The X-ray method lends itself less successfully to the study of
deglutition in man than in the other animals we have studied. The
thickness of the thorax, the distance of the œsophagus from the
surface, and the relation to dense tissues render the observation of a
swallowed mass difficult, especially when the mass is in rather rapid
motion. The few observations which we have to report were made on a
seven-year-old girl, placed in the sitting posture. Gelatine capsules
containing bismuth were used for solids, and were traced to a point
below the heart. The motion was very regular, and apparently due to
peristalsis, for the bolus descended without a hitch or irregularity of
any kind. Sometimes the capsule became fixed in the upper œsophagus,
at about the level of the second rib. Repeated swallows of water would
fail to dislodge it. An interesting point was noted here. With each
attempt at swallowing, the capsule would rise slightly, as if the
œsophagus was pulled up with the rise of the larynx; then the capsule
would descend to its former position.
Semi-solids--a mush of bread and milk--could be seen about as far as
solids; that is, to just below the heart. The motion of the mushy bolus
was the same as with solids, except that the rapidity was perhaps
slightly greater.
It should be noted here that with the human subject, as well as with
the horse, our results for semi-solids differ from those derived by
Meltzer’s method; for according to his statements semi-solids, like
liquids, are squirted down the œsophagus, and are not propelled by
peristalsis, as has been the case in our observations.
Liquids--bismuth and water--were seen only in the neck and upper
thorax. Here there was a decided squirt. With the rise of the larynx
the liquid was seen to pass rapidly through the pharynx and well down
into the thoracic œsophagus before it was lost to observation. The
rate, however, by estimation was less than that of liquids in the horse.
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