302 DIGESTION. 



contractions of the stomach itself are sufficient to produce 

 vomiting. 1 In this case, the stomach, containing food and 

 air, was protruded from the abdomen by a large wound. It 

 remained motionless while violent and ineffectual efforts at 

 vomiting were made, during the w T hole time that it was thus 

 out of the abdomen, and could not be excited to contrac- 

 tion, even by gentle irritation ; but when the stomach was 

 returned into the abdominal cavity, vomiting instantly took 

 place. 



All the facts bearing on this subject go to show that in 

 true vomiting, contractions of the muscular coats of the 

 stomach are not necessary, are not definitely connected 

 with the act, and are never capable of discharging any part of 

 the contents of this viscus. On the contrary, the observa- 

 tions of Magendie seem to show that the stomach is rather 

 relaxed than contracted during efforts at vomiting. 2 



1 CARPENTER, Principles of Human Physiology, Philadelphia, 1853, p. 408, 

 TODD AND BOWMAN, The Physiological Anatomy and Physiology of Man, Philadel- 

 phia, 1857, p. 565, and KIRKES, Manual of Physiology, Philadelphia, 1857, p. 195. 

 These authors quote the case reported by Lepine as presenting contractions of the 

 stomach itself, with discharge of part of its contents, while it remained out of the 

 abdominal cavity. Brinton ( Cyclopaedia of Anatomy and Physiology, London, 1859, 

 vol. v., supplement, p. 317) notices and corrects this error in previous quotations. 

 The case is also correctly quoted by Dunglison (Human Physiology, Philadelphia, 

 1856, p. 205), and by Milne-Edwards (Lecons sur la Physiologic, Paris, 1860, p. 

 333). 



2 MAGENDIE, Memoiresur le Vomissement, Paris, 1813, p. 12. Both Carpenter 

 and Todd and Bowman, base their opinion that the muscular walls of the stomach 

 are active in vomiting mainly upon the case reported by Lepine ; the former 

 quoting extensively from the original source, but the latter crediting the quotation 

 to "Paget's Eeport for 1845." Carpenter says : " The stomach, having wholly 

 protruded itself, it was seen to contract itself repeatedly and forcibly during the 

 space of half an hour, until by its own efforts it had expelled all its contents 

 except gases " (p. 408) ; and the same is said by Todd and Bowman, who speak 

 of the reporter as L'Epione (p. 565, note). In the original account of the case 

 referred to, there is no such statement ; but, on the contrary, the reporter says (p. 

 148) : " Thus, during all the time that the stomach remained out of the abdom- 

 inal cavity, there did not take place any apparent contraction of the muscular 

 fibres of this viscus, and nothing that it contained was expelled from its cavity, 

 notwithstanding the violent efforts at vomiting that the patient made. Hardly 



