The diseases of the stomach / by Dr. C.A. Ewald.

  • Carl Anton Ewald
Date:
1900, ©1897
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Licence: Public Domain Mark

Credit: The diseases of the stomach / by Dr. C.A. Ewald. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Dangers of Stomach Tube.—It is self-evident that the softer the instrument which is introduced into the stomach and the more rounded the edges of the openings are, the less will be the danger of injuring the mucous membrane. This occurs more easily, and has actually occurred, when rigid instruments and the stomach pump were employed. The tearing off of small pieces of mucous mem- brane has frequently been reported, as, for example, by Wiesner,* Yon Ziemssen,f Leube,;{: Schliep,* and others. Cramer \\ has re- ported a case where this occurred in a simple lavage of the stomach with the soft tube. This writer seems to be unaware of the fact that Boas ^ has carefully described the exfoliation of the mucous membrane which occurs in chronic gastritis, and has employed the microscopic examination of these particles for diagnostic purposes.^ As I shall show later on, the finding of these bits of exfohated mucous membrane is by no means infrequent. They are usually imbedded in blood-streaked mucus. JSTo serious consequences, such as bleeding or gastric ulcers, have ever resulted from them. This is probably due to the prompt contraction of the gastric walls, which closes any open vessels and approximates the borders of the dam- aged area. The possibihty of such an occurrence, and, in fact, of any severe lesion of the mucous membrane, is reduced to a minimum by the use of the flexible tube; and in this way there has been removed a serious objection which prevailed until quite recently against the internal exploration of the stomach in certain conditions, such as * Wiesner. tJeber der Behandlung der Ectasie mittelst der Magenpumpe. Ber- liner klin. Wochenschrift, 1870, No. 1. f Von Ziemssen. Zur Technik des Loealbehandlung des Magens. Deutsch. Archiv fiir klin. Med., Bd. x, p. 66. X Leube. Die Magensonde. Erlangen, 1879, p. 25. * Schliep. On the Stomach Pump in the Treatment of Chronic Gastric Catarrh. Lancet, December 14, 1872. II Cramer. Die Ablosung der Magenschleimhaut durch die Sondirung und ihre Folgen. Miinch. med. Wochenschr., 1891. Cramer erroneously states that Leube is the only author who is quoted on this subject in the newer text-books of Ewald and Rosenheim. All four of the above names were mentioned in the first edition of this work. ^ Boas. Magenkrankheiten, 3te Auflage, Bd. i., p. 225. ^ [An elaborate paper on this subject has recently been published by Cohnheim, Die Bedeutung kleiner Schleimhautstiickehen fiir die Diagnostik der Magenkrank- heiten. Boas' Archiv fiir Verdauuugskrankheiten, Bd. i, p. 274.—Ed.]