CORTIC-VISCERAL PATHOLOGY - a theoretical direction in medicine of the 20th century; postulates the possibility of reproducing pathological visceral reactions by a conditioned reflex. The formulation of the concept of K.-v. n. is historically associated with that stage of ideas about the structural and functional organization of conditioned reflexes, when the input and output links of their arc were usually localized within the cerebral cortex. The cortico-visceral theory of pathology developed by K. M. Bykov and other students of I. P. Pavlov, vulgarizing the teachings of the great physiologist, asserted the decisive role of the cerebral cortex in the development of almost all diseases; at the beginning of the 2nd half of the 20th century. this theory, which received the support of the party-state. leadership of the country, was declared the banner of owls. medicine, both theoretical and clinical, - a comprehensive theory of medicine, a guide to diagnosis (encephalographic study of higher nervous activity in each disease, etc.), treatment (for example, the unbridled expansion of electrosleep therapy) and prevention (so-called. protective regime in medical institutions, etc.). Like any attempt to universalize private patterns and create a single honey. "systems", this concept proved to be fruitless and was rejected by clinical practice. In modern science, higher nervous activity is considered as a complex multi-level multi-channel afferent-efferent organization. Conditioned visceral reflexes in their manifestations are much less related to the functions of the cerebral cortex than skeletal-motor ones. Therefore, the impulses from the internal organs under normal conditions for the most part remain outside consciousness. The term "cortico-visceral pathology" has lost its original meaning. It became clear that any forms of pathology of the internal organs are primarily mediated through the excitation of the corresponding subcortical structures of the brain and, due to the activation of emotional excitations, spread to the cerebral cortex. Some theoretical concepts of K.-v.p. were used by the founders of psychosomatic medicine.
In conclusion, it should be shown that the artificial opposition of the psychological and physiological approaches to the problem of the "specificity" of psychosomatic pathology, bringing them into the mainstream of ideological confrontation, impoverished both directions. One of them (cortico-visceral) actually adapted to the "lower part" human brain , abstracting from the complexity of human experiences, the role of unreacted and repressed into the subconscious emotions, the significance of experiences in early childhood. The second (psychosomatic) - addressed only the "upper part" of the human brain, operated only with concepts psychology and they tried to apply these concepts in the form of corresponding symbols to the activity of visceral systems. It is characteristic, however, that both these directions, for all their dissimilarity, have undergone the same evolution: from the initial recognition of a purely psychogenic nature psychosomatic diseases to the assumption of an important (and in some cases determining the specifics of the disease) role of local factors (" Achilles' heel", the focus of chronic irritation in the corresponding interoceptive zone). Such a path, it seems to us, indicates that true scientific knowledge involves a variety of approaches, while the combination of efforts of representatives of various directions allows us to go through this path much faster.
Basic principles of cortico-visceral pathology. The cortico-visceral theory of the pathogenesis of diseases was developed by Soviet researchers (K. M. Bykov, I. T. Kurtsin, and others) and is based on the reflex theory of I. M. Sechenov, I. P. Pavlov, and N. E. Vvedensky.
The main principles of cortico-visceral pathology (K. M. Bykov and I. T. Kurtsin, 1960) are as follows.
- The possibility of reproducing some pathological reactions according to the mechanism of a conditioned reflex, which shows the undoubted participation of the cerebral cortex in their pathogenesis. Indeed, after repeated injections of bulbocapkin into animals in a certain experimental setting, A. O. Dolin observed, under the influence of only the experimental setting, the emergence of a cataleptic state characteristic of the action of this poison. In the laboratory of A. D. Speransky, the possibility of conditioned reflex reproduction of anaphylactic shock was proved. There are many facts in the literature that testify to the possibility of conditioned reflex reproduction of relapses of other pathological processes.
- A large role in the pathogenesis of cortico-visceral diseases belongs to the neurotic state.
As is known, the occurrence of a neurotic state is associated with an overstrain of the excitatory or inhibitory processes of the cerebral cortex, as well as their mobility. An overstrain of the excitatory process occurs in animals under the influence of agents of great force or when conditioned stimuli are used that are too complex for the animal's nervous system. Overstrain of the inhibitory process occurs when the duration of negative conditioned stimuli is prolonged. Finally, impaired mobility is observed with a continuous change from an inhibitory state to an irritable state or, conversely, with a change in the dynamic stereotype.
Some foreign critics of I. P. Pavlov, casting doubt on his research, pointed out that the animals in the machine were fixed to a certain extent. Therefore, in their opinion, the data obtained cannot be transferred to normal conditions. However, back in 1924 in the laboratory of I. II. Pavlov, dogs that were outside the experimental environment developed a neurotic state as a result of the flood. Later, the students of I. P. Pavlov (P. S. Kupalov and others) proved the possibility of studying higher nervous activity and, in doing so, obtaining neuroses under conditions of free behavior of animals.
"Guide to Pathological Physiology",
I.R. Petrov, A.M. Chernukh
The doctrine developed by the school of IP Pavlov on the functional interaction of the cerebral cortex and internal organs. The extension of the ideas of the cortico-visceral theory to the field of pathology made it possible to understand the role of mental influences in the occurrence and course of certain diseases.
Big Encyclopedic Dictionary. 2000 .
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The doctrine developed by the school of IP Pavlov on the functional interaction of the cerebral cortex and internal organs. The extension of the ideas of the cortico-visceral theory to the field of pathology made it possible to understand the role of ... ... encyclopedic Dictionary
Developed by the school of IP Pavlov, the doctrine of the functional interaction of the cerebral cortex and ext. organs. Distribution of representations of K. in. m. on the field of pathology made it possible to understand the role of mental. influences in the emergence and ... Natural science. encyclopedic Dictionary
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CORTIC-VISCERAL THEORY - developed by the school of IP Pavlov, the doctrine of the functional interaction of the cerebral cortex and internal organs. The extension of the ideas of the cortico-visceral theory to the field of pathology made it possible to understand the role of mental influences in the occurrence and course of certain diseases.
- - internal musculature chordate organs. It originates from the visceral layer of the lateral plates. It forms part of the muscular system and is opposed to the parietal muscles ...
Biological encyclopedic dictionary
- - visceral nervous system, the same as the autonomic nervous system...
Veterinary Encyclopedic Dictionary
- - component compound words, meaning "pertaining to the cortex, to the cortical substance" ...
Medical Encyclopedia
- - sensory A. in the form of unpleasant sensations in the internal organs ...
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- - part B., covering the organs located in the abdominal cavity ...
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- - the general name of the phylogenetically old areas of K., participating mainly in the regulation of the vegetative functions of the body; now belongs to the limbic system...
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- - an integral part of compound words, meaning "relating to the cortex, to the cortical substance" ...
Big Medical Dictionary
- - direction in P., explaining the occurrence of a number of diseases by a violation of cortical-subcortical relationships and neurohumoral regulation of the functions of internal organs ...
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- - see Pulmonary pleura ...
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- - see Autonomic nervous system ...
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- - see the list of anat. terms...
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- - Ch. to irritations acting on the receptors of internal organs ...
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- - developed by the school of I. P. Pavlov, the doctrine of the functional interaction of the cerebral cortex and internal organs ...
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- - to the "ortho-viscer" ...
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Cortico-visceral theory of the formation of internal diseases Konstantin Mikhailovich Bykov, Ivan Terentyevich Kurtsin, which served as a development of the previous theory of Ivan Petrovich Pavlov, and more modern models:
1)
imprinting Konrad Lorenz,
2)
learned helplessness M. Zeligman.
Physiological model of intrapsychological conflict was created by Ivan Petrovich Pavlov and his students in the 20-30s of the XX century. Conducting experiments on animals, they found that the cause of somatic disorders is the "collision" of reflex processes. In other words, activation with the help of the same conditioned stimulus of two contradictory unconditioned reflexes, for example, such as food and defense.
According to this theory, psychosomatic disorders are based on a "clash" of conditioned reflexes, which contains logically insoluble contradictions.
Another physiological mechanism of psychological breakdowns- the formation of "pathological" conditioned reflexes. For example, bronchospasm in a patient with bronchial asthma, which occurs only at the sight of an image of an object that causes an allergy, and not when an allergen is inhaled.
Practical implementation of the cortico-visceral theory became conditioned reflex therapy, that is, the correction of pathological conditioned reflexes by colliding them with unconditioned reflexes. Back in the 30s, one of the first areas where conditioned reflex therapy was used was the treatment of alcoholism with the help of the formation of a conditioned reflex vomiting reaction, according to Izmail Fedorovich Sluchevsky.
The cortico-visceral theory explains the origin of internal (psychosomatic) diseases as follows: the cerebral cortex, using the mechanisms of conditioned reflexes, directly affects the state of internal organs, which causes an imbalance in excitation and inhibition at the level of the cerebral cortex. A non-specific method for the treatment of internal diseases with the help of prolonged artificial sleep was proposed.
From the standpoint of body-oriented psycho-correction, awareness of bodily sensations associated with one or another internal organ, and their elaboration contributes to the normalization of the functions of this organ. This effect is based on the coordination of the activity of the somato- and viscerosensory zones of the cortex and its frontal areas.
In humans, conditioned reflexes can be formed both at the conscious and unconscious levels. The most important practical consequence of this theoretical model is that at the subcortical, subconscious level, a reflex act can be carried out independently of the cortical, conscious level, and much faster, since fewer “instances” are involved.
In a multi-level, hierarchical management system, the "tops" they are inert, and they learn about what happened last, and only then they pretend that all positive processes occur thanks to their management, and negative ones - despite their disapproval. Usually, a habitual, conditioned reflex act occurs first, and only then does its awareness arise.
Emotions are also conditioned reflexes that function at an unconscious level, which are available to consciousness at a later stage. Recall about the theory of the origin of emotions according to James Lange: first, a reaction occurs at the level of the cortex of the right hemisphere of the GM and the limbic-reticular system, then vegetative accompaniment begins, that is, muscle tension caused by emotions, heartbeat and breathing become more frequent, which is significant for understanding emotions emphasized. When these physiological shifts are recognized by the "conscious" part of the brain, there is a proper human emotion.
Initially, we react to the situation around us subconsciously, the reaction can occur in tenths of a second, or, stretched out in time, when the emotion matures latently. Initially, there are emotionally induced shifts in the state of internal organs and muscles, and only by paying attention to them, we become aware of our feelings. But, if attention is not focused on this, then emotions create a background that manifests itself in well-being and mood.
Stereotypes of emotional response in standard situations are conditioned reflex reactions, which are formed, as a rule, in early childhood, switched to a subconscious mode of functioning, became automatic. For example, in an experiment on relearning motor skills: the subject, in response to a conditioned signal, continues to repeat the same automatic movement - a defensive reflex, despite attempts to stop it by willpower. The motor reaction does not have time to submit to conscious control, since the subconscious control mechanisms work faster. To retrain a person, it is necessary to make the mostly subconscious reaction more conscious. To do this, a person needs to be helped to return to the "right hemispheric" state, associatively associated with childhood, when the reflex reaction was just being formed. This is a return to the "primary" perception of the situation, when a person encounters significant information for the first time.
