The Posture Theory Homepage  The Visceroptosis Webpage ©
 

Left diagram

 The normal position of the internal organs

 Right diagram

The position of internal organs which have been permanently pushed lower into the abdomen by poor posture (visceroptosis)

Introduction to the subject of Visceroptosis

Visceroptosis is a condition in which the internal organs have been compressed and displaced by poor posture, the enlarging womb of pregnancy, tight waisted corsets, and a variety of other factors. This displacement stretches the attachments which hold the stomach, liver, and kidneys etc. in their proper place in the upper abdomen, and as a result they are suspended in a lower position. This produces a tendency for the kinking of tubular structures, ducts, blood vessels, and nerves leading to various problems such as indigestion, kidney problems, and faintness. However there has been much dispute about this, with the current consensus of opinion being that the condtion is trivial, and not a cause of chronic illness. In reviewing this matter I found the following book, and have summarised the information to give a report on the history of the subject.

A Review of a 1930 Book on Visceroptosis ©

This essay is from the 11th edition of The Posture Theory pages 259-261.

In a book called Visceroptosis and Allied Abdominal Conditions Associated with Chronic Invalidism, published in 1930, the author H. Bedingfield gives an account of the history of ideas on that subject from the 16th century to the early 20th century.
According to the author, 16th century writers claimed that the internal organs belonged in particular positions, and any variation in location was regarded as abnormal.
In 1837-41 French writer P.F. Rayer observed that a movable kidney was commoner for the right kidney and commoner in men, and was associated with general visceroptosis and hypochondriacal symptoms which could be relieved by supporting the kidney with a suitable belt.
In 1841 J. Cruveilhier gave a precise account of transverse colons which zig-zagged across the abdomen or looped down into the pelvis. He concluded that that was due to corset wearing which compressed and displaced the liver, which in turn distorted and displaced the bowel.
In 1870 R. Chroback suggested that the movable kidney was the cause of hysteria. L. Landau published another article on nephroptosis in 1881 which started a flood of literature on that subject, such that by 1897 A. Macalister was able to provide a select bibliography of 151 articles.
Between 1885 and 1899 Frantz Glenard wrote 30 articles and monographs on enteroptosis. His early articles proposed that sections of the colon could bow under the weight of faeces, which would cause a sharpening and narrowing of the nearby bends or flexures. That would further impair the flow of faeces and increase the weight in that section causing a strain on its attachments. He proposed that the hepatic flexure was the weakest and would give way first, and as that section of bowel descended it would drag on the pyloric end of the stomach and then pull down the transverse colon, ultimately producing obstructive kinks. The stomach and bowel would then tend to dilate prior to those kinks and contract after them.
He later proposed that disturbed liver function altered the bowel function and led to similar mechanisms of displacement, and he noted that disturbance in the circulation of the liver and bowel was followed by reduction in the tone of the bowel. "Glenard was the first to suggest that muco-membranous colitis was not a clinical entity but simply one of the symptoms of enteroptosis."
In 1903 Alex Blad of Copenhagen wrote a book called "On Enteroptosis" which referred to some 800 articles on visceroptosis and by 1912 H. Burckhardt of Berlin presented several hundred more. However interest in that subject then began to wane. From 1913 J.E. Goldwaith and his Boston colleagues proposed that body shape influenced health, with a narrow back and chest cramping the lungs and heart, and resulting in poor aeration of the blood, and low blood pressure. He also proposed that such physique disposed to enteroptosis.
There were suggestions that a narrow upper abdomen may result in the abdominal viscera lying lower. The lowest part of the stomach would then be lower than its outlet so it may not empty properly. The lower bowels would necessitate kinking, and, would drag on the solar plexus, with the suggestion that that would cause neurasthenia (fatigue).
It was also thought that with normal posture the stomach was tucked up into the arch of the diaphragm and held in place by the vacuum created by its high dome formation. The small intestines were held in place by a shelf formed above a narrow waist which in turn supported the transverse colon and stomach, and, as the abdominal cavity inclines upwards and backwards, the kidneys and spleen have support from the posterior abdominal wall. Any alterations in posture would tend to remove these supports and then under the influence of gravity the viscera may drop to the lower abdomen.
In 1916 E.C. Koenig and N. Mankell attributed chronic intestinal disorders in children to visceroptosis, and F.B. Talbot, L.T. Brown and W.H. Sherman described how training in posture and carriage removed the children's symptoms and restored their abdominal organs to their normal position.
In 1927 H. Moore and F.E. Wheatley of Boston claimed that if the child was trained to maintain a correct posture from early life, and wore no constricting garment around the lower thorax, nor excessively heavy ones from the shoulders, visceroptosis "would not and could not happen."
As well as considering the ideas about mechanical causes of visceroptosis, and visceroptosis as a cause of allied abdominal conditions, nervous disorders, neurasthenia and hysteria, the author also refers to various studies showing considerable variations in the position of internal anatomy between boys and girls, children and adults, men and women, and British and Americans, and concludes that differences between individuals represent a very wide range which can be regarded as normal.
There are references to individuals who have displaced anatomy yet have no symptoms with a further conclusion that variations in anatomy are compatible with normal health and were therefore not the cause of symptoms.

The postural ideas of the Boston doctors were dismissed by British orthopaedic surgeons who preferred "to regard posture and symptoms, not as cause and effect, but as expressions of an underlying cause", namely psychological factors, with a further quote from A.S. Blankart "there is frequent association of postural deformity with neurasthenia and with a neuropathic family history". The Boston exponents were also unable to explain all the diverse aspects of the condition, or why the abdominal symptoms were often accompanied by remote symptoms. However I note that the great majority of postural defects are acquired as the result of mechanical causes and that symptoms are a sequel, and that improvements in posture often relieve symptoms. The cause and affect between posture and symptoms would apply regardless of whether the postural defect was acquired or inherited.
The diverse aspects of visceroptosis are due to the multiple and diverse, often combined causes, and the remote symptoms emanate from abdominal disorders influencing the general health, and from the affects of postural mechanics on the entire body structure.
The ideas that corsets were a cause of visceroptosis were dismissed with the suggestion that many women with visceroptosis had never worn corsets.
However, I note that in 1903 it was possible to obtain 800 articles on visceroptosis and by 1912 there were several hundred more, after which such articles became rare. There is clear evidence that the extensive interest in the subject in the 19th century was due to the extreme symptoms resulting from severe visceroptosis caused by the 19th century corsets. Between 1900 and 1914 as the abdominal crushing corsets faded out of fashion, the symptoms became less common and less severe, which would have obscured the link between cause and effect and explain why interest in the subject waned.
In the Medline Express computer data base which covers worldwide medical publications for the thirty year period from 1966 to 1995, less than 70 articles (i.e. less than an average of three per year) are listed under the heading of visceroptosis. In the Cumulated Index Medicus only one article is listed in 1993, and one in 1994. Medline Express lists none between January and October 1995.
I suggest that the current paucity of articles is not due to the rarity of visceroptosis but because the influence of the very common condition has been underrated and neglected. The indigestion and multiple other aches and pains which should properly be attributed to visceroptosis are being dismissed as the trivial or imaginary products of a supposedly disturbed mind, and where there is no evidence of that they are attributed to supposedly mysterious or sub-conscious psychological problems. M.B.

 Visceroptosis An Outmoded Concept ?

"Gastroptosis . . . downward displacement of the stomach; a term based on the outmoded concept that variation in the position of the abdominal organs is pathological".

Reference: Dorland's Illustrated Medical Dictionary 25th edition (1974) p.636

In 1921 A. Rowland of the James MacKenzie Institute who studied 974 private and public hospital patients found that "no less than 49.48% fell into the group reserved for cases showing uncoordinated symptoms with no recognisable cause."
Reference: Visceroptosis and Allied Abdominal Conditions Associated with Chronic Invalidism (1930) p. 108

 
 

Diagram reference: The Ladies Guide (1904), Colored Plates supplement, Plate X11 - Posture Treatment

 The Treatment of Visceroptosis

In the nineteenth century the symptoms of visceroptosis were relieved by the woman removing her corset and kneeling on her hands and knees with her head and chest lowered, because this allowed the internal anatomy, which had been compressed into the lower abdomen, to slide toward the normal position in the upper abdomen.

The symptoms can also be relieved by laying on a bed with the head and shoulders propped up with pillows, and with two cushions placed under the knees to elevate them. This has the effect of relieving the pressure on the abdomen which occurs in people with poor posture who sit and lean forwards for long periods. Similarly the symptoms can be relieved by leaning back in a recliner chair with the legs slightly raised. M.B.

 

Surgical Treatment for Severe Visceroptosis
(extracts from The Posture Theory 11th edition p.261-262)


Gastroptosis - Occasionally, with downward displacement of the stomach, the stomach becomes adherent to structures in the pelvis and that may cause a sharp kink in the duodenum which impairs the emptying of the stomach. Where there are severe symptoms and x-ray evidence of gastric retention caused by the displacement, "gastric resection may be indicated".
Coloptosis - Downward displacement of the stomach is usually associated with downward displacement of other abdominal organs, particularly the colon, and sometimes the transverse colon descends into the pelvis. Where there are definite symptoms accompanying prolapse of the stomach and colon as indicated by clinical and x-ray evidence, "operations for relief of the prolapse are very beneficial". The types of operations which restore those organs with more natural supports to more normal positions result in less interference with their function than operations which introduce abnormal ligaments. Providing the surgical wounds are not strained and have an opportunity to heal properly, the stomach and colon should "remain in their replaced position".
Nephroptosis - Excessive mobility of the kidney can interfere with its drainage, or cause persistent pain and gastrointestinal disturbances. Such problems can be relieved by an operation which restores the kidney to a more normal and more stable position.
Reference: Operative Surgery (1953) p. 758-761 & 1206

The fact that some symptoms can be relieved by operations which restore abdominal organs to their normal positions leaves no doubt that visceroptosis is a cause of symptoms and that the diagnostic term is valid, and that the degree of displacement influences the likelihood and severity of symptoms. M.B.

When the internal organs are loose or low in the abdomen the tubular structures are prone to kinking and temporary obstruction of the flow of fluids or solids through them. Hence when the duodenum, colon, appendix, gall duct, or kidney ducts are kinked the symptoms of visceroptosis can include dyspepsia, vomiting, and constipation, and can imitate the pain of appendicitis and the colic of gallstones and kidney stones, and if the visceroptosis persists it can cause neurasthenia.

Reference: The Illustrated Family Doctor (1935) p.698-699.

Surgical treatment for visceroptosis included caeco-colon fixation, and gastropexy which resulted in marked improvement for 6-9 months, after which symptoms became worse.
Reference: Visceroptosis and Allied Abdominal Conditions Associated with Chronic Invalidism (1930) p. 135

I suggest that the short term benefits of earlier surgical methods of relieving symptoms were due to the replacement of anatomy to its normal position.
The symptoms may have returned after 6-9 months because the individuals had kyphotic (stooped) postures, and continued to slouch, or continued to wear corsets which put strain on the new surgical attachments and caused them to give way again. M.B.


View information on corsets and visceroptosis

Return to The Posture Theory Homepage

To order The Posture Theory book