Mental Influence In Dyspepsia And Indigestion





It is often said that this teaching as to the effect of the mind on

digestion and its eminent usefulness for the treatment of dyspeptic

conditions, is due to the attention that has been attracted to this

subject as a consequence of the prominence of Eddyism, New Thought,

Mental Healing, and the like. There are absolutely no good grounds for

any such assertion. Here in America, more than twenty-five years ago,

before there was any question of the modern mental healing movements,

our greatest medical clinician, Dr. Austin Flint, expressed himself

very emphatically with regard to mental influence over digestion, and

to solicitude of mind as one of the most frequent etiological factors

in dyspepsia.



Dr. Flint was thoroughly scientific in his medical observations, was

no seeker after notoriety, and he was reading his paper before the

older physicians of the period, and all of those who took part in that

first meeting of the New York Medical Association strove to make their

papers of scientific value. His words, then, must carry great weight:







Dyspepsia formerly prevailed chiefly among those who adopted, to a

greater or less extent, the foregoing maxims [the finicky rules of

dyspeptics which he deprecates and corrects as quoted later in this

chapter]. It was comparatively rare among those who did not live in

accordance with dietetic rules. The affection is much less prevalent

now than heretofore, because these maxims are much less in vogue.

The dyspeptics of the present day are chiefly those who undertake to

exemplify more or less of these maxims. It seems to me, therefore, a

fair inference, that dyspepsia may result from an attempt to

regulate diet by rules which have for their object the prevention of

the affection which they actually produce. It is to be added that an

important causative element involved in the practical adoption of

these rules is the attention thereby given to digestion. It is by

introspection and constant watchfulness of the functions of the

stomach, that the mind exerts a direct influence in the causation of

this affection.







Dietetic Rules of a Former Day.--In order to make definite just what

were the views of the olden times which he deprecates, he stated them

briefly and forcibly:



The views generally entertained, at the time to which I have

referred, largely by physicians and almost universally by

non-medical sanitarians, may be summed up in a few maxims as

follows: Eat only at stated periods, twice or thrice daily, and

never between meals, no matter how great may be the desire for food.

Never eat late in the evening or shortly before bedtime. In the

choice of articles of diet, carefully select those which reason and

personal experience have shown to be best digested; and never yield

to the weakness of eating any article of food simply because it is

acceptable to the palate. In order to avoid the temptation of

overeating, let the articles of food be coarse rather than

attractive, and eschew all the devices of the cuisine. Always leave

the table hungry. Study personal idiosyncrasies, and never indulge

in kinds of food which, although wholesome for most persons, are

injurious to a few who are peculiarly organized. With reference to

this last maxim, bear in mind that "what is one man's meat is

another man's poison." In order to secure, as effectually as

possible, a proper restriction in the quantity of food, it was

recommended by some physicians and to some extent practiced, that

every article be carefully weighed at meal times, and that a certain

quantity by weight be never exceeded. Vegetarianism or Grahamism was

advocated and practiced by many. Total abstinence from drink was

considered by a few as a good sanitary measure, compelling the body

to derive the needed fluids exclusively from fruits, vegetables, and

other solid articles of diet. Restriction in the amount of drink, as

far as practicable with regard to the power of endurance, was very

generally deemed important, so as not to dilute the gastric juice.



When to his question, "Do you regulate your diet," the patient

answered promptly and often emphatically in the affirmative, Dr. Flint

insisted always: "This is a good reason for your having dyspepsia; I

never knew a dyspeptic get well who undertook to regulate his diet."

When the patient asks then, "How am I to be guided," the reply is,

"Not by theoretical views of alimentation and indigestion, no matter

how much they appear to be in accord with physiological and

pathological doctrines, but by the appetite, the palate and common

sense." He then goes on to answer certain other objections that

patients are wont to urge, and says:



But the patient will be likely to say, "Am I not to be guided by my

own experience and avoid articles of food which I have found to

disagree with my digestion?" The answer is, that personal experience

in dietetics is extremely fallacious. An article of diet which may

cause inconvenience of indigestion to-day may be followed by a sense

of comfort and will be readily digested to-morrow. A variety of

circumstances may render the digestion of any article of food taken

at a particular meal labored or imperfect. As a rule articles

which agree with most persons do not disagree with any, except from

casual or accidental circumstances, and from the expectation, in the

mind of the patient, that they will disagree. Without denying that

there are dietetic idiosyncrasies, they are vastly fewer than is

generally supposed; and, in general, it is fair to regard supposed

idiosyncrasies as purely fanciful. Patients not infrequently cherish

supposed idiosyncrasies with gratification. The idea is gratifying

to egotism, as evidence that Providence has distinguished them from

the common herd by certain peculiarities of constitution.





Dietetic Instructions.--Finally Dr. Flint has a series of instructions

for those suffering from indigestion:



Do not adopt the rule of eating only at stated periods, twice or

thrice daily. Be governed in this respect by appetite; and eat

whenever there is a desire for food. Eat in the evenings or at

bedtime, if food be desired. Insomnia is often attributable to

hunger [italics ours]. In the choice of articles of diet, be

distrustful of past personal experience, and consider it to be a

trustworthy rule that those articles will be most likely to be

digested without inconvenience which are most acceptable to the

palate. As far as practicable, let the articles of diet be made

acceptable by good cooking. As a rule, the better articles of food

are cooked, the greater the comfort during digestion. Never leave

the table with an unsatisfied appetite. Be in no haste to suppose

that you are separated from the rest of mankind by dietetic

idiosyncrasies, and be distrustful of the dogma that another man's

meat is a poison to you. Do not undertake to estimate the amount of

food which you take. In this respect different persons differ very

widely, and there is no fixed standard of quantity, which is not to

be exceeded. Take animal and vegetable articles of diet in relative

proportions as indicated by instinct. In the quantity of drink,

follow nature's indication; namely, thirst. Experience shows

abundantly that, with a view of comfortable digestion, there need be

no restriction in the ingestion of liquids.





Removal of Solicitude as a Remedial Measure.--Many dyspeptics have no

subject that they occupy themselves with more seriously than their

digestion, and they thus divert blood needed for digestive purposes as

well as nervous energy that would help in it from the stomach to the

brain, in order to exercise surveillance over the process. As has been

well said, "Probably much more than half of the indigestion is really

above the neck." This does not mean that there are not cases that need

definite stomachic treatment, or even that patients who have succeeded

in functionally disturbing their digestion by thinking over much about

it, will not need gastric remedies.



The explanation of the many fads and remedies that cure indigestion,

real or supposed, is exactly this tendency of the suggestive influence

of such remedial measures to lessen the patient's solicitude about

digestion. Any change in diet that carries with it the persuasion that

for any reason digestion ought to be better, will, because of this,

make digestion better. Any habit of taking warm or cold water before

meals, or of chewing in a particular way, or of taking a particular

kind of food different from what is usually taken--exclusively cereal,

uncooked, largely fruit, vegetarian, etc.--will lift the concentration

of attention on the digestive process, and so give the stomach a

chance to do its work without interference from the brain.



Du Bois has quoted some striking testimony in this matter from Baras,

who wrote on the "Gastralgias and Nervous Affections of the Stomach

and the Intestines" as early as 1820. Baras had himself been a

sufferer from gastric discomfort, fullness after eating,

eructations of gas, constipation, and general depression. He consulted

most of the distinguished medical practitioners of his time. With one

exception they were convinced that he was a sufferer from chronic

gastro-enteritis. They added more and more to his concern about his

stomach, and furnished him with numerous sources of autosuggestion. In

spite of all that they did for him, his condition grew worse and

worse, he lost in weight, and was sure that his case was hopeless. He

was cured in a single day. His daughter was attacked with consumption,

and "in the moment my attention," says Baras, "was centered entirely

upon my child, I thought no more of myself, and I was cured."





Brain Workers and Indigestion.--Perhaps the best proof of how

necessary it is that people should not continue to occupy their

intellect seriously during the time when digestion is going on, is to

be found in the frequency with which complaints of indigestion occur

in literary folk. The complaints are heard most from literary folk

because they are more likely to tell their stories. They have their

work, and thoughts of it, always with them. So there is a constant

call for nervous and mental activity and for much blood in the brain

tissues. This subtracts from the nervous energy necessary for

digestion, and makes it impossible to conduct it with that perfection

which comes naturally to people who banish all other thoughts and keep

their minds free for the pleasures of the table and social intercourse

at meal time.



Nervous indigestion is so common among literary folk, teachers and

scientific workers, that various causes have been suggested for it.

Dr. George Gould, in his "Biographic Clinics," calls attention to it

and suggests that the cause is probably the need of properly fitted

spectacles. In our own time, when we are much more careful in the

matter of eyeglasses, and when most writers and professors wear

scientifically adapted glasses, the complaints still continue. The

reason is evidently something associated with the almost continuous

work that they do. Such people, too, are much more self-conscious than

others. They think more about their digestion and what they eat. They

often think that they differ from other people and have special

idiosyncrasies for food. These thoughts are sure to culminate in

nervous indigestion.





Food Faddists.--Literary folk and people who live the intellectual

life are very prone to take up with fads of various kinds and find

surcease from their sorrows in all sorts of out of the way dietaries,

modes of eating, food limitations and specializations. They constitute

a majority of the food faddists. Some of them--sure that they should

not eat meat--are strenuous vegetarians. Others confine themselves

entirely to food the life of which has not been completely destroyed

by cooking. They are fruit faddists, nut faddists, milk-product

faddists, and the like. Some of them try to persuade the world that it

eats too much; others that it eats too frequently. Some of them take

but a single real meal a day and have apologies for the other meals.

All want to lead people to their particular mode of life, as if all

the world had been wrong until they came to set it right. Some want

the rest of the world to chew seventy-times-seven before they swallow

and to adopt other exaggerations of attention to eating that are quite

contrary to instinct, the most precious guide that we have in the

matter of food choice and food consumption.



These intellectuals are always improved by their fads, no matter what

they may be. The reason is apparent. Their original digestive

disturbance was due to over-occupation with intellectual work. Then

they began to worry about their digestion and feared that nearly

everything they ate would disagree with them. This fear and solicitude

still further interfered with digestion. Next they acquired the new

fad. They became persuaded that they could eat certain things in

certain ways. They no longer disturb their digestion by anxiety about

it, but, on the contrary, help it by favorable suggestion. Now under

the new regime everything will surely go on well. Besides, they

usually learn the lesson of not doing intellectual work close to their

meals, and of spacing their work better. They learn to do a daily

stint of work and no more. One of the fads that goes with most food

fashions is abundant outdoor air. This always does good. Between the

favorable mental influence, the lessened work, especially just after

meals, and the increased outdoor air they get better and then they

attribute it all to their special fad about food. The "cure" is due

to psychotherapy and common sense, and not in any way to the special

fad.





Worry.--Worry of any kind will have the same effect as the

over-attention of the literary man or teacher to his work. Anyone who

brings his business home with him is likely to suffer and, unless he

has a superabundant supply of energy, will impair his digestive

function as a consequence of attempting to do business after dinner,

perhaps also stealing some of it in before and during breakfast.





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