blue and green. It also—but what else does it not do?
The story of adrenalin would have delighted the heart of Samuel Butler. His "Note Books," opulent as they are, would have been the richer in pages and pages with his comments on it. Contending as he did with the pompous, dogmatic mechanism worship of the new scientific clique of his time on the one hand, and the superstitions of the old theological caste on the other, he had to fight the hardest kind of guerrilla warfare in defense of the Purpose of Life. Adrenalin, that weapon of a gland tracing its ancestry back to the begetter of the brain itself, for brain and adrenal gland both have evolved from the small nerve ganglia of the invertebrates, would have backed up to the hilt his argument, which he had to elaborate on the indirect grounds of analogy and induction. Essential for defense, and for protection,— an organ in which everything necessary for the stratagems of retreat, or the offensives of attack, are supplied ad libitum, while everything non-essential or detrimental to the matter of the moment is inhibited, arrested and suppressed—no more perfect sample of the design with which Life is drenched could be imagined by the most closeted of passionate idealists.
FAILURE OF THE ADRENALS
As the gland of acute stress and strain, the adrenals in modern life are called upon to function more heavily and frequently than in the past. As a matter of fact, the life of the beast of jungle and field, as well as of savage and barbarian, is just as full of emergencies and shocks as that of the average city man or woman. In the case of the latter, however, inhibitions, education, and the conditions of modern living, improper food, sedentary indoor confinement, and universal rack and noise, have undoubtedly made greater and greater demands upon the adrenal glands. Chemical quantitative studies have shown that by repeated stimulation, the adrenal glands may be exhausted of their reserve supply of secretion, which returns only insufficiently if not enough time is given for recuperation. There results a condition of temporary or chronic adrenal insufficiency, supposedly an insufficient functioning of the gland as a whole. In persons so afflicted there appears a fatigability, a sensitiveness to cold, cold hands and feet, which are sometimes mottled bluish-red, a loss of appetite and zest in life, and a mental instability characterized by an indecision, and a tendency to worry, a weepishness upon the slightest provocation.
A certain number of the temporary breakdowns or nervous prostrations, which seem to be growing more common or fashionable, may be sometimes traced to such a deficiency of normal response to the needs of everyday conflict by the adrenal gland. In some, mental and physical elasticity are totally lost, and even the slightest exertion in either field often causes so much weariness and exhaustion as to be prohibited. Depression and even melancholia are associated with the fear of not being able to accomplish good work hitherto easy and enjoyed. Sometimes they are obsessed with the thought that they have lost their nerve completely, and so dread to commit themselves in even the most trivial of situations. The vacillating frame of mind is so distressing at times as to arouse thoughts of suicide. When these symptoms concur in the type of personality whom I shall describe as the unstable adrenal-centered individual, there is evidence for explaining the process as the effect of an insufficiency of secretion by the adrenal gland.
Shock, collapse, heart failure and sudden death following abnormal emotion, like an attack of rage, or the terrors of a railroad accident, or bad news, or excessive exertion like running a long race or climbing a high mountain when in poor general health, as the phrase goes, or in the terminal stages of infections like epidemic influenza or Asiatic cholera, have been put down to an acute insufficiency of the adrenal gland. A lowered temperature, blood pressure, and blood vessel tone, exhibited in tests of the response of the skin to stroking, are present in all of these and point the same moral.
In the second half of the 19th century, an American physician, Beard, described Neurasthenia, a general disturbance of the body and mind, not properly classifiable as a disease, but serious enough to incapacitate or at least greatly limit the sufferer. The neurasthenic is to be recognized by the fact that the most painstaking objective examination of his organs reveals nothing the matter with them. Yet, according to his complaint, everything is the matter with him. He cannot sleep when he lies down, he cannot keep awake when he stands up. He cannot concentrate, but still he is pitifully worried about his life. The slightest irritant causes him to go off the handle. As he works himself up into his hysterical state as a reaction to a disagreeable person or problem, irregular blotches may appear on his face and neck. Generally, his hands and feet are clammy and perspiring, his face is abnormally flushed or pallid, the eyes are worried or starey, unwonted wandering sensations involving now this area of the body, or now that obsess him. As the blood pressure is too low for the age, the circulation is nearly always inadequate and palpitation of the heart is a frequent complaint. So frequent, that attention is often centered upon the heart, a diagnosis of heart disease is made, and the unfortunate is doomed for life—to brood over horrible possibilities. The brooding over themselves and their troubles is one of the distinctive features of the whole complex. Neurasthenia may masquerade as any organic disease. An individual with a soil for a neurasthenic reaction to life will become neurasthenic when confronted by any stone wall, including a serious ailment within himself.
Beard's Neurasthenia leaped at once into the limelight. It was seized upon and applauded in Europe as a good new name for an old condition, observed particularly in Americans abroad to rest from the fatigues of the get-rich-quick games of industrial speculators. In fact, the name of the American Disease was given to it. Various theories about the effects of climate, sunlight per square inch and unit of time, oxygen content of the air, and so on, were offered up upon the altar of scientific explanation. Sir Arbuthnot Lane, famous protagonist of Lane's intestinal kink, said that all Americans were neurasthenic. Neurasthenia became one of the most popular of diagnoses, and remains so today.
Neurasthenia, regarded as a reaction of people to the stress and strain of life, has without a doubt increased. The most casual of observers will tell you that the generation of the Great War is a neurasthenic generation. It takes its pleasures too intensely, its pains too seriously, its troubles too flippantly. But what is neurasthenia? Beard himself regarded it as a chronic fatigue and loss of tone of the nervous system, a literal interpretation of his term. That the conception, as far as it goes, is valid is proved by the fact that it is the neurasthenics who furnish the majority of the clientele of the cults, the Christian Scientists, the osteopaths and the chiropractors, and who are the subjects of the faith and miracle cures, like those of Lourdes. That is because their particular disease, or what appears to them to be their very own disease—and they certainly cherish their ailments—is but an expression of, a compensation for, indeed a consolation for, the underlying feelings of insufficiency or inferiority. Were there no moral code, were there no social system, nor the consequent inculcated conscience to be responsible to, there would be no such disguising symptom as the disease which preoccupies the consciousness. The feeling of insufficiency would be there, and would be recognized as in itself the disease. To the physiologist and the psychologist, the feeling of insufficiency is the disease, no matter how spectacular the overlaying phenomena—a cripple on crutches or a man blind and speechless. Shell shock is now acknowledged to belong to this group.
Now one of the outstanding effects of disease of the adrenal glands is the feelings of muscular and mental inefficiency. And as a matter of fact, a good number of observations conspire for the idea that a certain number of neurasthenics are suffering from insufficiency of the adrenal gland. The chronic state of the acute phenomenon, known as the nervous breakdown, really represents in them a breakdown of the reserves of the adrenals, and an elimination of their factor of safety. In the light of that conception, the great American disease—dementia americana—is seen to be adrenal disease—and the American life to be the adrenal life, often making too great demands upon that life, and so breaking down with it.