Physiology of the pylorus, pilleus ventriculi and duodenum as observed roentgenographically / Lewis Gregory Cole.

  • Cole, Lewis Gregory, 1874-1954.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Physiology of the pylorus, pilleus ventriculi and duodenum as observed roentgenographically / Lewis Gregory Cole. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/18 (page 8)
    The motor phenomenon of the pyloric sphincter forms the heart of this communication. Cannon7 refers to the sphincter as the “keeper of the gate”; and before seeing his appropriate term, I referred to the sphincter in a previous communication8 as a butler, guarding the entrance to the intestine, and allowing only such food as is properly prepared to be served to the intestine. More recent observations, however, lead me to believe that the pylorus is not the only.* or the most important factor in replenishing the descending and horizontal duo- denum. p Several important questions regarding the function of the sphincter and its relation to the evacuation of the stomach should be considered here. Some of them have apparently been settled so conclusively by careful physio- logic observations that it is with the greatest amount of timidity that I approach the subject; but the roentgeno- graphic evidence is so significant that it cannot be ignored. Does the pylorus relax and contract periodi- cally for the expulsion of chyme, independently of each peristaltic contraction, or is the chyme forced through the pyloric sphincter by each systole? The question of whether or not the pylorus relaxes and con- tracts periodically, independently of each peristaltic con- traction, has been considered so definitely proved in the affirmative by careful physiologic observation that the energies of investigators have been directed solely toward determining the factors which control its contraction and relaxation. Let us first consider what physiologists regard as the periodic contraction and relaxation of the sphincter. In accordance with Mering’s theory of a rhythmically opening and closing sphincter, Cfannon describes the motor phenomena of the pylorus as follows: “Wave after wave passes with almost no perceptible variation of depth. Yet as the waves are passing with such notable uniformity the pylorus may open before the pressure of an approaching constriction, and the mass in the antrum then released will be driven forth into the duodenum. The next wave and perhaps many thereafter of approxi- mately the same depth may fail to press the food onward.” Schicker doubts a rhythmically opening and closing pylorus and believes that the pylorus is open 7. Cannon : Am. Jour. Physiol., 1907, xx, 289. 8. Cole, L. G.: Arch. Roentg. Ray, April, 1912, p. 427.