OJST THE STOMACH IN MAN AND THE ANTHROPOID APE. 41 



His gives an admirable account of the position and appearance of the contracted 

 stomach. The terminal part of the oesophagus takes a sharp turn to the left ; the 

 organ is bent on itself like a sickle, and the fundus sinks downwards so that it comes to 

 look directly backwards ; the surfaces look upwards and downwards and the curvatures 

 forwards and backwards — the greater curvature being at a slightly higher level than 

 the lesser curvature ; lastly, there is a gradual but decided downward slope of the upper 

 surface, which extends continuously from the fundus to the first duodenal curvature. 

 All these features were evident in my specimens of the contracted stomach, and very 

 markedly so in one of the two orangs which were examined. His does not enter into 

 the conditions which give rise to this position and form of the stomach. These are 

 sufficiently evident when the nature of the chamber within the abdomen which is 

 occupied by the organ is considered. The roof of this chamber, formed by the liver 

 and diaphragm, is more resistant, more unyielding, than the floor, which is formed to a 

 large extent by the transverse meso-colon buoyed up by the movable coils of small 

 intestine. As the stomach becomes empty and contracted, the intestines, acted on by 

 the abdominal wall, rise up and press it against the sloping visceral surface of the liver, 

 and the slope or gradual descent to the right which is so characteristic a feature of the 

 upper surface of the stomach in this state is the result. The high position of the greater 

 curvature and the bending of the lower end of the oesophagus are alike produced by 

 the same cause. 



His refers to the fact that the position of the empty stomach as described above is 

 directly the opposite of what was formerly held to be the case. It has been usual to 

 suppose that the contracted stomach was placed obliquely in the abdomen, and that as 

 it filled it became more horizontal. In this connection I may be permitted to mention 

 that about twelve years ago I made, by the reconstruction method, with the help of 

 my friend and assistant, the late Mr John Stirling, a series of models of the viscera in 

 the upper zone of the abdomen of a child, and in these the empty stomach presents a 

 form and position in exact conformity with the description now given by His. 



The picture given by His of the full stomach, whilst reproducing no doubt one type 

 of the organ in this condition (and perhaps the more usual type), cannot be regarded as 

 presenting the only position which is assumed by the viscus when it is filled. The 

 leading points of his description are the following : — The fundus rises upwards, and in 

 general form the organ becomes rounded ; it assumes an oblique position, so that its 

 surfaces look backwards and forwards ; the pyloric part ascends to its termination, and 

 the portion of the greater curvature formed by the pyloric vestibule (the camera 

 princeps) takes a mesial position and occupies a lower level than any other part of the 

 stomach. 



Of seven specimens in my possession in which the stomach is more or less well 

 filled, only one conforms with the above description. In the other six the expanded 

 organ retains very much the position which we have seen is distinctive of the contracted 

 stomach, with this exception, that, in the more pronounced cases of expansion, the 



TRANS. ROY. SOC. EDIN., VOL. XLV. PART. I. (NO. 2). 6 



