514: DISEASES OF THE STOMACH. 



however, is not constant ; on the contrary, it is rather rare. According 

 to the observations of Frerichs, to whom we owe most of what we 

 know concerning the anomalies of digestion, the hydrocarbons are 

 occasionally changed into a tough filamentous mass resembling gum, 

 and which is not unfrequently formed by lactic-acid fermentation out- 

 Bide of the body. The vomited substances not unfrequently consist 

 of large quantities of this non-nitrogenous material, which is thrown 

 up in mucous filamentous masses after painful retching. In other 

 cases, pure mucus with an insipid fluid is thrown up ; this form of 

 vomiting occurs chiefly in the chronic catarrh of drunkards, and con- 

 stitutes the celebrated vomitus matutinus (water-brash). Frerichs^ 

 who has carefully examined these masses, found that they were usually 

 alkaline, had a low specific gravity, always contained sulphurets, and 

 that alcohol added in excess threw down a white flocculent precipitate 

 which rapidly converted starch into sugar. This peculiarity of the 

 fluid showed that it was not formed in the stomach but in the salivary 

 glands. We have before said that irritations and diseases of the 

 stomach increased the salivary secretion; hence it appears that in 

 drunkard's chronic gastric catarrh, the saliva swallowed during the 

 night is thrown off in the morning as vomitus matutinus. In simple, 

 non-complicated chronic gastric catarrh, unaltered food is very rarely 

 vomited. If this does occur, it is usually mixed with a quantity of 

 mucus, and from admixture of butyric acid has a disagreeable, acrid 

 Bmell and taste, and occasionally contains a peculiar microscopic for- 

 mation, the so-called sarcina ventriculi. It can scarcely be doubted 

 that the sarcina, which, when it occurs in the stomach, is always found 

 in great numbers, is an algoid growth. It presents cells of the -^ to 

 yj-g- of a line in diameter, with square surfaces divided into four regular 

 parts ; usually several, sometimes very many .of these, are united into 

 smaller or larger squares. It is not to be supposed that it is this par- 

 asitic plant which, acting as a ferment, causes an abnormal decomposi- 

 tion of the contents of the stomach, for, in healthy stomachs (though 

 it rarely occurs there, it is true), its presence does not induce this ab- 

 normal decomposition. 



The sensation of hunger is almost lost, even when the patient is 

 much emaciated, and the body is very much in need of support ; fre 

 quently the patients can hardly be persuaded to take nourishment. In 

 other cases there is a feeling of hunger, but even a few mouthfuls 

 satisfy it. Finally, in some cases, particularly where much acid is 

 formed, there is occasionally pain in the stomach, accompanied by faint- 

 ness. As this is generally relieved by eating, it is commonly called 

 " wolfish appetite " (heiss-hunger). As there is no fever, the thirst is 

 aot increased ; it is often less, like the appetite. 



