The first region to decrease markedly in size is the preantral part
of the pyloric portion. The peristaltic undulations, caused by the
circular fibres, start at the beginning of this portion, and gradually,
by their rhythmic recurrence, press some of the contents into the
antrum. As the process continues, the smooth muscle fibres with their
remarkable tonicity contract closely about the food that remains, so
that the middle region comes to have the shape of a tube (Figs. 3 and
4--1.30 P.M. to 2.30 P.M.), with the rounded fundus at one end and the
active antrum at the other. Along the tube very shallow constrictions
may be seen following one another to the pylorus.
At this juncture the longitudinal fibres which cover the fundus like
radiating fingers, and the circular and oblique fibres reaching in
all directions about this spherical region, begin to contract. Thus
the contents of the fundus are squeezed into the tubular portion.
This process, accompanied by a slight shortening of the tube, goes on
until the shadow cast by the fundus is almost wholly obliterated (Fig.
5--5.30 P.M.).
The waves of constriction moving along the tubular portion press the
food onward as fast as they receive it from the contracting fundus, and
when the fundus is at last emptied they sweep the contents of the tube
into the antrum (Fig. 5--5.00 P.M. to 6.00 P.M.). Here the operation is
continued by the deeper constrictions till, finally (in this instance
at 6.12 P.M.), with the exception of a slight trace of food in the
fundus, nothing is to be seen in the stomach at all.
The food in the fundus may possibly be slightly affected by the
to-and-fro movements of the diaphragm in respiration. With normal
breathing the upper border of the cardiac portion swings through about
one centimetre; with dyspnœa, or deep breathing, through one and a half
or two centimetres. Since the lower border does not move so much, the
contents are gently pressed, and then released from pressure, at each
respiration. The pyloric portion is moved very little by the diaphragm,
the oscillation being less than a half centimetre.
Moritz has pointed out the value of an organ like the stomach for
holding the bulk of the food and serving it out a little at a time, so
that the intestines may not become congested during their digestive and
absorptive processes. All of the advantages supposed to be thus secured
to the intestines may be claimed also for the stomach itself. For
the preceding description indicates, and experiments to be described
later prove, that the stomach is composed of two physiologically
distinct portions: the busy antrum, over which during digestion
constriction-waves are running in continuous rhythm; and the cardiac
part, which is an active reservoir, pressing out its contents a little
at a time as the antral mechanism is ready to receive them.
THE MOVEMENTS OF THE STOMACH IN VOMITING
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