Dyspepsia in the middle ages: a reference in Giovanni Boccaccio's Decameron (14th century AD)?

.

'The voice of the stomach': the mind, hypochondriasis and theories of dyspepsia in the nineteenth century

Physicians and surgeons during the nineteenth century were eager to explore the causes of stomach and intestinal illnesses. Theories abounded that there was a sympathy between the mind and the body, especially in the case of the dyspepsia. The body was thought to have physical symptoms from the reactions of the mind, especially in the case of hypochondriasis. Digestive problems had a mental component, but mental anguish could also result from physical problems. Dissertations from aspiring as well as established physicians probed the mental causes of irritable bowel diseases and other diseases in the medical literature. Healing was thought to come from contextualizing the link between the problems of the mind and the resulting physical problems of the body.

[Brief analysis of professor YAN Jie's academic thought on functional dyspepsia treated with acupuncture and moxibustion]

The brief discussion is introduced in the paper on the academic thought of professor YAN Jie, the contemporary famous TCM doctor, on functional dyspepsia treated with acupuncture and moxibustion. Treatment based on "the three-regional acupoint selection" is applied to professor YAN's treatment for functional dyspepsia, in which, acupuncture is on Sibai (ST 2), Liangmen (ST 21) and Zusanli (ST 36), and the supplementary points are added accordingly. The academic thought is described as the combination of acupuncture and moxibustion based on strengthening healthy qi, supplemented by soothing the liver and psychological counseling. Also, an example is provided.

The value of curds and whey: BJN over 100 years ago

‘Little Miss Muffet sat on a tuffet eating her curds and whey, when down came a spider and sat down beside her and frightened Miss Muffet away.’ So goes the traditional nursery rhyme, but what are curds and whey?

Three centuries of stomach symptoms in Scotland

BACKGROUND

Stomach pain and discomfort have been reported since antiquity.

AIM

To follow the time trends since the 18th century of dyspepsia, gastric ulcer, duodenal ulcer, and benign oesophageal disease to test when dyspepsia started to become a major clinical problem.

METHODS

The annual in- and out-patient records of the last three centuries from the Scottish Royal Infirmaries of Edinburgh, Aberdeen, Glasgow and Dundee were analysed. In addition, dispensary attendances, clinicians' casebooks, students' notebooks and medical texts have been scrutinized for historic statistics of upper gastrointestinal disease.

RESULTS

Dyspepsia was first recorded in the 1750s and increased markedly subsequently. Such dyspepsia persisted after gastric and duodenal ulcers appeared in the late 19th century and then declined again in the late 20th century. Non-ulcer dyspepsia has remained the commonest diagnosis made after endoscopy for stomach pain in the beginning of the 21st century.

CONCLUSION

The current commonest diagnosis of stomach pain, dyspepsia dates from the mid-18th century. Any explanations of its causation need to consider this timing.

Review article: The history of hypnotherapy and its role in the irritable bowel syndrome

Hypnosis is a technique by which an individual can gain a degree of control over physiological as well as psychological function. This paper reviews the history of the phenomenon as well as the accumulating evidence that it is effective in relieving the symptoms of irritable bowel syndrome and improving the quality of life of sufferers. The physiological effects of hypnosis are also discussed coupled with an outline of how a hypnotherapy service might be provided.

[A remembrance of Clarín's illnesses in his centenary]

The Spanish famous writer Leopoldo Alas, also known by the pseudonymous of "Clarín" suffered from two main kind of illnesses: nervous and digestives. Both began early, when he was only thirty two. At that moment, and during all his thirties, nervous ailments were conspicuous, but digestive problems were growing up slow but steadily and became the most serious and even menacing during his forties. Nervous pathology was double: on the one hand, some attacks of migraine with visual disturbances (scotoma), dysphasia and other "indescribable nervous oddities", which happened about 4-5 times per year; on the other, several emotional and vague symptoms, such as melancholia, dejected mood, anxiety, nervousness, etc. Digestive symptomatology, consisting of atonic constipation, intestinal dyspepsia, febricula, and a feeling of being "as a blocked drain", is due--no doubt--to tuberculous peritonitis diagnosed by his young nephew Dr. Martínez. This serious illness was the cause of his death on the 13th June 1901, when he was only 49.

Alimentary diseases in the poor and middle class in London 1773-1815, and in New York poor 1797-1818

BACKGROUND

Although dyspepsia has been described for thousands of years, few studies have analysed its incidence before the 19th century when peptic ulcer first became a major dyspepsia-producing disease.

METHODS

The incidence of alimentary disease around 1800 was examined in three private practices for the fee-paying middle class and in five public dispensaries for the poor in London, as well as in one dispensary in New York.

RESULTS

The proportions of attendances for alimentary disorders were identical, 16%, in each of the three groups. Diarrhoea and dysentery were twice as common in the London dispensary than in private practice, presumably because of poor sanitation. Dyspepsia showed a similar incidence in the London dispensary and private practice, but was only half as common in New York. Worms were three times more common in dispensary patients in New York than in London. The incidence of diarrhoea and dyspepsia indicated no significant time trends over 43 years. None of the alimentary causes of death showed peptic ulcer at necropsy, and both haematemesis and intestinal haemorrhage were rare.

CONCLUSIONS

Around 1800, the infrequent deaths from alimentary conditions suggested that the ulcer epidemic had not yet started. Instead, it is probable that the dyspepsia was similar to the non-ulcer dyspepsia of today.

Hospital admissions for peptic ulcer and indigestion in London and New York in the 19th and early 20th centuries

The occurrence of peptic ulcer increased rapidly in all Western countries from the 19th to the 20th century, attributed to a possible epidemic of Helicobacter pylori, a new pathogenic strain, or a change in host susceptibility. The early trends in hospital admissions for peptic ulcer and dyspepsia in London and New York during the 19th century are reviewed to test these hypotheses.

The history of 'nervous disorders' from 1600 to 1840, and a comparison with modern views

In the 18th century the main varieties of nervous illness - hypochondria, hysteria, the spleen, the vapours and dyspepsia - became included under the general term 'nervous disorders'. When no physical disorder of the nerves could be detected in such conditions, the hypothesis of nervous disorder was replaced by the more vague concept of 'nervous temperament'. The fact that there is still no evidence of pathological change in such cases continues to expose physicians to the alternative hypothesis of a purely psychological cause. The modern era in our understanding of the nervous system may be said to date from 1843 when Du Bois Reymond showed the electrical nature of nervous conduction. The publication of Jorden's Briefe Discourse in 1603 may be taken to represent the start of a discrete period (1600 to 1840) in the history of neurotic illness.

Dyspepsia and non-ulcer dyspepsia: an historical perspective

Dyspepsia or indigestion is one of the most common disorders that is managed by general practitioners and gastroenterologists. Non-ulcer dyspepsia can be defined as upper abdominal pain or nausea in patients in whom endoscopy reveals no evidence of peptic ulceration or gastric cancer. Non-ulcer dyspepsia is a heterogeneous disorder and can be the result of such diverse entities as the irritable bowel syndrome, duodenitis or gastro-oesophageal reflux, or may be idiopathic ("essential" dyspepsia). This review traces the development of modern thought on dyspepsia and non-ulcer dyspepsia, from the 16th century to the present.