THE STOMACH. 1007 



membrane of the stomach, the tubes with shorter and more cubical cells, which are 

 finely granular. The y/cy//<- ///<//?</ (Fig. 630) are found all over the surface of the 

 stomach. Like the pyloric glands, they consist of a duct into which open two or 

 more ciecal tubes. The duct, however, in these glands is shorter than in the other 

 variety, sometimes not amounting to more than one-sixth of the whole length of 

 the gland ; it is lined throughout by columnar epithelium. At the point where 

 the terminal tubes open into the duct, and which is termed the neck, the epithe- 

 lium alters, the cells becoming much shorter and opaque: the lumen also becomes 

 suddenly constricted, and is continued down to the bottom of the tubes as a very 

 fine channel. Here also are found, between the epithelium and the basement 

 membrane, large spheroidal, coarsely granular cells, which were formerly termed 

 fn'l>ti'' 'V//X. and which produce an outward bulging of the basement membrane. 

 They are seen throughout the remainder of the tube at intervals, and give it a 

 beaded or varicose appearance. Below the neck the terminal tubes, in addition 

 to these isolated spheroidal cells, are occupied with finely granular, angular cells 

 (columnar, Klein), leaving only a small channel in the centre. They are continuous 

 with the short columnar cells of the neck, and are termed the central or chief cells, 

 because they are believed to be principally concerned in the secretion of the gastric 

 juice. The peptic cells, Avhich were formerly supposed to possess this office, are 

 now termed parietal or oxyntic cells. Between the glands the mucous membrane 

 consists of a connective tissue framework, with lymphoid tissue. In places this 

 latter tissue, especially in early life, is collected into little masses, which to a certain 

 extent resemble the solitary glands of the intestine, and are bv some termed the 

 lenticular glands of the stomach. They are not, however, so distinctly circum- 

 scribed as the solitary glands. The epithelium lining the mucous membrane of 

 the stomach and its alveoli is of the columnar variety. Beneath the mucous 

 membrane, and between it and the submucous coat, is a thin stratum of involuntary 

 muscular fibre (muscnlaris mucosce), which in some parts consists only of a single 

 longitudinal layer ; in others, of two layers, an inner, circular, and an outer, 

 longitudinal. 



Vessels and Nerves. The arteries supplying the stomach are the gastric, the 

 pyloric and right gastro-epiploic branches of the hepatic, the left gastro-epiploic 

 and vasa brevia from the splenic. They supply the muscular coat, ramify in the 

 submucous coat, and are finally distributed to the mucous membrane. The 

 arrangement of the vessels in the mucous membrane is somewhat peculiar. The 

 arteries break up at the base of the gastric tubules into a plexus of fine capillaries 

 Avhich run upward between the tubules, anastomosing with each other, and ending 

 in a plexus of larger capillaries, which surround the mouths of the tubes and also 

 form hexagonal meshes around the alveoli. From these latter the veins arise, and 

 pursue a straight course backward between the tubules, to the submucous tissue, 

 and terminate either in the splenic and superior mesenteric veins or directly in 

 the portal vein. The lymphatics are numerous; they consist of a superficiarand 

 deep set, which pass through the lymphatic glands found along the two curvatures 

 of the organ. The nerves are the terminal branches of the right and left pneumo- 

 gastric. the former being distributed upon the back, and the latter upon the front 

 part of the organ. A great number of branches from the sympathetic also supply 

 the organ. 



Surgical Anatomy. Operations on the stomach are frequently performed. By 

 strotomy" is meant an incision into the stomach for the removal of "a foreign body, the 

 opening being immediately afterward closed in contradistinction to ''gastrostoniy/' the 

 making of a more or less permanent fistulous opening. Gastrotomy is probably best performed 

 by an incision in the linea alba, especially if the foreign body is large. ly a cut from the 

 ensifonn cartilage to the umbilicus, but may be performed by an incision over the body itself, 

 where this can be felt, or by one of the incisions for gastrostoniy, to be mentioned immediately. 

 The peritoneal cavity is opened, and the point at which the stomach is to be incised decided 

 upon. This pardon is then brought out of the abdominal wound and sponges carefully 

 packed around. The stomach is now opened by a transverse incision and the foreign body 

 extracted. The wound in the stomach is then closed by Lembert's sutures i. e. by" sutures 

 i through the peritoneal and muscular coats in such a way that the peritoneal surfaces 



