Customer Reviews

The Second Brain : The Scientific Basis of Gut Instinct and a Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestines

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From the author who founded neurogastroenterology. Gershon gets pretty technical, but even a layman (like me) is drawn into his interesting subject. The book chronicles his thirty years of research into the "second brain": the independent nerve mass literally in the gut. Probably most doctors today aren't aware of this whole type of nervous system even though its presence was discovered decades ago. (This is why digestion is not affected by spinal injuries.) Somehow this body of knowledge was forgotton by medicine. 'Eclipsed' is the word the author uses. Gershon "rediscovered" the existence of the second brain and began doing research in the 1960s about the affect of neurotransmitters (like serotonin) and their effect on this bowel brain. In the process of his narrative he explains how different chemicals (like Prozac, LSD, adrenaline, acetylcholine, puffer fish toxin, etc) can affect the brain and the sympathetic and peripheral nervous systems. He also discusses diseases like Alzheimer's, etc. The best part of the book is the author's personal family stories which he weaves into his narration. I was very touched by the story of his mother's death from a bleeding ulcer, surgery and subsequent stroke, and Alzheimers. The only problem with the book is that it is at once too long and too short. Too long because sometimes it gets too technical and was a little hard for me to stay interested and excited. Too short because in spite of covering thirty years of research the story is only a prologue. It's part one and part two remains in the future. What are the implications of the second brain? Will knowledge of how it works help cure diseases? We begin with a monumental reawakening. A re-acknowledgement that the second brain is there. What it means we still don't yet know. We have learned that ulcers are caused by viruses. That some depression may be depression of the bowel brain. That Alzheimers effects both brains. But we don't know if problems with intra-brain communication can cause illness. Have we been treating the wrong brain? Can autism and Parkinson's disease be better treated by concentrating on the gut brain? So much promise for the future, yet still a lack of answers. I finished the book feeling a little incomplete.

The long tradition of first rate scientists who are also talented writers, such as Lewis Thomas and James Watson, is happily continued in "The Second Brain". Gershon describes the operation of the gut for the layman, managing to strike just the right tone without insulting one's intelligence or oversimplifying. The book, frequently witty and amusing, is part memoir and part up-to-date primer on the operation of the gut. A particular triumph is a description of a shootout at a scientific meeting in Cincinnati where Gershon's theories about the importance of seratonin were debated.

Later sections of the book become quite technical, such as the seven (?) different varieties of seratonin receptors described in Chapter 9. This is very detailed, but the problem here is that the very complex mechanism that nature has built does not satisfy our wish for simplicity. Gershon tries to show what the scientific struggle to gain understanding is like on the front lines as simple hypotheses often don't work out and complications multiply.

In the midst of this complexity, one finds the description of some truly marvelous experiments in embryology. The experimenters replace certain cells of chicken embryos with similar cells from quail embryos. As the embryo develops, it is possible to tell what's become of the originally implanted cells and thus trace the details of embryonic development. The elegance of the experiments and of the tools (immunocytochemical analysis etc.) is very impressive. I would have liked more.

This book is timely. Example: amusing comments on the "antacid wars" on TV. The book is crammed with astounding information and remains readable. However, if one forgets what the LES is, the only way to find out is by flipping pages. The lack of an index is inexcusable. The editors should hang their heads in shame. I'm going to wait until they turn on their computers and compile an index before I buy this book. Too bad!

I was interested in Gershon's hypothesis about the connection between taking the antidepressant Prozac and the potential for chronic neurological bowel disfunction. At first I was swayed, thinking that, yes, the receptors for serotonin would be desensitized by the longer exposure to the serotonin molecules, due to the blocking of the re-uptake receptor by Prozac. He then freightens the Prozac dependant person with the hypothesis that their natural production of serotonin will decline and further that ultimately, the person has to look forward to an irritable bowel followed by bowel immobility...all due to Prozac's action. What I am wondering is this, are these unfortunate effects of Prozac due to the blocking of the re-uptake receptors or is it due to a presumed increase of concentration of serotonin in the enteric nervous system? If the depressed person is on Prozac because of low seratonin levels, then it seems like their levels of seratonin would just be brought up to normal, thus relieving some of their symptoms of depression but not necessarily causing a surplus in the neurotransmitter, serotonin. I wish the author would more clearly explain this and also I would like it if he would explain how the blood/circulatory system relates to the transport of neurotransmitters in both nervous systems.

The enteric nervous system or the nervous system of the gut is what this book is about. It's not an easy read for people who have no background in science. Before reading this book, one should have a good understanding of ligands, receptors and neurotransmitters because the author doesn't do a very good job of explaining the basics. What makes this book especially difficult to read is the fact that it's highly technical and he uses medical jargon throughout yet he doesn't have a glossary nor an index. With that said, I think there's a tremendous amount of fascinating information in this book worth pondering on. People who are interested in science and medicine and like to read about how scientists go through the process of learning and discovery should read this book.

The main part started out how the author struggled to prove that serotonin was a neurotransmitter in the bowel. Then he went on to explain some of the complexities of the enteric nervous system in detail while asking questions, making more discoveries and explaining what others in the field are doing. I was mostly focused on the beautiful details describing the enteric nervous system. I don't think people realize (or care) that the entire lining of the digestive system from the esophagus all the way to the anus is lined with well over 100,000,000 cells that not only receive information but secrete chemicals that communicate with other parts of the body as well. The mere fact that there are more nerve cells in the bowel than in the spine tells us that digesting food is no simple matter. The enteric nervous system is highly complex because it has to coordinate and process all kinds of information not to mention chemically analyse its contents and secreting the right kinds of chemicals in the exact amounts to digest food and to propel it though the intestines. The propulsion of fecal matter in the rectum mainly just involves the enteric system and muscles of the colon, but it communicates with the spine and brain to coordinate its activities. Sever a connection between the three and you can lose your defecatory and urinary reflex or lose control over them completely. There is a storehouse of other interesting information in this book. One other interesting fact brought up in the book is that the surface membrane on one square centimeter of human intestine is enough ot cover a doubles tennis court. I imagine that the entire surface membrane lining of all of the intestines would at least cover a football field.

Reading books like this helps me to keep things in their proper contexts by making me ponder on the perfection of God's creation. When we go on exile from the world for a while, it makes us better equipped to tackle the problems of everyday life.

The author got my attention by promising that he was going to show that psychoanalysis and other psychological causation theories relative to gastrointestinal disorders were false. Once again I was taken in by an author trying to launch his theory by "proving Freud wrong." As with most such claims, he did nothing of the kind. His very interesting and as up-to-date-as-he-could-be picture of the structure and functioning of the gut serves as well to bolster psychological theory as it does biological theory. Only a mind-body dualist could claim otherwise. He offers the lay reader an understandable picture of the various research designs used to seek out genetic, developmental and functional information and, for this reason, I feel I got my money's worth. For all of his otherwise elegant and apparently objective presentation of his material, when he got to discussing psychoanalytical theory, all he could do was dismiss it out of hand with a few snickers and sneers. He did claim that there are few connections between the brain and his "Second Brain," but as it turns out there are quite a few. Cut these connections and the gut continues to function, perhaps much like a chicken with its head cut off. None of this does anything to prove that prior to being cut, the early life psychological experiences of a person might not shape up the "Second Brain" to be under and over-responsive to certain anxiety and stress cues. National Institute of Health research dollars are scarce these days and perhaps he was motivated by need to discredit others who might be competing for the same dollars (all at an unconscious level, of course). It is amazing that as he appeals for such strict objectivism, so much of his subjectivism shows through. One last concern; he seems to be saying that this extensive neural organization in the gut is as complex as the brain and, thus, deserves to be seen as a "Second Brain." He might be spending a bit too much time by himself in his laboratory. It takes a lot more that large amounts of Seritonin to make a brain.

I haven't finished reading this book, but other reviewers are right, in that, there is much interesting information here. They are also right that not having an index in a technically oriented book is inexcusable.

I would like to call readers attention to something related to this subject which fills the void, in a sense, of the complaint that there is really no "practical" help offered. There is a chapter ("Cayce's Castor Oil Packs") in a book ("Adventures Into the Psychic", by Jess Stearn) I read as a teen that addresses the general subject of the autonomic and sympathetic nervous systems from the practical point of how a lack of coordination between them lead to diseased states and how to get them "coordinated" again, via "Castor Oil Packs." The chapter in the book is an interesting read in light of this book. If you can't find the book, at least check out a couple of links: [...] or [...] (Please surf the Net further about castor oil packs, as I didn't have much time to offer links about this.) For readers looking for help with digestive, as well as other maladies, you might want to try this. It's simple and does not harm. Reportedly, it can do a LOT of good... meaning you can find numerous anecdotal reports of some amazing results!

If you are planning to be a student of medicine or neuro-psychology, then you seriously might start with this book. Gershon shares his 30 years of research of the gut and its enteric nervous system in a detailed story account, which is technical but very readable to the interested student. It may not be on your official prerequisite reading list given to you by the college you are about to attend, but trust us and read it anyway because it deserves to be for its revolutionary content. Until his research in this book revealed that the gut has nerve cells that act as a second brain, the gut went for too long unrecognized as capable of being an independent functioning organism, and its importance in both medical health as well as psychological health had taken a back seat to the head brain. Therefore, we highly recommend this groundbreaking book.

Let me state at once that this book is worth reading. It provides information that everyone should know about the workings of one's digestive tract, fundamentals that should be taught in high school biology, but aren't. It's a curious fact that few of us have more than a vague idea of what happens to the food we eat, and this book provides a detailed account of the digestive process. Sort of an owner's manual for the body. At times, though, it's too detailed for the casual reader who will be tempted to skim over the esoteric descriptions of intestinal biochemistry and research methodology.

I am not qualified to offer an opinion as to Dr. Gershon's central thesis -- that since 95 percent of the body's supply of the neurotransmitter serotonin is produced in the bowels, it seems likely that gastrointestinal malfunction might be the cause of of emotional disorders; that the "second brain," as Dr. Gershon calls the complex web of nerves controlling the digestive tract, might be controlling the boss in the head. (It is interesting to note that one of Freud's wayward disciples, Wilhelm Reich, who eventually went insane, proposed the same thing -- the viscera controlling the brain-- as part of his theory of "body armor.") It seems to be a plausible avenue of research that will eventually benefit the 20 percent of Americans who suffer from chronic tummyaches.

Dr. Gershon writes in a chatty style, but on occasion he lapses into painful academic prose with words such as "utilization" where good-old "use" would do. Fowler's Modern English Usage denounces such "long variants" at length and in scathing terms. If HarperCollins employed editors to assist technical and scientific authors, this could have been prevented.

In reviewing The Second Brain as a whole, I'd add my voice to the chorus of protest over the book's lack of either an index or a glossary. This is typical of HarperCollins, America's worst publisher. Another example of their shabby treatment of a worthwhile author is Bill Bryson's At Home. That book's UK edition has an index, but there is none in the US edition.

At least since being purchased by Rupert Murdoch in 1989, HarperCollins will do anything to save a buck: no index, no editing, and a cheap binding. I purchased the hardcover edition of this book as soon as it was released in 1998, not all that long ago, and already the paper has turned brown. Here's an important book by a respected author, a book that future generations will use as a reference, and the cheap paper is already deteriorating.

Cheers for Dr. Gershon; hisses for HarperCollins.

An excellent insight into the much neglected and amazing enteric nervous system.
Also insight into the 'argy bargy' of science and research-- egos and all.

I enjoyed it and found it a true revelation, but it is not for everyone; some pharmacy or medical knowledge is needed, and would make it more accessible.

If you wondered why anti-depressants make you, or your patients, sick read this.