THE 
AMERICAN JOURNAL 
OF THE MEDICAL SCIENCES 
FOB JANUAKY 1851. 
' ■/. ~7~ 
Art. I.— On..the Structure of the Mucous Membrane of the Human Stomach. 
By John Neill, M. D., Demonstrator of Anatomy in the University of 
Pennsylvania. (Read before the College of Physicians of Philadelphia.) 
[With a coloured plate.] 
It is with some hesitation that we present before this College a paper con- 
taining even an intimation that anything new connected with so well studied a 
structure as that of the human stomach is yet to be observed or described. 
Neither are we yet prepared to make the assertion that more recent and 
protracted examinations have brought to light any specific elementary forma- 
tion not noticed before, in some disconnected way, and allied with much that 
is irrelevant and imaginary. 
By the aid of microscopic and minute injections, we have been led to the 
conviction that, as a whole, the internal surface of the stomach has not been 
fully represented in any description or diagram. Notwithstanding all that 
older anatomists have written, shall we not be sustained in the statement 
that their views concerning this elaborate and complicated structure are con- 
fused and contradictory ? And although modern authorities are more uniform, 
may not their uniformity be the result of the adoption of a common error ? 
We should state that it is not the epithelial, but the true surface of the 
mucous membrane of the stomach to which we wish to call attention, and the 
facts we shall present can be observed by any one in the preparations upon 
the table. 
The surface of the mucous membrane presents different appearances in dif- 
ferent portions of the stomach j this fact not having been sufficiently appreciated 
by observers, we consider as one of the sources of error in the ordinary descrip- 
tions of this organ. By far the larger portion exhibits various modifications 
of the honeycomb structure, the cells are large and polygonal in some parts, 
No. XLL—Jan., 1851. 14 
Neill on Structure of the Mucous Membrane of Stomach. [Jan. 
in others, they are smaller, deeper, and rounder; the ridges between these 
cells are formed of one or more convoluted capillaries, and this arrangement 
of capillaries is particularly evident in the rugae. (See Fig. I.) The walls 
of these cells or pockets are formed of a network of capillaries, which subdi- 
vides each cell into smaller ones; these cells are what are ordinarily called the 
orifices of gastric glands, and the subdivision in the bottom of each cell corres- 
ponds with the described orifices of tubuli. In the antrum pylori, the struc- 
ture is modified, the ridges between the cells become larger, more elevated, 
(See Fig. II.),-and as we approach the pyloric orifice, conical villi make their 
appearance; these villi are more numerous and larger towards the pyloric 
valve, so that fewer of the angular or polygonal cells are visible in their 
interstices; they are not so large as the villi of the small intestine, but in 
other respects their external appearances are precisely similar. (See Fig. III.) 
When well injected, they seem to be composed of capillaries, closely united by 
a basement membrane, and forming a pyramidal projection. 
There may be said to be three different appearances presented by the micro- 
scopic examination of the injected capillaries of the mucous membrane of the 
stomach when deprived of its epithelium. First. The convexity of a large ruga 
will have a comparatively smooth and even appearance formed by convoluted 
and intertwining capillaries. Second. Any other portion excepting the antrum 
will exhibit cells or alveoli of different sizes and shapes, separated by ridges of 
various thicknesses, and these ridges are composed of capillaries arranged in 
the same manner as in the rugae. Third. In the antrum pylori there are 
conical villi, and cells exist in the interstices and at their bases. 
That the main point which we wish to prove may be understood in a few 
words, we would simply state that we consider the capillaries arranged in the 
form of “ ridges, cells, and villi.” The question may now arise whether this 
description in any manner deviates from those ordinarily given in the standard 
works of the day ? We consider that it does, particularly with reference to 
the villi, the existence of which, in the stomach, we wish fully to establish 
by description and demonstration. It might be asked whether the term 
villous has not constantly been used with reference to the mucous membrane 
of the stomach? Unquestionably it has, though in a vague and loose way, 
as indicating a smooth, velvety surface ; but not as implying a vascular, papil- 
lary projection to which the term villus is applied in the intestine. 
To corroborate the statement, that it is generally believed that villi do not 
exist in the stomach, we have o;\ly to refer to recent anatomical and physiological 
writers on the subject. Kirkes and Paget* teach us not only that there are 
• “Presents a peculiar honeycomb appearance produced by shallow polygonal de- 
pressions or cells. They are separated by highly elevated ridges, which sometimes, 
especially in morbid states of the stomach, bear minute narrow vascular processes, that 
look like villi, and have given rise to the erroneous supposition that the stomach has absorb- 
ing villi like those of the intestine. In the bottom of the cells are minute openings, &c., 
which are the orifices of perpendicular glands/’—p. 165. 1851.] Neill on Structure of the Mucous Membrane of Stomach. 
15 
no villi in a healthy stomach, hut that the cellular and houeycomh appear- 
ance characterizes the whole of its mucous membrane, and that the appearance 
is uniform. Neither Wilson nor Todd and Bowman speak of villi in the 
stomach. Carpenter* refers to “ pointed processes that have been mistaken by 
some anatomists for villi.” 
Hassall has neither drawing nor description of gastric villi in his Microscopic 
Anatomy. 
Horner}- says “ that none exist in the stomach or colon.” 
Quain and SharpeyJ state “ that these pointed processes may he compared 
to rudimentary villi, the perfect form of which only exists in the small in- 
testine.” 
Harrison,§ of the Dublin Dissector, denies the existence of true villi. 
Hodgkin}| seems to be ignorant of this structure in the stomach. 
Nov/ these authorities are sufficiently numerous and authoritative to con- 
vince us that although the term villous has been used with reference to the 
stomach, yet the authors just quoted do not believe that villi exist in the 
stomach. 
On the contrary, a number of other writers say that villi do exist in the 
* “ These pits are more or less circular in form, and are separated from one another 
by partition—like elevations of the membrane which vary in depth ; and sometimes 
even by pointed processes that have been mistaken by some anatomists for villi."’—p. 659. 
j- “ The mucous coat of the alimentary canal in a healthy state, and successfully in- 
jected, appears to consist almost entirely of a cribriform intertexture of veins/’ “In the 
whole length of the intestine there is, however, every variety of shape of villi, from 
oblong, curved and serpentine ridges, to the laterally flattened cone standing on its base, 
&c. Conformably to this definition of villi, none exist either in the stomach or colon.”— 
Vol. ii. p. 54. 
J “It is seen to be marked throughout, but more plainly towards the pyloric ex- 
tremity, with little depressions or cells, named alveoli, which have a polygonal form.” 
“The margins of these alveoli are elevated into pointed processes, which may be com- 
pared to rudimentary villi; the perfect form of these appendages only existing in the 
small intestine, and making their appearance in the duodenum.”—Part 111. p. 1025. 
§ “Numerous follicular papillae, but not true villi, project, and leave between them 
small depressions or pits studded with minute holes; these pits are more or less circular, 
and are bounded and separated by the follicular elevations; they are more distinct to- 
wards the pyloric portion of the stomach; four or five foramina are seen in each : these 
are the orifices of the small glands and ducts that elaborate the gastric fluid, the mucous 
being probably furnished by the follicles.”—Vol. i. p. 244. 
|| “ In fact, the surface of the mucous membrane of the stomach is generally described 
as villous; and even Billard appears to agree with this description of it. I have at 
least a doubt respecting the accuracy of this statement. To me the surface of the 
stomach, when viewed under the circumstances which I have mentioned, appears to the 
naked eye by no means perfectly smooth, but of an indeterminate character, very dif- 
ficult to describe.” “Whilst in the serous membranes, the assistance of a powerful micro- 
scope enables us to distinguish delicate fibres intimately interlaced, when the mucous 
membrane of the stomach is thus examined, I can only observe an amorphous semi-trans- 
parent mass in which no structural texture can be distinguished.”—Lect. xix. p. 270. 16 
Neill on Structure of the Mucous Membrane of Stomach. [Jan. 
stomach, and give descriptions of them, though none have made drawings of 
them but Berres,* whose magnificent work has fallen into my hands since 
the artist has given the accompanying representations. With the excep- 
tion of Berres, we believe no one has had the knowledge of this structure, 
although B&clardf says “ the villosities are nowhere more numerous than in 
the pyloric half of the stomach and small intestine;” and again, in a suc- 
ceeding paragraph, says, “ they are shorter and less numerous in the stomach 
and large intestine,” and in another denies the vascularity of them. If 
Bedard’s injections could not exhibit the vascularity of these villi, it is hardly 
probable that he could have any accurate idea of the structure, for it is only 
by successfully executed injections that the true form of the villi can he deter- 
mined. An opinion founded on no better data can hardly be more than an 
hypothesis, or an inference from the nature of the surface in other portions 
of the alimentary canal. 
Such also may be considered the value of Bichat’si statement upon this 
point. He reasons that they exist there, because they do in other parts; his 
Anat. Microsc. Corp. Human!. Auct. Dr. Josepho Berres, Prof., &c. Vienna, 1837. 
t “ The villosities whose existence is very general, but which are nowhere more 
numerous, larger, or more apparent than in the pyloric half of the stomach, and in the 
small intestines, and especially in the commencement of that intestine, are eminences 
still finer than the papillae.” 
“These villosities may with propriety be called the radicals of animals, are small folia- 
ceous prolongations of the internal membrane,” &c. “ Were first described by Fallopius 
and Azelli, and have been figured by Heivetius, Lieberkuhn, Pled wig, Rudolphi, 
Meckel, Buerger, and others, especially in the small intestine, being shorter and less 
numerous in the stomach and large intestines.” 
“Those of the pyloric half of the stomach and duodenum are broader than long, and 
constitute a small lamina.” “ There is not perceived the vascular texture which has 
been described as belonging to them.”—Elem. Gen. Anat., Bedard, translated by Knox, 
1830. 
£ The papilla of this system cannot be called in question at its origin, where it dips 
into the cavities, in the commencement even of these cavities, as upon the tongue, the 
palate, the internal part of the alge of the nose, upon the glans penis, in the fossa navi- 
cularis, within the lips, &c. Inspection is sufficient to demonstrate them there. But it 
is asked if the papilla exist also in the deep-seated parts of this system. Analogy indi- 
cates it, since the sensibility is as great there as at their origin, though with varieties that 
we shall point out; but inspection proves it in a manner not less certain. I think the 
villi with which we everywhere see them covered are nothing but these papilhe. This 
manner of regarding them by explaining their existence generally observed upon all the 
mucous surfaces, appears to me to be much more conformable to the plan of nature, 
than to suppose them in each place with different and often opposite functions. Besides, 
it is difficult to decide the question by ocular observation. The delicacy of these elonga- 
tions conceals their structure, even from our microscopical instruments—agents from 
which anatomy and physiology do not appear to me to have derived much assistance, 
because when we see obscurely, each sees in his own way and according to his own 
wishes. It is then the observation of vital properties that should especially guide us; 
now it is evident to judge by them, that the villi have the nature I have attributed to 
them.”—Bichat, Hayward's Translation, 1822. 1851.] Neill on Structure of the Mucous Membrane of Stomach. 
17 
generalizations lead him to assert the existence of structures we fear he had 
never seen. He says “ analogy indicates it,” hut “it is difficult to decide the 
question by ocular demonstration.” 
Billard, in his work on u Mucous Membranes,” speaks of the stomach as 
possessing villi, and says, “ they exist generally over its surface” (with which 
we cannot agree), although he describes them as “ more numerous towards the 
pylorus,” and that “ in the healthy stomach the naked eye perceives them but 
indistinctly.” 
Buschke* seems to have appreciated the labors of Berres on this point, and 
admits that the pyloric portion contains villi: and Krause also speaks of 
(l villous folds.” 
We thus see that even modern writers do not agree; and if this diversity 
of opinion exists at the present time amid the advantages which we possess, 
we should not be surprised at the conflicting testimony of those of older times. 
Some expressions in Hallerf might lead us to suppose that he had very 
clear evidence of the existence of villi, which he describes as “ projecting 
into the cavity of the stomach;” he speaks also of “ the inhaling veins open- 
ing in the pendulous villi.” 
Buysch| gives a drawing from one of his minute injections, which exhibits 
* Mais les cloisons interposees entre les glandes tubuleuses meritent de fixer Patten- 
tion. Sur les dentelures qui servent de lirnite si tranchee entre [’epithelium de I’oeso- 
phage et le commencement de I’estomac, il-y a, suivant Berres, des papilles longues de 
1-17 a 1-18 de ligne, sur 1-64 d’epaisseur, dans chacune desquelles penetre une anse 
vasculaire de 1-139 de ligne. Ces papilles servent peut etre a procurer une plus grande 
sensibilite aux points ou elles existent. Dans le reste de I’estomac, les parois interme- 
diaires entre les orifices des glandes ne s’elevent pas d’une maniere notable, et I’estomac 
n’a point, par consequent, des villosites proprernent dites, quoique sa membrane mu- 
queuse fasse le passage, par son aspect tomenteux, a cedes qu’on nomme villeuses. 
Mais les choses changent lorsqu’on approche du pylore. Ici, non settlement le mem- 
brane muqueuse devient plus epaisse, mais encore sa surface acquiert rapidement une 
tout autre apparence, qui mene ala formation des villosites de duodenum. Void com- 
ment j’ai trouve la metamorphose. Les orifices des glandes tubuleuses s’elargissent 
rapidement, et leurs intervalles commencent a se soulerer, deviennent par la mobiles 
et flottants, et acquierent das bords en Crete de coq, e’est-a-dire pourvus de pdites points 
a trois dents. Pendant que ces bords s’elevent ainsi en maniere de plis ou de lames que 
Krause nomme plica villasa, et auxquels il assigne 1-28 a 1-19 de ligne de hauteur, 
sur 1-56 a 1-28 de large, le fond des glandules tubuleuses se rapproche aussi davantage 
de la surface, et leur cavite tout entiere est alors de venue I’intervalle entre les villosites 
larnelleuses. D'abord leurs parois intermediates sont encore tubuleuses ; mais quand 
I’ouverture des glandes s’agrandit, elles ne tardent pas ase recourber irregulierement sous 
des formes diverses, en zig-zag, en rond, en spirale, continuant d’abord de tenir les unes 
aux autres par des saillies plus ou moins prononcees, et finissent par perdre entierement 
ces moyens d’union; de sorte qu’alors les glandules tubuleuses se continuent les unes 
avec les autres a la surface, et ressemblent plus a un labyrinthe qu’a un rayon de miel ou 
h un reseau.—Encyclop. Anat. Traile de Splanchnologie, par E. Huschke. Paris, 1845. 
f Haller’s Physiology, vol. ii. p. 161. Lond. 1754. 
J “Quando enim ventriculi arterias cera replevi rubra: posteaque inliquore idoneo ita 18 
Neill on Structure of the Mucous Membrane of Stomach. [Jan. 
the surface of the stomach as consisting of regularly-formed pockets or cells. 
He speaks also of villi, hut nevertheless confesses that his view of this ar- 
rangement was only particularly satisfactory in sheep. If he had satisfactorily 
injected the villi of the stomach, is it not probable that he would have given 
us a drawing of this structure in his work ? 
Fordyce says “ that as far as I can judge, it seems to be nothing but cel- 
lular membrane. When the surface was moderately moist, there seemed to 
be a number of thin fine membranes crossing each other, so as to form a 
number of angular cells.” 
Hewson states that the whole surface of the intestinal tube is covered 
with villosities, but admits that in the large intestine these bodies are so 
short, that the surface appears smooth to the naked eye, while no true villi 
are detected by the microscope; only the partitions between the cells resemble 
villi in their structure. In the stomach a nearly identical appearance is 
found. “At the upper part of this organ, the villous coat appears in a 
microscope like a honeycomb, or like the second stomach of ruminating ani- 
mals in miniature; that is, full of small cells, which have thin membranous 
partitions. Towards the pylorus these partitions are lengthened, so as to ap- 
proach to the shape of the villi in the jejunum.”* 
That these opinions should have but little weight with writers and teachers 
at the present day, and that they should be quoted merely as elucidating the 
history or the literature of the subject, ought not to surprise us, when we 
learn that their descriptions were generally based upon observations made 
with the naked eye, or with instruments in which the observers had but little 
confidence; for both Fordyce and Bichat, although they used microscopes, 
expressed themselves as deriving no advantage from them. Neither are we 
disappointed at the want of accuracy in their descriptions, when we reflect 
that their comparisons were derived in a great measure from the inspection of 
inferior animals, and that the meaning attached to such terms as cells, alveoli, 
crypts, pockets, lacuna, glands, villi, papilhe, &c., is conventional, and varies 
prius praeparatas partes hasoe macero, experior turn snperficiem interiorem ventriculi 
et intestini jejuni tunica quasa quadam papillosa vestitam esse. Fateri tarnen debeo, 
baud ita evidenter quidem in stomacho hurnano has papillas apparere, ut quidera in 
ovillo: quemadmodum hac in figura express!. Inde itaque et tanto facilius inducimur 
credere, et in homine ita obtinere, quum obscurius quidem similitude accedens in 
liomine observetur.”—Ruysch. Dec. Tert., p. 34 and 35, 1737. 
“ Voco autem banc intestinorum tunicam villo-papillosam, quia animadverti villosam 
istam snperficiem penitus simul esse papillosam, quemadmodum se habent interiora nos- 
trarum Genarum in suo imegumento, ut et labia oris, oesophagus, ventriculus, omniaque 
intestina, quum sit in bis omnibus ejusdetn apparatus continuata productio. Verum 
quidem est, in unoquoque non seque clarum id apparere; quum in Labiisgenis internis, 
et in intestinis maltorum hominum tunica bsec papillas basce nimis manifestas non 
possideat, attamen in aliis satis conspicua datnr.”—Ruysch, Dec. Secunda, p. 25 and 2G. 
* Dr. Sprott Boyd’s article on the Structure of the Mucous Membrane of the Stomach. 
Edin. Med. and Surg. Journal, IS3G. 1851.] Neill on Structure of the Mucous Membrane of Stomach. 
19 
with the different periods at which the authors above referred to have made 
public the results of their observations. 
We ought next to inquire what is taught by the principal physiological 
writers of the day upon this subject, and examine the evidence upon which 
they base their theories, and see how far the structure they demonstrate cor- 
responds with what we may conceive to exist. 
The investigations most frequently referred to are those of Sir E. Home 
and Dr. Sprott Boyd, although the diagrams of Ruysch, Horner, Todd 
and Bowman, and Berres are far more in accordance with nature. We refer 
now merely to the mucous membrane, and not to its epithelial investment, 
which has received so much attention from Wassmau, Henle, Wagner, Plas- 
sall, and others. 
Sir E. Home says: “ The structure upon the upper arch of the stomach 
which when magnified by a common lens had the appearance of glands, is 
shown by Mr. Bauer to be made up of cells in the form of a honeycomb; 
this honeycomb structure consists of cells of the greatest depth in this particu- 
lar situation, but over the whole surface of the cardiac portion of the stomach 
the appearance is so faint as to require a great magnifying power to render it 
visible. In the pyloric portion the cells in general have the same appearance, 
but there are small clusters, the sides of which rise above the surface, giving 
the appearance of foliated membranes.” 
And Dr. Sprott Boyd agrees with him, for he says “ the appearance of 
those cells, throughout the cardiac portion of the stomach, corresponds to the 
representation given of them by Sir E. Home. When the mucous membrane 
is extended, they appear tolerably regular both in form and size, varying from 
the one-two hundredth to one-three hundred and fiftieth of an inch in diameter, 
being smaller in the young man than in the adult subject. Towards the pylo- 
rus, the mucous membrane, which is thin throughout the great cul-de-sac of the 
stomach, becomes considerably thicker, the dimensions of the cells are increased, 
and an appearance somewhat resembling that described by Sir E. Home is per- 
ceptible. He mentions the patches distinguished by the foliated membranes as 
existing particularly towards the pylorus. They may be found, however, in the 
cardiac portion of the stomach likewise ; perhaps not actually at the great ex- 
tremity; but certainly opposite the termination of the oesophagus. In the 
engraving given by Home of these patches, the wall of each cell is represented 
as rising above the general surface of the stomach, and being cleft into a num- 
ber, ten or a dozen, of rounded segments, which form a complete fringe about 
the mouth of the cell. These projections of the mucous are, so far 
as I have been able to observe, much less numerous. There is no regular 
fringe, but here and there a prolongation of membrane, resembling an ordinary 
villus of the intestine, rises from a partition between two cells. These bodies 
from their small size are not easily distinguished; they give to the surface a 
more flocculent and velvety appearance than is presented by other parts of the 
stomach. The cells near the pylorus are in some cases about one one-hun- Neill on Structure of the Mucous Membrane of Stomach. [Jan. 
dredth of an inch in diameter, and on examining them on a dark ground, and 
with the aid of a reflector and a magnifier of a quarter of an inch focus, their 
interior is pretty distinctly seen presenting an appearance similar to what 
I have presently to describe as existing in the stomach of the pig, where it is 
more clearly visible and more easily examined. The floor of each cell appears 
perforated by numerous circular openings, as if a number of tubes opened on 
it; and on making a vertical section of the mucous membrane, it is seen to 
be composed of striae or fibres running perpendicularly from the free surface 
of the membrane to the cellular coat beneath.” 
The diagram of Dr. Boyd is the one which is usually copied into the text 
books of the day. Had it been made from an injected preparation, we think 
the nature of “ cells and the circular openings perforating their floor” would 
have been more distinctly demonstrated. The circular openings which he con- 
siders to be the orifices of tubule, which he describes partly from observation, 
and partly from analogy in the pig’s stomach, we consider to be simply the 
subdivisions of the cells into smaller and deeper ones by the arrangement of 
the blood-vessels. We have no disposition to make any innovations upon the 
terms “tubuli,” “gastric tubes,” “pyloric tubes,” &c., but merely wish to 
show that their parietes are formed of vessels, and that they are elongated 
cells or alveoli. 
It will be a question of great interest to determine the uses of the Gastric 
Villi. Their form and structure, and their resemblance to the intestinal 
villi would naturally lead us to associate them with the function of absorp- 
tion, although some, perhaps, who still consider the intestinal villi to be 
tactile, would wish to ascribe the same character to those of the stomach. We 
would not imply by the application of this term villi that their uses are pre- 
cisely similar to the villi of the intestine, that is, that they participate in the 
chyliferous absorption, or that their lymphatics should be called lacteals; on 
the contrary, we would believe that the fluid which they absorb is very 
different from that which has to be subjected to the influence of the bile and 
pancreatic juice previously to its removal from the intestine; for we have neither 
mesentery attached to the stomach, nor mesenteric glands for lacteals to pass 
through, did we suppose them originating in the villi of the pylorus. But is 
there no other absorption from the stomach than that of watery fluids by en- 
dosmotic action directly through the parietes of the blood-vessels ? May not 
these villi be the special apparatus for the absorption of the solution of the 
albuminose compounds ? Is there no nutrition except through the villi of the 
intestine ? 
EXPLANATION OF THE PLATE 
Fig. 1 exhibits the gastric cells and capillary ridges. 
Fig. 2 exhibits the cells becoming deeper and the ridges becoming more elevated 
and pointed. 
Fig. 3 exhibits the Gastric villi, together with gastric cells. -Ain.Jour.Med. Sciences, X.S.VoI.XX. Platt I. 
Lifli. of P S .Duval. Philai