VOMITED MATTERS. 133 



was always found after some time to be filled with air. It is to be 

 regretted that this air has not been analysed ; it is scarcely likely 

 that hydrogen and its gaseous compounds would be found in it. 



Frerichs likewise notices an accumulation of gas, which, strictly 

 speaking, is a sacculated emphysema in the serous coat of the gut; 

 in the intestines of swine he has frequently observed bullse of this 

 sort, as large as a pea or a hazel-nut, filled with air. 



Although from what has been already stated it may be readily 

 inferred what are the substances which occur, and which must of 

 necessity occur, in the matters discharged by vomiting, it yet may 

 not be altogether superfluous to notice systematically the different 

 characters of the vomitus in different conditions of disease. Unfor- 

 tunately, many of the analyses which have been made are of little 

 use : as in the diagnosis of a gastric disease, so also for a scientific 

 investigation of vomited matter, it is especially important to know 

 what period had elapsed since food was taken, or whether the 

 stomach was empty. Without this knowledge no inference of 

 any scientic value can be deduced. It is, however, much to be 

 lamented that even at the present day pathological chemistry (as 

 it is called) is as little based on physical diagnosis as on patho- 

 logical anatomy; thus we find numerous analyses of the vomitus 

 in dyspepsia, a word unsatisfactory to every rational physician, 

 and tending only to impede scientific inquiry. Every one must 

 know that dyspepsia and pyrosis may accompany not only chronic 

 gastric catarrh, but also the round (perforating) ulcer, cancer, and 

 other primary and secondary affections of the stomach ; if then no 

 pathologico-anatomical diagnosis be made, the analysis of the 

 matters vomited by dyspeptic patients can lead to no result ; when 

 it is impossible to make a certain diagnosis in dyspepsia or pyrosis, 

 nothing is gained by the attempt to analyse the vomited matters. 

 Notwithstanding the numerous, more or less accurate analyses of 

 vomited matters, we still know very little regarding the various 

 morphological and chemical constituents of the masses which are 

 discharged in the various diseases of the stomach and other abdo- 

 minal organs. All that is positively known may be included in a 

 few sentences. 



By far the most frequent cases are those in which the principal 

 part of the vomited matter consists of imperfectly digested or en- 

 tirely undigested food, and the chief reason of this is that the food is 

 usually the proximate exciting cause of the antiperistaltic motion. 

 Hence it follows that the food is more or less changed according to 

 the time in which it has been retained in the stomach : thus in the 



