Rumbles, p.1
Rumbles, page 1
For Frank
Introduction
Writing in 1794, Erasmus Darwin – physician, abolitionist and eventually grandfather to the founder of evolutionary theory – recounted the case history of a rather unfortunate patient. A girl of sixteen who, along with all the other awkward afflictions that puberty brings, was plagued by a remarkably vocal gut. Her bowels, Darwin recorded, ‘almost incessantly made a gurgling noise so loud as to be heard at a considerable distance, and to attract the notice of those who were near her’. The noise, which ‘never ceased a minute’, caused understandable distress to the sensitive patient, drawing public attention to the body’s innermost workings in a way that must have been especially excruciating for a teenage girl.1 Most of us, even if we have not had to seek medical treatment, will have heard the same resonant tumult from within. Of the seventy-eight organs of the body, the stomach is certainly among the noisiest. While the kidneys filter waste without a peep, the lungs quietly puff away and even the steady beat of the heart can only really be heard by pressing an ear up close to the chest, the belly is notoriously outspoken. It growls, gurgles and grumbles. Its clamorous sounds are often a source of embarrassment, drain-like modulations that bubble up from the deep without warning, bringing with them news of digestion and defecation. Its rumbles disturb the hushed silence of libraries and echo through the civilised quiet of museums, interrupt important interviews and make unwelcome interventions into promising first dates. There is something almost obnoxious in the way the organ barges its way into our social world, drawing attention to the fleshy fact of the body and its most shame-inducing functions. Even the medical term for gastric noises – borborygmus – has an unappealing bilious ring to it.
To quieten his patient’s obstreperous belly Darwin devised a specially tailored course of treatment: she was to swallow ‘ten corns of black pepper’ after dinner, take a daily dose of crude mercury and allow a ‘small pipe’ to be occasionally inserted into her rectum to ‘facilitate the escape of air’.2 This dispiriting prescription would seem to imply that they were dealing with a purely physical problem, but in his notes Darwin pointed to another possibility: an excessively noisy gut, especially in a young woman, was often a symptom of ‘fear’. Long fascinated by the complex relationship between mind and body, Darwin wagered that his patient’s unsettled mental state might produce gastric distress, trapping her in a dreadful cycle in which negative feelings upset the stomach, whose vocal protests then provoked even greater anxiety. According to this diagnosis, the gut was a uniquely sensitive organ capable of registering the slightest modulations of mood, but it also seems to have possessed a kind of social agency. In the case history recorded by Darwin, the talkative bowel was a problem not just because it caused physical discomfort, but also because its loud protestations exposed the murky inner workings of the viscera to the outside world.
Eating involves crossing the same border in the opposite direction, taking something from the outside into the deep interior of the body. This simple act has significant consequences because, as the historian Michael Schoenfeldt has observed, the incessant demands of appetite ‘require the individual to confront on a daily basis the thin yet necessarily permeable line separating self and other’.3 The everyday nature of tasting, chewing and swallowing obscures how momentous these small acts are not only in terms of sustaining life but also, as will become apparent, in shaping our identity. Demanding the attention of family doctors like Darwin, as well as dieticians, surgeons, gastroenterologists, public health officials and social reformers, the digestive system has long been central to how we understand the body, but the nature of its connection to our emotional, social, cultural and political lives is less clear.
Rumbles: A Curious History of the Gut asks how this noisy organ came to shape how we see ourselves and the world around us. Unearthing a fascinating gastric discourse from Ancient Greece to Victorian England, eighteenth-century France to twentieth-century North America, it draws together religious tracts, medical treatises, literary texts, anthropological studies and etiquette guides to argue that there is far more to the belly than might first appear. It recounts the complex history of the gut through a wildly diverse cast of characters: scientists – pioneering and wrongheaded in equal measure – Edwardian bodybuilders, hunger-striking suffragettes, philosophers, sandal-wearing vegetarians, Romantic poets, animal rights activists, psychoanalysts, witches, demons, royals, sanitary reformers, anatomists, microbiologists, novelists, city planners, playwrights and medieval alchemists. It is interested in all the different ways that we have conceptualised, visualised, animated and storied the gut. What metaphors have been called upon, what specialist lexicons have developed, what narrative strategies have we developed to understand the work of digestion?
Medicine is, perhaps, the most obvious place we might look for answers to these questions. This book visits laboratories, specialist clinics, anatomy theatres and lecture halls to spend time with a host of doctors beguiled by the gut’s mysteries. The history of medicine has fascinating stories to tell, but the language of the gut can just as easily be found in plays, poetry and prose. Buried in the viscera, far from curious eyes and prying fingers, throughout history medical descriptions of its operations have relied as often on metaphor and simile as they have on precise clinical terminology. Even today, when advanced technologies have exposed the workings of the organ to detailed scientific analysis, the question of how best to communicate with the gut remains subject to contestation. It may reveal important information to the careful ear of a medical practitioner, specially trained to decipher meaning from its splutters and gurgles, but it speaks to all of us regardless of our professional qualifications. Digestion is a pleasurable, disquieting, messy and universal experience, over which we are all able to claim some measure of linguistic authority. While the workings of other organs – the heart’s intricate assemblage of valves, atriums and ventricles or the networked neurons and firing synapses of the brain – demand clinical expertise, the digestive system has been formed by a lively public discourse in which specialist research jostles with a vast multiplicity of other ways of knowing, describing and inhabiting the body.
The stomach is, after all, an organ with which we are in near constant conversation. It demands to be filled several times a day and in doing so makes itself known to us in a way that is quite distinct from most of the rest of the body: we are conscious of its movements, while the work of other vital parts like the spleen, pancreas and liver continues well below the surface of our awareness. Though our sense of interoception, the brain’s perception of the body, is formed by receptors attached to all the internal organs, it is the growling stomach that seems to speak the loudest. Perhaps its uniquely active presence goes some way to explaining why the gut has so often been personified, endowed with individual characteristics and the ability to express itself in language. In Geoffrey Chaucer’s ‘The Summoner’s Tale’, one of the twenty-four stories published as The Canterbury Tales between 1387 and 1400, the belly of greedy Friar John appears to speak for him, while The Life of Gargantua and Pantagruel (1564), François Rabelais’ riotous Renaissance satire, features an ‘Italian woman of low birth’ whose stomach, when questioned, replies in a voice that is ‘weak and tiny, yet always well-articulated, distinct and intelligible’.4 Among the most erudite guts in this literary tradition is the narrator of Sydney Whiting’s Memoirs of a Stomach (1853), a much-beleaguered internal organ who recounts his alimentary troubles and digestive trials for the reader. Plagued by the debilitating effects of nervous excitement and continental cuisine during his owner’s college years, matters take a turn for the worse when he secures employment in the city. There, freed from familial and financial restraint, his master embarks upon a programme of regrettable overindulgence, as Mr Stomach complains: ‘My belief is, if I had never passed the Temple Bar, I should at this moment have been at least ten years younger in feelings; but as it is, my constitution is undermined, and not with blowing up, but blowing out.’5 The conceit of a gut that not only talks but talks back to expose the folly and greed of its owner so tickled Victorian readers that Memoirs of a Stomach became a bestseller translated into several languages. The popularity and persistence of this literary conceit suggests that digestion might play more of a role in shaping how we think about ourselves and the world around us than is usually acknowledged.
Even when it is not being creatively animated, the stomach has a lot to say because the organ and its processes are deeply embedded in the rhythm, culture and language of everyday life. Think of idioms like the familiar advice to follow a ‘gut feeling’ or the admission that you find something ‘hard to stomach’. A well-known German saying has it that Liebe geht durch den Magen or love goes through the stomach, while in Italy stare sullo stomaco means that someone or something is annoying, they ‘get on your stomach’, and if a Swede advises you is i magen, to have ice in your stomach, you need to play it cool. Outside of well-known sayings, we might consider the ubiquity of digestion as a metaphor for learning, or the rhetorical link between aesthetic taste and gustatory pleasure, or the prominence of scatological images in the rich lexicon of obscenity as further evidence of the peculiarly lively life that the gut seems to enjoy outside of the body. In The Second Brain (1998) the biologist Michael Gershon describes the digestive tract as an ‘open tube that begins at the mouth and ends at the anus […] a tunnel that permits the exterior to run right through us’.6 This image of the gut as a kind of opening, a crack where the world seeps in or a draughty corridor that it whistles down, is us ed by Gershon to make the case for a more nuanced understanding of the important ways that bodies and environments are entangled with each other. It is also a powerful illustration of how the gut mediates between the vast complexity of the exterior world and the sticky universe of interior life. Against the common conflation of mind with identity, this book argues that it is possible to read digestive processes – consumption, absorption, defecation – as other ways of making the self and making meaning in the world. As socially awkward as a loud belly might be, the rumblings of this garrulous organ can tell us a great deal about our shared culture and its history.
What Is the Gut?
Eating, seemingly the most mundane of acts, is in fact a rather complicated business. The digestive process requires a confederacy of different organs to work together harmoniously, entails the careful production of special chemicals and enzymes, and involves the remarkable assimilation of material from the outside world into the substance of the body. Digestion begins in the mouth with the release of saliva that – with the help of the teeth and the tongue – begins to break down food ready to be passed to the oesophagus, which pushes your meal downwards towards the stomach. The inner walls of this J-shaped organ are lined with glands that release gastric juice, while its muscly outer layers contract to mix this liquid with the food consumed to make what is known as chyme. This substance then moves into the first part of the small intestine, the duodenum, where bile from the gallbladder and enzymes from the pancreas break the material down further. The small intestine also features millions of tiny villi – finger-like structures with blood vessels inside – that channel the nutrients released by digestion into the bloodstream. After most of your meal’s goodness has been absorbed and transported around the body, what remains is moved on to the large intestine which uses bacteria to complete the final stages of digestion. Over several hours yet another transformation takes place as water is absorbed from the chyme and it becomes semi-solid faeces, ready to be transferred to the rectum and finally expelled via the anus. This multi-step procedure is coordinated by the brain, nerves and several dedicated hormones, which send signals around the body preparing each part to be ready to play its assigned role at exactly the right moment.
Over the last few decades there has been an explosion of research into the workings of the gut: many scientists now believe it plays a far larger role in human physiology than was previously realised, influencing not only gastrointestinal health itself, but also obesity, metabolic health, the immune system, cognitive function, mental illness and neurodegenerative diseases. Much energy has been devoted to exploring two of the organ’s most fascinating characteristics: namely, its peculiarly intimate relationship to the brain and the wild alliance of bacteria, archaea, viruses and fungi that it houses. Scientists have found that the gut communicates with the brain through several key routes in the body: the immune system, the vagus nerve that controls heart rate and digestion, tryptophan metabolism, which is associated with ageing and inflammation, and the enteric nervous system that governs gastrointestinal behaviour.7 Elsewhere, explorations continue into one of the most diverse habitats on the earth: the human microbiome. Our bodies play host to trillions of microbes. These are spread across locations as diverse as the eyes, lungs, skin and mouth, but by far the largest community is to be found in the stomach, colon, small and large intestines. Brought to light by advances in genetic sequencing that revealed the extent of its heterogeneity for the first time, the gut microbiome begins to develop in the womb and appears to have a hand in everything from gastric health and metabolic function, to sleep and mental wellbeing. In laboratories around the world researchers are attempting to understand the scope and significance of these connections. At the Max Planck Institute for Metabolism Research in Cologne scientists are using new imaging technologies to map the neuronal signalling pathways of metabolism; over at the University of Cork progress is being made in understanding the link between cognitive function and microbes, with the tantalising possibility that altering the flora of the gut may help reverse age-related deterioration of the brain; the Laboratory of the Gut Brain Axis at Mount Sinai Hospital in New York is exploring the possible role that the microbiome might play in treating patients with multiple sclerosis; and in Belgium at KU Leuven psychiatrists have teamed up with gastroenterologists and nutritionists to investigate the links between digestion and mood. Wide-ranging, varied and often involving cross-disciplinary collaboration, the riddle of the gut has produced one of today’s liveliest fields of research.
Research into the microbiome and advances in our understanding of biochemical signalling between the gastrointestinal tract and the nervous system have also provoked popular interest in the relationship between the stomach and the mind. Books like Giulia Enders’ bestselling Gut: The Inside Story of Our Body’s Most Underrated Organ (2015) and Alanna Collen’s 10% Human: How Your Body’s Microbes Hold the Key to Health and Happiness (2015) have told largely biological stories about the gut–brain axis, while texts like Gerd Gigerenzer’s Gut Feelings: The Intelligence of the Unconscious (2007), Emeran Mayer’s The Mind–Gut Connection (2016) and Alana and Lisa Macfarlane’s The Gut Stuff: An Empowering Guide to Your Gut and Its Microbes (2021) urge readers to transform their lives by tapping into the wisdom of the stomach. These books have, in turn, spawned a booming wellness industry dedicated to selling better digestion in the form of probiotics, juice cleanses and fermented foods that promise to revolutionise physical and emotional health from the belly up. All this attention has encouraged us to see the gut in a fresh light: as an organ of infinite complexity, containing multitudes of mysterious microbial life, deeply networked into the rest of the body, and strangely entangled with the intricacies of our psychic lives. These modern revelations are, though undeniably valuable, almost entirely the products of biomedicine, with the result that the gut we encounter across academic papers, self-help books, newspaper articles and promotional materials is one described and defined almost entirely by science. There are, however, other ways of imagining, representing and experiencing the body.
Take the word ‘gut’, for instance. A narrow definition of the term would have it refer only to the portion of the lower alimentary canal that connects the pylorus and the anus, but its common usage is far more expansive. It is often employed to denote the whole of the digestive system, a trend that has been encouraged by the popularisation of scientific research into the gut–brain axis that uses it as a more general descriptor. Look outside of medicine and its uses proliferate even further: the gut is the abdomen; the guts are the innards of the abdominal cavity, the bowels and entrails; to gut is to remove those entrails; a gut is a particularly fleshy belly, or even a person thought to indulge gluttonously. Away from the body the guts can refer to the interior of an object or to the key substance of an argument. We also use it to describe certain character traits and behaviours: to have guts is to be brave, to be gutless a coward; you can hate a person’s guts and threaten to have their guts for garters; working hard might involve sweating one’s guts out or busting a gut.8 As these diverse applications suggest, the gut exists not only as a part of the anatomy, but also as a powerful metaphor capable of producing and communicating meaning in language. Fascinated by the belly’s vigorous linguistic life, this book is committed to uncovering how ideas around consumption, digestion and defecation shape the world and our encounter with it. Where biomedicine views these processes as largely neutral functions of the body, Rumbles argues that they are in fact bound up with understandings of gender, race and class. What we eat, the foods we find palatable, those we find disgusting, the diets we follow, the practices we adopt around sanitation and the feelings we attribute to waste are all freighted with heavy social, cultural and political baggage. At stake here are big questions around subjectivity, technology, ideology, sexuality, spirituality, nationhood and identity, questions that lie far beyond the scope of science. To find answers it is necessary to turn instead to history.
