An Introduction to Gastro–Enterology
The Mechanics of the Digestive Tract
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The Mechanics of the Digestive Tract, Fourth Edition: An Introduction to Gastro-Enterology provides information pertinent to the mechanics of the digestive tract. This book reviews the various explanations for the downward progress of intestinal waves. Organized into 34 chapters, this edition begins with an overview of the main types of activity in the small bowel. This text then explains the nature of the polarity and the location of the mechanism that produces it. Other chapters consider the duodenal tonus contraction in which the wave seems to originate generally appears a few seconds before a gastric wave reaches the pylorus. This book discusses as well the polarity of the bowel that caused every contraction ring to spread caudad as soon it formed. The final chapter provides a list of books that are likely to be helpful to readers who are starting on their lifework in the fields of gastro-enterology and gastro-intestinal physiology. This book is a valuable resource for students, teachers, physicians, and research workers.
Table of Contents
Preface to Fourth Edition
Preface to Third Edition
Preface to Second Edition
List of Illustrations
I. The Motor Functions Of the Small Bowel
Two Main Types of Activity
The Polarity of the Bowel
The Several Forms of Activity
Activity in the Small Bowel of Man
Effect of Sleep
Changes in the Irritability of the Bowel
The Metabolic Rate of the Intestinal Wall
Summary
II. The Facultative Autonomy of the Digestive Tract
Evolution of the Nervous System
The Function of the Nerves
Summary
III. Some Theories that have Been Advanced to Explain the Polarity of the Small Bowel
Bayliss and Starling's Law, or the Myenteric Reflex
The Normal Rush Waves
Keith's Theory of Intestinal Control
Carey's Theory
Goerttler's Idea
Summary
IV. The Gradient Theory of the Polarization of the Bowel
Definition of a Gradient
The Polarity of the Heart
Gradients in Several Tubular Organs
The Gradient in the Rate of Rhythmic Contraction of the Intestine
Is the Polarity or Gradient Located More in the Myenteric Plexus than in the Muscle
The Origin of Gradients in the Egg and the Embryo
The Polarity of the Bowel is Primarily "Built In"
Is the Gradient the Cause of the Polarity
Is There a Gradient in the Bowel of Man
History of the Idea of the Gradient
Summary
V. A Possible Basic Metabolic Gradient
A Metabolic Gradient
Gradients in Chemical Composition
Axial Gradients in Lower Forms of Life
Summary
VI. Other Related Gradients
Gradient in the Force Exerted by the Intestinal Muscle
Gradient in Anatomic Structure
Gradient in Ability to Withstand Distention
Chemical Gradients Along the Mucosa
Resistance of the Intestinal Mucosa to Gastric Juice
Gradient of pH in the Intestinal Contents
Summary
VII. Ways in Which a Gradient Might Conceivably be Altered or Reversed
Factors that Might Alter the Gradient
Reversal of Gradients by Drugs
Ways in which Various Factors Might Alter a Gradient
Intestinal Obstruction
A New Law of the Intestine
Dietary Suggestions
Summary
VIII. The Syndrome Of Reverse Peristalsis
Vomiting
Regurgitation
Heartburn and Distresses Confused with it
Belching
Nausea
Motion Sickness and Nausea
Coated Tongue and Bad Breath
Feeling of Fullness After Beginning to Eat
Hiccup
Biliousness
Difficulties and Objections
Summary
IX. The Smooth Muscle of the Gastro-Intestinal Tract
Anatomic and Physiologic Characteristics
Types of Smooth Muscle
Response to Tension
Response to Direct Irritation
Summary
X. The Muscular Versus the Nervous Origin of the Rhythmic Contractions of the Gut
The Work of Magnus
Can Intestinal Muscle be Denervated Mechanically
Studies with Tissue Cultures
Contractions in Embryonic Nerve-Free Intestinal Muscle
The Heart of Limulus
Rhythmic Activity a Property of All Contractile Tissue
Light Thrown by the Electrogram
Anoxemia as an Instrument for Analyzing Nervous Structures
Pharmacologic Arguments
Nervous Influences Affect the Rhythmic Contractions
Summary
XI. The Structure and Functions of the Myenteric Plexuses
Methods of Study
Histologic Studies
The Anatomy of the Plexuses in the Stomach
Origin of the Enteric Nervous System
Functions of the Myenteric Plexuses
Physiologic Studies to Determine the Structure of the Myenteric Plexus
Types of Conduction Along the Small Bowel
Conduction which Enables Thousands of Muscle Fibers to Contract Together
Secretory Fibers in the Enteric Nervous System
Fibers Controlling Absorption
The Plexuses in the Stomach and Colon are Different from Those in the Small Bowel
Pre-and Post-Ganglionic Fibers
Nerves to Mediate the "Myenteric Reflex"
Effects of Certain Drugs on Conduction
Nolf's Model of the Myenteric Plexus
Summary
XII. The Extrinsic Nerves of the Digestive Tract and their Functions
The Peculiar Response of Smooth Muscle to Nervous Stimulation
Effects of Stimulating Vagus Nerves
Chemical Mediators
The Vagi and Splanchnics are Mixed Nerves
Afferent Impulses Injuring the Brain
Mixed Effects of Stimulating Sympathetic Nerves
The Nature of the Involuntary Nervous System
The Functions of the Intestinal Nerves
Vasomotor and Secretory Fibers
Psychic Effects
Effects from the Brain on the Stomach and Bowel
The Innervation of the Stomach
The Effects of Vagonomy in Animal and Man
How Far Down the Bowel do the Vagus Nerves Extend
Celiac Plexuses
The Influence of Nerves in Quieting the Bowel in Case of Peritonitis
Nerves to the Liver
Nerves of the Crop and Gizzard in the Chicken
Summary
XIII. Chewing and Swallowing
The Value of Chewing
The Esophagus
Swallowing
Reverse Peristalsis in the Esophagus
Air Swallowing
Dysphagia
Is the Act of Swallowing Essential to Life
Summary
XIV. The Cardia
Why the Cardia is Weak
Rhythmic Tendencies
Regurgitation
The Nervous Control of the Cardia
Cardiospasm and Hirschsprung's Disease
Summary
XV. The Movements of the Stomach
Way in Which Waves Travel Over the Stomach
Literature on Gastric Movements
Conduction in the Stomach
Changes in Tonus
A Humoral Influence on Gastric Activity
Mode of Travel of Solids and Liquids Through the Stomach
The Gastric Canal or Furrow ("Magenstrasse")
The Blood Vessels of the "Magenstrasse" and Duodenal Cap
The Position of the Stomach in the Abdomen
The Influence of Sleep
The Influence of Food and Drugs
The Stomach of Infants
Summary
XVI. Gradients in the Muscular Wall of the Stomach
The Primitive Digestive Tube and its Modifications
Differences in Rhythmicity in Different Parts of the Stomach
Differences in Tonus
Differences in Irritability and Latent Period
Differences in the Reactions of Excised Strips of Muscle
Summary
XVII. The Pylorus and the Duodenal Cap
A Fibrous Tissue Barrier
A Physiological Barrier
The Duodenal Cap
Influences Crossing the Pyloric Line
Passage of Material Through the Pylorus
The Emptying of the Cap
Autonomy of the Pylorus
The Control of the Pylorus
Re-Gurgitation of Duodenal Contents into the Stomach
Gastric Emptying Due to an Upset in Balance Between Intragastric and Intraduodenal Pressures
Nervous and Other Influences Affecting the Pylorus
Emptying Time of the Stomach as an Index of Digestibility of Foods
Pyloric Stenosis in Infancy
The Duodenum Below the Cap
Summary
XVIII. Hunger Contractions and the Pain of Ulcer
Hunger Contractions
The Pain of Ulcer
Notes on Abdominal Pain in General
Summary
XIX. Movements of the Stomach hat is Diseased or has Been Operated On
Movements of the Stomach that is Diseased
Effects of Removal of Portions of the Stomach
Summary
XX. Vomiting
Trigger Zones from Which Vomiting Can be Started
Regurgitation Due to the Efforts of the Digestive Tract Alone
The Part Played by the Voluntary Muscles
Behavior of the Stomach During Vomiting
Behavior of the Cardia and Esophagus
Behavior of the Bowel
The Vomiting Center
The Pathways for Afferent and Efferent Impulses
Influences Coming from the Heart
Pregnancy
Association Between Vomiting and Diarrhea
Practical Applications
Vomiting Not Always Prevented by Keeping Drugs Out of the Stomach
Summary
XXI. The Mechanics of the Gallbladder
Embryology
Anatomy
Filling of the Gallbladder
Absorption from the Gallbladder
Other Functions of the Gallbladder
Emptying of the Gallbladder
Effect of Cholecystectomy on the Bile Ducts
Mode of Production of Pain in Gallbladder Disease
Summary
XXII. The Muscularis Mucosae
Summary
XXIII. The Ileocecal Sphincter
The Gastro-Ileac Reflex
An Ileo-Gastric Reflex
Receptive Relaxation of the Colon
The Nervous Control of the Sphincter
Regurgitation Through the Sphincter
The Function of the Sphincter
Reason for Blockage of Waves at the Ileocecal Sphincter
Anatomy and Embryology
Summary
XXIV. The Appendix
Summary
XXV. The Movements of the Colon
The Water-Conserving Function of the Colon
The Colons of Herbivora and Carnivora
Movements of the Colon
The Formation of Mucus in the Colon
Nerve Supply of the Colon
Defecation
Summary
XXVI. The Length and Complexity of the Bowel as Influenced by Diet
The Length of the Small Intestine
Is Man Built to be Herbivorous or Carnivorous
Summary
XXVII. The Rate of Progress of Food Residues Through the Digestive Tract
The Rate of Progress in the Small Intestine
The Influence of High and Low Residue Diets
Summary
XXVIII. Constipation
Atony of the Colonic Muscle
A Possible Reversal of the Rectal Gradient
Lack of Vis a Tergo
The Abuse of Purgatives
The Peculiar Sensitiveness of the Rectum to Pressure
Puzzles as to How Bulky Diets Relieve Constipation
Attempts to Work Out a Surgical Treatment for Constipation
Summary
XXIX. Gas in the Bowel
Where does the Gas Come from
How Gas Gets Out of the Bowel
Flatulence and Aviation
Bloating After the Cutting of Nerves
Matters Historical and Amusing
Clinical Applications
Accute Dilatation of the Stomach
Borborygmus
The Action of Carminatives
Postoperative "Gas Pains"
Summary
XXX. Hunger, Appetite and Thirst
The Sensations of Hunger
Appetite
Thirst
Summary
XXXI. The Modus Operandi of a Gastro-Enterostomy
Function of the Stomach after Gastro-Enterostomy
Why does a Gastro-Enterostomy Give Relief in Cases of Ulcer
Summary
XXXII. The Electrogastrogram and Electro-Enterogram
Summary
XXXIII. Technical Methods and Apparatus
Roentgen Rays and the Barium Meal
Method of Auer
Gastric and Duodenal Tubes and Balloons, and Electrodes
Intestinal Fistulas
Opening the Abdomen Under Salt Solution
Excised Whole Small Bowel
Studies of Small Excised Segments of Bowel
Abdominal Windows
Transplanted Segments of Stomach, Pancreas, or Bowel
The Electrogastrogram and the Electro-Enterogram
The Gastroscope
Trans-Parent Fish
Useful Articles on Technic
Summary
XXXIV. On Books and Reading
Bibliography
Index
Product details
- No. of pages: 928
- Language: English
- Copyright: © Butterworth-Heinemann 1948
- Published: January 1, 1948
- Imprint: Butterworth-Heinemann
- eBook ISBN: 9781483223919
About the Author
Walter C. Alvarez
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