The sympathetic nervous system in disease / by W. Langdon Brown.

  • Walter Langdon-Brown
Date:
1923
Catalogue details

Licence: In copyright

Credit: The sympathetic nervous system in disease / by W. Langdon Brown. Source: Wellcome Collection.

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    merely a distinction without a difference, for he showed that a mercury tube could find its way into the stomach by its own weight. But I think we may conclude that this failure to relax is often produced by just the condi¬ tions which excite true spasm in other parts of the alimen¬ tary tract, for, as he says, it is often associated with organic disease lower down. In one very severe, and ultimately fatal, case of mine, an organic hour-glass con¬ traction was found in the stomach as well. Keith’s com¬ parison with the block system therefore applies. It may be that this peculiar reaction of the cardiac sphincter is related to its single innervation by the vagus, and the absence of sympathetic supply. The spasm so commonly observed with X-rays over an active gastric ulcer must also sometimes be due to the vagus, as it occurs in parts to which the sympathetic only supplies inhibitory fibres. One can hardly doubt that such spasm is as definitely protective in its inception as the spasm of the muscles round an inflamed joint, and the rigidity of the abdominal muscles over an inflamed appendix. What is not, perhaps, so fully recognized is the spasmodic element in many forms of dyspepsia, where the spasm, though protective in nature, is probably a large factor in causing the pain. I may refer parti¬ cularly to those forms of dyspepsia which are accompanied by hyperchlorhydria. What constitutes hyperchlorhydria ? In its strict sense it means that if we give a test breakfast of fifteen ounces of tea without sugar or milk, and two slices of dry toast, and then withdraw the contents at the end of an hour, the total acidity exceeds the normal 0.2 per cent. HC1. But this might arise in one of two ways : either there is oversecretion of hydrochloric acid, or there is a delay in the escape of the gastric contents, which by prolonged stimulation of the pyloric glands, where gastric secretin is formed, may enhance acidity. In other words, pyloric spasm may produce hyperchlorhydria. And I would