The movements of the food in the œsophagus / by W.B. Cannon and A. Moser.

  • Walter Bradford Cannon
Date:
[1898?]
Catalogue details

Licence: Public Domain Mark

Credit: The movements of the food in the œsophagus / by W.B. Cannon and A. Moser. Source: Wellcome Collection.

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    To determine whether the cardia offered any resistance to this rapid passage into the stomach, Meltzer1 tried another method. If a stethoscope is placed over the epigastrium during the swallowing of liquids, a sound can be heard from six to seven seconds after the rise of the larynx. The sound is caused by the passage of the swallowed mass, liquid and air, through the tonically contracted cardia. In a few cases the sound is heard immediately after swallowing, showing a probable insufficiency of the cardia. These phenomena led Kronecker and Meltzer 2 to modify their previous views. They now maintained that the mass is not squirted by the mylohyoids directly into the stomach, but halts a short distance above the cardia. Here it remains until carried into the stomach by the succeed¬ ing peristalsis, about six or seven seconds after the beginning of swallowing. The care with which these experiments were conducted has won general assent to their results. But the methods employed are not beyond criticism. Primarily it may be said that swallowing with one or more balloons and a stomach tube in the canal is not normal de¬ glutition. Moreover, semi-solids were found to yield less readily to pressure than liquids, and even to be delayed in their descent.3 Again nearly all the work was done with liquids and semi-solids; solids are not even mentioned. The investigators themselves de¬ clared that their results were true for liquids and semi-solids only, and admitted that a dry bolus could not be so swallowed. Yet the indiscriminate use of such terms as “ liquid,” “ swallowed mass,” and “ bolus,” easily leads to an inference that the results of these investi¬ gations are true for the swallowing of food of all consistencies. A difference in rate, however, certainly exists in respect to consistency, and it was to discover the actual movement of solids, semi-solids, and liquids in the normal oesophagus that the present work was undertaken. Over a year and a half ago it was suggested by Prof. H. P. Bow- ditch that if some substance opaque to the Rontgen rays were swal¬ lowed, it could be seen in its passage to the stomach and the nature of its movement thus determined. Anaesthesia could be dispensed with, — a desirable condition, since observers had found that it inter- 1 Meltzer: Centralbl. fiir die med. Wissenschaften, 1883, p. 1. 2 Kronecker and Meltzer: Archiv fiir Physiologie, 1883, Suppl. Bd., p. 337, 35i* 8 Kronecker and Meltzer : ibid., p. 337.