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In 2007, two Chilean physicians, Fernando Orrego and Carlos Quintana, published an article criticizing all previous diagnoses of Charles Darwin's illness, including Chagas' disease. They argued that the illness was Crohn's disease. In their opinion, the diagnosis of Chagas' disease can be “easily discarded” because Darwin did not show the acute symptoms of early Chagas' nor its later chronic symptoms of myorcarditis, megaesophagus, and megacolon. It is thought that their discussion of Darwin's gastrointestinal symptoms gives a picture of Crohn's disease that is vague and inchoate, and it is also believed that they largely ignore the stresses on Darwin's health of his working on his controversial theory of natural selection. In contrast to the diagnosis of Crohn's disease, the diagnosis of Chagas' disease postulates that Darwin had an active infection of his stomach and intestine that became arrested after inflicting permanent injuries. As a result of these injuries, his sensitivity to becoming ill from various mental stresses, including stresses from his evolutionary ideas, was greatly increased.

This chapter discusses the cancers of the upper gastrointestinal region. The most common upper gastrointestinal cancers are the cancer of the oesophagus, stomach, and pancreas. All these types of cancer are strongly associated with smoking. Oesophageal cancer may also be related to high alcohol intake, while cancer of the stomach may also be associated to ingested carcinogens and chronic mucosal conditions, which are prevalent in depressed societies. Upper gastrointestinal tumours infiltrate locally and spread via lymphatic drainage to regional lymph nodes within the mediastinum from the oesophagus and within the abdomen from the other sites. Prognosis of all these malignancies is generally poor, with only a ten per cent of long-term survival, the maximum of which is five years' survival.

This chapter reviews the epidemiology of stomach cancer, focusing on adenocarcinoma of the stomach, including that of the gastric cardia and gastoesophageal junction. Topics covered include classification, preneoplasia, demographic patterns, environmental factors, host factors, and preventive measures.

This chapter shows that socio-economic position at different stages of the life course can influence particular conditions in particular ways. Two conditions — stroke and stomach cancer — seem especially responsive to early-life influences. Other conditions — coronary heart disease, chronic obstructive respiratory disease, breast cancer, and suicide — appear to influenced by socially patterned exposures acting across life.

Political activism against the government seemed no longer necessary. The first year of the People's Republic of China was very successful. But Jin was no longer valued as a movie icon. Qin Yi, on the other hand, kept getting chosen for many film roles and soon became one of China's most popular stars. The couple often was so busy and many times in two different places that they did not see one another for weeks at a time. When Qin finally learned about Jin's infidelity, she was pregnant with their second child. The couple decided to sleep in separate rooms. Jin, by the close of 1958, was just too tired to work in any more films. In 1962, he had his stomach removed. He never recovered his health. For a decade, the old Rudolph Valentino of Shanghai had been sick and alone. He died on December 27, 1983 at the age of 73.

The Introduction to Part II, which includes Chapters 4-6, sets the stage for approaches to appetite developed between 1800 and 1850 in physiology and medicine. In the wake of the French Revolution, this era saw increased tensions over the proper role of science and medicine in addressing public and moral concerns raised by desires and demands for food. Researchers sought authority over appetite but recognized its ambiguous status as an object of investigation. Around 1800, competing views of appetite were clear in the work of the physician Erasmus Darwin and the anatomist-physiologist Xavier Bichat, the former celebrating the life-sustaining role of appetite whereas the latter warned against the threat to reason posed by visceral desires. Physiologists concentrated study of ingestion and digestion on observable actions and reactions, although some studied appetite using procedures such as vagotomy. Some physicians sought to refine classifications of appetite disorders, creating new diagnoses such as “neuroses of the stomach.” Others who were associated with emergent mental medicine tried, without success, to trace appetitive ills to lesions discoverable in autopsy. Their failure encouraged the sequestering of troubled appetite within the frame of psychiatric illness.

This essay investigates the emergence and evolution of philosophical and scientific inquiries into the nature of human digestion in the long eighteenth century. It suggests that shifting perspectives on digestion encouraged deep anxieties to form around the gut. Ultimately, these concerns underpinned a new set of therapeutic regimes designed to safeguard both dietary and bodily health.

The psychophysiology of the gastrointestinal system is a relatively unexplored area, in part due to the instrumentation and measurement problems of obtaining data from far inside this constantly changing many-meter-long system. Nevertheless, a number of studies of motor activity have been conducted, particularly in the more easily accessible two ends of the gastrointestinal tract, the esophagus and rectum, and also in the stomach. This chapter focuses on the motor activity of the stomach as measured with the noninvasive method of electrogastrography, a technique which records electrogastrograms (EGGs). EGGs reflect gastric myoelectrical activity as it is recorded from the abdominal surface with cutaneous electrodes. The physiological basis of EGGs is discussed, along with the psychophysiological recording procedure, typical recordings, common problems associated with EGGs, and analysis and quantification.

The chapter identifies satiation as a negative feedback process of control during a meal and depends on peripheral and central mechanisms for the detection, transmission, processing, and integration of the chemical and mechanical stimuli of the ingested food. Sherrington (1947) emphasized that satiation is an example of the kind of active inhibitory process necessary for central neural integration and is stimulated by ingested food which inhibits eating. Numerous techniques used to analyse the negative feedback produced by ingested food reveals that satiation is elicited primarily by mechanical and chemical food stimuli acting on specific receptors in mucosa lining the mouth, esophagus, stomach, and upper small intestine, and involves spatial and mechanistic synergistic interactions.

This chapter presents the text of Edith Garson's 1938 article about George Gershwin's musical career. Garson provided an overview of Gershwin in Hollywood from the time of his arrival in August 1936 to the moment of his death in the July of the following year. Though Gershwin completed songs for RKO films, the year 1936 represented a decline in his career. This is because his digestive system, which he called composer's stomach, continued to bother him.

Weeks after returning to Down, as Charles Darwin worked on a new edition of The Origin of Species and felt obligated to answer a “Multitude of Letters” from old and new correspondents about the book, his flatulence accentuated. He began consulting with a new London physician, Frederick William Headland, about his stomach. Etty's illness, along with the demands of scientific work, caused Darwin much distress. During the period of Etty's illness and improvement, Darwin had been able to carry on different kinds of work: intermittently writing parts of the big sequel to Origin, The Variation of Animals and Plants under Domestication, preparing a third edition of Origin, keeping up a “gigantic” scientific correspondence, and doing botanical work on Drosera and other plants. Several days after moving into a Bournemouth house, Darwin felt “squashier than ever” and began taking “two shower baths a day” in the hope of gaining “a little strength”. His feelings of “anxious looking forward” probably largely centered on fears of future illness in himself and his family.

This chapter follows the British diet into the bodies, bellies, bowels, and blood of its consumers. It begins by outlining ways in which early twentieth-century observers began to argue that a diet rich in meat, sugar and refined carbohydrates was damaging the body. This was an early example of the theory of evolutionary mismatch, which suggested that rapid change in human environments produced a milieu for which the human body was physiologically unsuited. The chapter then explores a series of key pathologies around which these ideas were articulated: tooth decay, dyspepsia, constipation, diabetes, heart disease and obesity. The chapter concludes by positing connections between this particular diet and the rise of anorexia nervosa.

This chapter discusses the effects of alcohol consumption on the gastrointestinal (GI) tract. Alcohol lowers oesophageal sphincter pressure, reduces acid clearance, and alters oesophageal epithelial function, contributing to an increased incidence of gastro-oesophageal reflux disease. Dyspepsia, chronic atrophic gastritis, and delayed gastric emptying are characteristic of chronic alcoholics. Upper GI bleeding in heavy drinkers is more commonly a consequence of variceal bleeding due to portal hypertension than to gastritis, while peptic ulcer disease and H. pylori infection have been shown to have a lower incidence in individuals who consume alcohol than abstainers. Finally, malnutrition in heavy drinkers is common and is due to the combined effects of diminished intake, decreased digestion, bacterial overgrowth and bile salt diarrhoea. Immunological effects of heavy alcohol consumption, such as delayed or deficient healing from colorectal surgery, should also be a major concern for health care providers.

This chapter describes Yakobson's use of improvisation to choreograph movements and gestures beyond what the body could do. In his company, Yakobson utilized the unexpected chance to reflect artistic freedom and a non-totalitarian view of the future. Upon the formation of his own company, Yakobson worked feverishly. At the same time, he was nursing an ailment that turned out to be stomach cancer. As his condition deteriorated, many opportunities opened up for his company and for himself to travel overseas. However, he died on October 17, 1975 at age 71.

This chapter discusses the ideas and themes underpinning the volume, contextualizing the importance of the gastric area in literary and medical culture, and more widely in the cultural imaginary of the eighteenth-century. It discusses the various ways in which stomach disorders, digestive motions, and belly-centred conceptions of the self and society complicate notions of the Enlightenment. Using examples from artisanal diaries, from scientific experiments, and from eighteenth-century novels, the chapter contextualizes and introduces the main themes of the volume: from revolutionary art’s visualizations of the viscera, to carnivalesque scatologies, to medical conceptions of the function of the stomach, and the city as bodily organism.

I explained the general basis of catalysis in Reaction 11, where I showed that it accelerated a reaction by opening a new, faster route from reactants to products. One of the ways to achieve catalysis in organic chemistry is to carry out a reaction in an acidic or basic (alkaline) environment, and that is what I explore here. In Reaction 27 you will see the enormous importance of processes like this, not just for keeping organic chemists productive but also for keeping us all alive; I give a first glimpse of that later in this section too. Various kinds of acid and base catalysis, sometimes both simultaneously, are going on throughout the cells of our body and ensuring that all the processes of life are maintained; in fact they are the very processes of life. I deal with acid catalysis in this section and base catalysis in the next. The point to remember throughout this section is that an acid is a proton donor (Reaction 2) and a proton is an aggressive, nutty little centre of positive charge. If a proton gets itself attached to a molecule, it can draw electrons towards itself and so expose the nuclei that they formerly surrounded. That is, a proton can cause the appearance of positive charge elsewhere in the molecule where the nuclei shine through the depleted fog of electrons. Because positive charge is attracted to negative charge, one outcome is that a molecule may be converted into a powerful electron-sniffing electrophile (Reaction 16). Another way of looking at the outcome of adding a proton is to note that a C atom with a positive charge is a target for nucleophilic missile attack (Reaction 15). Therefore, if a proton draws the electron cloud away from a nearby atom, then its presence is like a fifth-column agent preparing a target for later attack. Let’s shrink and watch as some acid is added to a molecule that contains a –CO– group, such as acetic acid. The protons provided by the added acid are riding on water molecules, as H3O+ ions, and arrive in the vicinity of the acetic acid molecule.

This chapter contains 50 questions, which exactly match the proportions of topic areas found in the European Specialty Examination in Gastroenterology and Hepatology (ESEGH), and is designed to act as a mock-examination for use in the final stages of preparation. The questions are unique to this chapter and therefore add to the coverage of the curriculum over and above that in preceding sections.

This chapter is devoted to diet studies on reptiles, specifically focusing on the source of samples, elucidating analytical techniques through macroscopic and microscopic means, and addressing certain analytical issues so that the role of diet composition, selectivity, and preference can be studied. Methods that aid in diet analysis include direct observation of feeding events; collection of stomach contents via dissection, stomach flushing, or forced regurgitation; collection of faecal matter; and stable isotope analyses. Additionally, the dietary composition of a species can be analysed via mass or by prey volume or prey numbers. The precision of volumetric measurements, however, is a direct function of the completeness of the remains examined, which in turn depends on gut clearance times. Gut clearance times in reptiles depend on external conditions (i.e. temperature, rainfall) other than on species-specific physiological performance, individual-specific physiological performance, and the prey/predator ratio.