214 Anatomy Applied to Medicine and Surgery. 



tion, or to adhesion from inflammatory processes outside 

 of the stomach. The constriction is often about the mid- 

 dle of the organ. Walsh, of Boston, analyzed the twenty 

 cases reported up to July, 1900, and found that the situa- 

 tion of the stricture was in the middle, in seven cases ; at 

 the junction of the upper and middle thirds, in three ; at 

 the junction of the lower and middle thirds, in four ; not 

 noted, in six. As to the size of the constriction, five 

 allowed the passage of a lead pencil ; six, the index finger ; 

 two, the thumb ; three, two fingers ; four, noted as narrow. 

 Gastric reflex neuroses are exceedingly common, 

 since, by means of the pneumogastric and the sympathetic 

 nerves, the stomach is brought into intimate relation with 

 the various other organs. The pronounced effects of the 

 nervous relationship between the heart and the stomach 

 are quite frequently brought to the physician's notice in 

 the shape of praecordial distress, disturbed cardiac 

 rhythm, palpitation, pseudo-angina pectoris, etc. When 

 the stomach is distended and forced upwards against the 

 diaphragm, there may result symptoms, such as disturb- 

 ances of the action of the heart, suffocating sensations, etc. 

 These arise from mechanical causes, but the subject we 

 are now dealing with refers solely to nervous reflex ac- 

 tions. The pneumogastric associates the stomach with 

 the lungs, as seen in gastric asthma, while the sympathetic 

 brings this organ into intimate relationship with all the 

 abdominal viscera, although the pneumogastric may share, 

 to some extent, this action of the sympathetic because of 

 the connection of the pneumogastric with the solar plexus, 

 from which arise the various plexuses for the innervation 

 of the different viscera. Dr. Gross states that there is 

 scarcely an internal disorder in which the gastric juice is 

 not largely implicated, since every affection of the stom- 

 ach is reflected to the other organs, and conversely every 



