“…From an original paper by Alvarez in 1915, it is also clear that he considered both ‘irritating lesions also raise the local tone’ and a change in patterns of contractions that impact transit, ‘factors such as differences in rhythm and irritability — play in altering the gradient of forces through the tract’ [Alvarez, 1915: 389]. After joining the staff of the Mayo Clinic in Rochester, MN in 1926, Alvarez continued to study the gradient of ‘irritability’ of small intestinal muscle, reflecting the frequency and amplitude of contractions [Alvarez and Hosoi, 1929]. Alvarez attributed the concept of irritability to altered contractions or motor activity.…”