LAUSR

In the latter part of the 19th century, the introduction of reliable anaesthesia and of antiseptic surgery enabled inspection of the abdominal viscera to be made by surgeons at laparotomy. To their surprise, the abdominal viscera revealed in the operating theatre were often found to be in positions quite different to those encountered in the cadaver, especially when the organs were exposed in preserved bodies in the dissecting room. For example, the anatomists taught that the pyloric end of the stomach was to be found in the 'transpyloric plane', level with the body of the first lumbar vertebra, a hand's breadth below the xiphisternum. A still further surprise followed the discovery of X-rays by William Roentgen, Professor of Physics at Wurzburg, in 1895 and then the X-ray visualisation of the hollow organs of the abdominal cavity by using radio-opaque contrast material, (in the first instance bismuth sulphate), introduced by Walter Cannon of Harvard University Medical School in 1897. The spleen, the kidneys and, in particular the hollow viscera – stomach, duodenum and intestines – were often found to be situated at a lower plane than that described in the textbooks. Partly, of course, because the X-rays were taken with the subject standing up, in contrast to the lying cadaver, and partly to the sheer weight of the contrast medium. The rest, we now appreciate, is explained by normal biological variations. For example, the long thin 'asthenic' subject tends to have a low-lying stomach compared to the higher positioned organ in the short, plump 'sthenic' individual. However, what can only be described as what we might call a 'non-disease' came into existence; 'visceroptosis'.