PHYSIOLOGIC STUDIES ON THE MOTOR ACTIVITIES OF THE STOMACH AND BOWEL IN MAN

Abstract

Rates of rhythmic contraction were counted with the roentgenoscope and found to be about 10 per min. in duodenum, jejunum, and ileum. Strips of muscle were removed from the stomach and bowel of an executed criminal. As in animals, so in man, there was a gradation in latent period in the stomach from short intervals at the cardia to long ones in the pars pylorica. There was a suggestion of a similar gradient from duodenum to lower ileum. The muscle of the duodenal cap was very sluggish, that of the terminal ileum next to the sphincter very active. The latent periods in different parts of the digestive tract were the same as those found in laboratory animals. The records from various parts of the stomach of man closely resembled those of muscle of similar origin in laboratory animals, with a fast rate at the cardia and a slow one in the pars pylorica. Rhythmic contractions of muscle from the bowel were irregular in rate and amplitude. The rate varied markedly from moment to moment, and there was no definite gradient from duodenum to ileum. In 2 men, records were obtained by passing a balloon into the bowel through a jejunal fistula. The rate of rhythmic contraction was variable but there was a suggestion of a gradient from duodenum to ileum. The rates were faster during digestion. There was no depression of activity during sleep. The pull on the balloon was most marked in the jejunum and least in the lower ileum. In a number of subjects studied there was evidence of a psychic tone produced by the thought, sight or taste of food. The presence of the balloon in the bowel seemed to induce sleep. The introduction of the balloon into the colon showed that this region of the bowel is comparatively unresponsive to distention. Rush waves and rhythmic contractions, similar to those in animals, were seen in a woman with a large ventral hernia. Heat and cold applied to the abdomen had no effect on these movements. Epinephrin temporarily inhibited them but after 3 min. caused them to be very active; rushes appeared and there was a desire for bowel movement. In a woman with gastric peristalsis easily visible through a thin abdominal wall a reverse wave ended in an eructation.