Diagnosis of dilatation of the stomach / by William Pepper and Alfred Stengel.

  • Pepper, William, 1843-1898.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Diagnosis of dilatation of the stomach / by William Pepper and Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    DIAGNOSIS OF DILATATION OF THE STOMACH. By WILLIAM PEPPER, M.D., LL.D., OF PHILADELPHIA, AND ALFRED STENGEL, M.D., OP PHILADELPHIA. (Prom the Pepper Laboratory of Clinical Medicine, No. 4.) The diagnosis of dilatation of the stomach meets wth two difficulties at the very outset: first, the class of cases to which the term is applicable, and, secondly, the difficulty of determining the lesser grades on account of the variability in the size of the normal organ. It would seem simple enough to decide what class of cases belong properly to this group of diseases; but practical experience leads us to believe that, though the diagnosis is made with unwarrantable frequency by those who are guided by superficial examination and by clinical symptoms often not at all distinctive, those who have pursued their studies from the modern scien- tific standpoint, on the other hand, withhold the diagnosis in certain instances in which a careful consideration of the whole subject would warrant the application of the term under discussion. The group of cases to which the latter observation has special reference is that desig- nated atony of the stomach or motor insufficiency. All writers, it is true, have recognized forms of dilatation dependent upon atony of the muscular walls of the stemach ; but it has been cus- tomary to apply the term atonic dilatation to cases in which the process is well advanced, reserving the names motor insufficiency and simple atony to cases supposed to represent loss of motor function without change of size of the organ. This view, we believe, is incorrect and founded on too narrow a consideration of the conditions present in the stomach. There are doubtless cases of chronic interstitial inflammation of the stomach, or perhaps even of ordinary chronic gastritis, in which the organ is not enlarged and yet in which the motor function is dimin- ished, just as there are cases of chronic interstitial myocarditis without