A case of acute gastric ulcer of the anterior wall / Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
1911
Catalogue details

Licence: In copyright

Credit: A case of acute gastric ulcer of the anterior wall / Anthony Bassler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    scopic blood was present witli one small clot. The feces voided the day before and two days afterward showed the presence of occult blood. Three cc-ray plates were then taken. Each showed that the stomach had discharged the greater portion of the ounce of bismuth given into the small intestine (hyper- motility), that the organ was large and low (dilatation and prolapse), and that the ulcer-bed was lined with bismuth. When the as-ray plates were held against the patient’s body, and the ensiform and umbilical markers on the plates matched to these parts on her body, the location of the ulcer noted on the plate corresponded exactly to the point of tenderness and the plastic exudate. Course of Disease.—The next morning when the patient w'ent into the hospital, the blood showed erythrocytes 3,700,000, morphologj' normal, hemoglobin 67 per cent. (Dare), color index 0.6, leukocytes 8,290, and dill'erential count normal. Kept steadily in bed for three weeks, she was fed by the Lenhartz method, the feedings of milk being given at stated times and amounts during the day and night. The admin- istration of finely comminuted foods was begun late in the third week. The stomach was maintained alkaline by a mixture of alkaline powders, without soda bicarbonate, this being given at three-hour intervals. The bowels were moved each day by a castile soap enema (not saline, because this increases the hydrochloric acidity in the stomach )T Liquor ferri albuminatis in 2 dram quantities in water t. i. d. was used to combat the anemia, and an ice-bag was employed during the first days to decrease the tenderness at the ulcer site, although this was hardly necessary as the patient was on her back all of the time. She made a perfect recovery, and when she left her bed there was no spasm of the left rectus, no tenderness on pressure over the ulcer site, and no plastic exudate. The blood had come up to 4,100,000 erythrocytes, 87 per cent, and color index 0.85. She was then fitted with a corset which raised the pyloric region over four inches; her feeding was increased to the taking of more solid foods, the alkaline pow- der kept up, the iron tonic diminished to half quantity each day, and Carlsbad salts used to move the bowels. She went into the hospital weighing 98 j)ounds, and now at the end of two months thereafter weighs 127 I’.ounds, and is without a symptom of digestive distress. The o;-ray plates of to-day do not show the ulcer; the .stomach is smaller in capacity, hyper- mbtility is no longer a feature, the test-meals are normal, and the feces tree from blood. 126 East Sixtieth Street. Reprinted frotn The Journal of the American Medical Aasociation July 22, 1911, Vol. LVIl, pp. 282 and 283 Copyright, 1911 Aincrican Medical Association, 535 Dearborn .-Ire., Chicago