The diseases of the stomach : bring the third edition of the "Diagnosis and treatment of the varieties of dyspepsia" revised and enlarged / by Wilson Fox.

  • Fox, Wilson.
Date:
1872
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Licence: Public Domain Mark

Credit: The diseases of the stomach : bring the third edition of the "Diagnosis and treatment of the varieties of dyspepsia" revised and enlarged / by Wilson Fox. Source: Wellcome Collection.

    34/318 (page 10)
    i'O ]l)IiiEASii8 OF THE STOMACH. is always to be found in the intestinal canal; tlie calibre of which, however, as may be observed in animals opened immediately after death, is nmch smaller than might be believed from the results of post-mortem examinations made after relaxation of the muscular coat has ensued. The terms in use to signify the conditions of distension are tympan- itis and meteorismus, the latter being employed for excessive degrees of distension common to the whole tract, and occurring acutely; but both, as in ordinary use, are more especially applied to the intestine rather than to the stomach, for which latter there is no distinctive nomenclature. The sources of the gas found in these situations have been long a* subject of discussion, and opinions are not as yet absolutely decided whether some secretion of this nature may not take place from the mucous membrane of the stomach and intestines. This view received in some measure the support of John Hunter^ (who, however, with his usual caution, admitted that it was not capable of receiving direct proof, and also that in many cases the gases formed were derived from fermentative changes, the result of imperfect digestion of the food).- It is chiefly based on the rapid distension which the stomach or some portions of the intestines may undergo, either when empty, or within a period after the ingestion of food which may be reasonably supposed to have been too short to allow of the fermentative process to have reached a height sufficient to account for the evolution of the amount of gas present. There is, however, an entire absence of evidence tending to show the spontaneous occurrence of any such secretion; and though it is possible that some diffusion may take place between gases already present in the intestine and those in the blood, all recently and carefully conducted experiments on portions of ligatured intestine negative the idea of a free secre- tion occurring from the mucous membrane ;^ and the distension of the stomach under the circumstances now alluded to may be accounted for in another manner, which appears to present a greater degree of probability. {a) It is believed by many that in the cases of sudden flatulent distension which occur in hysterical subjects under emotional influences, much of the gas present consists of air swallowed, and the power of thus distending the stomach is in some persons subject to the control of the will, and can by them be employed as a means to excite vomiting.^ (b) In other cases, especially in atonic and weakened conditions, it would appear to the author that the stomach, instead of remaining contracted when empty, has its muscular coats relaxed, and becomes filled with air entering from the cardia,*^ and 1 Obs. on Certaia Parts of the Animal Economy, 1792, p. 206. 2 lb p 203. ' Kiihne, Lehrbuch der Phys, Chem.^ 141. 4 Frerichs, Wagner's Handworterbuch der Physiologic, art. Verdauung, p. 867. ^^™BudgT'ha8 Bhown^t^ a large amount of air enters the stomach before the act of vomiting.