GASTRIC See also:

• ULCER

ULCER (ulcer of the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach)  , a disease of much gravity, commonest in See also:

• FEMALES

females, and especially in anaemic domestic servants . It is connected in many instances with impairment of the circulation in the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach and the formation of a See also:

• CLOT, ANTOINE

clot in a small See also:

• BLOOD

blood-See also:

• VESSEL (O. Fr. vaissel, from a rare Lat. vascellum, dim. of vas, vase, urn)

vessel (thrombosis) . It may be due to an impoverished See also:

• STATE
• STATE, GREAT OFFICERS OF

state of the blood (See also:

• ANAEMIA (from Gr. ay-, privative, and aiµa, blood)

anaemia), but it may also arise from disease of the blood-vessels, the result of See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long-continued indigestion and gastric See also:

• CATARRH (from the Gr. Karappeiv, to flow down)

catarrh . When clotting takes See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place in a blood-vessel the See also:

• NUTRITION

nutrition of that limited See also:

• AREA

area of the stomach is cut off, and the patch under-goes digestion by the unresisted See also:

• ACTION

action of the gastric juices, an See also:

• ULCER

ulcer being formed . The ulcer is usually of the See also:

• SIZE

size of a See also:

• SILVER

silver threepence or sixpence, See also:

• ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)

round or See also:

• OVAL (Lat. ovum, egg)

oval, and, eating deeply, is See also:

• APT

apt to make a hole right through the coats of the stomach . Its usual site is upon the posterior See also:

• WALL (O. Eng. weal, weall, Mid. Eng. wal, wane, adapted from Lat. vallum, rampart; the original O. Eng. word for a wall was wag or tenth)
• WALL, RICHARD (1694-1778)

wall of the upper curvature, near to the pyloric orifice . It may undergo a healing See also:

• PROCESS

process at any See also:

• STAGE (Fr. 6/age; from Lat. stare, to stand)

stage, in which See also:

• CASE
• CASE, JOHN (d. 1600)

case it may leave but little trace of its existence; while, on the other See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand, it may in the course of cicatrizing produce such an amount. of contraction as to See also:

• LEAD
• LEAD (pronounced iced)

lead to stricture of the pylorus, or to a See also:

• PECULIAR

peculiar See also:

• HOUR

hour-See also:

• GLASS
• GLASS (O.E. glees, cf. Ger. Glas, perhaps derived from an old Teutonic root gla-, a variant of glo-, having the general sense of shining, cf. " glare," " glow ")
• GLASS, STAINED

glass deformity of the stomach: Perforation is in most cases quickly fatal, unless previously the stomach has become adherent to some neighbouring See also:

• ORGAN

organ, by which the dangerous effects of this occurrence may be averted, or unless the See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition has been promptly recognized and an operation has been quickly done . Usually there is but one ulcer, but sometimes there are several ulcers . The symptoms of ulcer of the stomach are often indefinite and obscure, and in some cases the diagnosis has been first made on the occurrence of a fatal perforation . First among the symptoms. is See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain, which is See also:

• PRESENT

present at all times, but is markedly increased after See also:

• FOOD
• FOOD (like the verb " to feed," from a Teutonic root, whence O. Eng. foda; cf. " fodder "; connected with Gr. lrareicOae, to feed)

food . The pain is situated either at the See also:

• LOWER

lower end of the See also:

• BREAST (a word common to Teutonic languages, cf. the Ger. Brust, possibly connected with an O. Sax. brustian, to bud)

breast-See also:

• BONE (a word common in various forms to Teutonic languages, in many of which it is confined to the shank of the leg, as in the German Bein)
• BONE, HENRY (1755-1834)

bone or about the See also:

• MIDDLE

middle of the back . Sometimes it is See also:

• FELT (cognate with Ger. Filz, Du. vilt, Swed. and Dan. fill; the root is unknown; the word has given Med. Lat. filtrum, " filter ")

felt in the sides .

It is often extremely severe, and is usually accompanied with localized tenderness and also with a sense of oppression, and by an inability to See also:

• WEAR

wear tight clothing . The pain is due to the movements of the stomach set up by the presence of the food, as well as to the irritation of the inflamed See also:

• NERVE (Lat. nervus, Gr. vevpov, a bowstring)

nerve filaments in the See also:

• FLOOR (from O. Eng. flor, a word common to many Teutonic languages, cf. Dutch vloer, and Ger. Flur, a field, in the feminine, and a floor, masculine)

floor of the ulcer . Vomiting is a usual symptom . It occurs either soon after the food is swallowed or at a later See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period, and generally relieves the pain and discomfort . Vomiting of blood (haematemesis) is a frequent and important symptom . The blood may show itself in the See also:

• FORM (Lat. forma)

form of a See also:

• BROWN
• BROWN, CHARLES BROCKDEN (1771-181o)
• BROWN, FORD MADOX (1821-1893)
• BROWN, FRANCIS (1849- )
• BROWN, GEORGE (1818-188o)
• BROWN, HENRY KIRKE (1814-1886)
• BROWN, JACOB (1775–1828)
• BROWN, JOHN (1715–1766)
• BROWN, JOHN (1722-1787)
• BROWN, JOHN (1735–1788)
• BROWN, JOHN (1784–1858)
• BROWN, JOHN (1800-1859)
• BROWN, JOHN (1810—1882)
• BROWN, JOHN GEORGE (1831— )
• BROWN, ROBERT (1773-1858)
• BROWN, SAMUEL MORISON (1817—1856)
• BROWN, SIR GEORGE (1790-1865)
• BROWN, SIR JOHN (1816-1896)
• BROWN, SIR WILLIAM, BART
• BROWN, THOMAS (1663-1704)
• BROWN, THOMAS (1778-1820)
• BROWN, THOMAS EDWARD (1830-1897)
• BROWN, WILLIAM LAURENCE (1755–1830)

brown or See also:

• COFFEE (Fr: cafe, Ger. Kaffee)

coffee-like mixture, or as pure blood of dark See also:

• COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)

colour and containing clots . It comes from some vessel or vessels which the ulcerative process has ruptured . Blood is also found mixed with the discharges from the bowels, rendering them dark or tarry-looking . The See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general condition of the patient with gastric ulcer is, as a See also:

• RULE

rule, that of extreme See also:

• ILL

ill-See also:

• HEALTH

health, with pallor, emaciation and debility . The See also:

• TONGUE (O. Eng. lunge)

tongue is red, and there is usually See also:

• CONSTIPATION (from Lat. constipare, to press closely together, whence also the adjective " costive ")

constipation . In most of the cases the disease is chronic, lasting for months or years; and in those cases where the ulcers are large or multiple, in-See also:

• COMPLETE

complete healing may take place, relapses occurring from See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time to time . But the ulcers may give rise to no marked symptoms, and there have been instances where fatal perforation suddenly took place, and where See also:

• POST

post-mortem examination revealed the existence of long-See also:

• STANDING

standing ulcers which had given rise to no suggestive symptoms .

While gastric ulcer is to be regarded as dangerous, its termination, in the See also:

• GREAT

great See also:

• MAJORITY (Fr. majorite; Med. Lat. majoritas; Lat. major, greater)

majority of cases, is in recovery . It frequently, however, leaves the stomach in a delicate condition, necessitating the utmost care as regards See also:

• DIET

diet . Occasionally the disease proves fatal by sudden See also:

• HAEMORRHAGE (Gr. atµa, blood, and prryvvvac, to burst)

haemorrhage, but a fatal result is more frequently due to perforation and the See also:

• ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape of the contents of the stomach into the peritoneal cavity, in which case See also:

• DEATH

death usually occurs in from twelve to See also:

• FORTY

forty-eight See also:

• HOURS, CANONICAL

hours, either from See also:

• SHOCK, or COLLAPSE

shock or from See also:

• PERITONITIS

peritonitis . Should the stomach become adherent to another organ, and fatal perforation be thus prevented, chronic " indigestion " may persist, owing to interference with the natural movements of the stomach . Stricture of the pylorus and consequent See also:

• DILATATION (from Lat. dis-, distributive, and lotus, wide)

dilatation of the stomach may be caused by the cicatrization of an ulcer . The patient should at once be sent to See also:

• BED
• BED (a common Teutonic word, cf. German Bett, probably connected with the Indo-European root bhodh, seen in the Lat. fodere, to dig; so " a dug-out place " for safe resting, or in the same sense as a garden " bed ")

bed and kept there, and allowed for a while nothing stronger than See also:

• MILK (0. Eng. meoluc; from a common Indo-European root, cf. Lat. mulgere, Gr. ?t dXyetv)

milk and See also:

• WATER

water or milk and See also:

• LIME
• LIME (O. Eng. lim, Lat. limes, mud, from linere, to smear)

lime water . But if bleeding has recently taken place no food whatever should be allowed by the stomach, and the feeding should be by nutrient enemata . As the symptoms quiet down, eggs may be given beaten up with milk, and later, See also:

• BREAD

bread and milk and See also:

• HOME
• HOME, DANIEL DUNGLAS (1833-1886)
• HOME, EARLS OF

home-made broths and soups . Thus the diet advances, to chicken and vegetables rubbed through a See also:

• SIEVE (O.E. sife, older sibi, cf. Dutch zeef, Ger. Sieb; from the subst. comes O.E. siftan, to sift)

sieve, to custard See also:

• PUDDING

pudding and bread and See also:

• BUTTER (Lat. butyrum, Gr. 0obrvpov, apparently connected with $ous, cow, and rvpbs, cheese, but, according to the New English Dictionary, perhaps of Scythian origin)

butter . As regards medicines, See also:

• IRON [symbol Fe, atomic weight 55.85 (0=16)]

iron is the most useful, but no pills of any sort should be given . Under the See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence of See also:

• REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

rest and diet most gastric ulcers get well . The presence of healthy-looking scars upon the See also:

• SURFACE

surface of the stomach, which are constantly found in operating upon the interior of the See also:

• ABDOMEN (a Latin word, either from abdere, to hide, or from a form adipomen, from adeps, fat)

abdomen, or as revealed in post-mortem See also:

• EXAMINATIONS

examinations, are See also:

• EVIDENCE (Lat. evidentia, evideri, to appear clearly)

evidence of the truth of this statement .

It is unlikely that under the treatment just described perforation of the stomach will take place, and if the surgeon is called in to assist he will probably advise that operation is inadvisable . Moreover, he knows that if he should open the abdomen to See also:

• SEARCH, or VISIT AND SEARCH

search for an ulcer of the stomach he might fail to find it; more than that, his search might also be in vain if he opened the stomach itself and examined the interior . 'Serious haemorrhages, however, may make it necessary that a prompt and thorough search should be made in See also:

• ORDER
• ORDER (through Fr. ordre, for earlier ordene, from Lat. ordo, ordinis, rank, service, arrangement; the ultimate source is generally taken to be the root seen in Lat. oriri, rise, arise, begin; cf. " origin ")
• ORDER, HOLY

order that the surgeon may endeavour to locate the ulcer, and, having found it, secure the damaged vessel and See also:

• SAVE, or SAVA (Ger. Sau; Hungarian Szdva; Lat. Savus)

save the patient from death by bleeding . Perforation of a gastric ulcer having taken place, the septic germs, which were harmless whilst in the stomach, escape with the rest of the contents of the stomach into the general peritoneal cavity . The immediate effects of this leakage are sudden and severe pain in the upper See also:

• PART

part of the abdomen and a great shock to the See also:

• SYSTEM

system (collapse) . The muscles of the abdominal wall become hard and resisting, and as peritonitis appears and the intestines are distended with See also:

• GAS

gas, the abdomen is distended and becomes greatly increased in size and ceases to move, the See also:

• RESPIRATORY

respiratory movements being See also:

• SHORT, FRANCIS JOB (1857– )

short and See also:

• QUICK

quick . At first, most' likely, the temperature drops below normal, and the See also:

• PULSE

pulse quickens . Later, the temperature rises . If nothing isdone, death from the septic poisoning of peritonitis is almost certain . The treatment of ruptured gastric ulcer demands immediate operation . An incision should be made in the upper part of the middle See also:

• LINE

line of the abdomen, and the perforation should be looked for . There is not, as a rule, much difficulty in finding it, as there are generally deposits of See also:

• LYMPH

lymph near the spot, and See also:

• ETHER, (C2H5)2O

ether signs of See also:

• LOCAL

local inflammation; moreover, the contents of the stomach may be seen escaping from the opening .

The ulcer is to be closed by See also:

• RUNNING

running a " See also:

• PURSE (Late Lat. bursa, adapted from Gr. Gupta, hide, skin; possibly O. Eng. pusa, bag, has influenced the change from b to p)

purse-See also:

• STRING

string " suture in the healthy See also:

• TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

tissue around it, and the place is then buried in the stomach by picking up small folds of the stomach-wall above and below it and fixing them together by suturing . This being done, the surface of the stomach, and the neighbouring viscera which have been soiled by the leakage, are wiped clean and the abdominal See also:

• WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")

wound is closed, See also:

• PROVISION (Lat. provisio)

provision being made for efficient drainage . A large proportion of cases of perforated gastric ulcer thus treated recover . (E .