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The birth of modern surgery – from Lister to the 20th century
Published in Harold Ellis, Sala Abdalla, A History of Surgery, 2018
Now that inspection of the abdominal viscera was possible at operation, surgeons found, to their surprise, that the position of the organs was often quite different to the findings in the cadaver, especially in the preserved bodies of the dissecting room. A still further surprise followed the discovery of X-rays by Wilhelm Roentgen (1845–1923), professor of physics at Wurzburg, in 1895 and then the X-ray visualisation of the abdominal organs by contrast material, first by using bismuth sulphate introduced by Walter B. Cannon (1871–1945) at Harvard Medical School, in 1897. The spleen, kidneys and, in particular, the stomach and intestines were often situated in a lower plane than described in the anatomical textbooks. Some of these appearances, in fact, were brought about by the weight of the contrast material in the stomach and bowel, with the patient in the upright position but the rest, as we now know, simply represented normal biological variation. However, what can only be described as a ‘non-disease’ came into existence – ‘visceroptosis’.
‘Neurasthenia gastrica’ revisited: perceptions of nerve-gut interactions in nervous exhaustion, 1880–1920
Published in Microbial Ecology in Health and Disease, 2018
One of them was the Canadian physician Hugh McCallum, who in 1906 stated that he looked upon ‘ptosis of any of the abdominal viscera as a stigma of neurasthenia, and quite as pathognomonic of it as a sharp haemoptysis is of pulmonary tuberculosis’ [15, p.1032]. In a previous paper, he stated that as many as 90 percent of female cases of neurasthenia were ‘victims of visceroptosis’, and he argued that the symptoms of visceroptosis were practically the same as those of neurasthenia – ‘with or without local distress’, which suggested a direct causal link [49]. Examples of symptoms of gastric neurasthenia which were also reported in visceroptosis, were a disturbed appetite, ”a sense of fullness in the epigastrium, belching, acid taste” and burning pain in the epigastrium after eating. The general nervous symptoms included ‘general weakness, changeable and depressed moods, headaches and fulness of the head, vertigo, (…) disturbance of sleep’, and a number of other ailments [38, p. 540]. Among the etiological explanations for the visceroptosis as such, were a ‘bad standing posture’, ‘badly-fitting garments’, high-heeled shoes and corsets, ‘the imperfect use of the lower zone of the thorax, the absence of fat, and the want of tonicity in the abdominal musculature leading to defective intra-abdominal pressure’ [47,49, p. 345, 50].
Autointoxication and historical precursors of the microbiome–gut–brain axis
Published in Microbial Ecology in Health and Disease, 2018
This presents one of the other reasons behind autointoxication’s fall from grace: the fact that it was regularly conflated with other conditions and theories, including infarctus (impacted faeces, a theory associated with Johann Kampf, 20), constipation, distention, and visceroptosis. Charles Bouchard’s early interest in abdominal distention, for example, was one of the reasons behind his opponents’ initial dismissal of his broader theory of autointoxication [27]. Autointoxication theory was also (and still is) often confused with visceroptosis, a condition associated with physician Frantz Glénard which broadly referred to the displacement or prolapse of the bowels [28]. Baron and Sonnenfeld’s 2002 article, for example, examines visceroptosis and autointoxication concomitantly and dismisses both as ‘nonexistent disease entities’ [17].