VOMITING. 301 



cases of disease in which, it has been impossible for contrac- 

 tions of the stomach to take place. It is well known that 

 the characteristic mode of contraction of the striated, volun- 

 tary muscles is rapid, violent, and followed by sudden relaxa- 

 tion ; and that where it becomes necessary, in the performance 

 of any of the vegetative functions, that such muscular action 

 should take place, as in the action of the heart in propelling 

 the blood forcibly into the arterial system, the striated mus- 

 cular fibre is found. On the other hand, the characteristic 

 mode of contraction of the non -striated, involuntary muscular 

 fibre is gradual, enduring for a certain time, and followed by 

 a slow relaxation. These facts point at once to the kind of 

 muscles which we would suspect to be engaged in the pro- 

 duction of vomiting. The act is always violent, sudden, and 

 convulsive, and is entirely inconsistent with the mode of con- 

 traction of non-striated muscles, as it has been observed in 

 other situations. 



A remarkable case is mentioned by Longet, in which a 

 young girl, with the intent to commit suicide, swallowed a 

 large quantity of a mineral acid. She vomited continually 

 up to the time of her death ; and in the vomited matters were 

 found numerous shreds of the coats of the stomach. At the 

 autopsy it was found that the stomach had been destroyed, 

 except little portions of its walls, which were adherent to 

 the surrounding parts. These were united to the adjacent 

 viscera and the walls of the abdomen by inflammatory ex- 

 udation, so as to form a cavity which was not a stomach, 

 but which communicated freely with the oesophagus. Yet 

 this patient, without a contractile stomach, vomited freely 

 during the last hours of her life. 1 



A case of extrusion of the stomach, reported by Lepine, 

 in 1S44, 2 is often misquoted so as to make it appear that the 



1 LONGET, Traile de Physiologic, Paris, 1861, tome i., p. 141. 



2 LEPINE, Plaie penetrante de V abdomen ayante donne issue d Tistomac, d Pare 

 du colon, et d V epiploon, guerie en vingtet un jours, suivi de reflexions mr levomissc- 

 ment. Bulletin de P Academic Royale deMedecine, Paris, 1843-'44, p. 1 46 et seq. 



