THE DIGESTIVE SYSTEM. 



537 



Fiu. 310. CHUOMC GASTRITIS. 

 Showing new-formed fibrous tissue betwt 

 gastric tubules. 



gion. Microscopical examination shows alterations varying in different 

 parts of the organ and in different stages of the disease. The surface 

 epithelium, may be degenerated and exfoliated. The detached epithelium 

 with leucocytes may be mingled with 

 the mucus covering the surface. The 

 gastric glands may be variously al- 

 tered. They may be dilated, or elon- 

 gated and tortuous, or hyperplastic ' 

 or atrophied; their epithelium may 

 be flattened, degenerated, or detached. 

 The interstitial tissue and the sub- 

 mucosa may be infiltrated with small 

 spheroidal cells or new-formed larger 

 polyhedral cells (Fig. 309), and new 

 fibrous tissue may form (Fig. 310), 

 thus often greatly thickening the 

 mucous membrane and causing at- 

 rophy of the glands. The lymph- 

 nodules at the base of the glands may 

 be enlarged from hyperplasia. On 

 the other hand, the mucous mem- 

 brane, as contraction takes place in the new-formed interstitial tissue, 

 may undergo great atrophy (Fig. 311), so that it is pale, thin, often gray 

 in color, with more or less pigmentation. 



The formation of new fibrous tissue may later involve the muscularis 



also, leading to various distortions 

 of the stomach. 



Croupous Gastritis (Membranous 

 or Diphtheritic Gastritis) .This 

 form of gastric inflammation, most 

 common in children, may be as- 

 sociated with diphtheria or with 

 other infectious diseases, but may 

 occur independently. In adults 

 it is usually secondary to typhus 

 fever, pneumonia, pyaemia, ty- 

 phoid fever, the exanthemata, and 



Showing atrophy of the mucous membrane with much Other illf ectlonS, and may f ollow 



new-formed fibrous tissue. tlie i llg estiou of irritant poisons. 



The excitants are thus of the most 



varied kinds, as is the case in pseudo-membranous inflammation else- 

 where in the body. The false membrane may be in small patches or 

 line a considerable portion of the stomach. 



Exudative Gastritis (Suppurative or Phlegmonous Gastritis). This proc- 

 ess is characterized by the formation of purulent and other exudate in 



1 See Cone, "Welch Anniversary Contributions to the Science of Medicine," p. 877, 

 1900, bibliography. 



@Jtm3* . 



FIG. 311. CHROXIC GASTRITIS. 



