140 CONTENTS OF THE INTESTINAL CANAL. 



the vessels ; but most commonly it is of a dark brown red colour, 

 coagulated, and mixed with fragments of food. In capillary 

 gastric haemorrhage, which may take its origin in various diseased 

 conditions, as, for instance, in round (perforating) ulcer of the 

 stomach, in gastric cancer, in hsemorrhagic erosions of the mucous 

 membrane of the stomach, and in disturbances in the circulation in 

 the spleen and liver, the blood is retained for a longer time in the 

 stomach, and we then have the brown or black vomitus, having 

 the colour of chocolate or resembling coffee-grounds, to which the 

 earlier pathologists attached so much importance. The remains of 

 blood-corpuscles are always to be found on examining this kind of 

 vomitus with the microscope. Any one not trusting to his powers 

 as a microscopist, may easily obtain a red fluid by heating the dried 

 mass \vith alcohol containing sulphuric acid, in which the presence 

 of hoematin is indicated not merely by the general character of its 

 solid residue, but also by the abundance of iron in the latter. Fat- 

 globules, epithelial structures, &c., are also found in these masses. 



Sugar has very often been found in vomited matters : 

 MacGregor,* Polli,t and, more recently, Scharlau, J have found it 

 in the contents of the stomachs of diabetic patients : two observa- 

 tions made by Frerichs, appear to confirm these observations; 

 for in the matters vomited by diabetic patients after the adminis- 

 tration of an emetic, he found a large quantity of sugar, but no 

 dextrin. It was also worthy of remark that notwithstanding the 

 neutralization of the acid vomited matters, no lactic fermentation 

 could be induced. 



Frerichs believes that this experiment throws some light on 

 the pathogenesis of diabetes. Although this indication, if it turn 

 out to be constantly exhibited, should undoubtedly not be over- 

 looked, yet we still think that the proximate and essential cause of 

 diabetes is hardly to be sought in the prima via; for in the 

 normal condition, starch is converted into sugar in the stomach, 

 and sugar is found in the blood ; moreover, sugar is formed in the 

 liver ; that is to say, it is not only found therein, as Bernard asserts, 

 but, as I have observed, far more sugar proceeds from the liver 

 through the hepatic veins, than is conveyed to it through the portal 

 vein and the hepatic artery; hence, for the present, it seems more 

 correct to assume with C. Schmidt, that in diabetes the conversion 

 or regressive formation of the sugar is impeded. Moreover, it 

 need not excite our wonder that a large quantity of sugar is found 

 in the contents of the stomachs of diabetic patients, since there is 



* Lond. Med. Gaz. May, 1837. t Omodei annali univers. 1839. 



$ Zuckerharnruhr. Berlin, 1846. Op. cit. p. 804. 



