322 Hemorrhage from the Stomach. 



Most frequently blood wliicli has been extravasated into 

 the cavity of the stomach enters the intestinal tract and leaves 

 the body with the feces. During its way out it is always changed 

 materially; the hemoglobin is decomposed and the albumen 

 undergoes putrefaction, hence the feces are tar-like discolored, 

 soft, or on the contrary dry and very fetid. 



If the hemorrhage is profound the general s}anptoms of 

 internal hemorrhage become manifest; pallor of the mucous 

 membranes, small pulse, perspiration, dizziness ; repeated small 

 hemorrhages lead to chronic anemia. 



Diagnosis. Gastric hemorrhage can be diagnosticated only 

 upon the basis of hematemesis, or upon the removal of bloocl- 

 tinged masses with the stomach tube and then only if it can be 

 ascertained that the blood comes from the vessels of the stomach 

 and did not get into the latter from some other place. The 

 difference between pulmonary hemorrhage and hematemesis 

 has been pointed out elsewhere (see page 89) ; it should here 

 again be mentioned that blood may get into the stomach from 

 the nose, from the buccal cavity and from the respiratory 

 tract; such hemorrhages must be excluded before a diagnosis 

 of gastric hemorrhage can be made reliably. There is also the 

 possibility that dogs may vomit previously ingested blood ; this 

 is often indicated by the fact that no anemia can be observed 

 in spite of large masses of blood vomited. Whether blood 

 voided with the feces comes from the stomach or from the 

 anterior portion of the intestinal tract cannot be determined 

 solely by the appearance of the feces; the clinical history of 

 the case and the examination of all other organs must determine 

 the diagnosis. 



Treatment. In order to stop the hemorrhage the patients 

 should be placed at rest and should be made to swallow ice or 

 some cold water; in dogs external applications of ice may be 

 made in the region of the stomach. Subcutaneous injections 

 of ergotin (5-10.0 gm. or 0.2-1.0 for small animals), extr. hydras- 

 tis (8-10.0 g-m. or 0.2-0.5 gm.) are used with advantage. To 

 diminish the movements of the stomach opium internally (5- 

 10.0 or 0.1-0.5 gm.) is useful, eventually combined with astrin- 

 gents (acetate of lead, tannin, tannoform, tannalbin, sulphate of 

 iron, chloride of iron, alum). Gelatin may also be used either 

 alone or with wine internally; also adrenalin or suprarenin (for 

 dogs every hour 30 drop doses of the 1% solution). Caution 

 is necessary in internal medication since it may further stimu- 

 late vomiting. 



As long as the hemorrhage lasts, the animals should be 

 starved, then they should receive only fluid, soft and masliy 

 feed for several days. 



Literature. Qnalitz, Z. f. Tk., 1891, 459.— Schneidemiihl, Tm. R., 1888-89, III, 

 13.— Vogel, Eep., 1863, 116. 



