Emotional component of ulcer susceptible constitution

T H E concept of the human constitution in relation to disease held in this clinic has sought to envisage the individual human being as an organ-ismal entity built of multiple components. The latter have been grouped in the four categories of morphology, physiology, immunity and psychology, and the qualities representing each panel have been studied by whatever de-pendable methods were available. So far as subjects of gastric and duodenal ulcer are concerned, anthropometric technics * have supported the earlier clini-cal belief that sufferers from that ailment belonged, within variable limits, to the linear division of mankind. Moreover, in the physiological panel of such persons the electrocardiogram has shown a consistent tendency to a long normal P: R interval, a finding which accords with the widely held notion of vagus nerve relationship to ulcer.2 The present report presents an inquiry into the character of the ulcer type's psychological panel. It is not an attempt to prove again that such persons are especially sensitive to emotional stimuli. The fact that they are nervous and possess the habit of worrying has long been fully recog-nized. The purpose here is rather to investigate the emotional quality of the ulcer susceptible male, to correlate it as far as possible with his morphol-ogy and physiology and to form some estimate of its quantitative participa-tion in the total reactions of that type of human organism. The ulcer itself may then be regarded as the inevitable product when these specialized human creatures react with certain peculiar onslaughts of environment, as well as with life generally. Our experience among these interesting people over a period of 20 years or more leads us to believe that in the morphological phase perhaps they do * Received for publication November 21, 1941