A practical treatise on medical diagnosis for students and physicians / by John H. Musser.

  • Musser, John Herr, 1856-1912.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on medical diagnosis for students and physicians / by John H. Musser. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    1137/1378 (page 1017)
    In cases of gastritis, therefore, endeavor to find a local cause for the symptoms. If there is no history of indiscretion in diet, of exposure, of exhaustion, or mental shock that might have arrested digestion, then inquire for a history of exposure to contagious diseases and look for the earlier evidences of exanthemata. If the result of the examination is still unsatisfactory, examine the condition of each individual organ, par- ticularly bearing in mind meningitis, pneumonia, peritonitis, nephritis, and the general infections. Mycotic and pseudomembranous gastritis may occur secondarily to typhoid fever, pneumonia, pyaemia, and smallpox. In very rare instances actual diphtheria of the stomach has been observed. The fermentation incident to the presence of yeast-fungi and sarcinae in dilatation causes irritation, and these organisms may perhaps irritate the viscus directly. The mucous membrane may be covered with patches in areas or through- out its whole extent. Rarely tuberculous inflammation with ulceration takes place. Many other micro-organisms are frequently present, and though they are chiefly non-pathogenic they may contribute to the trouble and often cause fermentation and consequent irritation. Klebs found Bacillus gastricus with numerous spores in the tubules as the cause of a gastritis. The mucous membrane itself usually escapes infection by micro- organisms because of the character of its secretion. The acid gastric juice is antagonistic to micro-organisms and causes their death. Tuber- culosis, for instance, rarely attacks the stomach for this reason. Phlegmonous Gastritis. This is a very rare affection, in which the inflammation is seated in the submucosa and leads to perforation. The onset is sudden. The chief local symptom is intense pain in the epigastrium, with a burning sensation. The anorexia is absolute, the tongue is dry, and the acidity is increased. The fever is high and accompanied by delirium and chills. The pulse is small, rapid, and irregular. The matters vomited first consist of mucus, then pus. The patient is extremely restless and anxious, even delirious, and early passes into coma. Death takes place from collapse. It is impossible to make an absolute diagnosis, as local peritonitis and abscess of the liver are characterized by the same symptoms. In abscess a tumor may form in the epigastrium. The disease may be idiopathic, but frequently occurs in septicaemia, and follows trauma. The subjects are often alcoholics. Toxic Gastritis. This form of gastritis is allied to the former in the severity of the general symptoms. It is the result of the swallowing of irritating poisons, of which phosphorus, arsenic, bichloride of mercury, and caustic acids and alkalies are the most common. It is attended by inflammation of the mouth, oesophagus, and stomach. The flow of saliva is excessive, the patients are unable to swallow and constantly vomit blood, which is often mixed with shreds of mucous membrane. The patient is restless,