ON THE STOMACH IN MAN AND THE ANTHROPOID APE. 39 



side, writes as follows : " An examination of several specimens and an earnest search 

 through the literature of this subject has convinced me that there is no proof whatever 

 of the existence of an hour-glass stomach due to a congenital deformity. ... So far 

 as I am aware, there is not a single specimen or an accurate record in existence which 

 can be accepted as evidence of the congenital origin of this disease." Moynihan is not 

 alone in this view ; on the Continent the congenital explanation of certain forms of 

 hour-glass stomach has never been received with the implicit faith which has been 

 accorded to it in this country and (perhaps to a less extent) in America. Chabrie and 

 others not only deny the congenital origin of any form of the condition, but also call 

 in question the accuracy of the view that pathological lesions are at any time responsible 

 for the constriction. 



a. B. 



Fig. 5. — Two examples of Hour-glass Stomach. 



A represents a specimen obtained from Professor Ei,liot-Smith of Cairo. The connection between the two chambers is 



somewhat tubular. 

 B is the outline of a stomach obtained, in the dissecting-room. 

 In neither case could the forefinger be passed with any degree of ease from the one chamber into the other. 



For my own part, I am satisfied that hour-glass stomach never arises as a congenital 

 deformity. With Moynihan, I hold that not an atom of proof can be advanced in 

 support of such a view. Still, there are many cases in which biloculation of the stomach 

 occurs in which no pathological lesion of the kind mentioned by Moynihan as 

 being responsible for the condition can be detected. We have seen how, during 

 the active stages of digestion, the stomach, by strong contraction of the walls of its 

 right half, becomes differentiated into two physiological portions. Between this 

 condition (fig. 23) and the bi-saccular state which is distinctive of the typical hour- 

 glass form, in which there are two widely expanded sacs communicating by a narrow 

 throat or cylindrical passage, every gradation may be met with. Compare from this 

 point of view, and in the following order, fig. 23 (PI. III.), the ' Schniirmagen ' 

 described by His (22; see his PL XVIII.), fig. 36 (PI. IV.), and lastly the outline 

 figs. A and B (fig. 5). In all these cases of what may be called physiological hour- 



