When I was first studying the anatomy and physiology of the digestive system, there was no such thing as the lower oesophageal sphincter. Now all of the textbooks seem to mention it. The prevailing view, in my student days, was that food entering the stomach was prevented from returning up the oesophagus (reflux) by the acuteness of the angle at which the oesophagus entered the stomach. Despite there being numerous sphincters associated with the alimentary canal, one place where one was not to be found was at the gastro-oesophageal junction. It was even remarked that this might seem surprising. This, of all places along the alimentary canal, was a place where a sphincter would be decidedly advantageous and might be expected to be found.
Times have changed. Now the lower oesophageal sphincter does exist—if the textbooks are to be believed. Now it is often known simply by its abbreviation, LOS.
There is a related story about an old, rather curmudgeonly professor of mine. A guest speaker would be invited to give a talk to the staff and students of his department on the first Tuesday of each month during term time. A colleague was charged with the task of sending out invitations and making all the arrangements. The speaker was left with the details of their talk—title, topic, etc. Story has it that on one occasion, the speaker’s topic strayed into the area of the lower oesophageal sphincter, which he began to describe. There being no such structure in the anatomical canon at that time, the professor apparently rose to interject. He is reported to have risen and pointed out that “We don’t teach this here” and, turning to the audience, said, “Students, please ignore what this man is saying.”
I was not witness to these events. It was a story that entered department folklore before my arrival. As reported, the story is to characterise the professor’s rather brusque personality. Having experienced it, I can certainly attest to his brusqueness. However, I find the story a little difficult to believe in the form that it is related. In the time I was in his department, Prof. was always courteous to the visiting speakers. If something like this story did happen, I suspect that he may have interjected in a more polite way than department folklore remembers. He may instead have interjected to counsel caution about what at that time was not in the textbooks or in any of the regular teaching. We must remember that we were teaching medical students and that that would have a bearing on their later careers—not to mention the lives of their patients.
Looking at the most up-to-date edition of Grey’s Anatomy available about that time shows that there was only a footnote about sphincters in the lower oesophagus having been found in a few primate species so far studied. There was no such structure accepted at that time.
