1909.] Pathology of Gastric Ulcer. 237 



upwards to the surface, which they cover with flattened cells. These flattened 

 cells grow out, and cover the whole raw surface by the 8th to the 10th day. 

 The surface cells become cubical, and from them grow down tubes forming 

 the new glands. Till the 30th day the glands are formed of cubical cells ; at 

 this time " pepsin cells " become differentiated at the base of the glands, and 

 till the 55th day the glands increase in numbers. They make no mention of 

 the development of oxyntic cells, but from a consideration of the figures in 

 their paper I gather that they mean oxyntic cells by the term " pepsin cells." 

 The above changes only occur at the stated times if the animal eat no food 

 for four or five days at the beginning, and be then put on milk, and finally 

 milk and bread for a time. If it be allowed to eat solid food at the beginning, 

 regeneration has hardly commenced by the 8th to the 12th day. 



The ulcers do noc invariably heal in this rapid fashion, and in one case I 

 found an unhealed ulcer on the 21st day. The microscopic investigation of 

 this ulcer shows that its base is formed of dense fibrous tissue, which passes 

 out on each side and blends with the muscular coats of the stomach. The 

 edge of the mucous membrane on one side is recurved, but not on the other. 

 At both edges the mucous membrane has grown out for a short space in a 

 single layer of cells, and there ends at the edge of the ulcer. 



The granulation tissue of the floor of the ulcer has fungated above the 

 level of the regenerated mucous membrane, and this partially organised 

 granulation tissue, for a depth of one-sixth of the whole thickness of the wall 

 of the stomach, has undergone necrosis, the necrotic tissue extending up to the 

 edge of the growing epithelium, where it stops. It is impossible for the cells 

 to grow over this dead tissue, and hence the delay in the time of healing. 

 This animal was fed on the same diet as the other twenty. 



I have microscopically examined only one scar as old as 55 days. 



The mucous membrane in this specimen is regenerated as described by 

 Griffini and Vassale, but no oxyntic cells are present except at the very edge 

 next to the normal mucous membrane. The mouths of the glands in places 

 are dilated, and the glands widely separated by interstitial tissue. 



The base of the scar is formed of loose fibro-cellular tissue, embedded in 

 which are seen isolated strands of muscular tissue (fig. 2). 



In another specimen, 41 days old, the base of the scar is formed of dense 

 fibrous tissue, with thin and atrophied muscular tissue between it and the 

 peritoneum. The edges of the normal mucous membrane are recurved. The 

 regenerated mucous membrane is thin and the glands short, implanted 

 directly on the fibrous tissue, and all dilated and lined by cubical cells. The 

 mouths of the ducts are very wide. The interstitial tissue is excessive in 

 amount and separates the glands widely. There are no central nor oxyntic 



