Near the middle of the last century Haller, after confirming the
results obtained by Schwartz and Wepfer, summarised his knowledge of
the motor functions of the stomach as follows. In general, contraction
alternates with relaxation, so that the stomach is, now here, now
there, made narrower by longitudinal or transverse depressions; then
in these same places relaxation and bulging occur. So long as both
apertures are closed the food is driven hither and thither by the
shifting movements. It first takes a definite direction when the cardia
or the pylorus opens. If the cardia opens, there is an antiperistalsis
followed by regurgitation and vomiting. If, on the contrary, the
pylorus relaxes, a contraction, starting at the œsophagus, pushes the
contents of the stomach into the duodenum. The pylorus allows the
passage of fluids, but if it be stimulated by over distention or by
hard pieces of food, it closes tightly.
Such was the knowledge of gastric movements in Haller’s time. A
comparison of his descriptions with those in any standard work on
physiology published ten or fifteen years ago will show that, despite
very many researches, little advance had been made. Examinations
of animals and men with gastric fistulas, studies of the stomach
through the atrophied abdominal wall, and vivisection have yielded
numerous results; but these have not been harmonious, and have led to
much controversy. Prominent in this mass of material as a valuable
contribution are Beaumont’s careful observations through the gastric
fistula of Alexis St. Martin. Beaumont’s work has recently been
confirmed by Hofmeister and Schütz, who, with Rossbach, Hirsch,
Openchowski, and others, have presented during the last twelve years
much new and interesting information. Since, however, it will conduce
to clearness to set forth the results of these investigations in
connection with my own work, their consideration will be deferred until
later.
It will then appear that these later investigations, like the earlier
researches, disagree as to the details of the stomach movements.
Such differences in results are the proper outcome of the abnormal
conditions under which the studies have been conducted. Obviously, in
order to see the natural movements of the stomach, the organ should be
observed in its natural state, and not after it has been disturbed by
removal from the abdomen, or by the adhesions and losses of substance
incident to gastric fistulas.
As a means of watching the gastric motor activities under normal
circumstances, Dr. H. P. Bowditch, in the autumn of 1896, suggested the
use of the Röntgen rays. The present paper is the result of the work
thus far completed. The kind assistance and stimulating counsel of Dr.
Bowditch throughout the investigation are gratefully acknowledged.
THE ANATOMY OF THE STOMACH AND ITS RELATIONS TO THE SHADOW
Public-domain text, read in full here on John Shaqi.
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