1907

Based on two cases that “the specific excitant of the exophthalmic goiter is the emotion fear,” Crile sought to eliminate preliminary fear in hyperthyroidism by deceiving patients about to receive operations and thereby established the principle of “the shockless operation,” which he termed anoci-association, later anociation: by blocking off the field of operation via a local anesthetic, he prevented harmful associations (noci-associations) that would produce “exhaustion” in nerve cells and the discharge of nervous energy otherwise caused by the trauma (Crile I, 205-208, 218).