The diseases of the stomach / by Dr. C. A. Ewald ; Authorized Translation from the 2d German ed. with special additions by the author by Morris Manges.

  • Ewald, C. A. (Carl Anton), 1845-1915.
Date:
1892
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Licence: Public Domain Mark

Credit: The diseases of the stomach / by Dr. C. A. Ewald ; Authorized Translation from the 2d German ed. with special additions by the author by Morris Manges. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    PAGB neoplasms, (a) which exert pressure from without (tumors of the mediastinum and retroperitonreum and aortic aneurisms), (/3) which involve the entrance to the stomach and stenose it.—Dilatation of the oesophagus above the stenosis. Pressure and traction diverticula; simple ectasia. Case of carcinoma of cardia which was operated, with report of autopsy.—Treatment of strictures at the cardia: passing bougies; permanent canulse and tubes; gastrostomy (description of operation by - Sonnenburg). Feeding of the patient; nutrient eneniata; diet after formation of a gastric fistula. LECTURE IV. The Stenoses and Strictures of the Pylorus. Megastria and Gas- TRECTASIA. DILATATION OF THE StOMACH 110 Plaster models of stomach (demonstration). Diagnosis of large and of dilated stomachs. Inspection; percussion ; palpation (ot the tip of the sound, Leube); auscultation (succussion, deglutition-murmurs, Eosenbach's method); measuring capacity of the stomach (filling with water).—Etiology of dilatation of stomach. I. Mechanical narrowing or closure of pylorus (a) in the walls of the stomach themselves, (^) extending by continuity from without), a. Cancerous tumor; cicatricial stenosis ; congenital narrowness of the pylorus; bending of the duode- num toward the pylorus ; spastic contractions of the pylorus. 5, Tumors which press on or surround the pylorus growing from the pancreas, liver, omentum, or the glands. Kelations of wandering kidney to dilatation of the stomach. II. Dilatation of the stomach due to weakness of the muscles of the stomach (atonic gastrectasis). a, Enfeebled tone of the muscular fibers; 5, weakness and paralysis of the motor nerves of the stomach ; c, exclusion of localized areas of the muscular fibers of the stomach.—Pathological anatomy of the dilated stomach.—Symptoms of gastrectasis. Insufficiency of the stomach. Micro-organisms in the stomach. Chemical relations of the gastric juice. Slowing of absorption and motion of the stomach. Peristaltic unrest of the stomach (Kussmaul). Pityriasis of the skin. Muscular spasms. Tetany. Relations of the urine.—Diagnosis of gasti*eetasis.— Course and prognosis.—Treatment. Diet. Withdrawal of fiuids. Peptone prepa- rations and peptonized milk. Nutrient enemata. Drugs. Prevention of stagna- tion of the contents of the stomach. Lavage. Massage and electricity to the stomach. Operative dilatation or excision of the stenosis. Demonstration of sev- eral patients with gastrectasis. LECTURE V. Cancer of the Stomach 1C2 Statistics. Sex. Heredity. Causes. Traumatisms, chronic ulcer of stomach. —Pathological anatomy : scirrhus, medullary, colloid, villous, and telangiectatic varieties. Localized tumors and diffuse cancerous infiltration.—Site.—Sequel£e of cancer of the stomach: diminution in size, dilatation of, changes in site, ti'action on, bending and constriction of the stomach.—Primary and secondary gastric cancer. Propagation of cancer. Thi-ombosis. Swelling of the lymphatic glands, ulceration, perforation.—Symptoms of gastric cancer. Course and duration. Ex- ceptions to normal course. Statistics of individual symptoms.—Diagnosis : (1) Absence of free hydrochloric acid in the stomach-contents, and its presence even up to the death of the patient. Relations of pepsin and rennet. Presence of other acids in place of or along with hydrochloric acid. (2) Specific tissue-elements in the vomit or in masses evacuated through the tube. The mistaking of cancer- ous cell-nests and epithelial shreds of the mucous membrane. (3) The cancerous tumor (differential diagnosis from tumors, etc., of other organs, and fecal masses). Pain in the tumor. (4) Cancerous cachexia (hysterical cachexia).—Dittereutial diagnosis between cancer and ulcer of stomach, severe gastric catarrh, atrophy, amyloid degeneration of the mucous membrane of stomach, severe hysteria and neurasthenia.—Treatment. Condurango bark. Symptomatic treatment of pain,