Duodenal and gastric ulcers / [by William Pepper].

  • Pepper William, 1843-1898.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Duodenal and gastric ulcers / [by William Pepper]. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    tion of diet, the vomiting persisted. It presented itself rather as a frequent raising of small quan- tities of dark colored mucus, which at times had a purulent appearance. There were rapidly pro- gressive emaciation, weakness and anaemia. On February 5 she had a large haemorrhage from the intestine. The blood was dark, but not offensive. This caused extreme debility. Between that date and February 14, there was continued dis- charge of blood from the bowel, including six large haemorrhages. There was not a single drop of blood vomited. I saw her first on February 5. She was pro- foundly anaemic, and partially collapsed. During the ensuing ten days it seemed scarcely possible that she should survive. Examination showed tenderness to the right of the median line, and there was a distinct circumscribed induration be- low the lower edge of the right ribs, corresponding to the position of the duodenum. This could be outlined as a painful lump of about two inches in diameter. There was no jaundice at any time. She continued to raise frequently small amounts of dark mucus. There was no melsena after Feb. 14. Fortunately the rectum continued retentive, and the nutritious enemas were evidently ab- sorbed. She remained in a desperate condition for nearly three weeks, and even then her im- provement was so slight and gradual, that her recovery seemed doubtful for some time longer. The lump described above gradually decreased in size, and now, May 1, is no longer perceptible. She continued to eject mucus in decreasing amounts until early in April, since when it has stopped entirely. The stomach rapidly regained its digestive power, and she is now able to eat quite freely and without any distress, meat, vegetables, bread and butter. All is well di-,