QVEST. IX. Of the scituation and consent of the vppermost mouth of the stomacke.
THE difference or controuersie concerning the scite of this Orifice is neither light nor vnprofitable, because the resolution thereof stinteth the strife among the Physiti∣ans concerning the application of Topicall or locall medicines.
All men doe agree that it inclineth rather to the left hand then to the right, but the que∣stion is, whether it bee nearer the spine of the backe, or the gristle and blade of the breast. Some thinke that Nature framed this gristle to be a defence for it and for no other cause, * 1.1 and therefore hath placed it there-under: for say they, those that vomit or reach for it, doe finde a paine at this gristle and none at the spine or racke of the backe. And Hippocrates conceiueth that the extuberation or distention of the stomacke at the orifice is not backe∣ward but forward; whereas he sayth, That the repletion of the stomacke is a direction for bro∣ken ribbes. Wee with Galen doe assigne the place of this orifice to bee in the left part to∣ward * 1.2 the spine, not that it lyeth or resteth vpon it as the gullet doeth, but because it com∣meth nearer to the spine then to the breast-blade. And therefore it is that when the gullet or the vpper orifice are affected; we thinke it fit to apply locall medicines both to the back∣part * 1.3 and to the fore-part. That that was propounded concerning the paine of them that reach to vomit, and the direction for the ribbes, is to be referred to the bottome, and not to the vpper mouth of the stomacke; for as we haue obserued, the meate which wee eate is not conteyned in his mouthes or orificies but in his cauitie, which wee doe not deny doeth rather leane to the breast-blade then to the spine.
But the reason why the breast bone is payned when the vpper orifice is affected is * 1.4 meerly Anatomicall; the midriffe being tyed to the bone, and the mouth of the stomacke adhaering to the large passage made in the midriffe for his conueyance thereout; and ther∣fore the breast-blade is payned by this continuity, because paines are rather felt in the ex∣treamities or ends then in the middest, as is to bee seene in streatched membranes. Con∣cerning the sympathy or consent of this orifice with the heart and membranes of the brain Hippocrates and Galen are very plentifull; for this mouth being affected, the syncope or * 1.5 sounding, the exolution or fainting of the spirits, and such like symptomes doe ouertake vs as when the heart it selfe suffereth violence, whence this part amongst the ancients as wee sayd before, is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. In wounds of the head, the skull being either broken or s••i∣uered, and the Dura meninx or thicker membrane of the braine exposed or layde open to the ayre, which is vncouth or strange vnto it, the Patient presently vomiteth yellow and * 1.6 Aeruginous or greene choler, because the stomack by reason of societie, is drawne into con∣sent and sympathizeth with the membrane, as well because of the similitude and likenesse of the substance, as also of the community of vessels, which are the chiefe causes of consent or sympathy; as Galen obserueth in his Commentaries vpon the first section of the 3. Booke of Hippocrates Epidemia.