Enteroptosis and its relation to functional disturbances / by W.F. Hamilton.

  • Hamilton, W. F. (William Fawcett), 1865-1948.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Enteroptosis and its relation to functional disturbances / by W.F. Hamilton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    very rarely is found away from its normal position while the pancreas has been once recorded as dragged down (Kokitansky, Treves). About the subject of the Etiology of Enteroptosis much interest cen- tres and numerous theories have been advanced to account for its occurrence. Kuttner and Dyer affirm that no cases of congential gas- troptosis have been observed. Stiller (1890) says that Enteroptosis is a congenital anomaly. It occurs in those whose muscles are soft, whose bony organisation is delicate and upon them but a small deposit of fat may be found, flliere is usually found in such patients a floating tenth rib. Enteroptosis is found in men as well as in women, although much less frequently. Two of the cases herewith reported were male patients, although the percentage of men is much smaller in a large series of cases as shewn by Glenard, Meinert, Schwerdt and indeed by all observers. The French writer reports 404 cases, 306 of which were among women ; in Meinert’s series, 88—90 per cent, were females, while in Schwerdt’s series of 95 observations, 89 were in women. Preg- nancies and tight lacing are the chief causes, according to Manges, for this great difference between the sexes. In answering the question as to the etiology of the condition, Dr. Schwerdt, of Gotha, states that the essence of this disease is to be sought for in an atony of the whole nervous system which affects the muscles of the whole body. As active causes of such a condition he enumer- ates heredity, unhealthful methods of living and working, all chronic diseases, the wearing of corsets and lack of care in the pregnant state and in childbed He regards this disease as a constitutional ailment. The abdominal organs are kept in place very largely by a certain degree of intra-abdominal pressure, and when this is greatly diminished, ptosis is the result. The corset contributes to this condition, among other ways (I.) by diminishing the tone of the body walls and suspensory ligaments of the organs, and (II.) by interfering with the mechanical and chemical functions of digestion thus impairing nutrition. The teaching of Schwerdt upon this point is more theoretical than that of Meinert, who regards the corset as a means of altering the. relation of the parts chiefly by direct pressure. There is doubtless no one cause or group of causes which will suffice to explain the occurrence of this disease or condition. We may con- clude then that :— 1. The intra-abdominal pressure is altered. 2. Many causes contribute to this end. 3. The organs may be displaced by being pulled down. 4. In all probability a congenital predisposition exists in the con-