THE HUMAN STOMACH AND THE CANALIS GASTRICUS.

338 to practise in that country. The committee was stream being accounted for in this way. That the satisfied with the evidence produced, and resolved stomach really makes a coordinated effort to direct as follows :the fluid into a channel at its lesser curvature is thus That so long as the Order in Council of Jan. 7th, 1915, suggested by X rays. Finally, there must be recogremains in force any person who produces evidence satis- nised the active part played by the oblique muscle of factory to the Registrar that he has obtained the degree of the stomach in accomplishing this local canalisation. Doctor of Medicine in the Belgian universities of Brussels, It is probably by the contraction of its upper fibres Ghent, Liege, and Louvain, and is legally authorised to that the bismuth, as seen by the screen, was so practise medicine, surgery, and midwifery in Belgium ; constantly held up below the cardiac orifice. This and who satisfies the Registrar as to the other particulars specified in Section 12 of Part II. of the Medical Act, 1886, sheath of muscle, in fact, is of more importance shall be entitled to be registered in the Foreign List of the than was supposed, and its action aids in forming this functional " canalis gastricus." Further proof Medical Register. Further communications received by the Registrar of the specialisation of the lesser curvature of the of the General Medical Council, through the clerk of pars cardiaca for some function other than that of the Privy Council and His Majesty’s Minister at slowly pressing the food out into the outer pyloric Havre, from the Belgian Government, afford official part is shown by the marked difference in the confirmation of the evidence placed before the action of the muscle along the lesser curvature as Executive Committee as to the education and seen by X rays, the change occurring at the incisura examinations on which medical qualifications are angularis. The whole diameter of the pars pylorica conferred by Belgian universities and colleges. takes part in active peristaltic waves coursing The Acting Minister of the Interior, in the course towards the pylorus. It is, however, very rare to of his note to Sir Francis Villiers, used the follow- see any indentation of the lesser curvature in the ing appreciative words: "Veuillez croire, Excellence, pars cardiaca. There thus seems to be a fundaque le Gouvernement Belge est tres sensible a cette mental functional difference between the two nouvelle marque de la sympathie de 1’Angleterre et parts, which gains its best explanation from the qu’il en remercie vivement les autorites de votre facts above discussed. pays." In the absence of complete information on SMALL-POX, VARICELLA, AND "ALASTRIM." Jan. 22nd, the question of the recognition of dental held over was until the THE discussion at the ltoyal Society of Medicine Belgian diplomas next meeting of the Executive Committee. arising out of a paper read by Dr. W. G., Armstrong on the subject of the epidemic of smallpox at Sydney in 1913 was in many respects THE HUMAN STOMACH AND THE CANALIS interesting and suggestive. The peculiar feature GASTRICUS. of the epidemic in question was the mildness of IT has been commonly supposed that fluids and the symptoms, although the population affected solids on being swallowed must necessarily be was largely unvaccinated. Thus, in many instances mixed up in the stomach, but there is now much there were but few cutaneous lesions, while in a important evidence to show that such a view must patient who presented a severe confluent eruption on be revised. It is held that fluids can be swallowed, the face and extremities the constitutional disturbin fact usually are swallowed, and yet not mix with ance was so slight that the man’s complaint was only other ingesta within the lumen of the stomach; of the insufficient food given him and of the they pass on, by the aid of a special arrangement soreness of his feet if he tried to stand on them. to be immediately noted, direct from the cardiac There was only one death among over 1000 cases of orifice to the pylorus. Comparativeanatomy has the disease. Coincidently with this epidemic of shown that such an arrangement holds good for small-pox there was an increase in the prevalence ruminants, and at a later time it was discovered of varicella, but the behaviour of the two diseases that cariaivora. possess the same faculty, despite the with regard to vaccination negatived any possifact that in them the stomach is a single chamber. bility of the epidemic being of hybrid character. Recently Dr. F. T. Lewis has called attention to a Epidemics of specially mild small-pox have been canal along the lesser curvature of the human observed in many parts of the world and have foetal stomach; he has called it the " canalis received different names, such as milk-pox, gastricus." He says’’it suggests a continuation of Cuban itch, Spanish measles, and " alastrim " ; and the oesophagus and may become a tube during doubt has prevailed as to the identity of these its physiological activity, by the approximation of mild forms with true variola. Dr. C. J. Martin its lips." Some recent radiographic and anatomical luoted a reuort by Ribas, of Sao Paulo, who upheld researches by Dr. Geoffrey Jefferson in the Jonrnal jhe diversity of the local disease known in Brazil of Anatomy and Physiology (1915, vol. xlix., p. 165) s " alastrim" from small-pox owing to its low give further strong support to the likelihood of nortality, its trivial degree of constitutional dissome action such as this persisting in adults turbance, the absence of the characteristic smell, and realising in this way a selective course to md the possibility of successfully vaccinating the pylorus for fluids. Screen examinations of )atients within a short period after the attack. On 22 normal people after being given a mixture he whole, the evidence is in favour of regarding of bismuth oxychloride and milk of the consistency ull these conditions as mild variola, and the success of thin cream showed that in 18 instances the fluid If Dr. J. Burton Cleland and Dr. E. W. Ferguson n inoculating calves with material derived from was confined to the lesser curvature; in the other patients in the Sydney epidemic affords powerful 4 cases it spread rapidly over the sides of the but these stomachs were atonic. That stomach, upport to this view. Dr. Martin, however, suggests hat the three diseases-small-pox, chicken-pox, such a course does not merely represent the shortest path gravity would demand is shown by the holding nd "alastrim "-are of common parentage but have ecome so far differentiated as to breed true at the. up of some portion just below the cardiac orifice. Nor does Dr. Jefferson agree wholly with Dr. resent time. Hertz that the normal empty stomach is contracted 1 Proceedings of the Royal Society of Medicine, December, 1914, down like a piece of small intestine, the localised Section of Epidemiology. ____

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