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THE MIND-BODY RELATIONSHIP IN COMMON DISEASE 
"The organs weep the tears the eyes refuse to shed" (Osler)


Today we appear to be on the threshold of new thinking in the field of medicine as it is loosening its hold on the body as the primary source of disease  Actually, this would not surprise the founder of modern psychiatry, Sigmund Freud, who initially tried to explain the workings of the mind by studying neurophysiology.  He believed that someday schizophrenia would be found to be organic in origin, and gave this as the reason that his method of psychoanalysis was inappropriateness for treating this group. In later life he stated that if he had to do it all over again, he would become a psychic researcher, and he actually published a paper on telepathy in dreams (1925) wherein he stated:  "One arrives at a provisional opinion that it may well be that telepathy really exists and that it provides the kernel of truth in many other hypotheses that would otherwise be incredible."  However, these surprisingly progressive ideas have been largely discounted by his followers.


Similarly in medicine, if we go back to the early 1900s, we find that Sir William Osier, considered to be the founding father of modern medicine, is attributed with the statement regarding
tuberculosis:  "What goes on in the patient's mind is more important that what goes on in his chest." And about 20 yearslater, Harvey Cushing, the famous brain surgeon from Harvard, who was, incidentally, a biographer of Sir william Osier, made the statement:  "Highly strung people are particularly susceptible to peptic ulcers or nervous indigestion which ceases to give trouble if the patient's mind can be put at rest.  I know this will sound unfamiliar to some because to my knowledge this is the first time that the suggestion has been made that ulcers might be nervous in origin." 


Although these insightful observations of the relationship of the mind to common disease were largely ignored by their followers, even the most conservative physician today when he comes across a case of peptic ulcer, high blood pressure, or heart disease gives advice such as "Relax", "Don't be so ambitious", "Slow down and don't take things so seriously"; thus recognizing the role of mental stress in aggravating physical illness.


But still today, in most medical schools, medical students are  taught to differentiate between functional and organic disease.  If nothing can be found by physical examination and laboratory studies, then it must be in the mind, and if it's in the mind, it's called "functional".  Once the fact that it is functional has been thus established, then the patient gets a prescription for a psychiatric medication. It's not considered important or real unless it's organic, something which can be observed by our highly technical scanning instruments. 

I believe that it is a tragedy of our times that in modern hospitals the very important emotional rapport between physician and patient by the laying on of hands, which was so important to healing in the past, is becoming all but obsolete.

Dr. F. G. Crookshank, a British doctor, who rebelled against the progressive dehumanizing of medicine, sardonically commented to his colleagues:  "Organic disease is what we say we cure and don't.  Functional disease is what the quacks cure and we wish we could".

An interest in the interrelationship between mind and body antedates the era of Hippocrates.  Primitive societies believed that diseases were caused by spiritual powers and so had to be fought by spiritual means.  Skulls as old as 10,000 years have been found with trephine holes, suggesting that an attempt was being made to release an evil spirit from the body.

In ancient Babylonia and Assyria religion dominated medicine and suggestion was the major tool of treatment.  The Egyptians had similar ideas about the causes and the cures of diseases. For them, disease was the work of demons, spirits, jinns, ghouls, or spirits of the dead, all of which would enter a man's body through the nostrils, mouth or ears.  Suggestion also played a powerful part, but oral rites and priestly incantations were combined with manual rites such as drawing magic circles around the patient, making sacrifices to the gods, wearing amulets, and eating various herbs.  The incantations were considered more important than the drugs, although many of the drugs did have inherent therapeutic effects.  

As the medical historian, Sigerist stated:  "The day came when drugs were prepared and given without incantation and this was the moment when magic and medicine separated, when physician and magician-priest became different individuals."

The ancient Hebrews relied more on prayer than on magic, and the prophets were looked upon as healers next to God. Medical historians observe that though Hebrew physicians eventually gained esteem, their practice continued to be restricted.  They were given no jurisdiction over the hidden diseases such as mental illness, internal disorders, or epilepsy.  These were in the province of God.  One of the functions of a prophet was to "bind up the broken heart".  

Although the Hebrews had a good knowledge of anatomy, they ascribed emotion to the heart:  Knowledge is stored up in the heart; the heart knows and understands.  The phrase “...with all your heart" denotes conscious resolve in which the whole being consents.  Such thoughts as joy, gladness, fear, pride, and sorrow spring from the heart.  The man devoid of understanding is the man without heart.  In this they were not far from correct.

We also read from the scriptures an early use of music therapy.  When Saul developed a mental aberration which resembled! manic-depressive psychosis, David played on the harp and Saul was refreshed and "the evil spirit departed from him".

In ancient China bodily weakness and disease was believed due to an imbalance between Yin (negative force) and Yang (positive force).  The Chinese medical book, Nei Chela. written at the time of the Yellow Emperor (ca. 2500 B.C.) states: "Man's fear and apprehension, his passion and his suffering, his notion and his rest, they all cause changes, within the body and the mind."  Diseases were divided into two groups:  those due to external influences such as wind, cold, dryness, and moisture; and those caused by internal emotions of joy, grief, anger and fear.

The ancient Hindus believed, among other things, that many illnesses were due to karma from''a previous lifetime.  The Vedas (oldest, most sacred Hindu books of knowledge) contain classifications of mental derangements and trace origins of these illnesses to angry gods and devils. 

The ancient Greeks under Hippocrates and the early Romans under the influence of Galen were strong proponents of the holistic approach to medicine. As Socrates stated: "As it is not proper to cure the eyes without the head, nor the head without the body, so neither is it proper to cure the body without the soul".

In the Dark Ages (500-1500 A.D.) mysticism and religion dominated medicine.  "Sinning" and possession by the devil were believed to be the cause of disease.  A fear of devil worshippers and of witches rapidly mounted, and bizarre and grisly accounts of their origin and activities rapidly developed. 

With the coming of the Renaissance (1500-1700 A.D.) there was renewed interest in the natural sciences and their application to medicine.  Advances in anatomy (Vesalius), autopsy (Morgagni), and the microscope (Leeuwenhoek) caused psychic considerations to be rejected as unscientific.  The study of the mind was relegated to religion and philosophy. Thus when Mesmer appeared  in 1784 with his theory of animal magnetism, he was ridiculed by the professional world.  Mesmer believed that human beings were influenced by the planets by an invisible substance that filled both man and the universe and which he decided was magnetic energy.  Thus one man may cure a disequilibrium or disease in another through "animal magnetism".  

Mesmer used a wooden tub filled with magnetized water to accomplish a crisis in which an individual would scream, break into a sweat and then convulse. His fame spread rapidly and caused so much consternation among the physicians of his day that Louis XVI sponsored a committee of the most respected scientists and physicians of the day to investigate him.  The committee, to a man, was very impressed by what they saw, especially, the convulsions and the rapport of the patients, "even when in a swoon, to the voice of the magnetizer.”  But no fluid could be observed by the five senses, and in the Age of Enlightenment, what could not be seen did not exist.  Having thus established the nonexistence of animal magnetism to its own satisfaction, the Academy then refused to discuss the subject of “Mesmerism” or accept any further reports on this phenomenon for almost a full century.

The 19th century saw the growth of the laboratory-based medicine of Pasteur and Virchow.  Disease was now seen to have its origin in disease of the cell and the psychosomatic approach was discarded since all disease must be associated with structural cell changes.  The disease, not the patient was now treated. 

Although most medical historians simplify the beliefs of the ancient healers and misinterpret their true significance so as to make them appear somewhat naive or absurd, thus justifying modern concepts of medicine as the ultimate culmination of man's wisdom, it cannot be denied that today's physician is no more successful in alleviating the common anxieties and physical distresses of the general population than was the medicine man of primitive societies.  In fact, I recently came across the startling statistic that over 60% of our younger population, under 30 years of age, suffer from a chronic illness or ailment of one type or another requiring regular medical treatments.  Clearly, the time is coming when we must reexamine what we are really accomplishing through our healing arts, and to reconsider some previously dismissed concepts of disease even though they may appear quite different from our own.  

In commenting upon modern medicine's refusal to accept new ideas, Franz Alexander stated:  "It is one of the paradoxes of historical development that the greater the scientific merits of a method or principle, the greater will be its effects in retarding subsequent developments.  The inertia of the human mind makes it stick to ideas and methods which have proved of value in the past even though their usefulness has served its turn."

In the beginning of the 20th century, Freud's early psychoanalytic formulations emphasized the role of psychic determinism in somatic conversion reactions.  Franz Alexander subsequently differentiated conversion reactions from psychosomatic disorders.  He showed how chronic stress, anxiety, or worrying can lead to severe deterioration or malfunction of many bodily organs.  Organic vulnerability is a variable factor in psychosomatic illness.  Although certain types of emotional stress seem to be more destructive to certain organs, the actual symptom does not have symbolic significance, nor does it serve as a defense against anxiety as in conversion hysteria.  In fact the symptom commonly results from the lack of an adequate defense system. Organ specificity appears to be partly familial and partly a learned response pattern dating back to early childhood.  

Hans Selye, Director of the Institute of Experimental Medicine in Montreal, was chiefly responsible for popularizing the idea of stress as a cause of illness, or "the syndrome of just feeling sick." It can manifest itself in various ways - a slight fever, headache, sore throat,irritability, nausea, etc.  But if we have some particular disorder to which we are prone - migraine, rheumatism, indigestion - or if we happen to encounter the microbes of a specific disease at that time, the illness may take on a specific form, even though stress induced."  

The body's increased susceptibility to disease while under mental stress is demonstrated by the following experiments: Mice exposed to stress have greatly increased susceptibility to herpes simplex virus which causes cold sores in humans. The clinical disease of arteriosclerosis can only be induced in monkeys after they are exposed to constant stress in addition to taking a high-fat, high cholesterol diet. Rats who were given a toxic substance which they could usually toss off without ill effect when allowed to run free, succumbed when restrained in fear during the administration of this poison.


Prolonged sleep deprivation produces a characteristic EKG pattern (reduction of alpha wave activity), decreased production of ATP, elevation of ACTH level and the appearance of an unusual indole related in structure to serotonin and LSD-25, which has also been noted in states of artificial stress.


 


Research today is increasingly supporting many of the statements of Edgar Cayce.  His idea was that disease was dis-ease of the mind; that mind is ever the builder.  Positive thought is the building block of the temple;  anger and hate are poisons that destroy the body.  The mind and body are so closely linked that if the nervous enervation were severed, let's say, to one area, leaving the blood vessels and the nutrition and everything else intact, all the muscles of the hand would begin to degenerate within a few weeks.
 

A human being is an indivisible whole, where thoughts are as much a part of the body as of the mind, and not merely a collection of organs whose functions are bound solely by the laws of physical chemistry.  If the mind is not constantly getting feedback from at least one of the 5 senses, then within as little as 48 hours such sensory deprivation can result in hallucinations in the average person because the mind is constantly testing reality through the feedback from the body. As soon as the link is broken between the body and mind, both will suffer.  There is a very direct link between biochemistry, neurology, psychiatry and physiology.



We are learning much more about the way in which metabolic disturbances may cause mental symptoms.  Manic-depressive psychoses, for example, may be due to altered changes in the sodium/potassium  levels in the blood, and the administration of lithium often effectively alters the salt ion balance In people with this disease.  Post-partum depression is now known to be due  to hormonal imbalances during and following pregnancy.  Depression is believed to be more common following the delivery of a boy because of the androgen changes in the woman's body.


We now know that chronic stress may lead to a build-up of steroids, ACTH, or cortisone in the body, which can effect mental functioning. Severe vitamin deficiency, chronic toxicity and heavy metal poisoning can lead to a variety of psychotic states with schizophrenic-like symptoms. The Mad Hatter in Alice in Wonderland characterized the mercury poisoning that hatters were then prone to. The insanity of many Roman Emperors such as Caligula and Nero have been attributed to lead poisoning from their expensive lead wine vessels. Alzheimer’s disease is now attributed to the use of aluminum cookware.


Recent research into the biochemistry of anxiety by Pitts (1969) at Washington University has shown that in certain predisposed individuals anxiety attacks can be induced by injecting sodium lactate into the blood stream.  Anxiety attacks are defined as acute episodes of extreme fearfulness accompanied by feelings of impending doom, fear of going insane, or fear of a heart attack. Lactate is a normal product of muscle metabolism.  It tends to form a chemical bond with calcium.  Thus calcium gluconate injections relieves the attack, and has been used as an effective treatment for years, although the mechanism was not initially known.  Today, Insurance companies are slowly  trying to make psychiatric counseling obsolete by treating all cases of depression, common anxieties, and neuroses with drugs.  This, however, does not reduce sufficiently the underlying emotional factors that can lead to diseases of the lungs, heart, and the entire intestinal tract.


The hypothesis of psychosomatic unity  states that there is a simultaneous  hormonal and body response to every emotional response.  This hypothesis has now been borne out by a variety of studies.  In fact the brain centers which control emotions  and visceral or bodily reactions are very closely situated in the hypothalamus and other midbrain areas.  


Studies done on the lungs and nose show that mucous secretions increase as much as eight times during states of provoked emotional tension.  Hay fever subjects were exposed to small doses of pollen which would not ordinarily bother them, but if they were under an emotional conflict, then this small amount of pollen could re-trigger an attack.  Asthmatic attacks may also be precipitated by rage or depression.




Engel (1956) reported several years of study of an infant, Monica, who was born with esophageal atresia and had a surgically made gastric fistula. Among many studies made was the rate of hydrochloric acid secretion by the stomach under a variety of conditions.  It was evident that gastric secretion was intimately integrated with the total behavioral activity of the infant.  When She related actively to the experimenter, be it with pleasure or anger, the rate of secretion rose.  The highest mean secretion rate occurred during rage, when she related most actively to an object in her environment and with least control over instinctual drives.  Another high period of secretion accompanied reunion with mother after being left for a prolonged period with a stranger.
 

Drs. Ervin and Mark at Massachusetts General Hospital were convinced that a specific kind of dysfunction of the limbic system gives rise to a recognizable  "dyscontrol syndrome" in many individuals who commit murder assault,  child abuse,   rape,  or manslaughter by reckless driving.    In fact, it might be speculated that the psychiatrist of the future may well be a neurologist specializing in disorders of the limbic system.

The more we learn about the body the more we recognize its marvelous complexities.  We must not be like the neurologist who stated that acupuncture couldn’t work because it has no known neurological basis.  Rather, we must be humble in the limitations of our understanding of the life forces that sustain our bodily functions.     The surgeon can only bring together the two ends of a broken bone, but it is an unconscious energy process beyond our present understanding that actually joins and heals it.  Similarly, no physician has ever healed a disease by the prescribing of a pill. All that can be hoped for is that the medication will somehow alter the environment in a way that will stimulate or permit the life force already present to work properly.  Probably just as often, the suspicion of William Osier is more true:  "The patient who takes medicine has now two conditions from which he must recover. "    

The life force may be stimulated in a variety of ways,  and no healer   should claim that his treatment method must be used to the exclusion of all others.    Jesus, in the Aquarian Gospel (Section XV) states this so well: 
 
"On some he laid his hands, and they were healed; to others he just spoke the Word, and they were full restored to health; but others had to go and wash in certain pools; and others he anointed with a holy oil.
 
"A doctor asked him why he healed in divers ways,  and he replied,
 
"Disease is discord in the human form, and discords are produced in many ways.

"The body is a harpsichord; sometimes the strings are too relaxed,  and then inharmony results.

"Sometimes we find the strings too tense, and then another form of discord is  induced.

"Disease is many-formed, and there are many ways to cure, to tune anew the mystic harpsichord.”
 
 
 
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