Abstract

EN MASSE DESCENT OF THE VISCERA In ptosis en masse, the abdominal visceral mass moves downward and forward, pushing the incompetent walls before it, without at first causing much change in the interrelations of the viscera, except that the more movable organs tend to descend farther and more rapidly than the less movable ones. This process is seen in its simplest form with the subject lying in the recumbent position when the descent of the diaphragm is insufficiently antagonized (fig. 4, c , in a preceding paper 1 ). In the supine position gravity acts in a ventrodorsal direction, and, for a time, offers an obstacle to mass descent, since it tends to hold the viscera toward their attachments to the posterior wall of the abdomen, while at the same time it reenforces the retaining powers of the anterior abdominal walls (fig. 1 A ). In the lateral recumbent position the direction of

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