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November 25, 1911

The Goulstonian Lectures on the Sensibility of the Alimentary Canal.

JAMA. 1911;LVII(22):1794. doi:10.1001/jama.1911.04260110294038

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These lectures consitute an excellent discussion of this new field of knowledge. The author contributes numerous experiments and clinical observations of his own as a basis for the theories advanced. The failure to elicit a response to tactile stimulation from the mucous membrane of the entire alimentary tract down to the anal canal is in accord with previous observations. His conclusions, however, that the esophagus and stomach are insensitive to stimulation by dilute hydrochloric acid and organic acids, and that the contact of hydrochloric acid with a gastric ulcer does not directly produce pain but only secondarily by inciting muscular tension, are at variance with the prevailing teaching. With Ross and Head, he believes in two distinct types of pain; the one a true visceral pain, produced only by tension of the muscular layer; the other a referred pain, afferent impulses from the affecteda 0organ first proceeding to the spinal

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