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.