Mechanisms protecting against gastro-oesophageal reflux: a review.

Thomas Willis in his Pharmaceutice Rationalis published in 1674-5 clearly recognized that the oesophagus may be closed off from the stomach and described 'a very rare case of a certain man of Oxford [who did] show an almost perpetual vomiting to be stirred up by the shutting up of left orifice [of the stomach]'. His diagrams (Fig. 1) of the anatomy of the normal stomach show a band of muscle fibres encircling the oesophagogastric junc-