An Introduction to Gastro–Enterology

An Introduction to Gastro–Enterology

The Mechanics of the Digestive Tract

4th Edition - January 1, 1948

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  • Author: Walter C. Alvarez
  • eBook ISBN: 9781483223919

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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


    II. The Facultative Autonomy of the Digestive Tract

    Evolution of the Nervous System

    The Function of the Nerves


    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


    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


    V. A Possible Basic Metabolic Gradient

    A Metabolic Gradient

    Gradients in Chemical Composition

    Axial Gradients in Lower Forms of Life


    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


    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


    VIII. The Syndrome Of Reverse Peristalsis



    Heartburn and Distresses Confused with it



    Motion Sickness and Nausea

    Coated Tongue and Bad Breath

    Feeling of Fullness After Beginning to Eat



    Difficulties and Objections


    IX. The Smooth Muscle of the Gastro-Intestinal Tract

    Anatomic and Physiologic Characteristics

    Types of Smooth Muscle

    Response to Tension

    Response to Direct Irritation


    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


    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


    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


    XIII. Chewing and Swallowing

    The Value of Chewing

    The Esophagus


    Reverse Peristalsis in the Esophagus

    Air Swallowing


    Is the Act of Swallowing Essential to Life


    XIV. The Cardia

    Why the Cardia is Weak

    Rhythmic Tendencies


    The Nervous Control of the Cardia

    Cardiospasm and Hirschsprung's Disease


    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


    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


    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


    XVIII. Hunger Contractions and the Pain of Ulcer

    Hunger Contractions

    The Pain of Ulcer

    Notes on Abdominal Pain in General


    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


    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


    Association Between Vomiting and Diarrhea

    Practical Applications

    Vomiting Not Always Prevented by Keeping Drugs Out of the Stomach


    XXI. The Mechanics of the Gallbladder



    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


    XXII. The Muscularis Mucosae


    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


    XXIV. The Appendix


    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



    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


    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


    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


    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


    The Action of Carminatives

    Postoperative "Gas Pains"


    XXX. Hunger, Appetite and Thirst

    The Sensations of Hunger




    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


    XXXII. The Electrogastrogram and Electro-Enterogram


    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


    XXXIV. On Books and Reading



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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