REPAIR IN EVOLUTION 81 



obviously supported by the embryology of the organ that 

 there is no need to go into details beyond noticing that 

 in the fourth week there comes the first dorsal bulging in 

 the foregut. But if evolution is still proceeding, is it 

 absurd to suggest that the common symptom of a general 

 disturbance of health known as dilated stomach may be a 

 pathological process actually in the process of becoming 

 physiological ? According to some physicians, few modern 

 stomachs do not suffer at times from an amount of 

 dilatation which is pathological ; i.e. the gastric mus- 

 culature fails to react correctly. The stomach may yet 

 be such a functioning dilatation pouch as to enable the 

 human race to do with no more than one meal a day, or 

 even less. Our descendants will have all the more time 

 for work. This by no means implies that the empty 

 stomach should be any larger than it is now in healthy 

 subjects. Before the invention of X-rays the gastric 

 apparatus was always pictured in text-books as usually 

 seen on the post-mortem table. The dead stomach was 

 shown as the portrait of the live one : the weakened pouch 

 of the sick man as that of the live and healthy subject. 

 But nowadays it is known that such extreme dilatation is 

 natural only when a large meal has been taken. When the 

 healthy stomach has emptied itself it has contracted so 

 that it nearly resumes its ancient cylindrical character 

 and then goes into a state of rest or relaxation. With 

 further development it might hold still more, and yet react 

 in the same way. The suggestion that functional failure 

 or disease, which becomes organic and destructive in many, 

 may, in reacting and surviving organisms, alter their outlook 

 on life and all their activities, seems to me powerfully 

 reinforced by these considerations. The disadvantageous 

 variation does work, and finally improves the race. It 

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