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Traffic Jams on the Number Two Express  

From The Spring edition of Contentment magazine.

By Lewis Coleman, MD, FAIS 

This article presents a fresh hypothesis based on stress theory that explains the pathophysiology of ulcerative colitis (which afflicts the colon), regional enteritis (which afflicts the small intestine), interstitial cystitis (which causes intense urinary bladder pain), and the sensitivity of bowel and kidney function to surgical stress, which manifests as postoperative nausea, vomiting, acute renal failure, and “bowel ileus” that renders patients unable to digest food in the aftermath of surgical stress. All these conditions are commonplace and defy explanation by conventional medical theory. 

Stress theory has always promised to revolutionize medicine by providing simple, safe, comfortable, and inexpensive treatments directed at the underlying cause of disease. In this case, it indicates that these conditions are all caused by excessive sympathetic nervous hyperactivity that inhibits microvascular perfusion and causes painful oxygen starvation in afflicted bowel and bladder tissues. These conditions can all be controlled and cured using synergistic combinations of narcotics that inhibit sympathetic nervous activity and carbon dioxide that releases oxygen from the blood into tissues. In most cases, breathing small concentrations of carbon dioxide mixed with room air is all that is needed. 

Ulcerative colitis and regional enteritis are painful inflammatory conditions that promote cancer and cause bowel ulcerations and chronic bloody diarrhea. Nowadays, they are regarded as the same disease. Surgery is counterproductive because the disease inexplicably reappears in previously healthy bowels after the afflicted bowel is removed. These inflammatory bowel diseases are closely associated with amyloidosis and rheumatoid disease, which is unsurprising because amyloid protein is a subunit of collagen, which is generated for tissue repair.1 

Interstitial cystitis (IC) causes severe bladder pain that necessitates frequent painful urination, but it seldom causes visible changes in bladder tissue. Amyloidosis of the bladder is rare and rarely present in IC, which is consistent with the absence of tissue damage. The source of the pain is mysterious, and there is no known treatment for the condition.  

My curiosity about these maladies was piqued by coincidence. While I was in medical school, my mother nearly died of “toxic megacolon” that necessitated emergency colon resection and an ileostomy after a long history of ulcerative colitis. My surgical internship group included a female intern who had been the “Littlest Mouseketeer” on the Disney television show.2 She married one of my friends in the internship group and became a rare lady urologist. She openly regarded medicine as “show business,” proclaimed herself to be an expert in interstitial cystitis, published books on the subject, was interviewed on national television, became embroiled in malpractice lawsuits, and lost her license. This mysterious illness also plagued several of my friends and relatives. 

Orthodox medical theory cannot explain these conditions or why they disproportionately afflict women. No causative viruses or bacteria are involved. Many suspect that they are caused by emotional adversity. Still, until now, there has been no mechanism that explains how emotions affect disease, and without a testable explanation, the idea seems weak. Medical consensus does not categorize these conditions as rheumatoid diseases, although they are often associated with rheumatoid disease that is regarded to be secondary. However, the close association of rheumatoid diseases with bowel and bladder disease is consistent with stress theory, which postulates that the same mechanism causes all forms of the disease. 

The bowel and the bladder are intensely innervated compared to most other tissues. In late 1700, Dr. Marie-Francois-Xavier Bichat, who is remembered as the” Father of Histology” (the study of body tissues), was so impressed by the quantity of nervous tissue surrounding the bowel and bladder that he speculated that it functions as a “secondary brain.”  

During the 1800’s Dr. Claude Bernard demonstrated that blood perfusion determines organ function.3 Early in the 20th century, Dr. Christian Bohr discovered the hemoglobin-oxygen dissociation curve, which enabled an understanding of the mechanism of oxygen transport and delivery, which captures oxygen from the atmosphere and delivers it to cells deep within the body.4 Soon thereafter, Dr. George Washington Crile discovered that morphine supplementation during general anesthesia improves surgical outcomes by preventing harmful nervous hyperactivity.5 During the same era, a German researcher, J. Tannenbaum, proposed that a submicroscopic, molecular level “capillary gate mechanism” regulates microvascular blood flow,6 based on his reasoning that capillary surface area was vastly greater than the sum total of all larger vessels combined and that relatively low pressures, flows, and turbulence prevails in capillaries as compared to larger vessels. During the same era, Dr. Yandell Henderson discovered that carbon dioxide improves all aspects of oxygen transport and delivery and has powerful therapeutic properties. 

Dr. Hans Selye7 proposed that a single mechanism explains all forms of disease. Dr. George Washington Crile observed that narcotics prevent sympathetic nervous hyperactivity, a significant factor in all forms of what was then called “shock.” Unfortunately, the simplistic concept that nervous control of “vasoconstriction” and “vasodilation” of arteries and arterioles controls blood flow resistance. Most of the evidence that supports this idea is derived from “in vitro” studies that are irrelevant to “in vivo” circumstances, and the idea is incompatible with numerous observations. Still, it has prevailed in the absence of a testable capillary gate mechanism. Furthermore, much of this important knowledge has been confused and promoted for nearly 100 years by what I call the “Leake/Waters” hoax that serves corrupt commercial interests.11,12 

Today, with the help of advancing research technology, we can describe the capillary gate mechanism that clarifies the nature of hemodynamic physiology, including cardiac output, blood flow, oxygen delivery, blood pressure, and pulse rate by regulating microvascular flow resistance in accord with autonomic balance (subconscious nervous activity) in capillaries, as Tannenbaum anticipated.6,13  

Narcotics prevent harmful sympathetic nervous hyperactivity that “closes” the capillary gate, increases microvascular flow resistance, elevates blood pressure, reduces tissue perfusion, undermines tissue oxygenation, and invites hypoxic organ damage. Parasympathetic nervous activity releases nitric oxide from capillaries, which opens the capillary gate, reduces microvascular flow resistance, lowers blood pressure, increases cardiac output, and optimizes organ perfusion, oxygenation and organ protection.

Carbon dioxide is the primary regulator of the capillary gate. It directly releases nitric oxide from capillaries and opens the capillary gate in accord with organ and muscle activity. 

Hypercarbia also releases oxygen from blood into tissues to elevate tissue oxygenation, which enhances organ protection and function. Furthermore, hypercarbia counteracts narcotic respiratory depression and accelerates narcotic metabolism and clearance from the body.14 Thus, hypercarbia and narcotics go together like love and marriage to promote tissue perfusion and oxygenation and protect organs. 

Last, but not least, we know that tissue hypoxia is extremely painful. For example, cardiac ischemia causes “angina” pain. Chronic tissue hypoxia also promotes harmful collagen production in tissues. For example, chronic hypoxia induces harmful collagen deposition in heart tissues that undermines contractility and causes heart failure.15-17 Myocardial infarction (heart attack) halts oxygen delivery to heart muscle, causing severe hypoxia pain. Strokes, however, are pain free because brain tissue lacks pain sensors. 

During my anesthesiology residency I was brainwashed to employ mechanical hyperventilation during general anesthesia to “rid the body” of carbon dioxide, which was regarded as “toxic waste, like urine.” However, I suspected from the start that this was nonsense because I knew that every cell in the body continuously produces carbon dioxide and water as the result of the intracellular “Krebs Cycle” that converts food into adenosine triphosphate (ATP) that serves as a universal source of cellular energy. If carbon dioxide were toxic, then we would all be dead. If it had narcotic properties, then we would all be drunk. So, when critical care clinical research re-discovered the therapeutic safety and benefits of carbon dioxide in the late 1980’s and capnography (which measures exhaled CO2) and pulse oximetry (which reflects arterial blood oxygenation) became available, I learned to supplement general anesthesia with modern synthetic narcotics and hypercarbia to improve surgical outcome. I was gratified to observe that this technique preserved postoperative respiratory drive and minimized postoperative pain, fever, tachycardia, hypertension, dysrhythmias dementia, delirium, laryngospasm, nausea, vomiting, and bowel ileus. My patients emerged from anesthesia promptly and clear-headed, calm, and comfortable. I was surprised that nausea, vomiting, and bowel ileus were also rare with this technique, because the prevailing consensus held that narcotics cause nausea and vomiting. I soon realized that the real problem was uncontrolled surgical stimulation and mechanical hyperventilation which undermined bowel and brain perfusion and oxygenation during surgery. My suspicions were confirmed by research literature.14,18-30 I thought I had discovered something significant, but I didn’t realize until years later that I had merely re-invented the wheel. The principle of “pre-emptive analgesia” using narcotics and CO2 supplementation had been understood since the earliest days of modern anesthesia.5,11,31 

My previously published paper titled, The Mammalian Stress Mechanism Explains Covid, Long Covid and Sudden Death, was inspired by the experience of a friend named Susan D, a 76 year old lady in excellent health who collapsed after her fifth COVID jab and was subsequently discovered to have suffered an unexplained decrease in her blood hemoglobin level to 6.1 (normal is 12-15).32 Susan had a long history of significant emotional adversity, and had suffered severe interstitial cystitis pain for most of her adult life. She had consulted several doctors and undergone various treatments, all to no avail. By this time, I had published my book that described the mammalian stress mechanism,33 and her story inspired me to hypothesize that her emotional angst activated sympathetic nervous hyperactivity, which caused hypoxic pain in her urinary bladder by selectively activating the capillary gate mechanism in her bladder tissues. Based on this hypothesis I suggested that she breathe small amounts of carbon dioxide mixed with room air whenever she perceived a fresh onset of bladder pain. I explained how she could obtain a small tank of carbon dioxide and fit it to a flow meter and an oxygen mask. She soon discovered that it promptly relieved the bladder pain. Furthermore, by consistently treating herself with CO2, she reduced the frequency and severity of the pain attacks. 

Of course, one sparrow does not make a spring, and this single report of treatment success is unconvincing. However, it is consistent with known science, and I believe that it should be tested in more patients. The implications extend beyond merely relieving bladder pain. It may be that breathing small amounts of carbon dioxide could relieve the attacks of abdominal pain suffered by victims of ulcerative colitis and regional ileitis, and perhaps other forms of unexplained pain. It might even prevent the inflammatory bowel damage caused by these horrible illnesses, and perhaps even cure them. 

The mammalian stress mechanism, which is described in my book, 50 Years Lost in Medical Advance: The discovery of Hans Selye’s stress mechanism, explains how emotional adversity induces sympathetic nervous activity in detail, and I believe I have identified a new category of diseases caused exclusively by harmful sympathetic nervous hyperactivity that can be treated and controlled by breathing small amounts of carbon dioxide, much like “mountain sickness.”34 Perhaps the most dramatic example of this phenomenon is “sudden death syndrome” where people are literally frightened to death in the presence of terrifying circumstances. My favorite example is the studies of Kario et al who documented the results of the horrific 1995 Hanshin-Awaji earthquake in Kobe, Japan, where the incidence of sudden death in the absence of injury was directly related to distance from the earthquake epicenter. The Kario study also documented elevations of von Willebrand Factor, blood coagulability, and other blood abnormalities in earthquake survivors.35-42 

Conclusion 

Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution. The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction. 

– Rudolf Virchow 

“Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” 

– Rudolf Virchow 

Thousands of patients needlessly suffer and die from the ravages of bowel disease. It is time for medicine to emerge from the “Dark Ages.” We sneer at past practitioners who employed bloodletting and leeches, and smeared feces in wounds, even as we embrace ignorant habits like mechanical hyperventilation that is inherently dangerous and confers no benefits, and illogically treating cancer with toxic chemicals, radiation, and mutilating surgery that are known causes of cancer. For too long medicine has functioned as an art based on experiment embellished by cowardly consensus that mocks science and enables corrupt corporations to manipulate medicine into a deceitful racket. Our patients deserve better. 

Now, for the first time in medical history, the discovery of the mammalian stress mechanism provides a theory that enables physicians to direct their treatments at the actual cause of disease, as opposed to guessing based on fickle symptoms. This paves the path for genuine reform and revolution, and should be embraced with excitement and even celebration, for it promises the prospect of freedom from the eternal curse of disease and premature death.  

It is time for the stress mechanism to be independently tested to enable its confirmation and refine its treatments. It is being shunned and ignored by corrupt medical publications. Politics is the underlying cause of this problem, and only politics can fix it. Must its blessings await the arrival of our great-great grandchildren? Why not us? Why not now? 

References 

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Lewis Coleman, MD, FAIS is a board-certified anesthesiologist who completed his BS degree in biology at Ohio State University, earned his MD degree from New York Medical College, and completed his surgical internship and anesthesiology residency at UCLA, followed by 40 years in private practice. Coleman’s basic sciences instruction at NYMC miraculously coincided with the two-year sojourn of Dr. Johannes Rhodin, a famous Swedish pioneer of electron microscopy who was retained by the school to upgrade its curriculum. Dr. Rhodin was an expert on the stress theory of Hans Selye. His stress theory lectures devastated the dogma of classical physiology and convinced Coleman that stress theory represented the future of medicine. Many years later, these lectures miraculously enabled Coleman to identify Selye’s long-sought stress mechanism. Thus identified, the stress mechanism enables Selye’s “Unified Theory of Medicine” that promises a new era of health, longevity, and freedom from the eternal curse of disease. Its implications exceed the bounds of medicine and confer a “unified theory of biology” that explains embryology, extinction, evolution, ethology, intelligence, anatomy, taxonomy, the Cambrian explosion, and dinosaurs, and resolves the disparities of Darwin, Lamarck, Baldwin, and saltation. Its distant implications reside in the realm of science fiction. His website http://www.stressmechanism.com is dedicated to stress theory and offers relevant materials free of charge. His book, 50 Years Lost in Medical Advance: The Discovery of Hans Selye’s Stress Mechanism, is available on Amazon. 

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