これまで消化管の自律神経支配については, 自律神経脱落現象腸外反射, 神経刺激効果および腸内反射効果をもとにして論じられてきたが, 各研究者の間には十分の意見の一致がみられなかった.著者は, 自身および協力者の研究結果からつぎに要約するような見解に到達した.
1) 腸内反射の研究結果によると, 腸壁にはAuerbach神経叢中に亢進と抑制の両種神経細胞が存在し, 前者はコリン性であるが, 後者は非アドレナリン性であり, その伝達物質は未知である.
2) 副交感神経線維には, 腸壁内に入って亢進細胞に連結するものと, 抑制細胞に連結するものとある.交感神経線維は, まず前脊稚神経節中でニューロンを交代した後, 亢進性のものは亢進細胞と連結し, 抑制性のものはアドレナリン性であって, そのまま筋に終る.
3) 正常時においては, 腸-腸外反射の場合のように, 一般に副交感神経では亢進線維, 交感神経では抑制線維の興奮が優越するけれども, 腸のおかれる条件如何によっては, 壁内神経要素の興奮性に異変が起り, その結果として効果が逆転することもあり得る.
4) 結局, これまでの研究成績の不一致は壁内神経要素の組織学的また生理学的複雑さと, これら要素の興奮性の不安定に帰因するものと考えられる.
5) 上述の消化管の自律神経支配の特徴を考慮しながら, 消化管運動に関する薬物の作用機序究明のすすめ方に論及した.

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The present study was made to investigate the details of gastric emptying mechanism in man.
For this purpose thrity-four patients with surgical diseases of the stomach who underwent proximal gastrectomy, resection of the gastric body, and antrectomy in our department were studied.
Bipolar needle electrode was sewn into the pyloric wall muscle under the serosa after the gastrectomies. Electrical activity of the pylorus and cinefluorographic image of the residual stomach using barium food were simultaneously recorded by means of cine-oscillo-synchronizing unit on the 7th through 22nd day after operation.
The results obtained are as follows:
1. In the groups of proximal gastrectomy and resection of the gastric body electrical activity of the pylorus was accelerated and gastric emptying was also promoted when the patient exchanges his posture from lying his back to standing upright.
2. In the group of antrectomy, however, both the electrical activity of the pylorus and the gastric emptying were not influenced by the same postural exchange as above.
From these results it is conceivable that mechanical stretch cued of food on the pyloric antrum is a factor promoting the gastric emptying mechanism.

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To clarify the gastric emptying mechanism. the present study was made using thirty one mongrel dogs. A rubber balloon was inserted into the stomach through the mouth and a bipolar needle electrode was sewn into the pyloric wall muscle by laparotomy. The electrical activity of the pylorus was investigated when the cardia, body, and antrum of the canine stomach was distended respectively by inflating the balloon with air or water.
The results are summerized as follows:
1. Distension of the cardia and body caused little changes in the pyloric action potentials.
2. In a condition which the antrum. was distended a marked increase in electrical activity of the pylorus was observed.
3. Effect of distension of the antrum. on the electrical activity of the pylorus was not influenced by anesthetizing the gastric mucosa using 4 % Lidocaine.
From these findings it is suggested that each portion of the stomach. wall has a different response from the others to stretch stimulus and the antrum has a factor promoting the gastric emptying by revealing the most effective response to stretch.

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It is generally known that the transection anastomosis of the stomach results in the hypermotility of the pyloric portion. The cause of this hypermotility, whether it could be rendered to the transection of the gastric wall or to the simultaneous vagal. denervation distal to the transection line has been a matter of dispute. The present experiment was designed to study the motility changes of the canine stomach with the use of electromygoraphy after transection-anastomosis of the stomach with or without preservation of the vagus nerves.
1) Transection-anastomosis of the stomach with vagal preservation elicited abnormal hypermotility of the pyloric portion; e.g., prolonged discharge interval of normo-peristalses, faster propagation velocity and frequent occurrence of anti-peristaltic discharges.
2) Transection-anastomosis of the stomach without vagal preservation yielded almost the same results as mentioned above.
3) Bilateral truncal vagotomy alone failed to show any noticeable changes in gastric motility. Consecutive transection-anastomosis on the vagotomized stomach resulted in the same changes of the pyloric; portion as seen after transection- anastomosis with vagal preservation.
These results suggest that abnormal hypermotility of the pyloric; portion seen after transection-anastomosis can be attributed to the effect of transection of the gastric wall per se but not to the one of vagotomy.

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The pathognesis of achalasia has not yet been entirely clarified. The author undertook animal experiments in order to study the role of the central nervous system concerning the pathognesis. In 49 adult eats, destructive lesions were made bilaterally in the hypothalamus either with carbolic acid (Phenol) or with electrocoagulation. In those cats that had survived for more than 7 days, the esophageal movements were studied with X-ray, electromyogram and intraluminal pressure curve, and the extent of the hypothalamic lesions was identified histologically by serial sections. Seven eats were used as controls.
The 10% phenol solution was injected into 8 animals among which 7 survived for more than 7 days. Serial sections performed in 2 cats did not disclose any destructive lesions in which cases any signs of diglutition or any X-ray abnormalities of the esophagus could not be observed.
Electrocoagulation was used to make lesions in 34 cats among which 24 survived for more than 7 days. Serial sections revealed lesions involving the ventromedial nucleus of the hypothalamus bilaterally in 3 cats which showed signs of diglutition and radiographie evidence of passage disturbance of the esophagus. In contrast, in those 17 cats in which the lesion failed to involve the ventromedial nucleus, no signs of diglutition or motion disturbance of the sophagus were observed.
It is thus possible to produce achalasia in cats by bilateral electrocoagulation of the ventromedial nucleus of the hypothalamus. This suggests the possible role of the central nervous system in the pathognesis of achalasia.

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1) Sulpirideは0.05～5mg/kgの静注によって多くの場合イヌの生体内胃腸運動の亢進をときに充進と抑制の混合した効果を, まれではあるが, 抑制効果のみをひきおこした.上述の効果は支配神経切断後にも認められた.
2) Sulpirideは10^-5～5×10^-4g/mlでイヌ, ウサギ, ダイコクネズミの胃および小腸の摘出条片の運動に対しても, 生体内胃腸運動におけると同様な作用を示した.
3) Sulpirideの運動亢進効果はtetrodotoxinあるいはatropine適用後には消失した.しかし抑制効果は依然として残存した.
4) トノサマガエルの腹直筋のacetylcholine痙縮はsulpirideによって著明に増強された.
5) Sulpirideは迷走神経の電気刺激によってひきおこされた胃腸運動亢進効果を著明に増大させた.
6) Sulpirideは胃腸壁内神経叢中の運動亢進ニューロンを刺激することよって胃腸運動亢進を, 胃腸筋に直接作用することによって運動抑制をひきおこすものと考えられる.
7) さらにsulpirideはphysostigmine様作用を有するものと考えられる.

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