The Second Brain: A Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestine (Anglais) Broché – 17 novembre 1999
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Présentation de l'éditeur
Dr. Michael Gershon has devoted his career to understanding the human bowel (the stomach, esophagus, small intestine, and colon). His thirty years of research have led to an extraordinary rediscovery: nerve cells in the gut that act as a brain. This "second brain" can control our gut all by itself. Our two brains -- the one in our head and the one in our bowel -- must cooperate. If they do not, then there is chaos in the gut and misery in the head -- everything from "butterflies" to cramps, from diarrhea to constipation. Dr. Gershon's work has led to radical new understandings about a wide range of gastrointestinal problems including gastroenteritis, nervous stomach, and irritable bowel syndrome. The Second Brain represents a quantum leap in medical knowledge and is already benefiting patients whose symptoms were previously dismissed as neurotic or "it's all in your head."
Biographie de l'auteur
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The title is somewhat misleading. 'The second brain' is a catchy phrase, but only token effort is made to prove the assertion. In simple terms, Gershon argues:
1. At the cellular level, enteric neurology uses the same building blocks as spinal neurology, so there is no evidence enteric neurology couldn't be a second brain.
2. The fundamental process managed by enteric neurology is the peristaltic reflex.
3. The peristaltic reflex requires sophisticated neurological controls for managing
a) motion of food through the gut
b) control of pH, viscosity, appropriate digestive enzyme, etc.
4. Since the gut can function adequately despite cutting the neural connection between spine (brain) and gut, the neural mass in the gut must constitute an independent cognitive center (brain).
The first 100 pages address Gershon's efforts to prove enteric neurology uses the same neurotransmitters as the spinal chord. The second 100 pages offers a tour of the gut, starting at the mouth and walking down the lining to the colon. The final section provides a blow-by-blow description of his lab's trial-and-error experimental approach to enteric developmental neurology, with emphasis on microbiological techniques for examining the neural crest's role. There is little or no text defining the systemic nature of a 'brain', and then asking if the enteric neural system qualifies for the title 2nd brain. In short, Gershon avoids the quagmire of differentiating peristaltic reflex from peristaltic cognition.
Since one cannot address this question without assimilating most of the material Gershon presents (perhaps without the historonics), and the book is so much fun as it is, who am I to complain?
The academic battles Gershon fought to make enteric neurology an accepted academic field of study.
How 17th century European poisons help illuminate enteric neurology.
How cholera is perfectly designed to fool enteric defenses (including enteric neural signals).
A detailed review of developmental issues producing aganglionic megacolon (Hirschsprung's Disease)
Scattered about are surprising literary references:
"[the bowel's lining is] very much like the fields of Agincourt after Henry V finished dealing with the French army, a turf littered with the rotting remains of dead soldiers. The soldiers in the bowel, of course, are fallen enteric nerve cells..."
"Functional bowel disease is what Winston Churchill called the Soviet 'Union in 1939: a riddle wrapped in a mystery inside an enigma."
Gershon concludes with a wonderful, and very personal, answer to his recently deceased father's often asked question: 'what practical benefits does your research offer?'
I thought his development of the history of the branches of the nervous system was fascinating and demonstrated some of the politics and the effects of unexamined assumptions on how scientific discoveries are interpreted.
There is an extensive section on the use of various toxins to discover how the nervous system was organized and this section is developed very logically and includes a lot of interesting scientific history. Sometimes, it included more than I wanted to know, but I must say he was very comprehensive.
This book is also well organized in thorough in every respect. The tour of the GI is well done and includes all the important things one would want to know.
I have a very good background in biology and for me this book was a pleasant read. However, it is not always an easy read and it certainly doesn't read like a dime store novel. It is a book that is intellectually challenging, but fascinating and relatively easy to read considering the scope and depth of the topic.
This is not a quick fix manual for people with gastrointestinal ailments. It is more about how the gut is built and how it works. It would be useful book for someone with gastrointestinal ailments for understanding this part of the body, but the emphasis is not on disease mechanisms and treatments. If that is the only thing you are looking for, then this book may not be for you.
I think we all admit tacitly at some level that the gut has some sort of special relation to the rest of the body in terms of sophisticated neurological processing. I think this is revealed by common sayings such as "I have butterflies in my stomach" or "I had a gut feeling something was wrong." Gershon presents a plausible explanation for the sophistication of the GI tract that sheds some light on why these expressions may have entered our lexicon.
If you are interested in the mind-body connection, this is also a useful book. It reopens many questions about the gut and how it interacts or works independently of the brain. It is great food for thought that reopens a lot of questions about how the body is organized and the relationship of the brain to the internal workings of the body. I'm not saying it's revolutionary, but it certainly challenges the current paradigm in some significant ways.
Some interesting facts that Gershon bring up is that the vast majority of serotonin is made in the gut, not the brain. He also points out that if the vagus nerve is cut, the bowel can still go on functioning without input from the brain. He also talks about the density of neurons in the gut and how no other area of the body except the brain can match it. These facts have interesting implications and lead one to formulate some interesting questions for reflection.
Also recommended: Biological Treatments for Autism, Tissue Cleansing Through Bowel Management,
It is not a book for those who search treatment for their personal health problems. Personally, I was expecting a little more information concerning gut functioning and mood, but that is just me. The book is very well written, interesting, but prepare yourself for a big load of detailed information.
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