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Have you ever had a gut feeling about something? A sense of knowing something, without knowing how you knew? As body- oriented practitioners, we might wonder: why is this called a "gut" feeling, anyway? An instinctual sense of certainty has long been associated with our bellies, and not just in the English- speaking world. The French also say this kind of knowing is viscéral, the Japanese speak of hara-gei, 1 and the German use Bauchgefühl (literally, a belly feeling). Along with instinctual certainty, the gut is associated with many other body-mind phenomena. Why do we say our stomach gets "tied up in knots" by stress? We don't say we get "butterflies in the arm" when we're excited or anxious—why are there butterflies in the stomach? Along with the heart, the belly is probably more often linked to emotional, mental, and psychological states than any other part of the body. Understanding the significant role of the viscera in the body's emotional responses can only help manual therapists in their work. THE ENTERIC NERVOUS SYSTEM It turns out that the viscera's complex neurology might help explain why we associate so many body-mind phenomena with this part of the body and why hands-on work here can be either emotionally settling or emotionally evocative. The enteric nervous system, our viscera's neural network, contains some 100 million neurons, more than either the spinal cord or the rest of the peripheral nervous system. 2 The enteric system also uses more than 30 neurotransmitters, more than anywhere outside of the central nervous system. 3 In fact, more than 95 percent of the body's serotonin is found in the gut, which is one reason why drugs that alter this neurotransmitter's balance, such as some antidepressants, can also cause gastric disturbances. The size and intricacy of the belly's enteric nervous system have led some science writers to call it the "second brain." 4 Though not capable of thought, the enteric nervous system is far more complicated than what is required for digestive functions alone. 5 It seems to contribute a great deal to our emotional state, sending information to the brain that constantly informs our felt sense of ourselves, as a kind of predisposition or background mood for the brain's mental processes. 6 106 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 5 technique MYOFASCIAL TECHNIQUES Working with the Mesentery By Til Luchau The mesentery (blue) forms the fascial connection between the intestines and the posterior abdominal fascia on the front of the spine. It provides both support and a pathway for the viscera's neural complex. Pictured here is the mesentery of the small intestines. The parietal peritoneum (transparent blue), which is continuous with the mesentery, is also pictured. Source images courtesy Primal Pictures, used by permission. 1 Neurologically, the digestive viscera are innervated by the dorsal branch of the vagus nerve—a key part of the parasympathetic nervous system. It is the parasympathetic "rest-and-repair" system that calms and regulates the sympathetic "fight-or-flight" activation of stress, fear, and trauma. The relaxed, sleepy feeling after a meal is an example of the vagus nerve at work. Because the vagus nerve's axons are about 80 percent sensory (that is, carrying information from the viscera up to the brain), our gut affects our brain much more than the brain affects the gut. This might be why hands-on work with the abdomen seems particularly sedative, at least when done noninvasively and gently. Skilled work with the belly can literally, and very effectively, calm an upset mind. THE MESENTERY'S MYSTERIOUS ANATOMY The intestines are suspended in the abdominal cavity by the mesentery, a folded fascial membrane connected to the anterior aspect of the lumbar region (Image 1). As well as

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