Ulcer Route?

Ever since Boston's late great Surgeon Harvey Gushing showed that impulses from the brain, communicated through the nervous system to the digestive tract, could cause peptic ulcers, thousands of ulcer victims have had their vagus nerve severed by surgery to break the chain of cause & effect. It usually worked, but sometimes the ulcers recurred--presumably because mental stress had found a new route to the stomach, but how, nobody knew. Lately physicians have noticed that heavy doses of ACTH or cortisone may start old ulcers up again.

At Boston's Peter Bent Brigham Hospital, where Gushing did much of his work, a team of researchers headed by Dr. Seymour Gray put two & two together. This undesirable effect of ACTH and cortisone on ulcer patients, they reasoned, revealed a second pathway by which emotional stress reaches the stomach: through the pituitary and adrenal glands and their hormones. To test their theory, they gave ACTH to patients whose vagus nerve had been cut, and found that it made their poor stomachs react just as if the vagus nerve had been intact, i.e., the stomachs became overactive, secreted too much of the digestive juices. One patient began to have ulcer pains; at that point, the researchers had to stop.

Naturally, say Gray and his colleagues, their tests indicate that precautions must be taken in ordering ACTH and cortisone for ulcer patients. They may also lead to a new understanding of how ulcers start and how they should be treated.

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