INFLUENCE OF THE DIAPHRAGM ON THE ESOPHAGUS AND ON THE STOMACH

In the anesthetized dog, two different types of contraction were noted when the cardia was examined by the insertion of the finger into the esophagus through a gastrostomy opening.¹ One type of contraction (the esophageal) was circular and constricting; it was reproduced at will by stimulation of the peripheral end of the vagus, and also by stimulation of the esophagus itself at any level above the gastro-esophageal junction. The second type, which was due to the contractions of the diaphragmatic pillars, was a progressively downward milking contraction and was coincident with each inspiration. The diaphragmatic contraction became more pronounced when diaphragmatic breathing became more forcible. The maximum contraction was noticed when the diaphragmatic crura were stimulated with the faradic current.

Clinical evidence of a relationship of the diaphragm to the cardia was brought out by Chevalier Jackson² and Tucker.³ Jackson stated that the "diaphragmatic pinchcock or hiatal narrowing is both