. A practical treatise on medical diagnosis for students and physicians . (Steele and Francine), in other words, pressure on the 1038 DISEASES OF THE STOMACH. stomach from above, or removal of the support from below by the sink-ing down of the contents of the lower half of the abdomen, A varietvof factors may bring about such a state of affairs : tight lacing and thepressure of the waist-band, pressure from a neoplasm of the liver, dilata-tion and pyloric obstruction, general muscular debility and emaciationafter an acute systemic disease, relaxation of the abdominal walls anddiastasis of the


. A practical treatise on medical diagnosis for students and physicians . (Steele and Francine), in other words, pressure on the 1038 DISEASES OF THE STOMACH. stomach from above, or removal of the support from below by the sink-ing down of the contents of the lower half of the abdomen, A varietvof factors may bring about such a state of affairs : tight lacing and thepressure of the waist-band, pressure from a neoplasm of the liver, dilata-tion and pyloric obstruction, general muscular debility and emaciationafter an acute systemic disease, relaxation of the abdominal walls anddiastasis of the recti (Webster) after repeated pregnancies, and finally,traumatism and sudden muscular over-exertion. Steele divides the casesinto primary gastroptosis with pyloric dilatation and secondary gastro-ptosis with general dilatation, the gastrectasis in the latter group beingprobably the basal condition. Fig. 371. Fig. Dilatation with pyloric obstruction. Gastroptosis, with general dilatation. It is evident from the causes enumerated that women are the chiefsufferers from the disease; but as the available statistics are. hardlynumerous enough to furnish a trustworthy basis for calculation, andthe condition may, in addition, exist without producing symptoms, theincidence is difficult to determine. The proportion as regards sex isprobably about 7 to 1 in favor of women, except in the secondaryand much rarer form, gastroptosis with general dilatation, in whichthe relation is reversed. The disease is most common in early adultand middle life; but the fact that a few cases in children have beenreported by Hemmeter would seem to indicate that more careful physicalexamination might result in a considerable lowering of the age whose occupations require them to stand for a number of con-secutive hours, as saleswomen, and motormen and conductors on trolley- PHYSICAL SIGNS OF GASTROPTOSIS. 1039 c


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