The health of the stomach has always been the subject of intense medical and popular interest. Yet despite this it is an area of medical, social and cultural history that has previously been neglected as a topic of analytical enquiry. This study is the first exploration of the complex relationship between the abdomen and modern British society. It traces the development of the management of gastric conditions by various, often competing, members of the medical profession, detailing conflict between the ideas and values of surgeons, physicians, psychologists and gastroenterologists. Not simply a history of medicine, the work uses material drawn from both the medical profession and popular culture to explain why the myriad experiences of the stomach and its illnesses have regularly occupied prominent positions in British society and cultural thought. Miller demonstrates how the framework of ideas and concepts established in medicine related to gastric illness often reflected wider social issues including industrialization and the impact of wartime anxiety upon the inner body.
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Dyspepsia was recognised as one of the great afflictions of the 19th century and medical stories about its causes were both unstable and resonant. Ian Miller's book begins at a point of rapid change in the scientific understanding of how the stomach functioned in health and disease...It's a story about changing notions of the stomach's role in overall human bodily function, of the nature of its diseases in relation to other aspects of the human body and mind, of treatments brought to bear on those diseases, and, above all, of contests for the right authoritatively to pronounce on stomach function and dysfunction...A history of the stomach really does work as a site for understanding how we've come to think about minds, bodies and modernity.
Over the 150 years of Miller's story, a great deal changed, and, less visibly, remained the same, in the way doctors and the laity understood stomach complaints. Driven by various brands of medical expertise, dyspepsia began to split into a range of more or less discrete conditions. It started out as one thing with many forms, and it became many things, each with its own diagnostic practices, causes and cures. Much of this followed on from the work of Beaumont and others in the 1820s and 1830s: new techniques appeared for securing knowledge of the stomach and its doings. Different techniques tended to belong to different kinds of medical practitioner. Who had the right to interpret human innards?
Among the increasingly prominent specific ailments, peptic ulcers took pride of place.
The history of the stomach, as Miller shows, does not simply rise towards reductionism. The stomach's management and feeding is too implicated in frames of personal identity and moral value to be encompassed by chemical and structural accounts. Throughout the 19th and 20th centuries there were many attempts to secularise the stomach - to disconnect the understanding of its pathologies and the prescription of its care from mental and moral life - but they never wholly succeeded. --Steven Shapin, London Review of Books, 30 June 2011
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