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there developed a pulsating enlargement of the thyroid gland； an increased prominence of the eyes； marked increase in perspirationprofuse sweating evenpalpitation of the heart； increased respiration with frequent sighing； increase in blood…pressure； there were 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 resembled closely those of fear and followed in the wake of a strain which was due to fear。
In young women exophthalmic goiter often follows in the wake of a disappointment in love； in women； too； it frequently follows the illnesses of children or parents during which they have had to endure the double strain of worry and of constant care。 Since such strains usually fall most heavily upon women； they are the most frequent victims of this disease。 Now； whatever the exciting cause of exophthalmic goiter； whether it be 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 which has been presented as an explanation of the genesis and the phenomena of fear be correct； then that hypothesis explains also the emotion of love。 If fear be a phylogenetic physical defense or escape which does not result 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 may 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。 That the emotions in Graves' disease are abnormally acute is illustrated by my personal observation of the death of a subject of this disease from fear alone。 Whatever the exciting cause of this disease； the symptoms are the same； just as in fear； the phenomena are the same whatever the exciting cause。
Figures 12 and 16 show the resemblance between the outward appearances of a patient with Graves' disease and of a person obsessed by fear。 Fear and Graves' disease have the following phenomena 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； and in Graves' disease analogous changes are seen （Figs。 13 C and 15）。 In Graves' disease there seems to be a composite picture of an intense expression of the great primitive emotions。 If Graves' disease be 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 there must be secreted in excessive amount some substance that activates the motor mechanism。 The nervous system in Graves' disease is hypersusceptible to stimuli and to thyroid extract。 It might follow that even a normal amount of thyroid secretion would lead to excessive stimulation of the hypersusceptible motor mechanism。
This condition of excessive motor activity and hyperexcitability may endure for years。 What is the source of this pathologic excitation？ The following facts may give a clue。 In suitable cases of Graves' disease； if the thyroid secretion is sufficiently diminished by a removal of a part of the gland or by interrupting the nerve and the blood supply； the phenomena of the disease are diminished immediately； and in favorable cases the patient is restored to approximately the normal condition。 The heart action slows； the respiratory rate falls； the restlessness diminishes； digestive disturbances disappear； tremors decrease； there is a rapid increase in the body weight； and the patient gradually resumes his normal state。 On the other hand； if for a period of time extract of the thyroid gland is administered to a normal individual in excessive dosage； there will develop nervousness； palpitation of the heart； sweating； loss of weight； slight protrusion of the eyes； indigestion； in short； most of the phenomena of Graves' disease and of the strong emotions will be produced artificially （Figs。 15 and 23）。 When the administration of the thyroid extract is discontinued； these phenomena may disappear。 On the other hand； when there is too little or no thyroid gland； the individual becomes dull； stupid； and emotionless； though he may be irritable； while if a sufficient amount of thyroid extract be given to such a patient he may be brought back to his normal condition。
Hence we see that the phenomena of the emotions may within certain limits be increased； diminished； or abolished by increasing； diminishing； or totally excluding the secretion of the thyroid gland。
Graves' disease may be increased by giving thyroid extract and by fear。 It may be diminished by removing a part of the gland； or by interrupting the blood and nerve supply； or by complete rest。 In addition； at some stage of Graves' disease there is an increase in the size and in the number of the secreting cells。 These facts regarding the normal and the pathologic supply of thyroid secretion point to this gland as one of the sources of the energizing substance or substances； by means of which the motor phenomena of animals are executed and their emotions expressed。
Anger is similar to fear in origin and； like fear； is an integration and stimulation of the motor mechanism and its accessories。 Animals which have no natural weapons for attack experience neither fear nor anger； while the animals which have weapons for attack express anger principally by energizing the muscles used in attack。 Although； as has already been stated； the efficiency of the hands of man has largely supplanted the use of the teeth； he still shows his teeth in anger and so gives support to the theory that this emotion is of remote ancestral origin and proves the great persistence of phylogenetic association。 On this conception we can understand why it is that a patient consumed by worrywhich to me signifies interrupted stimulation； a state of alternation between hope and fearsuffers so many bodily impairments and diseases even。 This hypothesis explains the slow dying of animals in captivity。 It explains the grave digestive and metabolic disturbances which appear under any nerve strain； especially under the strain of fear； and the great benefits of confidence and hope； it explains the nervousness； loss of weight； indigestionin short； the comprehensive physical changes that are wrought by fear and by sexual love and hate。 On this hypothesis we can understand the physical influence of one individual over the body and personality of another； and of the infinite factors in environment that； through phylogenetic association； play a role in the functions of many of our organs。 It is because under the uncompromising law of survival of the fittest we were evolved as motor beings that we do not possess any organs or faculties which have not served our progenitors in accomplishing their survival in the relentless struggle of organic forms with one another。 We are now； as we were then； essentially motor beings； and the only way in which we can meet the dangers in our environment is by a motor response。 Such a motor response implies the integratio