Irritable Bowel Syndrome.
A decade ago, I would’ve been mortified to type those words. Recent years, however, have seen a surge in awareness of digestive disorders—IBS, celiac disease, lactose intolerance, ulcerative colitis—such that I find myself constantly trading war stories. A journalist friend doesn’t leave the house without his Lactaid. An art-historian pal goes days on white bread and rice, her stomach requiring the blandest fare possible. A musicologist colleague grimly claims he can’t eat “anything with a skin.”
Science and commerce have risen to meet the need: wide-ranging medical research into once arcane procedures like fecal-matter transplants, an over-the-counter digestive-remedy industry valued at more than $20 billion, and endless Instagram and #GutTok gurus hawking stomach cures like aloe-vera juice, ice-water baths, and left-side sleeping. A 2020 survey by the Rome Foundation, which promotes GI health, says that more than 40 percent of the globe suffers from a digestive disorder. Almost half the population, seemingly, feels something isn’t sitting right.
Some months ago, I began to wonder, Where has this crisis come from? And why, given all of this alimentary advocacy, and all of my own dietary austerity, is my stomach, at forty-five, still rioting? Doctors and the internet provided only partial answers, so I went looking in books, where I found a sprawling body of medical history and, surprisingly, literary history on these indelicate matters. The gastrointestinal agonies of writers, it turns out, forms practically its own canon, one that dates back almost to the beginning of Western science’s attempts to understand the digestive tract. For more than two hundred years, countless bizarre theories and treatments were adopted and feverishly promoted by men of letters, including such esteemed figures as Voltaire, Coleridge, Twain, Henry James, Kafka, and Beckett.
While the root causes of our collective dyspepsia eluded me, never mind a cure, I did find strange comfort in such company. And I got some context and understanding. The literary history of indigestion, I came to see, has much to tell us about why we seem to be living, once again, in an age of the stomach.
***
In 1700, Bernardino Ramazzini, a professor of medicine in Modena, Italy, published his seminal
Diseases of Workers. His study of laborers—porters, bakers, blacksmiths, mirror makers—first identified what we now call repetitive-stress injuries: bowed legs, rounded shoulders, humped backs. Ramazzini also considered the travails of “the learned.” By hunching over books for hours on end, he argued, scholars and philosophers brought on arthritis, weak eyesight, and, through compression of their pancreatic juices, dire ventral infirmities. Ramazzini held that the stomach couldn’t properly mulch its food while the brain was busy digesting its own sustenance. Indeed, so deleterious was a life of contemplation, he contended, that it was even possible to “die of wisdom.”
Early Enlightenment anatomists saw the gut as the seat of the imagination; it processed emotions and perception and was so spiritually attuned it perhaps even contained the soul. Any disruption below was of grave import. Following Ramazzini’s study of the learned, physicians theorized and investigated a set of conditions known as
les maladies des gens de lettres, wherein mental exertion and overeating led to “engorgement of the viscera of the lower abdomen,” as well as “hypochondria, melancholy, and hysteria.”
Naturally, the patriarchal nexus of medicine and letters produced further absurdities. Women, due to supposed softness in their “cerebral pulp,” were thought incapable of the intellectual endeavor necessary to truly injure the bowels. Even as hysteria came to be seen as a feminine complaint, doctors remained stubbornly fascinated by the straining of men. Or, as Anne Vila, a scholar of French literature, puts it, science found a way for
les gens de lettres to be “nervous in a manly way.” (...)
It wasn’t just food that became productively unsettling in the nineteenth century. Writers were similarly agitated by the expulsive and inspirational effects of coffee and tea. Balzac wrote that coffee “acts like a food and demands digestive juices…it brutalizes these beautiful stomach linings as a wagon master abuses ponies; the plexus becomes inflamed; sparks shoot all the way up to the brain.” Across Europe, gut trouble became a mark of the consummate artist.
Literary men in America, however, were less sure. In 1858, an advice column, “Manly Health and Training,” appeared in the
New York Atlas newspaper. One Mose Velsor stumped for early-rising, fresh air, and bare-knuckle boxing, and warned of “The Great American Evil—Indigestion.” Velsor advised against fried potatoes, prostitutes, condiments, and “too much brain action and fretting”—all of which might result in a sickly male specimen whose “bowels are clogged with accumulations of fearful impurity.”
Mose Velsor was one of Walt Whitman’s many pseudonyms and used for the hackwork he undertook after the first printing of
Leaves of Grass received little notice. The
Atlas columns can read less like advice than a wounded man’s self-exhortation. “To you, clerk, literary man, sedentary person, man of fortune.… Up!” And “Eat enough, and when you eat that, stop!”
Mark Twain also took up the cause. Motivated by either his notoriously bad business sense or his own frequent stomach pain (or, more likely, both), he peddled a digestive powder, licensed from the English Plasmon company, as both treatment for dyspepsia and a superfood: “One teaspoon is equivalent to an ordinary beefsteak.” George Bernard Shaw was convinced and “generally dined off a Plasmon biscuit and a bean.” To the novelist William Dean Howells, Twain instructed, “stir it into your soup…use any method you like, so’s you get it down.” Perhaps unsurprisingly, given such appeals, the Plasmon Company of America, like many of Twain’s other commercial ventures, quickly went bust.
Others fared far better. Particularly in America, new ideas about purity, diet, and hygiene proliferated in the second half of the century. A Connecticut minister, Sylvester Graham, introduced his Graham Bread (later, Graham Cracker), which was bland enough to stomach easily while also aiding in the avoidance of drink and masturbation. (Graham believed that sugar fueled intemperate feelings like lust and greed.) At his Battle Creek, Michigan, sanitarium, John Harvey Kellogg (of Corn Flakes fame) treated his digestively ailing patients by prescribing them abstinence, hydrotherapy, electrotherapy, phototherapy, and yogurt enemas. At one point, Kellogg claimed his sanitarium hosted more than seven thousand patients a year, many of them wealthy and willing to pay the rapidly increasing fees. A gastric boom was well underway and about to take another curious turn. (...)
By the late nineteenth century, constipation was dreaded as the “disease of diseases.” In 1895, an entrepreneur named Horace Fletcher set out to cure it. Fletcher had been a gifted athlete in his youth but at forty found his energies sapped by stoppages below. His solution: Produce as little bodily waste as possible. His system: digesting “in the head” by chewing his food at least two hundred times, into a slurry that slid down unaided.
Newly energized by his method, Fletcher set about promoting it, performing somersaults and high-dives in his underwear before crowds, mailing his own ash-like turds—no more odor than “a hot biscuit”—to scientists. He eventually converted Kellogg to his regimen; every meal at Battle Creek began with a “chewing song.” Other celebrity chewers included John D. Rockefeller, King Edward VII, and writers like Sir Arthur Conan Doyle, Twain (again), both William and Henry James, and Upton Sinclair, who called Fletcherism “one of the great discoveries of my life.” Its benefits, apparently, weren’t only physical. In 1903, Fletcher observed a “literary test subject” who subsisted off a glass of milk and four exhaustively chewed corn muffins per day. After eight days, the subject had made just one hot biscuit but had written sixty-four thousand words.
Legitimate medicine would soon discredit Fletcher, but the literary world’s infatuation with mastication lingered in the imagination of an insurance lawyer from Prague. In Franz Kafka’s “A Hunger Artist,” an anonymous professional faster starves himself in view of the public, at first to great curiosity and acclaim, then absolute indifference, until finally he dies unnoticed and un-mourned. The story has been interpreted as religious parable, self-portrait, and as representing modern man’s alienation from family and nation. But perhaps we might read it more directly.
Kafka struggled with constipation. He visited sanitariums, tried laxatives made from powdered seaweed, and obsessively notated his meals and bowel movements, or lack of them. No surprise, then, that he was drawn to Fletcherism. Kafka’s father was so disgusted by his son’s incessant chewing he would hide behind his newspaper at dinner. The hunger artist is likewise unimpressed by his own feats of starvation. “I have to fast,” he says, “I can’t help it.… I couldn’t find the food I liked. If I had found it, believe me, I should have made no fuss and stuffed myself like you or anyone else.”
I read this line with a shudder of recognition. In the worst nights of my sleepless stomach, I ate nothing for days at a time. Sometimes wasting away seemed preferable to enduring yet more intestinal agony. I’m struck, too, by how much the family-dinner scene early in
The Metamorphosis resembles Fletcherism. “It seemed remarkable to Gregor that among the various noises coming from the table he could always distinguish the sound of their masticating teeth.” Fletcher’s method seems insane now, but in the grip of dyspepsia, you’ll try anything. The internal turbulence doesn’t just “mar the soul’s serenest hour,” as Twain once wrote; it seems to choke the very life and joy out of you. (...)
Of course, indigestion hasn’t been the torment solely of the literati. Other artists suffered, too, some famously. There has been a surprising amount of scientific investigation into whether Beethoven had IBS. Kurt Cobain harbored for years an undiagnosed stomach pain. His love of Kraft mac & cheese and strawberry milk probably didn’t help, but lactose intolerance wasn’t much discussed, or not so publicly, in the 1990s. “Thank you all,” Cobain wrote in his suicide note in 1994, “from the pit of my burning, nauseous stomach.”
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