34 STUDIES IN DIGESTION 



tightly closed for about six hours, until such time 

 as firm cementing of the wound has taken place. 

 Even if food was given, the same effect was seen. 



Skiagraphy of the stomach after a bismuth meal 

 has now attained a high pitch of perfection, and 

 furnishes us with our most reliable means of diagnosing 

 hour-glass contraction or simple dilatation. Photo- 

 graphs should be taken just after swallowing, and 

 again after several hours have elapsed. 



SENSATION IN THE STOMACH. 



In his recent Goulstonian lecture, Hertz shows 

 that the sensory functions of the viscera are much 

 more limited than those of the skin. The stomach 

 does not possess any temperature sense or any 

 tactile sense, nor is cutting painful. The feeling of 

 heat or cold after swallowing liquids is appreciated 

 by the lower end of the oesophagus. Temperature 

 and tactile sense are quite well developed in the 

 oesophagus, and localization is very accurate seldom 

 more than an inch out. 



Hydrochloric acid may be poured into the stomach, 

 either through a stomach-tube or gastrostomy 

 wound, without producing any sensation at all, 

 even if the percentage rises to 0-5 or even 2, and this 

 is true also in cases of gastric ulcer. Alcohol does 

 excite a burning feeling. Distention of the stomach 

 causes a sensation of fullness ; the amount of dis- 

 tention necessary depends on the tonicity of the 

 gastric muscles. Gastralgia, whatever its cause, is due 

 to colicky, irregular contractions of the muscle, the 

 pylorus remaining closed. There is often a referred 



