Volume 2

A system of medicine / edited by J. Russell Reynolds.

Date:
1870-1872
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    1014/1058 (page 990)
    undergo, not only during life but also after death, an acid fermentation and become capable of producing the phenomena of softening both simple and gelatimform, not only in the stomach, but also in the intestines; and that when these changes have occurred in the latter organs, their contents have been found to present an acid reaction. These fermentative processes may originate in imperfect digestion, to which infants are so liable. They are, however, most easily excited through the catalytic effects of the mucus produced by catarrhal inflammation. When present, they also tend to cause the acuter forms of gastro-intestinal catarrh, the symptoms of which correspond very closely with the disorders which have been described as synrptomatic of these changes in the mucous membrane, but which are really only the consequences ol the inflammation thus set up. The softening, on the other hand, is on this hypothesis believed not to occur during life, but to be the result of the post-mortem action of the acids thus generated upon the coats of the stomach.1 (e) It remains to be shown why the condition is present in some cases and not in others; and perhaps among the most important of the former class must be reckoned those cases in which the membrane has been found softened, while the stomach is empty, as has been observed by Blundell, Cruveilhier, and Dr. Budd.2 It is to elucidate these cases that Briicke’s and Bernard’s observations before quoted give the most satisfactory clue; and to these must be added the possibility brought forward both by Dr. Budd and Virchow,3 that in many other diseases there is a tendency to a perverted secretion of the stomach, which pro- bably exercises a peculiarly corrosive influence after death; though, as Virchow4 lias remarked (and his observations are supported by Camerer), the most irritating secretions formed during life appear to have no influence in producing this effect so long as vitality persists.5 (/) The frequent absence of these softenings has been fully explained by Drs. Budd6 and Pavy7 to be due to the alkaline reaction of the blood, neutralizing the acidity of the gastric juice, and also to the proportion borne between the amount of this fluid in the vessels and the acid re- action of the contents of the stomach. Immunity of the posterior wall, while the anterior portion has been affected, has further been explained by the former author to depend on the gravitation of the blood to this part of the stomach; or, as in a case reported by Burns, on the presence of an alkaline dropsical fluid in the cavity of the abdomen. (tg) The process of softening appears to be only slightly influenced by external temperature8—a fact explicable by the observations of kfasse9 and Elsaesser,10 that the cooling of the internal organs of the 1 See, in support of this view, Virchow, Wurzburg Verhandl. i. 296 ; Archiv Path. Anat. v. 359. 2 A remarkable instance of this kind is given by Dr. Budd, On the Stomach, 1855, pp. 16, 17. 3 Wurzburg Verhandl. loc. cit. 4 Archiv, vol. v. p. 360. 5 It now, however, appears to be probable that this may occasionally occur. See Ulcer, Etiology, also p. 992. i 6 Croonian Lectures, Medical Gazette, 1847; and Diseases of Stomach, 1855. 7 Phil. Trans. 1863. Treatise on Digestion, 1867. 8 Elsaesser, loc. cit. 51. 9 Untersucli. zur Phys. Path. 1835. 10 Loc. cit. p. 69.