The kinetic drive : its phenomena and control Wesley M. Carpenter Lecture before The New York Academy of Medicine, 1915 / by George W. Crile ; edited by Amy F. Rowland.

  • Crile, George Washington, 1864-1943.
Date:
1916
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Licence: Public Domain Mark

Credit: The kinetic drive : its phenomena and control Wesley M. Carpenter Lecture before The New York Academy of Medicine, 1915 / by George W. Crile ; edited by Amy F. Rowland. Source: Wellcome Collection.

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    adrenals; by the excision of a portion of the thyroid and of the adrenals; and, if still further blocking of brain impulses be required, by dividing the cervical sympathetics as well. One would not expect these procedures to produce any subjective change in the patient. No function would be lost. He could work, be subject to emotion, and respond to in- fection as before, with the following exceptions—his power of physical exertion would be diminished, as would his response to emotional stimuli. or to infection. His acid excretion would diminish and his sugar tolerance would increase. In short, those diseases that are temporarily improved by morphin should be permanently improved by this process of dekineticization. | On this conception I have ventured on new surgical ground, and have performed fourteen operations on patients with chronic diseases resulting from an excessive kinetic drive. I first operated on eleven hopeless epileptics, then on three cases of Raynaud’s disease, and finally on an advanced diabetic. All made good operative recoveries. The operation performed in different stages comprised the excision of one adrenal, the excision of approximately three- fourths of the thyroid, and the division of the cervical sympathetic trunks. It is now two and a half years since the first of these operations was performed. It was not expected that epi- lepsy would be cured, but that the force of the attacks would be diminished and perhaps the intervals lengthened, for, since the epileptic attack represents a powerful temporary kinetic drive, it seemed possible that the severity of that drive might be modified. No case has been cured, but all made good operative recoveries, and the severity of the at- tacks and the length of the intervals have been favorably influenced. ‘The fact that some of these cases showed an