99 



in the anterior part of the stomach, at the unienoi' the two-thirds on the 

 left side, with the third on the right of that viscus ; that is, about eight 

 fingers' breadth from its greater extremity, and only four from the py- 

 lorus. It extended from the greater to the lesser curvature, In other 

 respects, it was the only organic affection of that vkcus. 



It should be stated, that for several years, the patient had been thin 

 and emaciated, and had led a languid life, which was terminated by a col- 

 liquative diarrhoea. She seemed to be supported only by the small quan- 

 tity of food which passed through the pylorus, into the duodenum, where 

 it received the influence of the bile, whose action on the chyme, is, as 

 we shall presently state, absolutely essential to the separation of the nu- 

 tritious parts*. Not that there was any thing to prevent the absorbents of 

 the stomach from taking up a certain quantity of nutritious particles, but 

 that small quantity of food in an imperfect condition, was of very little 

 service in imparting nourishment, and, in that respect, she was in similar 

 circumstances to patients who are affected with obstruction of the pylo- 

 rus, and reject the greater part of their food, when, digestion being over, 

 this contracted opening can no longer allow any food to passf. 



XXII. While the alimentary solution is going on, the two openings of 

 the stomach remain perfectly closed ; no gas disengaged from the food, 

 escapes along the oesophagus, except when digestion is imperfect. A 

 slight shivering is felt, the pulse becomes quicker, and more contracted, 

 the vital power seems to forsake the other organs, to concentrate itself 

 on that which is the seat of the digestive process. The parietes of the 

 stomach are soon called into action ; its circular fibres contract in differ- 

 ent points ; these peristaltic oscillations, at first irregular and uncertain, 

 acquire more regularity, and act from above downwards, and from the 

 left to the right, that is to say, from the cardiac to the pyloric orifice. Be- 

 sides, its longitudinal fibres shorten it, in the fcv***imr6f its greatest dia- 

 meter, and bring nearer to each other it3 two orifices. In these different 

 motions, the stomach rises over che pylorus, so that the angle which it 

 forms with the duodenru> almost entirely ceases, and this facilitates the 

 escape of the food. It has been observed, that during sleep, digestion 

 takes place much more readily, when we lie on the right, than on the 

 left side, and this circumstance has been ascribed to the compression of 

 the liver on the stomach. It is much more likely to depend on the cir- 

 cumstance, that when we He on the right side, the passage of the food is 

 facilitated by its own weight, the natural obliquity of the stomach, from 



* This is very satisfactorily demonstrated by the experiments of B. C. Brodie, F. R. 

 S. He applied ligature's on the common gall duct (choledochus communis) and found 

 that the change of the materials taken into the stomach was affected as usual. Chyme 

 was formed. But when the chyme passed into the intestines, there was no chyle pro- 

 duced, nor could any trace of it be found in the intestines or lacteal*. As the mass ap- 

 proached the larger intestines, is became thicker, by the absorption of the watery parts, 

 but without any other change. 



As the results obtained in Mr. Brodie's experiments were uniformly the same, we be- 

 lieve him justified in concluding, " that the office of the bile is to change the nutritious 

 part of the chyme into chyle ; and to separate from it the excrementitious matter." See 

 Phil, and Med. Jour. No. 12, p. 400. Godman. 



f Cases, in many respects similar to the above, are recorded by different writers. 

 Haller, in his" Chirurgical Dissertations," has the history of a woman with an aperture 

 in her stomach, through which she was nourished for twenty-seven years. For other in- 

 stances of tistulous openings in this viscus, consult the " Irish Transactions," and "Me- 

 dical Facts and Observations. " Chapman. 



