A dictionary of medical diagnosis : a treatise on the signs and symptoms observed in diseased conditions / by Henry Lawrence McKisack.

  • McKisack, Henry Lawrence.
Date:
1907
Catalogue details

Licence: In copyright

Credit: A dictionary of medical diagnosis : a treatise on the signs and symptoms observed in diseased conditions / by Henry Lawrence McKisack. Source: Wellcome Collection.

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

    572/604 (page 556)
    8. The Quantity of Vomited Material may be trifling, being in cases of gastric catarrh and gastric ulcer often little more than saliva and mucus. In dilatation of the stomach, as already mentioned, the vomit may be very copious, several pints being usually evacuated at a time, and a recurrence may take place in a few days. 9. An examination of the Contents of the Stomach is often required. The methods to be adopted are indicated in the article on the subject, at p. 387. Here the clinical significance of the result of the examination is considered. (i.) Food, mucus, and saliva are found in all conditions causing vomiting, and are of no diagnostic value. (ii. ) Bile is regurgitated from the duodenum into the stomach in persistent vomiting from any cause. It occurs in acute and chronic gastric catarrh, in vomiting from other reflex origins besides the stomach, and particularly in intestinal affections. In obstruction of the bowels, acute and chronic, and in peritonitis, bilious vomiting is constantly observed. (iii.) Fsecal vomiting is a further stage of the reverse peristalsis causing bilious vomiting. It occurs in obstruction of the bowels and in peritonitis, and is said to have been seen in hysteria. (iv.) Free hydrochloric acid in excess (hyperchlorhydria) is an evidence in favour of gastric ulcer. It sometimes occurs in nervous dyspepsia, in acute and in chronic gastric catarrh. Absence or diminution of free hydrochloric acid (hypochlorhydria) is the rule in cancer of the stomach, in dilatation of the stomach from atony or from chronic catarrh, and sometimes from cicatricial contraction of the pylorus. At times this condition is found in nervous dyspepsia, in anaemia, and in fevers. Free lactic acid is often found where free hydrochloric acid is absent, and is a sign of abnormal fermentation. Supersecretion of the gastric fluids is found in catarrh of the stomach, in the gastric crises of locomotor ataxia, in gastric neuroses, and sometimes in gastric ulcer. (v.) Blood may be vomited in large or small quantities (hsema- temesis). It may be shed in the respiratory passages or in the oesophagus and swallowed, to be afterwards ejected from the stomach. It may be the result of (a) ulcer of the stomach or ulcer of the duodenum. In these cases the blood is usually vomited at considerable intervals, and may be copious, {b) Cancer of the stomach. Here the blood is usually less copious, and only appears at a late period of the disease, when cachexia is well