ROUND ULCER OF THE STOMACH. 171 



motion, and more tardy in its action when it begins, but once set 

 going, it does more work than under normal conditions for the same 

 amount of stimulation. We have, therefore, in all probability, two 

 typical conditions of the living substances when thrown out of 

 equilibrium namely, an unstable and an inert. 



It happened that in one of our dogs a ROUND ULCER formed in the 

 gastric cul-de-sac, which steadily increased in size, gave rise from time to 

 time to violent bleeding, and finally, after perforation of the stomach-wall, 

 produced a secondary peritonitis. (Observations and Experiments of 

 Dr. A. N~. Wolkowitsch.} During the development of the ulcer, a con- 

 tinuous and increasing hypersecretion was observed, the flow finally 

 exceeding the normal by three to four times. Of much greater interest, 

 however, than this hypersecretion was the fact that a sharply pro- 

 nounced deviation from the ordinary hourly rate of flow, appeared. 

 This was especially marked after feeding with bread, as was first pointed 

 out by Dr. P. P. Chigiri. The normal secretion after bread is charac- 

 terised by a copious flow during the first hour, then a great fall in 

 the second to, as a rule, about half the former value. As in previous 

 instances a further analysis revealed that two different periods of secre- 

 tion were here sharply separated from each other, namely, a period of 

 free psychic and centrally excited flow, and one of much weaker 

 chemically excited secretion, brought about by reflex action. In our 

 do" with the round ulcer the secretion of the first hour departed in no 



o L 



way from the normal, but in the second it remained at its previous 

 height, instead of dropping to about one-half. In the succeeding hours 

 also, the secretion was considerably greater than normal. The following 

 are the figures in question : 



Normal secretion. 

 26-2 c.C. 

 13-0 

 13-0 , 



Pathological secretion. 

 26-2 c.c. 

 26-6 

 15'S , 



How is this deviation from the ordinary progress of secretion to be 

 explained ? The following appears to me to be the most correct view. 

 Since the centrally excited secretion of the first hour is normal, it shows 

 that the glands, the centrifugal nerves, and the corresponding nerve 

 centres are all in normal condition. Further, when an increased 

 secretion in the second hour is observed, and we know that this secre- 

 tion is a reflex one, it must be taken to prove that the augmented 

 excitability of the secretory apparatus at this stage, has originated either 

 in the centripetal nerves or in their nerve endings. Here, then, in all 



