HEMATEMESIS 161 



hemorrhages have been slow and continuous fatty degenera- 

 tions of the heart, liver, kidneys, gland cells are observed. 

 The original cause will in part determine the nature of the 

 pathological changes. The mucous membrane of the gastro- 

 intestinal tract is pale, and remains of the hemorrhage will 

 be noticed along its course, which is of a dark color and more 

 or less tarry. At the seat of the hemorrhage will be found 

 eroded vessels, and .sometimes imperfect clot formation. 

 Other lesions found are those of ulceration, foreign bodies, 

 depending upon the original cause of the hemorrhage. 



Symptoms. These depend very largely upon the amount 

 of hemorrhage and rapidity with which it flows. When 

 the amount of hemorrhage is small the symptoms may be 

 entirely overlooked. The vomited blood may be only in 

 small quantities often poorly mixed with the ejected food. 

 The color of the blood depends upon the amount and length 

 of time remaining in the stomach. When fresh, the color is 

 bright and the cells are unchanged; when retained in the 

 stomach some time before it is ejected, it is dark, the oxy- 

 hemoglobin being changed to hematin, and resembles coffee 

 grounds. A microscopic examination of the ejected mass 

 will at once reveal the presence of large numbers of red cor- 

 puscles unless the blood has been retained in the stomach 

 long enough for the red corpuscles to become entirely dis- 

 integrated. 



When severe hemorrhages take place in the stomach, some 

 of the blood will pass into the intestinal tract to be passed 

 out with the feces. The feces will be of a dark tarry consist- 

 ency, with a disagreeable odor. If examined the blood 

 pigment will be found in large quantities. 



General symptoms of internal hemorrhage are noticed in 

 the more severe cases. The mucous membranes suddenly 

 become pale and colorless, the pulse very weak and often 

 imperceptible, dyspnea and general weakness appear. If 

 repeated hemorrhages do not result fatally the patient 

 suffers from chronic anemia. 



Diagnosis. This depends upon the presence of the blood 

 mixed with the vomitus. Tare should be taken in making 

 the diagnosis in the dog as they often eat large quantities of 

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