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Tuesday, January 28, 2014

A Short History of Vomit: Part 2

Part 2

Modern medicine has determined that the physiological action of vomiting (emesis) is a force which can and often should be harnessed. There are over the counter drugs like Benadryl which can stop vomiting or drugs like Syrup of ipecac which can induce vomiting. The prescription drug Navoban halts vomiting while the prescription drug apomorphine hydrochloride triggers a bout of vomiting. Still other people opt to avoid pharmaceuticals all together and self medicate with marijuana to stave off the urge to vomit or opium to coax a vomit response.

Airsickness, which a form of motion sickness, is the bane of any traveler and a logistical nightmare for the onboard service personnel. The end result for those people suffering from airsickness is the urge to vomit. In order to minimize the mess created, facilitate hassle-free desposal and eleviate the gangway congestion the infamous airsickness bag was created. The bag is occasionally and affectionately referred to as a “barf bag”. In 1949 Gilmore Schjeldahl redesigned the airsickness bag for Northwest Orient Airlines. His bag departed from the earlier versions, which were constructed of wax or cardboard paper, by lining the inside of the bag with plastic.

Most psychiatrists and psychologists today, in their peer reviewed journals, refer to a vomiting mental illness as one in which a person induces vomiting. These are deemed either bulimia nervosa or anorexia nervosa. On the other end of the psychological spectrum is Emetophobia; the irrational fear of vomiting.

Vomiting as a method of treatment has long been associated with the lability. Ancient European civilizations held the belief that illnesses were cured when the correct type and amount of fluid could be purged from the body. This callow yet fundamental causality held sway over diagnosis and treatment all the way through to the late middle ages. Vomiting was the mortar which held this principle together. 
The Greek philosopher, physician and founder of western medicine, Hippocrates 460-370 BCE, expounded in his humor theory that a person can be "...rebalanced by bloodletting, blistering, purging by vomiting or anal purgatives, or other potions that would cleanse the body." 

The Roman physician, Galen 131–200 AD, refined the 4 temperaments theory of Hippocrates. Galen envisioned vomit as a diagnostic tool for curing mental illnesses which were seen as fluid imbalances. These four temperaments were classified as choleric, melancholic, sanguine, and phlegmatic and corresponded to the bodily fluids bile, black bile, blood and phlegm respectively. Different ratio combinations of these fluids produced as many unique personalities and personality traits. If a physician, following the four temperaments dictum, judged a aberration in a patients fluid balance, he would then recommend a cure which entailed vomiting. In other words, by the act of vomiting the physician was capable of tweaking the ratios of body fluids and thusly, stave off or cure mental illnesses.

The the Middle Ages saw a continuum in the (re)balancing act of the 4 temperaments as a diagnostic treatment of mental illness. A noteworthy departure in thought was that the physicians of the Middle Ages sought to bring the body into equilibrium as opposed to willfully altering intrinsic personality traits in order to create new ones. A medieval pharmacopoeia was more elaborate than its classical predecessor. It included laxatives, cupping and leeches for bleeding. However, the tool d'force was the emetic. Vomit inducing preparations were as copious as the ingredients in them.

It might be argued that the Classical Civilizations acquired their conceptual knowledge from the older civilizations surrounding them through cultural and technological diffusion. It is held that Ancient Egyptians anthropomorphized the body as a series of waterways and canals. Logic dictates that canals and waterways are prone to become occluded and it wasn't a quantum leap of thought to attribute that to the human body. Egyptian physicians reasoned that inducing vomiting might unblock the canal and cure the illness.

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