Stoma

“ In this pitiable disease, through the valve of the colon, through the pylorus, the cardia, and the pharinx, are ejected, first, the contents of the stomach and intestines, with the excrement and even clysters themselves; then the fluid from the lacteals, which is now poured into the intestines by their retrograde motions, is thrown up by the mouth; and, lastly, every fluid, which is absorbed by the other lymphatic branches, from the cellular membrane, the skin, the bladder, and all other cavities of the body ”

“ The digestive organs furnish strongly marked lesions. The mouth presents the most constant scorbutic feature, a stomatitis in which the gums are infiltrated, spongy, livid, and the seat of fatty degeneration; the teeth are loosened or have already fallen out. The stomach and small intestines are thin-walled, and the mucous membrane is often softened, and in places ulcerated; similar changes have been noted in the solitary glands. Follicular ulceration of the large intestine occurs, with softening and infiltration of the mucous membrane. ”

“ The post-mortern appearances are most marked in the digestive canal, and comprise red spots and erosions on the palate, lips, tongue and pharynx; intense congestion of the lining of the fourth stomach, which in places is covered with a grey or reddish pultaceous deposit, under which the membrane is deeply ulcerated. Similar lesions are seen in the small intestine, caecum and rectum. The membrane lining the air passages is congested throughout, and the lungs are emphysematous. ”

“ The head having been opened, the brain was submitted to inspection and acknowledged to be healthy; and the same of the tongue, the œsophagus, the larynx, the bronchi, the lungs, the heart, the spleen, the kidneys, the bladder: the womb was somewhat engorged, and larger, heavier than normal, but without any trace of inflammation. All the principal joints were opened and found healthy; likewise glands, arteries, veins and lymphatics. The alimentary canal was carefully examined throughout, without discovering any organic lesion in the stomach or large intestine. ”

“ The STOMACH is situated in the left side of the abdomen, immediately below and in contact with the diaphragm. It has two openings; one connected with the œsophagus, called the car ́di-ac orifice; the other connected with the upper portion of the small intestine, called the py-lor ́ic orifice. It is composed of three coats, or membranes. The exterior or serous coat is very tough and strong, and invests every part of this important organ. The middle, or muscular coat is composed of two layers of muscular fibres, one set of which is arranged longitudinally, the other circularly. ”

“ The stomata are usually placed in depressions produced either by the thickened or papillose outer epidermal cells. The guard-cells are in the plane of the surrounding cells. The stomata are more numerous in members with a larger number of veins. ”

“ By the side of the figure of the sting is represented the point of a fine needle (fig. 20) , showing that the expression “sharp as a needle” has no force when microscopic bodies are in question.
Stom ́ata (στὁμα, mouth) .—On viewing a strip of epidermis, the observer will be sure to notice certain oval or roundish bodies (Pl. I. fig. 13 a) , composed of mostly two kidney-shaped cells in apposition but leaving a chink between them; these are the stomata. They communicate beneath with the intercellular passages, of which they may be considered the mouths ”

“ When the Pains invade first in the Stomach, they become less sharp, and the Patient feels less Inquietude, as soon as the Cause of the Pain has descended out of the Stomach into the Intestines, whose Sensations are something less acute than, or somewhat different from, those of the Stomach. ”

“ When the nerves cannot take up nutrition, they will then take up destruction and other elements which are detrimental to the process of nutrition, and there is no other process for relief but to unload. The load [Pg 235] ing that has been deposited in the stomach was for the purpose of sustaining a being. The stomach itself is a sack. When filled to its greatest capacity, it irritates all the surroundings, and in return they irritate the stomach. ”

“ In the Stomach and Bowels it excites most violent Pains like a Cholic; and in the Bladder, Symptoms so greatly resembling those of the Stone, that Persons, who are neither deficient in Knowlege nor Experience, have been more than once deceived by them. ”

“ The alkalinity of the blood circulating in the walls of the stomach prevents the digestion of the mucous membrane. If this action on the walls of the stomach is prevented in any way, the development of an ulcer is aided. ”

“ Indeed, there is no comparison between these two processes; we have only to consider what the stomach contains—phlegm, bile, pneuma, [innate] heat, and, indeed the whole substance of the stomach. And if one considers along with this the adjacent viscera like a lot of burning hearths around a great cauldron—to the right the liver, to the left the spleen, the heart above, and along with it the diaphragm (suspended and in a state of constant movement) , and the omentum sheltering them all—you may believe what an extraordinary alteration it is which occurs in the food taken into the stomach. ”

“ Should the stomach become adherent to another organ, and fatal perforation be thus prevented, chronic “indigestion” may persist, owing to interference with the natural movements of the stomach. Stricture of the pylorus and consequent dilatation of the stomach may be caused by the cicatrization of an ulcer. ”

“ Gastrostomy for feeding should be done if dysphagia be severe, and has the advantage of putting the esophagus at rest. The passage of a stomach-tube for feeding purposes may be done, but it is often painful, and is dangerous in the presence of ulceration. Pain is not marked if the lesion be limited to the esophagus, though if it is present orthoform, anesthesin, or apothesin, in powder form, swallowed dry, may prove helpful. ”

“ But the inside of the body also has a skin, as have all its organs. The interior of the head, the throat, the gullet, the lungs, the stomach, and all the intestines, are lined with a skin. This is called the mucous membrane, because it is constantly secreting from the blood a slimy substance called mucus. When it accumulates in the lungs, it is called phlegm. This inner skin also has nerves, blood-vessels, and lymphatics. ”

“ The pancreas is examined by turning the stomach toward the thoracic cavity, cutting or tearing the gastrocolic omentum, and cutting the exposed organ by a longitudinal incision through head, body and tail, or by means of parallel transverse incisions made through the different parts of the organ. ”

“ The descriptions and illustrations of the stomach in anatomical works must be disregarded as cadaveric. In the living body, the empty stomach is usually found, on endoscopic inspection, to be a collapsed tube of such shape as to fit whatever space is available at the particular moment, with folds and rugae running in all directions, the impression given as to form being strikingly like searching among a mass of earth worms or boiled spaghetti. ”

“ When food is introduced into the stomach, the peristaltic contractions of that organ roll it about, and mingle it with the gastric juice, which disintegrates the connective tissue, and converts the albuminous portions into the substance called chyme, which is about the consistency of pea-soup, and which is readily absorbed through the animal membranes into the blood of the delicate and numerous vessels of the stomach, whence it is conveyed to the portal vein and to the liver. ”

“ The mucous and serous membranes of the canal and the glandular elements of the associated organs are the parts most subject to inflammatory affections. Among the several sections of the digestive tract itself, the oesophagus and jejunum are singularly exempt from inflammatory processes; the fauces, stomach, caecum and appendix, ileum, mouth and duodenum (including the opening of the common bile-duct) , are more commonly involved. Stomatitis, or inflammation of the mouth, Inflammatory lesions. ”

“ Despite all this the stomach is one of the best-equipped mechanisms in the world. It, at least, is not modern. After their age-long development the organs of the body are remarkably standardized and adapted to the work required of them. It is safe to say that ninety per cent. of all so-called "stomach trouble" is due not to any inherent weakness of the organ itself but to a misunderstanding between the stomach and its owner. ”

“ The mucous membrane of the stomach and bowel, less able to withstand the effects of irritation, even of a minor character, readily passes into a condition of chronic catarrh, while it frequently is the seat of small abrasions, haemorrhagic erosions, which may cause vomiting of blood and the appearance of blood in the stools. ”

“ The floor of the ulcer may be the submucous, the muscular, or the serous coat, or, if the whole thickness of the stomach be perforated, it may be some adjacent organ to which the stomach has become adherent, this organ being usually the pancreas or the left lobe of the liver or neighboring lymphatic glands. ”

“ Stomatitis is an inflammation of the mucous membrane lining the mouth and is produced by irritating medicines, feeds, or other substances. The symptoms are swelling of the mouth, which is also hot and painful to the touch; there is a copious discharge of saliva; the mucous membrane is reddened, and in some cases vesicles or ulcers in the mouth are observed. The treatment is simple, soft feed alone often being all that is necessary. ”

“ The stomach has a soft, spongy appearance, and, when not distended, lies in folds. During life, it is ordinarily of a pinkish color. It is provided with numerous small glands, which secrete the gastric fluid necessary for the digestion of food. The lining membrane, when divested of mucus, has a wrinkled appearance. The arteries, veins, and lymphatics, of the stomach are numerous. ”

“ In continuation of the specialized epithelium of the perradial furrows in the floor of the stomach the inner wall of the stomach pocket shows a strip of similar densely crowded columnar cells leading from the gastric ostium downwards to the canal of the sensory club. ”

“ It is the Receptacle of the Aliments or Food convey'd thither thro' the Oesophagus or Gullet, which is a Canal, or kind of streight Gut that reacheth from the Throat to the Mouth of the Stomach. The Stomach it self is situated immediately under the Diaphragm or Midriff, between the Liver and the Spleen, having two Orifices, whereof the Left is properly call'd Stomachus, or the Upper, and the Right (at its other Extremity) Pylorus, or the lower Orifice. Its Figure resembleth that of a Bag-Pipe, and the greater part of its Body lies toward the Left side. ”

“ We shall only add, that the motions of the muscular fibres of the stomach are associated with those of the heart and arteries by direct sympathy, as appears by the weakness of the pulse during the exhibition of an emetic; and that the absorbents of the stomach are associated with the cellular and cutaneous absorbents by reverse sympathy, as is shewn by the great absorption of the mucus of the cells in anasarca during sickness; at the same time that the absorbents of the stomach invert their actions, and pour the mucus and water thus absorbed into that viscus. ”

“ Pain and heat in the tumour and belly increase; and the former becomes very tender, and tense as a drum.421 The circulation is more hurried, and restlessness and intolerable anxiety supervene. The patient becomes worse and worse every hour; feculent matter in large quantity is vomited or gulped up with great distress, and is commixed with bile, with vitiated mucous secretion from the stomach and bowels, and with whatever may have been recently swallowed; in fact, the peristaltic action of the alimentary canal above the strangulated part is inverted, and all the contents are ejected. ”

“ Other causes are closure of the duct of Wirsung, the retained secretion producing pressure upon the glandular tissue; the extension of inflammation from adjacent organs, as the bile-duct when there is an impacted gall-stone, or the stomach and duodenum, especially in cancer and perforating ulcer, where the floor of the ulcer is formed by the pancreas; the pressure of tumors, as aneurisms of the abdominal aorta and coeliac axis; chronic alcoholism; and syphilis. ”

“ The serous surfaces are capable of being influenced by the affections of the other organs; this is very evident in the organic diseases of the heart, the lungs, the liver, the spleen, the stomach, the womb, &c. organs, which without having any known connexion of functions with the serous surfaces, influence them however so that all their morbid defects of organization are accompanied, in the latter periods, by different serous collections in the great cavities, collections evidently owing to a derangement of the organs which constantly exhale this fluid. ”

“ Those who open dead bodies know that they are frequently healthy in incipient phthisis. 6th. We speak of a bad stomach, a weak stomach; this most commonly should be understood as applying to the mucous surface only. Whilst this secretes with difficulty the nutritive juices, without which digestion is impaired, the serous surface exhales as usual its fluid, the muscular coat continues to contract, &c. In ascites, in which the serous surface exhales more lymph than in a natural state, the mucous oftentimes performs its functions perfectly well. ”