. Transactions of the College of Physicians of Philadelphia . iency due to pyloricstenosis, the result of ulceration and spasm of the pylorus, whichwas demonstrated by a subsequent operation. In Fig. 10 we seea marked peristaltic wave in the lower third of the stomach nearingthe pylorus. It involves both the lesser and greater curvatures andcorresponds to what has been described as the sphincter antrumpylori. A second commencing wave is seen between the middleand upper thirds of the stomach, while the perpendicular ruga> ofthe cardia and left side of the stomach are shown by the bismuthrema
. Transactions of the College of Physicians of Philadelphia . iency due to pyloricstenosis, the result of ulceration and spasm of the pylorus, whichwas demonstrated by a subsequent operation. In Fig. 10 we seea marked peristaltic wave in the lower third of the stomach nearingthe pylorus. It involves both the lesser and greater curvatures andcorresponds to what has been described as the sphincter antrumpylori. A second commencing wave is seen between the middleand upper thirds of the stomach, while the perpendicular ruga> ofthe cardia and left side of the stomach are shown by the bismuthremaining in them as the stomach expands laterally. It shouldbe particularly noted that the lungs are filled with air, shorteningthe sagittal length of the stomach, while its base is at the iliac crestor a little below it. When this plate is compared with Fig. 11 ofthe same stomach, taken immediately after the other, but with fullexpiration instead of full inspiration, the contrast in the length ofthe stomach is easily noted. The base remains at the same level,. Fio. 11 Fio. 12 lkoxakd: a hontgknock aimik stidy ok I Si 1 onlj it is narrower, while the peristaltic wave, called the sphincterantrum pylori, has disappeared and a scc< ml wave is shown inthe tniddle third of the stomach. In addition, a very small notchon the onier border of the stomach between the upper and middlethirds indicates the commencement of another peristaltic wave. The third plate, Fig. 12, shows the stomach and intestines of thesame patient six hours after the bismuth meal. The residue ofthe bismuth meal is shown in the lower part of the stomach withmarked peristaltic waves. Bismuth is seen in the pylorus and thedescending and ascending links of the duodenum. The greaterportion of the meal has, however, passed into the cecum and theptosed ascending colon, but the transverse and descending portionsof the colon are empty. This is in marked contrast to the condi-tion of the colon in Fig. 9, where
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