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   In Vol. I it was learned that an emotion is a complex of reflexly aroused nerve-muscle-gland reactions and that the nervous, muscular and glandular reactions in certain emotional states are such as to inhibit or suspend certain functions--digestion and excretion, for example--while other of these reactions favor the performance of these functions.

   Bad news cuts off a hearty appetite. Grief may suspend the appetite for days. Ordinary mental processes do not so greatly influence hunger, but fear, joy and other emotions temporarily abolish the sensation. The so-called destructive emotions abolish not only hunger but also the so-called "hunger contractions" of the stomach and the secretion of digestive juices.

   The digestive secretions are, to a great extent, influenced by the emotions. While I do not intend to treat of such matters in detail at this place, we need to know that moods and emotions profoundly influence the secretions of all the glands of the body and, thereby, exert a tremendous influence upon the whole of the nutritive processes.

   Psychic secretion is that part of the digestive juices which flows in response to one's mental states and emotions and sense pleasures. The flow of the salivary and gastric juices is influenced by so-called psychic factors. The sight, smell or anticipation of a meal will cause these secretions to be poured out. The stomach "waters" as does the mouth. The taste of food, even where the food never reaches the stomach, will cause the gastric juice to be poured out. People in a state of mental exhilaration, who are joyous and happy, or who experience a feeling of well-being, have better digestion than others. The so-called psychic secretion lasts about thirty minutes and constitutes approximately twenty per cent of the total amount of gastric juice.

   Strong emotions like rage, fear, jealousy, worry, etc., and all intense mental impulses immediately stop the rhythmic motions of the stomach walls and suspend the secretion of the digestive juices. Fear and rage not only make the mouth dry, they dry the stomach as well. Pain impairs the secretion of the gastric juice, stopping entirely the psychic secretion. Not only do all strong "destructive" emotions inhibit the delicately regulated psychic secretion, but even too great joy will do likewise.

   Nervously depressed people have poor psychic secretion and are usually chronic dyspeptics. Observations made on mental patients, particularly those suffering from the so-called maniac depressant psychoses, have shown that their psychic secretions are poor or negligible. Even a normal man who was about to take an examination, about which he had doubts about his ability to pass, required to digest and send a meal out of his stomach, two hours longer than under normal circumstances.

   Worry, fear, anxiety, apprehension, excitement, hurry, fretfulness, irritableness, temper, despondency, unfriendliness, a critical attitude, heated arguments at meals, etc., prevent the secretion of the digestive juices and other secretions of the body and cripple not only digestion, but the whole process of nutrition.

   Mental excitement results in the same weakening reactions upon the body as do intoxicants. It occasions the same degeneracy and loss of vital reserve as do alcoholics. Corrosive worries, burning thrills, the searing fires of uncontrolled emotions, freezing fears and similar mental and emotional states lower vitality, weaken digestive power and leave the food in the digestive tract a prey to microbes.

   None of us go through life without repeated shocks, emotional upheavals, worries, periods of anxiety and of irritation. But the average man and woman is usually able to throw these off in a brief period. The fact that one is not able to throw them off quite readily, shows that there is something wrong.

   A few years ago I put forth the theory, based on my experience, that worry, fear, shock, etc., seldom or never produce disease in the really healthy, because these are able to throw off such states before serious damage is done. This theory was reproduced in my Food and Feeding, in 1926.

   In 1928 Dr. P. E. Morhardt, of Paris, reported the results of his long continued studies of nutrition and mental factors. He found that such emotional shocks as the loss of a loved one, loss of fortune, etc., become disease-producing because the body is in a state of "vegetative and nutritional unbalance" at the time. Such shocks are survived by the really healthy with a minimum amount of injury and leave no bad effects. They frequently result in permanent troubles in those whose health, particularly their digestive health, has been neglected.

   Diabetes is given as an example of "nutritional unbalance" which leaves the nervous system in no condition to bear up under strain or shock. Other weaknesses resulting from haphazard eating and neglect of the body produce the same effects upon the brain and nerves, so that the first "emotional upheaval" greatly aggravates the condition and produces more serious troubles. Often the mind itself, already affected by the previous nutritional unbalance and toxemia, becomes deranged.

   In dealing with sugar in the urine, in diabetes, Dr. Cabot says: "As soon as marked worry comes to the patient's life, up goes the sugar when it has been scanty or absent before." The noted surgeon, Crile, gives us the dictum: "When stocks go down, diabetes goes up."

   Shock, as from a wound or an operation, will cause sugar to appear in the urine. Apprehensiveness and "nervousness," or excitement do likewise. Worry, as from financial loss, is a common cause of functional glycosuria (sugar in the urine). An argument is frequently responsible for an increase in blood-pressure, gastrointestinal (digestive) disorders, gall-bladder troubles (these being outgrowths of the digestive derangements), and acute exacerbations of diabetes.

   Every mood or emotion reacts upon every cell and every function in the body. Destructive emotions create discord in the physical functions of the body. "The angry man sends a torrent of rage into his own constructive cell-world," as Dr. Gibson expresses it, and disrupts the orderly working of his cells, and "previous tissue structures, once pillars of vital strength, are reduced to ruin and ashes."

   Dr. Geo. A. Molien, of Denver, reports that many surgical operations may be avoided if the mental and nervous factors in the cases are corrected. He cites several cases in which operations had been advised but refused, the patients completely recovering from ailments diagnosed as gastric ulcer, appendicitis, pancreatic and intestinal disturbances and from persistent vomiting, after mental and emotional relief were secured.

   Dr. Weger recalls a case cited by Cannon, which came under the care of Dr. Alvarez, of a man who suffered with persistent vomiting, having begun when an income tax collector threatened the man with punishment if he could not explain a discrepancy in his tax statement. The vomiting ceased as soon as the matter was straightened out, Dr. Alvarez, himself, going to the tax collector, as a therapeutic measure, to iron out the difficulties.

   Dr. Weger calls attention to an experience that we have had many times. He says: "In my own institutional practice, it has come to be known among the staff that there are an unusual number of adverse digestive reactions during the twenty-four hours between noon of Sunday and noon of Monday. Patients ordinarily receive more visitors on Sunday afternoon than on any other day. Some relatives or friends bring disconcerting or depressing news. Some visitors have an unhappy effect on the patients, disturbing them by rude approach, incessant talking, a harsh, jarring tone of voice, or by the subject discussed. Unhappy situations are frequently recalled, even though the suggestion be inferential. Then again, there are patients who are worked up several days in advance in anticipation of the visit of a husband, wife, brother or sweetheart. Sunday afternoon passes without the expected visit; the emotions evoked by anticipation, impatience, uncertainty, anxiety and disappointment may for some persons be just as harmful as too much visiting is for others. As evening approaches, digestive discomforts become noticeable. Some patients have a feeling of weight in the stomach; others, gas in the bowels, some become nervous; others have headache; and some persons have a combination of these symptoms."--Genesis and Control of Disease.

   I have seen similar results from the receipt of a letter bringing unpleasant news, or from the failure to receive an expected letter. A patient of mine, who had two checks returned by her bank, was so upset that not only was her digestion greatly impaired, but all of her symptoms were made much worse. Although the matter of the checks was quickly straightened out, the patient did not get over the effects of the incident for three or four weeks. Another case became worked up almost daily because she was away from her husband. The arrival of her father and her son brought emotional peace for the week they were present and during this time she had no digestive troubles and nervous symptoms. When they left, her emotional upheavals began again and her digestive and nervous troubles were renewed. A third case suffered with fear of hell because a medieval-minded preacher had told her she was doomed to hell, as an adulteress, due to the fact that she had married again while her divorced husband was still alive. Such fears troubled her digestion and her sleep.

   Dr. Weger says: "In my opinion, at least two-thirds of the patients who complain of gastric and intestinal discomfort in varying degrees of intensity are the victims of emotional unbalance." Omitting cases of cancer, ulcer and actual organic diseases of these structures, and assuming that the patients have been correctly fed, as regards amounts and combinations, I would say that more than two-thirds of such patients are victims of emotional unbalance.

   Dr. Weger continues: "Our routine in such cases is to use the stomach tube at once and have the patient miss supper. Almost invariably the debris that is returned by the lavage is undigseted food, sometimes the entire noon meal. A light meal that should have been in the intestines in four or at most five hours, may be found in the stomach eight or ten hours later if the attendants are not appraised of the discomfort and measures of relief instituted earlier. If the patient does not report the discomfort and takes supper, both meals may frequently be washed out of the stomach the following morning. The less soluble foods, those that contain considerable roughage, usually constitute the bulk of that which is returned. The inference is that in these motility may have been more profoundly impaired than the secretion of gastric juice. The question has, however, not been accurately determined. It is quite possible that certain types of patients will have more decided disturbance of motility while others will have impairment of secretions."

   These phenomena also occur to a slight degree in those who are fearful and worried about their diet. Those who anticipate trouble from their meal, who eat in fear and trembling and who are anxious about the outcome, will be sure to have trouble for these things inhibit to some degree the normal operation of the nutritive processes.

   It is also quite probable that the length of time that elapses after the meal is taken before the bad news, disquieting visitor, etc., arrives, may determine whether chiefly roughage or the whole meal will be found in the stomach. The secretions, once they are poured out upon the food in sufficient quantity, will continue their work despite the effects of the patient's emotions upon gastric motility or upon the secretory glands.

   I do not favor the use of the lavage and find that most of these symptoms are nervous and mental rather than the effects of the food laying in the stomach. There is no reason why a little undigested food in the stomach should, of itself, cause distress, for the stomach is designed to receive and hold undigested foods. The discomfort will be relieved by the lavage. It will also be relieved, in most cases, by a hot pack placed over the stomach, with the food left in the stomach. I believe that the lavage secures relief from the discomfort in the same manner that the pack does and not merely because it empties the stomach. Some nervous states (not cases of ulcer) have pain and discomfort in the stomach only when it is empty and not when it is full.

   Some of these cases are relieved by a little kindly encouragement or by intelligent sympathy. In other cases the discomfort passes off in a short time without the lavage, pack or suggestive treatment. In others, a little manipulation of the abdomen suffices to give complete relief. I do not favor the manipulation and mention it here only in illustrating my thought.

   A lavage is a severe tax upon the patient and its frequent use, and this would be necessary in a certain type of patients, cannot but injure the patient. I have given many lavages in the past, but I employ them no more.

   The practice of having the patient miss the meal or several meals if necessary, has my enthusiastic endorsement and has been my practice for years. It is a natural and an instinctive procedure, where instinct is permitted to hold sway.

   Many times I have observed angry and frightened animals refrain from eating until, after the passage of considerable time, these emotional states had passed off. I have seen cows frightened and abused by angry milk-men and have seen them cease eating and not again resume eating for an hour or more after the milk-man had departed.

   It is true that under the same circumstances many civilized men and women that also refrain from eating, find, indeed, that they lack all desire for food, but it is also too often true that many men and women will eat large meals under these and similar circumstances. Psychic and vital hygiene demand that under conditions of emotional stress eating should be refrained from. Every one of my readers will enjoy better health in the future if they follow the example of the young grief-stricken lady who, thinking that she had been deserted by her lover, did not eat for three days, saying, when the lover returned, that she could not eat, and refrain from all food until emotional calm is restored.

   Noise while eating disturbs digestion. Noise, and "jazz" both reduce salivary and gastric secretion nearly one-half. Noisy crowds, excitement and the emotional stress these occasion inhibit and derange digestion. Quiet, cheerful surroundings, with congenial companions enhance digestion.