Perspectives in Biology and Medicine

OBSERVATIONS ON THE GALLIC GASTRIC ILLUMINATI IRVIN M. MODLIN and GARY P. LAWTON* Introduction The subject ofdigestion and the role ofthe stomach have been ofconsiderable importance in France for many years. Rarely has a nation been so closely associated with food and the sciences relating to its digestion. Indeed a substantial component of French literature revolves around the pleasures of the table and the great culinary schools of thought that have evolved from this preoccupation. A not dissimilar degree of attention has been paid to the cultivation of the vine, with the subsequent multitude of extraordinary wines all capable of different interactions with various foods. Despite the fact thatJulius Caesar had definitively stated that all Gaul was divided into three parts, the French nation continued to focus on the stomach and not bile. They were not misled by gall and its three constituents, and thus chose to reflect on gastric rather than bile acids. Two common denominators unite the digestion offood and wine. The first is acid, upon which digestion is critically dependent, and the second is the vat in which all human fermentation occurs—the stomach. The basis ofgastric digestive function relates to hydrochloric acid secretion, whilst different kinds of acids form an important part of the structure ofwine. So important to the nation has this question of food and digestion become that the pages of its history are replete with the comments ofits great political scientific and literary figures in this regard. Even Napoleon recognized that his military successes were due to the fact that his army "marched on its stomach." The backbone of his troops, the old guards, who were responsible for cutting a swathe through most of the European armies of the time, used as one their battle cries Vive l'intérieur/They too were aware of the importance of digestion in securing success. Similarly, in the scientific field, the notable physiolDepartment of Surgery, Yale University School of Medicine and *West Haven VAMC Correspondence: Dept. ofSurgery, Yale University School ofMedicine, P.O. Box 208062, New Haven, CT 06520© 1996 by The University of Chicago. All rights reserved. 0031-5982/96/3903-0943$01.00 Perspectives in Biology and Medicine, 39, 4 ¦ Summer 1996 | 527 ogist Claude Bernard also spoke with philosophic conviction of Ie milieu intérieur. This paper takes a broad look at the contributions of notable French physiologists, internists, and surgeons to the understanding of the physiology of digestion and the elucidation of the therapeutic strategies for dealing with diseases of the stomach and duodenum. It reflects on some gourmands , politicians, and sundry acids to provide a background againstwhich the gastric revolution unfolded. René Antoine Ferchault de Reaumur (1683-1 757) By the 16th century, there still existed considerable controversy as to the events that occurred in the lumen of the stomach. Although there was a general acceptance that the process that took place in regard to the digestion of food was an active one, many still adhered to the concept that it was passive and indistinguishable from putrefaction. The exact nature of the agents involved in the process of this digestion of food were for the most part entirely unrecognized, and some physicians even believed that primal spirits played a part in this process [I]. A number of reactionary and thoughtful individuals, including Paracelsus, Van Helmont, and Spallanzani , had written effectively about their individual concepts of gastric function [2]. Their ideas ranged from chemical principles ofan undefined nature, to archei (spirits), to the presence of acid as proposed by Spallanzani . Against this widely differing background of opinions, the contributions of Reaumur are of considerable interest [3]. He was born in 1683 at La Rochelle, the son of a prominent local judge. Even as a child, he was regarded ofprodigious intellect and excelled in his studies. Since he declined to follow in the legal footsteps of his father, he studied mathematics, physics , and natural history in Paris. By the age of 25, he was elected to the Académie des sciences and was recognized as one of the finest minds of his generation. Reaumur was closely involved with the court ofLouis XIV, who became his patron and supported his diverse interests, which included...