Emotionless Stomach

It is not often that doctors get a patient with a window in his stomach, but when they do, they make the most of it. From the first such case that was carefully studied, in the 1820s,* they garnered many details of the mechanisms of digestion; in more recent cases they studied the psychosomatic relationships between the emotions and the stomach. But always the doctors had to deal with a patient whose feelings (and stomach reactions) were his and his alone, the product of all his heredity and environment. To find out how the stomach would work in an emotional vacuum--and thus establish bench marks for surveying emotional effects--they needed a patient with a hole in his stomach and no emotions. But where to find one?

Grab & Milk. In New Orleans last week, Dr. Ronald Doig told a gathering of Southern medical researchers that just such a patient had appeared and had been studied at New York Hospital-Cornell Medical Center. A Louisiana farm worker, he was so injured in an auto accident that all the higher centers of his brain were knocked out. Caring for him month after month at Shreveport Veterans Hospital was a forbidding task. Eventually, the doctors made an opening in the patient's abdominal wall and stomach for direct feeding. (This freed the patient of nose tubes, and if he ever recovered the power to chew and swallow food, his stomach and belly could be closed up again.) Then he was flown to New York City for stomach studies.

In Manhattan Dr. Doig and other members of the New York-Cornell stomach-peeping team checked to see whether the mere sight of food, without mental awareness of it, would start the patient's stomach working. It did not. But the physical touch of food entering the stomach set off a chain of automatic reactions. The stomach "grabbed" the food with firm muscles and "milked" it on its way down the intestinal tract. And the stomach did these same things when the doctors inserted a small balloon on a string.

Reverse Effects. Several of the tests were to find out how an emotionless stomach behaves with certain drugs. This is important, because normal patients often have such strong emotions that they can reverse a drug's natural action (e.g., sleeping pills may keep a man awake if he firmly believes that he is getting a stimulant). Atropine has been a puzzle, because in theory it should cut down stomach activity, but in practice small doses sometimes do the opposite. Doctors had thought, but could not prove, that this was due to emotional factors. The Louisiana farmhand provided the proof: his stomach always, uniformly and monotonously, slowed down when he got atropine, even in tiny doses.

While he served to answer some questions, the unfortunate but invaluable patient raised some new ones. Insulin usually excites the vagus nerve, and this sets the stomach to working faster. Doctors have believed that this effect is transmitted through the more primitive brain centers. The farmhand had these primitive centers intact, so his reaction to an insulin injection should have been normal. Surprisingly, it was not. His stomach simply did not respond. Why? Dr. Doig and his colleagues suspect that insulin must work through higher brain centers after all.

* Alexis St. Martin, a French-Canadian voyageur, took a shotgun blast in the abdomen at Fort Mackinac in 1822, but his life was saved by Army Surgeon William Beaumont. A small opening in St. Martin's abdominal wall and stomach remained, and through it, over many years, Beaumont made hundreds of observations on stomach functions.

This file is automatically generated by a robot program, so reader's discretion is required.