Discussion on the nature of visceroptosis, usually described as Glenard's disease / introduced by Arthur Keith.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Discussion on the nature of visceroptosis, usually described as Glenard's disease / introduced by Arthur Keith. 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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    a semi-fluid mass. In the upright position this mass is rendered more or less rigid by the con- traction of the abdominal walls, especially when a severe muscular effort is being made; in such conditions the intra-abdominal pressure may rise to 90 or 150 mm. of mercury. It is clear then that the cause of visceroptosis must be sought for in a disturbance of the sup- porting mechanism of the belly wall. Concerning this mechanism little is at present k«own. There is clearly a nerve complex between the viscera and muscles of the abdomen ; clinicians have accu- mulated a great deal of evidence showing that such a nerve mechanism must exist. With disease of certain organs, certain muscular segments of the belly wall become painful when used or pressed, a localized visceral affection may call forth a local- ised spasm or contraction of the muscle. Change in posture causes an involuntary contraction of the muscles which support the viscera. Dr. Hill has shown that the condition of the abdominal musculature is co-ordinated with the blood content of the abdomen. More important than the actual contraction, for the subject of this dis- cussion, is that condition of the muscles known as their tonus, a condition at present being illu- minated by the researches of Sherrington. The tonus of the belly wall muscles is regulated reflexly, the afferent impulses which regulate the tonus apparently come from end-organs situated in the abdomen. Now there is within the abdomen an extensive series of end-organs of most obscure import—the Paccinian corpuscles—found in abun- dance in the mesenteries of all the abdominal viscera, and scattered freely by the sides of the venous plexuses of the abdomen. Similar bodies are situated at points of compression throughout the limbs, and are the stations at which afferent impulses arise to regulate the tonus and contraction of the limb and body muscles. The Paccinian