CHAPTER II.

The Abdominal Organs

THE ABDOMEN

The abdomen is the largest of the great cavities of the body. Above is the thoracic cavity, containing the heart and lungs. Below is the pelvic cavity containing part of the viscera.

ABDOMINAL MUSCLES

The abdomen is closed in above and separated from the lungs by a dome shaped thin sheath of muscle known as the diaphragm.

As there is no bony structure to reinforce the front wall of the abdomen, there is a very strong muscular wall formed of several layers of muscles. These muscles run in various directions, cross one another and are fused together, thus forming a protection and support to the soft internal organs.

These muscles are known as the rectus abdominus, transversalis, internal oblique, external oblique, and pyramidalis.

The rectus abdominus is the innermost muscle and extends the entire length of the front of the abdomen. This muscle is inserted into the cartilages of the fifth, sixth and seventh ribs, and extends downward in a straight, vertical line to the junction of the pubic bones.

The transversalis, so called because its fibres run crosswise, is the innermost of the flat muscles of the abdomen and runs immediately beneath the internal oblique, extending from each side of the body and the six lower ribs, and is attached to other muscles in the front of the body.

The internal oblique extends, for the most part, in an oblique line upward, from the crest of the ilium or haunch. The general tendency of this muscle is upward and forward toward the front of the body, where its fibres are attached to other muscles in the front of the abdomen.   Some of its fibres, however, situated at the side, pass almost vertically upward and are joined to the cartilages of the lower ribs ; whereas other fibres, originating low down in the side of the abdomen, are attached to the pubis.

The external oblique is situated nearest to the surface. It is the largest of the flat muscles of the abdomen, is broad and thin, and extends for-the most part, in an oblique line forward and downward from the sides of the body toward a centre line in the abdomen, where it interlaces with the muscles from the opposite side of the body.   The external oblique commences at the sides of the body from the eight lower ribs.   The fibres from the lower ribs proceed obliquely downward and, instead of meeting in the centre of the abdomen, are attached to the top of the ilium (innominate bone).

The pyramidalis is a small, triangular-shaped muscle situated at the lower part of the abdomen in front of the rectus muscle, previously described.

Over these muscles is a layer of fat, and then the skin.

Briefly described, the rectus runs up and down in the centre of the abdomen, the transversalis runs crosswise, and the internal and external oblique muscles run diagonally on top of each other, in opposite directions.   These muscles play an important part as a relative factor in abdominal hernia.

The purpose of these muscles is to permit bending movements, and at the same time, form a strong, firm wall to protect and hold in position the abdominal viscera (organs).

Muscles are powerless to act without impulse from the nerves.

CONTENTS OF THE THORACIC, ABDOMINAL AND PELVIC CAVITIES

The alimentary canal, with the exception of the mouth and gullet (oesophagus), is situated in the abdomen and pelvis.   The digestive organs and certain glands comprise the alimentary canal.   The stomach (Fig. 3, No. 4) lies immediately below the diaphragm and is a portion of the alimentary canal, dilated so as to form a bag, with an opening on the left through which the food enters and on the right through which the food passes on to the bowels.

Connecting with the stomach is the duodenum (Fig. 3, No. 5) which is the first part of the bowels. The duodenum terminates in the small intestine.   The small intestine (Fig. 3, No. 9) measures about 20 feet in length and lies in coils occupying the middle and lower part of the abdomen.   It ends in the large intestine.

The large intestine is larger in circumference than the small intestine, but is only approximately five feet in length. The first section of the large intestine, where it joins the small intestine, is known as the cæcum, which is a large blind ; pouch, having its blind end directed downward and its open end upward, where it enters into the next section of the large intestine, known as the colon. The vermiform appendix is joined to the blind end of the cæcum.

Contents of abdominal cavity.

The colon ascends upwards, on the right side of the abdominal cavity, as far as the liver.   This part of the colon is known as the ascending colon.   It then turns to the left, this bend being known as the hepatic (liver) flexure (bend).   After turning to the left, it crosses the body, running just below the stomach and the liver, this section being known as the transverse colon.   When it reaches the spleen, on the left side of the abdominal cavity, it bends again (this bend being known as the splenic flexure) and proceeds downward, this section being known as the descending colon.   The colon then takes a double curve, resembling the letter S, this curve being known as the sigmoid flexure ending in a straight, downward section of the large intestine, from six to eight inches long, known as the rectum.

Matter is passed through the intestines by means of waves of muscular contractions or worm-like movements, known as peristalsis.

The bladder is a membranous sac, situated in the lower front of the pelvis, in front of the uterus. The urine from the kidneys passes into the bladder, where it is allowed to accumulate until discharged.

The liver, Fig. 3, No. 3, is the largest gland in the body and is situated in the upper part of the abdominal cavity, immediately under the diaphragm, being principally on the right side, the lower part of it touching the intestines.

This gland furnishes a secretion known as bile, which aids digestion, the fluid passing from the liver to the duodenum, if digestion is in process. Otherwise the fluid is stored away in the gall bladder, on the under side of the right lobe, until needed. It is in this sac or gall bladder that gall stones sometimes form.

The pancreas is a gland about six inches in length situated in the back of the stomach. It furnishes another digestive fluid, which is conveyed to the duodenum through what is known as the pancreatic duct.

The spleen lies to the left of the stomach.   This is not shewn in the drawing.

The kidneys are two large, bean-shaped glands, situated in the back of the abdominal cavity, one on either side of the spinal column.   They are placed behind the peritoneum (the membrane which lines the abdominal walls).   Each kidney is about four inches long, from two to two-andone-half inches wide, and one inch thick; and weighs from four to six ounces.   Their upper ends are on a level with the top of the twelfth thoracic vertebra and extend down to the third lumbar vertebra.   The right kidney is usually about ½ inch lower than the left.

A cord placed horizontally round the body, at the level of the navel, would pass just below the lower end of the right kidney.   The lower end of the left kidney would be half an inch higher.

The kidneys, in a healthy subject, are surrounded by a mass of fat and loose tissue.   The main function of the kidneys is to separate the urine from the blood, and this waste matter is passed out of the kidneys through tubes called ureters, to the bladder.   The function of these organs is a very important one, because, if the waste matter were not removed, the blood would soon become poisoned, resulting in serious trouble.

Movable kidney is a condition found most often in thin subjects. The kidney becomes misplaced and moves forward and downward. As a general thing the extent to which it moves is but a fraction of an inch, although the movement may become greater.

In the female, the uterus is situated in the pelvic cavity, between the bladder and the rectum.   The uterus is held in place by ligaments, which under certain conditions become relaxed, allowing the uterus to become misplaced.

The various organs in the abdominal cavity are dependent upon each other and various muscles for their proper position ; in other words, if one organ becomes misplaced, the others are likely to be affected.

PTOSIS

Ptosis means a dropping down or sagging of some of the abdominal organs notably the stomach, large intestine, and small intestine.   Ptosis is often caused by relaxation, stretching, or loss of tone of the abdominal muscles.

It may be that only one organ, possibly the stomach or liver, or colon, will be affected, but usually if one organ sags, the entire contents of the abdomen will be affected.   Enter-optosis means a general ptosis or sagging of the abdominal organs.

Many ailments, the causes of which appear to be obscure, originate in ptosis of one or more of the abdominal organs.   It is easy to be seen that if these organs are sub jected to undue strain or placed in an unnatural position they cannot function properly, and the machine, provided by nature for converting the food into energy, is handicapped in its work. Methods of supporting and controlling are dealt with in subsequent chapters.

VISCEROPTOSIS

Visceroptosis means visceral ptosis--it is practically the same as enteroptosis.

GASTROPTOSIS

Gastroptosis means sagging of the stomach.   Methods of supporting and controlling are dealt with in subsequent chapters.

CHRONIC INTESTINAL STASIS

This is the scientific name for chronic indigestion or for sluggishness and clogging of the intestines (constipation) often caused by ptosis of the viscera.   In other words, the weakened abdominal muscles permit a sagging of the intestines, which are thus prevented from doing their normal work.   See later chapters for methods of supporting and controlling.

FOR TUBERCULAR CASES

The physical strain of hard coughing frequently is a very heavy drain on the patient's vitality.   By supporting the abdomen, much of the strain is relieved.

HERNIA OR RUPTURE

There are five places in the muscular abdominal wall as described which offer natural outlets for hernia.   The umbilicus or navel situated in the centre ;   the inguinal canals, one on each side (see arrow A, Fig. 2) ; and the femoral canals situated just below and to the side of the inguinal canals.   (See arrow B, Fig. 2).

These "canals" extend from the inside of the abdominal cavity to the outside ; their inward and outward ends are known as the "inner ring" and "outer ring"

Hernia is a protrusion of some part of the intestines or some other internal organ, and is most commonly found in one of the five natural openings described in preceding paragraph although as a result of a wound or other abnormal conditions which weaken the abdominal wall, a hernia will force its way through what would otherwise be the solid muscle.   This is called a ventral hernia.

Thus we have four general types of hernia to understand. The umbilical, inguinal, femoral and ventral.   There are other types of hernia, but these are the types usually met.   The umbilical is most common in large people.   A later chapter deals with methods of controlling.

THE SPLANCHNIC CIRCULATORY SYSTEM

There is a great vein (the portal vein) connected with a network of smaller blood vessels which carries blood from the stomach, intestines and spleen to the liver.   This is known as the splanchnic circulatory system.   The blood undergoes some change in the liver, the exact nature of which is not known, but which prepares it for transmission to the lungs. As we breathe into our lungs, the oxygen from the air again modifies the composition of the blood, and it is then ready to be sent throughout the body to build and sustain life.

This network of blood vessels which carries the blood between the stomach, intestines and spleen to the liver is so large that it is capable of holding practically all the blood in the body.

When the intra-abdominal pressure of the flat abdominal muscles is normal there is a steady pressure on these blood vessels which prevents them from filling up too much with blood.   Thus, we have a reservoir automatically controlled by the flat abdominal muscles.

Unfortunately few people, over the age of 30, are able to boast of a flat abdomen.

Faulty posture causes such a constant strain on the abdominal muscles that in time they do not properly control the splanchnic system.

The result is that persons whose abdominal muscles are not strong enough to maintain the flat pressure against the splanchnic circulatory system experience a tremendous settling of blood in this whole region.   Eminent medical authorities state that this condition is a direct forerunner of indigestion, tuberculosis and many other ills.

It is obvious also that if a great deal of the blood in the body settles in this region, other portions of the body are robbed of what they need.   For example, the brain is dulled.   Persons suffering from this congestion of blood in the abdominal region are handicapped in the race of life.   The mental powers of such persons are impaired.

A clearer idea of this condition will be obtained by referring to Fig. 3 in this booklet.   The liver is shewn in Fig. 3 and is above and to the right of the stomach and intestines.

This splanchnic congestion leads to intestinal stasis, which is nothing more nor less than clogging of the intestines--constipation.   Intestinal stasis means steady intestinal poisoning from the waste that has not been thrown off.

The importance of this matter to you as a Spencer corsetière lies in the fact that the person who has an erect, normal posture (see Chapter III.) is at once freed from the danger of congestion of the splanchnic system.

Some of the symptoms of splanchnoptosis are headache, nervousness, dullness, indigestion, constipation, "dragged-out" tired feeling, and other run-down conditions.

VARICOSE VEINS

The usual treatment for varicose veins is an elastic stocking, and perhaps it may surprise you to know that in cases of obesity, or heavy pendulous abdomen, the Spencer Supporting Corset, or the Spencer Belt, will afford great relief to varicose veins.

The reason for this relief is that there are certain important veins which pass downward through the abdomen, and in a pendulous abdomen these are sometimes so constricted as to greatly impair the circulation of the blood. This impaired circulation seems to manifest itself sometimes in the form of varicose veins.

As soon as the abdomen has been lifted, correct circulation is restored and this appears to result in a rapid improvement of the varicose veins.

Of course, a difficulty which is of years' standing cannot be cured in an hour, but we have had a large number of reports of cases where women who have been obliged to wear heavy, hot and expensive elastic stockings for years, have discarded them after putting on the Spencer.