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April 10, 1967

The Corticovisceral Theory of the Pathogenesis of Peptic Ulcer

JAMA. 1967;200(2):186. doi:10.1001/jama.1967.03120150142051

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Pavlov's teachings that autonomic functions are integrated in the cerebral cortex and that cortical disturbances result in the development of various diseases have significantly influenced physiology and medicine, particularly Russian medicine. In this volume data are reviewed, mainly from Russian sources, bearing on such aspects of Pavlovian physiology as exteroceptive and interoceptive reflexes, the relationship between them, their integration in the cerebral cortex, and how functional disturbances of the cortex lead to pathological processes. The authors then apply these principles to ulcer disease, concluding that peptic ulcer develops when we have "disturbances of the higher regulatory mechanism which appear either as a result of collision between extero- and interoceptive stimulations of the cortex or as a result of disturbances in interoceptive signalization." This seems equivalent to the term "psychosomatic disease" used in this country.

The most interesting consequence of this idea is the authors' strong advocacy of sleep therapy "as

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