The diseases of the stomach : bring the third edition of the "Diagnosis and treatment of the varieties of dyspepsia" revised and enlarged / by Wilson Fox.

  • Fox, Wilson.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of the stomach : bring the third edition of the "Diagnosis and treatment of the varieties of dyspepsia" revised and enlarged / by Wilson Fox. Source: Wellcome Collection.

    245/318 (page 221)
    there is a considerable uniformity in their descriptions of the appear- ances observed, and which they attributed to tlie same cause. Stomachs in this state present, usually at the fundus, a portion where the membrane is evidently thinner than natural, or is entirely absent over an area of variable extent, while for some distance around it is softened and pulpy. The transparency of the tissue is greatly increased, allowing the white submucous coat to appear through the membrane, while the colour varies with the quantity of blood con- tained in the part. If this is small, the coats of the stomach are of a bluish white; if it is more considerable in amount, they are brownish or blackish. The vessels also may be seen of a blackened colour, ramifying through the affected area, and their blackened contents may often be expressed in drops from their eroded ends. Occasionally, but not commonly, very early stages of this process are observed, when the superficial layers of the mucous membrane are separating in flakes and are much softened, bat not wholly dis- solved. The surface of the membrane may have, under such circum- stances, a somewhat whiter and more opaque appearance, corresponding to the form described by Cruveilhier as the Eamollissement pultac^. In some cases the membrane is uniformly affected; in other instances, when the stomach is contracted, the softening affects only the prominent rugse, leaving the intervening sulci unchanged. Occa- sionally, also, the coats of the stomach and of the intestines are found uniformly swollen, transparent, and jelly-like, having lost all trace of structure, and resembling albumen, or presenting appearances seen in tissues after the action of an acid. The extent of surface over which the change in question may occur is variable, as is also its precise seat. The whole of the stomach ]ias been found thus softened, but more usually the condition is limited to the fundus or posterior portions; while in other, but rarer, instances it IS seen only in the pyloric region or on the anterior wall, while the parts above mentioned have escaped. Often the softened portion is found to be abruptly limited by a well-defined border; but in other cases it merges insensibly into the surrounding membrane. ' The softening and erosion often proceeds to perforation of some parts of the stomacli, mtestmes, or oesophagus,^ allowing their contents to escape into the abdominal or pleural cavities, and in such cases analogous effects have been produced on contiguous viscera, especially 0.1 the spleen liver, kidneys, or lungs; and in the last-named organs the change may be produced either subsequently to that of the diaphragm, or directly by perforation of the a3Sop]iagus, in the latter of which cases the alteration is usually found in the left side of the thorax. ihe edges of the perforation of the stomach ensuing in this manner are thiii ragged, eroded, transparent, and having an appearance (to use the words of Hunter) very much like that kind of solution which fleshy parts undergo when half digested in the living stomach, or when acted on by a caustic alkali. o , ui wuen ' Wilkinson King, Guy'a Hosp. Rep. vii. 1842.