Diseases of the stomach : including dietetic and medicinal treatment / by George Roe Lockwood ... ; illustrated with 126 engravings and plates.

Lockwood, George Roe

Date:: 1913

Credit: Diseases of the stomach : including dietetic and medicinal treatment / by George Roe Lockwood ... ; illustrated with 126 engravings and plates. 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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$some round-celled infiltration between the tubules and extending into the submucosa, which is often edematous. The solitary lymph follicles are often swollen, and leukocytes may be present in the intertubular tissue. The lumina of the glands contain debris of degenerated cells. Leukocytes, red blood cells, and desquamated epithelial cells, in, various stages of degeneration, are mixed with the stringy mucus covering the surface. Symptoms.—The symptoms begin usually within a few hours after the exciting cause, but may be delayed for twenty-four to thirty-six hours. In the mild cases, nausea and vomiting may be absent, the chief complaints being headache, mental depression, loss of appetite and coated tongue. The bowels may be constipated or there may be diar- rhea. An example of such an attack is as follows: ]\Iale, aged forty-two years. One week ago he went to a country hotel, where he ate heartily of badly cooked food. Next morning he awoke with a headache, xjoated tongue, and complete anorexia. He felt depresesd and miserable. He remained in bed two days on a milk diet, and gradually improved, although his appetite was a long time in returning. His bowels, though previously regular, became constipated and mo\'ed only after taking calomel. In the more severe cases the patient com])lains of uneasy feelings in the stomach that merge into nausea. Vomiting soon occurs, the vomited matters consisting of the contents of the stomach, mixed with mucus, and usually offensive from the presence of organic acids. There is almost invarial)ly a reduction or even an absence of hydrochloric acid, although very rarely this form of acidity may be normal or excessive. Acute gastritis, with a total acidity of 40 or over, should arouse our suspicions that more than simple acute catarrh is present. Lactic acid is rarely present. The tongue is usually dry and coated, and there is apt to be thirst. A diffuse tenderness may be elicited by ])ressure on the ei)igastrium. In ordinary gastritis the vomitiiuj usuaUy ceases as soon as the stomach is emptied, and is repeated only after ingestion of food. When the vomiting is prolonged, the diagnosis of gastritis should not be made without reservation. Watery vomiting or the vomiting of large (luantities of fluid con- taining free hydrochloric acid does not occur in acute gastritis, but suggests some form of pyloric closure, commonly seen with ulcer, more rarely with cancer of the stomach. Pain as a sym|)toni of acute gastritis is not usually observed exce])t in the attacks that follow a gross dietetic error. In these cases cramp-$