正常の消化管運動の型式やその経過を研究するには, 腹窓法やX線照射法を用い, 映画撮影法を併用する. しかし, 正常運動からさらにすすんで運動の機序をくわしく研究しようとすると, このような方法だけでは足りず, 多少の興奮性低下を犠牲にしても, 開腹した状態で, あるいは剔出腸管について研究をすすめなければならない.
生体内腸管あるは剔出腸管のいずれにおいても, その収縮にともなってひき起される縦あるいは横径, 容積および内圧の変化が腸運動の示標とされ, それぞれについて描記法が工夫されてきた.この総説では, それぞれの方法の得失について論及し, いまのところ, 生体内腸運動の描記法としては, ゴム球法にまさるものがないこと, また内圧を一定にした状態, すなわち等張力性状態で収縮による容積運動を描記しながら, いろいろな刺激や薬物による影響を検討するのが最良のやり方であるとみなされることを述べた.
正常消化管の運動型についての諸家の見解は古くから今日にいたるまで不一致のまま推移しているが, 近年, 北アメリカの諸学者はゴム球法によって描記された収縮曲線を振幅と緊張の状態によってType IからIVにいたる波型に分類し, それぞれが本質的に異なるものであると考え, 機能的にも別個のものとしてし理解しようとしている.
著者は上述の理論の不当である理由を述べ, 自己の理論の正当なることを強調する.すなわち著者によれば, 消化管の正常運動は一見多種多様, 複雑な外観を呈するけれども, 本質的にはただ一種の律動収縮波とみなすことができる.この見地にたてば, ゴム球法では, この収縮波が伝播の途次ある一局所においてひき起す容積あるいは内圧変動をとらえていると考えられる.そして収縮波であるから当然のことではあるが, 波の強弱によって差異はあるけれども, 常に内容推進の力をもっている.
上に述べた見地に立てば, 消化管は, 収縮波によってその内容が推進される一種の管系であり, その内容推進にはPoiseuilleの法則V=πr⁴p/8ηlEがあてはまると考えることができる.この式でVは腸管の容積移動(ml/sec)を示し, pは腸管の収縮波の振幅で, これで推進力が表示されており, rは腸管の半径で, 緊張の度合を示しておる.実験例をあげ, pおよびrの変化の内容輸送に及ぼす影響を論じた.

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To clarify the mechanism of delayed gastric emptying after vagotomy, and the related problem whether the vagotomized stomach develops pylorospasm under any condition, the author studied the motor function of the canine stomach with the use of electromyography when warm water was instilled before and after vagotomy.
Regardless of whether vagotomy had been performed or not, a marked excitation of the pyloric portion of the stomach occurred, resulting in a spasm-like abnormal excitation and anti-peristalsis as the intra-gastric pressure was risen by instillation of water. However, the vagotomized stomach required much more water than the non -vagotomized stomach to develop the same degree of excitation of the pyloric portion, and this difference was probably due to hypomotility or hypotonicity of the vagotomized stomach. On the other hand, vagotomy did not cause pylorospasm or abnormal excitation of the pyloric portion, although hypomotility of the stomach was present.
The above results suggested that the vagotomized stomach developed hypomotility or hypotonicity first, resulting in stasis and retention of the gastric content. And, the higher intra-gastric pressure due to this stasis and retention was followed by the occurrence of spasm-like abnormal excitation of the pyloric portion and anti -peristalsis. Therefore, “pylorospasm” was considered to occur secondarily as a result of gastric stasis and retention, but not primarily because of vagotomy.

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1)métoclopramide 5mg/kgの静注は多くの場合イヌの外来神経無傷ならびに切断大腸の運動の亢進をひき起すが, 支配神経がすべて切断された大腸ではこの薬物に対する感受性が増大する.たとえば, 0.5mg/kgが5mg/kgの効果に匹敵する.
2)métoclopramide10^-6～5×10^-5g/mlはラットの剔出大腸片の収縮を著明に亢進させる.また壁内神経要素の麻痺を来たすと考えられている薬物, tetrodotoxinを適用した後においても, 著明な収縮がひきおこされる.
3)1)および2)に述べた結果からこの薬物は直接大腸筋を刺激興奮させるものと考えられる.

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1. The spontaneous contraction of the isolated colon was inhibited by mebeverine at doses greater than 1×10^-7g/ml. The effect of mebeverine was stronger than that of papaverine or buscopan. Two kinds of movement occur in the rabbit colon, peristaltic movement and the local tonic wave. The local tonic wave is produced mainly by the ring muscle. Papaverine mainly inhibited the peristaltic contractions but the effect of mebeverine and that of buscopan were the inhibition of tonic contractions. These drugs showed greater inhibitory effects on the colonic activity than on the small intestinal one.
2. The antispasmodic properties of mebeverine against the evoked contractures yb acetylcholine 10^-5 g/ml or BaCl₂ 10^-3g/ml were stronger than those of papaverine and buscopan.
3. When mebeverine 10^-5g/ml was applied on the isolated colon the spontaneous contractions were enhanced about 50% of the cases. The phasic and tonic contractions were enhanced with the increase of spike discharge. The mechanisn of this phenomenon is obscure.
4. When 5mg/kg mebeverine was induced intravenously, the movement of the colon was slightly inhibited. But sometimes colonic movement enhanced, tachycardia appeared, respiration became irregular, tonic convulsion appeared and the animal died. But when mebeverine was given orally no significant alteration of colonic motility was observed.

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Albino rats of Wistar strain with normal sexual cycle on the basis of their vaginal smears were used and anesthetized with Mintal (pentobarbital) injecting 5 mg/100 g intraperitoneally in acute experiments. Spontaneous electromyographic activity of the rat uterus in vivo was recorded using a concentric electrode (silver wire, 50μ diameter). One electrode was placed in the tubal side and the other electrode in the cervical side of a corpusuteri of the rat. Electromyographic recordings were made with a 2 channel inkwritingapparatus. The spontaneous electrical activity of the rat uterus in situ could be observed through the cycle. The basic electromyographic patterns of the nonpregnant ratuterus at the estrus were the train of spike and the spike burst. From proestrus to estrus, the spontaneous spike discharges increased in amplitude and in frequency and became of a set of their discharges. In some cases the spontaneous spike discharges were observed sporadically at the diestrus of the cycle and the castrated condition.

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Electromyograms of the duodenum in rabbits were recorded from the four points, namely the choledochoduodenal junction, other point of the duodenum on the junctional level, oral and anal points of the duodenum. Further, circular and longitudinal muscles were incised, and electromyograms were recorded.
1. In healthy rabbits, action currents taken from each point showed no difference in number and amplitude of bursts, but slight difference was observed in intervals of bursts.
2. By incision of the circular muscles, only number of bursts remarkably decreased at the choledochoduodenal junction, however, amplitude of spikes slightly decreased and interval inbetween bursts did not show so remarkable changes at other points of the duodenum.
3. By incision of the longitudinal muscles, amplitude of spikes decreased in every point, but number of spikes and rhythm of bursts showed no remarkable changes.
Action currents of every point were accelerated by administration of vagostigmin, imidarine and secretin, but were inhibited by atropine.
It is thought that action of choledochoduodenal junction is not influenced by the duodenal muscle, and electromyogram at choledochoduodenal junction is remarkably influenced by incision of circular muscles of the duodenum, and electromyographical changes of every point is not so remarkable by incision of longitudinal muscles.
It is unable to conclude whether the movement of choledochoduodenal junction is functionally dependent or independent from the duodenal wall muscles.

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Intestinal stenosis were produced in the lower small bowel by a longitudinal inverting plication of the intestinal wall by squeezing the bowel by balloon with continuous pressure, and by making a reversed segment of bowel. After these procedures, the action potentials were recorded from the stomach, duodenum, jejunum, ileum, terminal ileum, and ascending colon by extracellular electrodes fixed in their muscular layers. Results were as follows;
I. By the inverted plication, action potentials of oral ileum and duodenum showed higher activities four days after the operation which, however, became normal in every portion of the tracts seven days after the operation.
II. By squeezing of the bowel, increased electric activities in the portion proximal to the squeezed ileum was observed, but no remarkable changes were found in the duodenum or stomach. On the otherhand, decrease of discharge was found in the distal ileum.
III. In reversed anastomsis, it was revealed that the reversed segment when made not shorter than 10 cm in length was good for producing the intestinal stenosis. Increased potentials and irregular pattern were investigated in the oral part of intestine. In the reversed intestinal segment, high potentials were kept continuously and the peristaltic movements were predominantly isoperistaltic. No propagation of movements beyond the anastomotic line was observed.

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The pressures in the esophagus and gastro-esophageal sphincter in 22 healthy unanesthetized dogs were studied by the use of three small open tipped tubes with internal diameter of 1.4 mm. The tubes were introduced and manipulated without anesthesia through the previously made esophageal fistula. To record the resting pressure, an open tipped tube was withdrawn slowly from the stomach back to the esophagus. The swallowing action was induced by an injection of water into the esophagus.
The resting pressure in the esophagus was less than that in the f undus of the stomach.A band of elevated pressure was recorded at the gastro-esophageal junctional area in thedogs while at rest. The mean maximal pressure in this area was 9.5 cm H₂O and themean width was 2.6 cm H₂O.
As for the changes in pressure during swallowing, the peristaltic waves were seen to sweep downward in the esophagus. In the gastro-esophageal junctional area, the negative wave (relaxation) occurred 4 seconds after the onset of water injection inducing swallowing, lasting about 3 seconds, and was followed by the positive wave (contraction) lasting 3.3 seconds.

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Manometric studies were performed in 1.2 unanesthetized dogs with the left sided esophagostomy and additional operative procedures of 3 different types; (A) division of the phrenico-esophageal ligament, (B) division of the phrenico-esophageal ligament and the modified Heller's esophago-cardiomyotomy (4 cm), and (C) intrathoracic lower esophagomyotomy (6 cm) just above the diaphragm. The resting pressure in the esophago-gastric junction were then measured.
After division of the phrenico-esophageal ligament, the resting pressure in the esophago-cardiac sphincter fell from 13.2 to 4.8 cm H₂O. After lower esophagomyotomy no obvious changes were noted in the resting pressure.
The phrenico-esophageal ligament plays an important role in producing the high pressure zone in the esophago-gastric junctional area.

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Electrical activity of the digestive tract of human has been studied using small bipolar Ag-AgCl needle electrode. The subjects studied were 111 patients operated upon in our department. The electrodes were sewn into the gastrointestinal wall muscle under the serosa at the time of various abdominal operations . The lead wires of electrodes were brought out through an incision in the abdominal wall.
Action potentials from the stomach, duodenum, choledochoduodenal junction, jejunum, ileum, gall bladder and colon of these patients were recorded for 1 to 22 days after operation. All recordings were made in the ward with a 2-channel DC amplifier with ink writers. The electrodes were removed by pulling them out after recording. All experiments mentioned above could be performed without any complications.
Peculiar discharge pattern of action potential was observed on different site of the gastrointestinal tract. Electrical activity of the residual stomach after various gastrectomies, electrical response of the digestive tracts to the electrical stimulation through the electrodes and influence of food loading were observed and discussed.
It is considered that the research method mentioned above is a useful technique for studying pathophysiology of the human gastrointestinal motility.

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The present study was made to investigate the details of bile flow mechanism into the duodenum in man.
For this purpose nineteen patients with gallstone disease operated upon in our department were studied. After cholecystectomy and/or choledocholithotomy, a metalic catheter was inserted into the common bile duct toward the duodenum to identify the choledochoduodenal junction, the muscle of Oddi. A bipolar Ag-AgCl needle electrode was sewn in the muscle of Oddi. Another electrode was implanted into the anterior wall of the duodenum. T-tube was set in the common bile duct. The action potentials of these muscles were recorded with a 2-channel DC amplifier with ink writers for 5 to 17 days after operation. At the same time, the action potentials displayed on a cathode-ray oscilloscope and biliary radiogram on an image intensifier were simultaneously recorded on the cine film.
The results obtained are as follows:
1) Electrical activities of the Oddi's muscle and the duodenum were recorded almost simultaneously, but they were different in the detailed discharge pattern. 2) When an electrical stimulation was given to the muscle of Oddi, the action potential was markedly accelerated and the intraductal pressure was elevated, but no change of the discharge pattern was seen in the duodenum. Reversely, when the same stimulation was given to the duodenum, the electrical activity was markedly accelerated in the duodenum, but the muscle of Oddi was not influenced and also the intraductal pressure was not elevated. 3) Bile flow was interrupted at the terminal portion of the common bile duct when electrical activity of the muscle of Oddi was observed. 4) When bile was poured into the duodenum, electrical activity of the muscle of Oddi was not observed. 5) Bile flow was not interrupted by the electrical activity of the duodenal wall muscle.
From the above observations the author concluded that the muscle of Oddi had a sphincteric mechanism and acted independently of the activity of the duodenal wall muscle.

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These studies were performed in the duodenum of dogs to elucidate the following problems, 1) the role of the extrinsic nerves on the electrical activities, 2) the effects of pancreozymin, gastrin and secretin, 3) the existence of pacemaker, 4) the manner of slow wave conduction, and 5) the effect of hypoxia.
The electrical activities of the duodenum are scarcely influenced by vagal nerve and mesenteric plexus but controled by a certain pacemaker locating at the upper duodenum cranial to the papilla of Vater.
Intravenous administration of pancreozymin provokes the vigorous contraction of the intestine, which is recognized at the same time as spike potentials electromyographically. Gastrin lowers the slow wave potential or abolishes it. No change is observed in case of secretin.
It may be suggested that in the duodenum there is a mechanism similar to the impulse conducting system in the heart, which was postulated by Keith in 1915. When the slow wave potential is low or near zero level, the contraction of the intestine does not occur. Therefore the fact shows that the slow wave potential for the contraction of the intestine must be higher than a certain level. The low potential of slow waves induced by rapid withdrawal of blood or by clamping the vessels nourishing a segment of the intestine indicates the invalidity of the longitudinal smooth muscle cells of the intestine caused by hypoxia.

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