127 
P A T H O 
n£t of infpiration was completed, and while the mufcles 
of the glottis remained fixed, a bolus of the unchanged 
aliment rofe rapidly from the ftomach, with the firft effort 
at refpiration, at the moment when the diaphragm had 
juft relaxed, and the re-aCtion of the abdominal mufcles 
commenced. But expiration did not take place until the 
alimentary ball had pafled completely into the mouth, as 
the glottis remained clofed until then : upon this having 
taken place, expiration was immediately effected ; and 
fo rapidly did expiration fucceed to the regurgitation of 
the alimentary bolus, that the latter (unlefs when the 
attention was clofely applied to the fubjeCt) appeared as 
part of the expiratory aCt. 
The ruminating procefs was never accompanied, at 
any time, with the fmalleft degree of naufea, nor any pain 
or difagreeable fenfation. The returned alimentary 
bolus was attended with no unpleafant flavour, was in 
no degree acidulous, and was equally agreeable, and was 
mafticated with additional pleafure, and with much 
greater deliberation than when firft taken. The whole 
of the aliments received at any one meal was not re¬ 
turned in order to undergo this procefs, only the part 
that had undergone an infufticient maftication ; but which 
indeed conftituted the greater portion of folid aliment. 
That taken at the commencement of a meal was the firft 
difgorged ; this was afcertained by eating from a variety 
of lolid difhes, or from partaking of different portions of 
the fame. The more fluid portions were not always re¬ 
turned, unlefs along with the more folid or imperfectly 
mafticated parts. When, however, the ft’omach was 
diftended by a large meal, the fluid contents were fre¬ 
quently returned, and fubjeCted to this procefs. 
This affeCtion may be confidered as having been paflive- 
ly under the control of the will j and, although it fome- 
times took place when nearly unconfcious of the pro¬ 
cefs, yet it never occurred when the mind was incapable 
of being aCted on by external impreflions received by the 
fenfes. Thus, if at any time, from previous fatigue, and 
the concentration of the organic nervous energy towards 
the digeftive organs, fleep was induced immediately after 
a full meal, this affeCtion did not take place; but flatu¬ 
lence, acrid eruftations, &c. afterwards fupervened, and 
continued for fome time, in confequence of the gaftric 
j uices being inefficient to the production of the requifite 
changes on the ingefta retained in a ftate of imperfeCt 
divifion. Very frequently, when the ruminating procefs 
was thus prevented, or voluntarily fuppreffed when cir- 
cumftances required it, the ingefta, both fluid and folid, 
were returned at the end of feveral hours ; but w : ere then 
generally acid, frequently acrid and bitter, and fometimes 
in fo large a quantity as to fill the mouth beyond its ca¬ 
pacity of retention. But even then no cardialgia nor 
gaftrodynia was experienced, nor the fmalleft degree of 
naufea; and even thefe difgorged matters were attempted 
to be mafticated, although generally thrown out on ac¬ 
count of the difagreeable tafte. 
“ In fpeculating upon the nature of this cafe,” fays Dr. 
C. “ it appears evident that the energy of the digeftive 
and affimilating organs was greatly diminifhed: confe- 
quently the ftomach, deriving its influence, whether that 
prefiding over the mufcular aCtion or vafcular fecretion, 
from the fame fource, namely, the organic fyftem of 
nerves, experienced a proportionate diminution in its fe- 
creted juices. This was rendered apparent by the changes 
which took place in the aliments, when taken even in 
very moderate quantity, and when retained without 
being fubmitted to re-maftication. Connected with de¬ 
bility of this organ, an increafe of its animal fenfibility, 
which it derives from the diftribution of the eighth pair 
of nerves, appears to have been prefent. Under thefe 
circumftances, the gaftric juices (being, as inferred, in 
dim in idled quantity) could be fufficient only for a fmall 
portion of aliment, which neverthelefs had been taken 
in an abundant quantity; and, having combined with 
that part whofe ftate is moft favourable to fuch an ad- 
VOL.XIX. No. 1292. 
LOGY. 
mixture, and being, by the ufual aCtion of this organ, 
conveyed to the pylorus, the imperfeClly-mafticated 
portions, and that part which remains impenetrated by 
the gaftric juices, tnuft either continue at the cardiac ex¬ 
tremity, or be propelled there by the aClion of the fto¬ 
mach. That the undigefted portions of the food do not 
only remain in that fituation, but may, by a peculiar and 
complicated aCtion of this organ, be conveyed there, 
may be proved not only by reafoning upon the nature of 
its organic aClion, but has even been demonftrated by 
large fiftulae of this organ, fituated at its anterior con¬ 
vexity, and opening externally at the epigaftric region. 
In a cafe in the Hopital de la Charite, under the care of 
Corvilart, the complicated aClion of this organ was wit- 
nefled, conveying the digefted portions of the ingefta 
towards the pylorus, which pafled only in very fmall 
quantity, while the bulk of the unchanged aliment was 
propelled, by a contrary aCtion, to the oppofite extremity 
of the organ. It cannot be fuppofed improbable that the 
irritation produced in this part of the ftomach by the un¬ 
changed aliments in ruminating individuals, fliould ex¬ 
cite the animal fenfibility of this organ ; and, if the hrain 
be in a ftate capable of receiving the fenfation, it is pro¬ 
pagated to the organs of refpiration, and their aCtion 
induced through the medium of the fame let of nerves, 
namely, the par vagum, that forms not only the refpira- 
tory clafs, but alfo the connecting chain between the or¬ 
ganic and animal orders of the grand nervous fyftem ; 
and, while it bellows an exquifite fenfibility on the pul¬ 
monary fyftem, it likewife gives a requifite, but fparing, 
(hare of its influence to this important organ. 
“In effecting the procefs of rumination, the organic 
contractility of the ftomach can do no more than, by an 
elective procefs (foon to be explained), place the aliments 
about to be returned in a fituation, in refpeCt to thecar- 
dia, favourable to the excitation of the animal fenfibility 
of this organ, and to its ready regurgitation and propul- 
fion along the cefophagus. So loon as the demand is 
made upon the fenfibility by the fituation of the alimen¬ 
tary bolus, the par vagal clafs of nerves is excited to 
aCtion, and a full infpiration is effected, as has been de- 
fcribed. The introduction of the bolus into the cardiac 
extremity of the cefophagus, may be confidered as ef¬ 
fected by the ordinary contractility of the ftomach ; per¬ 
haps fympathetically heightened at the moment by the 
re-aCtion of the abdominal mufcles ; while, at the fame 
time, the diaphragm has juft undergone relaxation, in 
which the cardia may, from intimate nervous commu¬ 
nication, fuffer a fimilar participation, and thus give fa¬ 
cility to the afcent of the alimentary ball in the cefopha¬ 
gus, which immediately contracts behind it from the ir¬ 
ritation produced by its pafl'age, and the bolus is thus 
conveyed to the mouth. 
“The influence of the will appears to be requifite, 
fince the procefs is interrupted during fleep. But this 
influence is only puffively engaged in the production of 
the ruminating aCt, by bringing about the co-operation 
of the refpiratory organs. The elective procefs exer- 
cifed by the ftomach in this affeCtion, is fimilar to that 
which it employs in periods of health, and may be con¬ 
fidered as relative to the degree of digeftive energy, and 
to the comparative dates in which the various ingefta 
may enter the ftomach. 
“In the debilitated ftate of the ftomach, and confequent 
deficiency of the fecretions, digeftion can be perfectly 
performed only when the aliments are prefented in fmall 
quantity, and in a favourable ftate, from complete com¬ 
minution and from intermixture with the falivary juices. 
If, however, in this ftate of the organ, the food is con¬ 
veyed rapidly into it, poflefled of neither of thefe requi- 
fites, fo as to produce fudden diftention, a re-aCtion of 
this vifcUs upon its contents takes place; and, as the im- 
perfeCtly-mafticated food conftitutes the greater portion 
of the ingefta, there is abundance prefent to be returned 
into the cardia, while there is a deficiency of aliment in 
LI a fit i 
