OCR Text |
Show DISEASES OF THE ORGANS 0F DIGESTION. [finertox VI. loss of a quantity 111' its t'unctional tissue and the dense condition 111' some 111' the re111aining. 11111 work 01' digestion c1111 be '111'1'11111 on 3'111'3' i111pcrt'cct3'.1 'l'he obliterated portions 31e1'e. ne1er 1'11113' 1'-e-established.111111 a wry 111111 single 1113111r 111' epithelium took the plate 111' the normal t'unctional tissue. (1', cicatrix. J), duodenum. TA 111.1: VI. GAs'i'nn' 1.1as1ox's. F111. 1.- Partial stenosis 111' 11111 pyloric opening 1'1'o111 enormous hypertrophy of the mus1'1111a1'coat. 111' the. stomach in the pyloric region. 1',p3'1o1us. I), duodenum. T1111, 11111s11111ar tissue. T I". fibrous tissuc. F111. 2.-Partial stenosis with incontinence or insufficient closure 111' 11111 pyloric. orifice, 1'1'11111 enormously hypertrophied mucous 1111111'1111'ane in the pyloric region, 1'1111033'ing 3'ery deep and very cxtensiyc ulceration 111' the tissues. The hypertrophy is here not. only 111' the high13'-thickened and condensed mucous 111embrane, but also an enormous enlargement. 111' portions 01' the sub-mucous structures, raising the mucous membrane into hiO'h and extensive 111111s,13'11ich project. into the c111 113' 111' the. org1u1.11 c1111stitutes on one hand an obstacle to 11111 tree passaee ol' the digested food into the intestine. 11111111113 pr1'1ducing dilata- Fi1.‘.4.- Ertensire l)1'/r/2‘(111'r111 of 11111 .\'/1111111111. 11 1'1/1 1111/.ss11c .\on- malignant 11II/[1f/y1Ir/s1'u of Ill/1' 1[1u'.ous' .1111111- 111'/I110. "hen111y'pcit1'ophy of the 5.11.11111111111'1113'11'1 ol' the. mem- 111111111 r111 1ches 11 11115.1'1'1111111111 it finds no more space upon its sub-mucous basis, it 1111111 ops into ridges 111111 111pies$10ns, 111111113'i11g' the wavy lines 111' the krypts and 1'11llicles. 111 this case the 111111'11111usl3'-e111l.11'.1_,1'c11 1111111111.11111 in the p3 1111i1 region has still retained its pl 13 siological111'1111ctc1‘ 11111111 the t'tmdus 3311i1'l1'1s e.\cec111nI1.1'l3' 11i11111111, it formed into 11 number 111 polypi. 11111111 are iis'ehss 1111' functional purposes. 113' its t'olds asstuning an areolar arrangement, tion in the. cardial region; on the other 11and,i11sul'1cient there are found. a little distant 1'1'11111 the py1or11s,11 number closure of the. opening ,thei'cb3 permitting the bile and pancr 1111110 juice to penetrate 11'11111 the. duodenum 1111111133 111'11 into the stomach, interfering 33ith gastric. digestion to 11 111pl'11cs 31 here the glandular lay er 1111s reac 11111 the highest degree11t'113pti"1111]'1l13'. 1\ 1111111'11111 111spheroi1l pioIicctions great. extent. crease, assume a longitudinal shape, 11nd from this, by still 1"'111111e1:.1"'11o31t 1. pass into pedun1 1111111111 or non- 111111111111111111111 pol3pi. The head 111'1'ree 11\t1'e1nit3' 111 those 3cgetati11ns usnall3 inc'11c1ses 111111111111111 111111 for 111s club-s-haped c\c1'11scenc es I. >03 111111 111 331111111 1111311 a common base. The3 disfigure the 111emb1'ane, and. when there are many (11' them, disturb diIe'cstion. Internally thc polypi are made 11p of e11orn1o11s131-1i1111e11.1;ast1'ic 11'1111111s. 211111 occasionally 111'1'11111 c3sts. containing 3ello13is11oseium 111' mucus Their illtcrglandulai tissue constitutes pecu liarly cloisoned netWork 111' dense eonnect'ne-tissue, occupying a considerable space 111' the 1111.111111111111. 0 E, tesophagus. 1' 1'. polypous cxcrescences. M .11, mucous 11111111111'211111. .1". 1'11llicles. are 1111 med 1111111 e 11111 surl'ace, 13111111. by still further i11- 111 11111 (esophageal portion and the cardia there is strong constriction in the walls, a remnant of extensive cicatriza- tion in that. region. The ci 'atricial tissue is 3'er3' dense. partly 01' cartilaginous consistence, utterly devoid 111' any glands 111' t'ollicles, and hence useless t'or digestive function. E, ect:1111' state 01' the cardia. P, pylorus. E, erosion. C. cieatrix. F111. 3. -P1'I(/m(ntaz‘1'01z (Ind C'1'c1'111'1'21111'011 of 11m 111111'011s Coat of 1116 Stun/(11,11. '1‘1he membrane'is partly 1'cstmcd 11om 1131cnsi3' e ulce11'11tion, but has lost many 01 its "lands and follicles espc1i11lly in the fundus and the pyloric 1110'.ion 11 has 11 stliped appearance and'15 still partly induratcd, so 111111.33'ith the 111.111iteste11 113' a variety 111' 1111211 and general s3111pton1s. 111111 is very liable to assume 11 Very chronic t'orm. The pro\i111.1te cause is always alteration ot' gastric secretion from the mucous mem- porous layer 111 the e\ter11111 str. 1111111 01' the basement 11111111111'111111. Such111111111111'1'1111111-1'111'suc'h it 111al|y is-is 11111'113s the tirst symptom ot' alcoholism. gastromalacia. and many t'orn1s of slowly- 11111'eloping changes 111' the 111111'1111s 11111111111'111111. which. it" not promptly checked. 33'ill sooner 111' later111.1get1erate into a malignant lesion. irritant poisons produce 3'11111iti11g. 33'11i1-11 continues for some time even al'tei' their passage t'roni the organ. unless the tissues ot' the stomach 11111'1- at once been destroyed by their contact. Acuteperitonitis1111\'aI1'sin1luecs 3'11111iti11g. 111its1xl11‘oni1' t'orin, especially when the serous layer 111' the stomach is 2111111111111 \1itl1 11\11111si111. l13pe1'plasi1.1 311111iting always 1111111's.111 acute peritonitis 13ith 11\t111s11 e 1'11111iting. the'11111111 111.1ts ot' the stomach ale \ery ot'ten t'ound. alter death in an almost normal 1111111111011, possibly sliglI'1113 11111111111 l‘or outside11'1uses ot'3'on1itinI1.1' 33'1'111ust look to the llf‘l‘\OUS s1'st11111,c11ietiy the I111111111111111's. 111/mud" has long ago 1111111111- strated this hot 113' 1'11111111'1113.‘ stomachs 111' small annuals and skilltull3 substituting"111 11111'11' p'l111e hogs I111 1111111‘1s. liI'3'i11t1'o11111inI1.r 111‘111111. ('11/111111111) tartrate ot 11111111111113 into those 1111i111a s' reins etl'orts 11t111111iting. desiIe'nates it as .'"'/"""' tor/11111111111111 111113.11‘11111 11111Iiorit3 <11 cit-05 to it1sutl‘i1iei11'3'ot'secretion11t'111uri11ti1'1111d1'1-13 s11111111111 to 1111 inadc changes are 10111111 in the. stomach 111'1'111111111111. there ai‘e so11111tin1es 111111111 11111111111111st insig11iticai1t l'unctional distur b11111111s: especially 3'11111'1tiug. a s3mpton1 that 111ight pr'o3e ot the highest diagnostic 11111111,is 3'e1'3' t'lI‘11111u1ntl3' absent. 1111111 11111111 3'11111iting exists. it 1'111 not always be aseribedtto the lesion 1o'11ted in the stom1111 and sometimes even 111113"i11I1.1 ot the inside ot' the bladder took place. 111131111. 3'on1iti11gisone111' the i11stin1ti1'c 11111"3e-111tions to protect the body against the injurious substances introduced into the alimentary organs 111' into 11111 blood. 1111' not only does the stomach eject the 11111111si1'11 substance placed in its 1'111'ity. 11111 it 111s1111:"'1111i1soi1 t'oratimethc 1'11111tion1111\1-retion. and eliminates 11111111 11 good portion of many inI'iuiious substances 111111111111111 into 11111111111111..\1's1111i1 111111si111ila1 poisons 11111-11 .111'1111113 1111s111'1'l1111111 the blood or 11'-11111 directly pla11-d into it. pr-1odu11 1-.\'1r11t'ion ot the substames t'ro111 the blood 113' the 131111111 intestinal mucous ment- 111111111. besides the 111111'111111i11il 1111 ot emptying its 1'-oi11111ts. 111 1'111'3'111aI111' diseases 111' other organs (nephritis lcp-to 111e11ingitis. its-11,11 1111' it is Very 11111111 111111 to causes e\isti11It.1 outside ot' the organ. sul1-111'11c11i1oidal 1111-11111I1.1‘itis. 11'11.)111111itinI<.1 1s 11 constant p1111i1on1- 1111'sid1s the 1111111 and drink, the substances 3'on1ited 111113 be enon. 11it1111ut. 1111111-1'111'. the existeme 111'- any .1"as11ic lesion. Sudden mental disturbance and hysteria are \‘1‘1'3' ot'11n accompa» nied 113' 3on1iti11g. (‘1.1 1,-11111/1/1'11111111111/ \11o1111/11/-'1'l1e 3.1.1t1i1 11111111us111etnbrane 1s 11111 little sensiti3e to tone 11.11s 1111 111-1 has pr'o1111 11y intio- ducing 1111111 through 1111 titulous 113111111113." ot' his p.1ti1nt. \11'111111111 intestinal Vessels and at10ph3' ot' the walls 111' the stoi11'11c11.'l'l1e result 111 it is incomphte and rte1111111111 absorption of the partly1ligested t'ood. 211111 derangement 111' 11111 secretory and exerctory t'unetions. Dilatation ot' the 111'g1u1.11abitu'.11 1'1'111stipation. lack 111' assimilation, 1111111111 trophic state 111' tissues, and a variety ot' ner3'ons disturbances will follow. Digestive troubles 1'1'on1 chlorosis are 1'11'incip'11113'1"11111'11111111'121-11 113' neuro- 11111seular phenomena such 11s epigastric pains. cramps sometimes vomiting; very seldom dyspepsia t'rom secr'etoir 11crangements. 111111 still more >e1do111.11'1111111'111113' 111ganic lesions or simple ulcer.s These neuro- muscular distl11‘b11111esare not ditl'crcnt 1'111111 simplegastralgia or nervous 111111iting‘. e\1:ept that 11111111 is a total absence 111' 1'11sc11l111' 111111"n1111 and good color 111' the inttgu» 111111t in 11111 latter. (NH/1 lawn/s 1/1'III/111111114.111/1111111111) (1. -\ss 1.I.\1#1)1//11}1~'1Iaf1'11111 1)1'.-'~t11111111111 of ("1.11111 .\"111".11‘1o/1-111s [11111111111 (7/11. [11'1"11/11. To. 1121, (piate quantity of pepsin. 'lheie 1'11/11‘1111111/1'N is 3erI'3 ot'ten an ii1s1111i1'i1111 supply 111' gastric Iiuice. «'11 111111.111' a l13'pt111s111"1etio11 ot muc us. and little or no 111'tlitti1e gastrit Iiui1c. Occasionally t1‘1111e maybe a 3'er3 1131111111111 pulse but it does not. indi1at111 any gastric iriitation. 111 the abo3'11-11e.s1ribed diseases. 11'1'111111 some 111 the 11111pts1 mucus. 11101111. bile. 111111'o-bile. 111'son1ttin1es 111'1111 pus. 1.111111 causes oftho vomiting are the substances. in 1311-11111'it3' or 1pu1lity,11x- l 1 l istim.‘1 in the. organ. and kee1I1in1.1 up the irritation pr'odu1e'd b3 them. \ome. people Vomit 111.11'1111"1113 1""11'13 morning. '11111. substances ejected are usually glairy mucus and some bile. or a highly 11.11113 yellowish liquid ot' neutral or slightly alkaline reaction. containing some 11ilit1'113'in or bili1'iiidin. The appetite 111' such persons for their 11111111i11I1.1'1ne111 ishaidly 111'1'1'di111i11isl1ed. 11111111 1'1'us1'1onsi111111s it 1111c to acciunul- 1111111 111' 1111111 1pu111tities ot' mucus st111‘111111111urIint." 11ight'111 the stomach trom hy1ptIrtr1o]1'113 111' the mucous 11111111111‘11ue in 11.01 catdial region. 1111calls it 1111111'1'11111 Ir/m/iou/mu The increase 111' secretion of mucus in 1111- st11111a1-11 when empty must. undoubtedly be 1111en1or111oa state 111' constant irritability. 11'11ic11.1cts111111‘1'1111'111s's steadily upon the s111'r11tor.'.11paratus.tl1an to mere 11y pe1"11opl1yol the s1111 11'113' 3.1111111." 11>) in thes :11'11'1111'3 glands 11311111‘s1'11reti1111 can only 1111 due to 111-1'.1111'1_'11111111 ot the trophic nerves (either irritation 111' 111111111so- dilator. or pm" 113' sis. perm.11111111 other 11.1.1111 111.1113 subst. 1111-1s and sudden 11111113411 111 t11'11p11atur'e produce distinct 211111 1111ten paint'ul s111sations upon it \s its t'1'11111ionis 111sseI11ti11113' based upon 1'1111111\ .111i1"il3 111111111 t'Iom s1111cral 111111111s11-‘1111a.i is 3'1‘113 pione to 1111 irritat11d 111111 1111111111 11y 3"1113 3"'11'1111 11-111\ 111111cts: lil1131'1se1s'11possil1le to 3111111111111 111. 1113 rctlex p1-h1nom1natron1 the mats 111 the st11111'1'11,11Iupo11 the \isc1'1.111 the circulation. respiration. and the t‘t'l‘t'l1l'11'5plllzll and sympatln'tic \111I'1‘311 11nd 11'i11.1m's 1\pc'11in11ntsI 1111\‘1 1"'t\'t1ll1'tl 11111 1111‘11111s. 11111 111.1111111at rise 111 am 1'1 11 p1css111e and s l11\3'-111ss 111 pulse are produced 113 irrit- 111qu the 31 1111s ot' the sto11111111. l'I'l1e1 destiibe it or temporary. ot' the vase-contractors). AH 1111111333 (in .\11111'11/1111 1.'/1r/1U/lH/l'f‘ .\1\‘."\IUII of 1111 Pregnancy. (sea-Sickness. 1111113'11111111111' poisons and emetics act. by 1'111tl1x irritation upon the secretory apparatus through the t1opl1i1 ne'r3es.'l'11c 11111113t'orming epithelium ot' the minous11111'1111111111111s 1e'I'11 soon li1.'111iti1'd 113'11113 1113.111degrteot'1I1.1I'3p1r1111i.1 11\itingin the tissue. and soon \3ill undergodcs31111111.1ti1111.t11131111111.11'1111111111'1-1111111.1'11s.1111d 111111'11l111 a component 01 the «brie-at 111111111113'111' 111111111 oozing tlnoug'h 1111- 1111'11c11'd 111111 gastric tisttd '1(./111om1/ 1/1 ".1 1111/1111/111‘. 1'37 \ p also 111/11111111111.111/11111111/1/s (1111/ 111' \1/1,..._.]11/1/_ 1.171) 1111 1111 ("Hill/1'11]! 1711; 1]"[1/1/‘1.(111 1111: 111/infill, 111/HI- "111111 the rage sI'111111pttli1tic 111". 1c- til:1111c11ts ot the 111-ck 31'-11e 1111 through 11111111 3111s 11o slo1111ess ot pulse: 11111 the i111"11111s111:11'111'1111 p11ss1111 1'1111111in11l Irritation ot' the stomach 11 1111s \\'as pr1‘1duccd in a 3'111'1113' 111' ways. 113' 11.17 posing the opcnevl organ to 1111- 1111'. 11y 1111111111'1111111111111 1'11' 1s11111111 through the1111111111.atnlbyeleetricit3. 11111111 11 current sutl1ciently |