244 Dr. C. Bolton. Further Obsei^vations on the [Nov. 16, 



membrane completely reformed as I related in describing the normal healing 

 of acute gastric ulcer. 



In Group I, Experiments 1, 3, and 5 are conclusive. In Experiment 1 

 there was no motor insufficiency and the ulcer healed in the usual way, 

 leaving a small stellate scar, within 21 days. In Experiments 3 and 5 there 

 was motor insufficiency and the ulcers were unhealed on the 21st and 35th 

 days respectively. Experiments 2, 4, and 6 are of use as controls to show 

 what the iilcers were like in the early stages. 



In Group II the 26th day animal had motor insufficiency and an unhealed 

 ulcer. The 56th day animal showed a scar with considerable fibro-cellular 

 thickening and imperfectly formed glands. The fibrous thickening and 

 imperfect glands show a delay in the healing, but I have not included this 

 case because I was unable to prove that there was motor insufficiency, the 

 animal having J 5 hours in which to dispose of its 60 grammes of food, 

 although I think that it was present. 



In Group III the 41st day animal had an unhealed ulcer and motor 

 insufficiency. There was dense fibrous thickening of the sclerotic type and 

 the mucous membrane which was reformed consisted of a single layer of cells 

 such as should be present on the 8th or 10th day of normal healing according 

 to Griffini and Vassale. 



In Group IV the 52nd day cat had a scar of considerable fibro-cellular 

 thickening covered with a mucous membrane composed of very imperfectly 

 formed glands such as should be present on the 16th day of normal healing. 

 The 55th day cat had a scar the base of which was not so dense, and the 

 glands were almost completely reformed. 



It is quite evident from these experiments that retention of food produced 

 by motor insufficiency may delay the healing of an acute gastric ulcer for a 

 period at least twice the length of the normal. Diffijrent degrees of 

 insixfficiency produce dih'ercnccs in the amount of tlelay. 



The delay occurs at two stages : — 



(1) When a single layer of epithelium covers the base of the ulcer and 

 before glandular formation has commenced (= 10th day of normal healing). 



(2) When the glands have boon reformed but the central and oxyntic cells 

 not differentiated. The glands are merely formed of duct epithelium at this 

 stage (= 16th day of normal healing). 



Whotlier, if the animals had been allowed to live, completely formed glands 

 would liavo eventually developod is a very interesting question. In the 

 normal healing of nn ulcei' there may l)o sonic delay, as is seen from the two 

 cases quot(!d abovo, in which one was delayed owing to necrosis of the 

 granulation tissue at the base of (ho ulcer, and the other was healed, hut 



