192 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 



It is quite certain that ulceration may result from the unwise use 

 of drugs, like tartar emetic or arsenious acid, especially if these be 

 administered for long periods ; but such ulceration always occurs at the 

 same points, viz., at the deepest portion of the rumen, reticulum, or 

 abomasum. 



On the other hand, ulceration due to secretory disturbance occurs at 

 different points, and the figure opposite shows that the mucous folds 

 themselves may be injured and perforated. 



Lesions. Ulceration of the abomasum varies in severity. The case 

 referred to showed excavated ulcers from the site of which a portion 

 or the whole of the epithelium and glandular layer had been shed ; true 

 round ulcers, which had destroyed the entire depth of the mucous mem- 

 brane and had produced chronic inflammation and sclerosis of the muscular 

 layer ; and finally perforations resembling cleanly punched-out holes. 



The Symptoms are those of a mild form of ordinary acute gastritis, 

 without marked fever, and without special injection of the conjunctiva. 

 The appetite is diminished and irregular, but more as a consequence of 

 excessive reHex sensibility of the injured organ than from absence of 

 hunger. This excessive reflex sensibility of the abomasum causes relative 

 or absolute gastric intolerance, so that only a small amount of the food 

 ingested passes towards the intestine. 



Absolute intolerance on the part of the abomasum may even occur, 

 as in a case described by Moussu in 1895, which produced a very special 

 form of impaction of the rumen, absolutely different from primary 

 impaction. 



Intolerance of the abomasum for food already ingested and rumi- 

 nated may extend to the omasum. Peristalsis of the rumen then ceases, 

 and slight tympanites occurs. The most ciiaracteristic condition is the 

 existence of obstinate constipation. If ulceration takes place without 

 producing any important vascular lesion, which, however, is rare, the 

 faeces are hard and coated, but without other peculiarity ; if, however 

 (and this appears to be the rule), local haemorrhage occurs, the extra va- 

 sated blood is modified by the gastric and intestinal juices, and the faeces 

 appear of a black, tarry colour. This coloration is very significant, 

 and differs from that produced by the bile. It occurs only in gastric 

 haemorrhage, and at intervals. 



Diagnosis. The diagnosis of gastric ulcer is difficult, and can only be 

 arrived at with confidence when the above-mentioned coloration of the 

 faeces can be detected. 



Prognosis. From an economic standpoint the prognosis is grave. The 

 patient may recover ; the ulcers may heal, but cicatrisation is always pro- 

 longed, and as, on the other hand, the glandular apparatus of the abomasum 

 is generally more or less injured, complete recovery is impossible. 



