1909.] 



Pathology of Gastric Ulcer. 



247 



Its properties, which have been examined, have been found to correspond 

 to those of the gastrotoxin formed by immunising the rabbit with guinea-pig's 

 gastric cells. 



2. Acute gastric ulcer in the cat heals within a few weeks, as in the case 

 of the guinea-pig. This result agrees with those of other observers who 

 have produced lesions by injury of the gastric mucous membrane of dogs. 



3. The ulceration produced by gastrotoxin is more extensive if produced 

 whilst the stomach is digesting than whilst it is resting ; in the latter case 

 ulceration may fail to appear. 



4. Motor insufficiency of the stomach definitely delays the healing of 

 gastric ulcer for at least twice the normal time. There is more thickening of 

 the base and less complete regeneration of the gastric glands than occurs in 

 cases of normal healing. This may explain the beneficial effect following 

 gastro-enterostomy for chronic gastric ulcer in man. 



5. The character of the mucous membrane covering the base of an ulcer, 

 in which the healing has been delayed, varies in proportion to the delay. 

 It may consist of a single layer of epithelial cells on the 41st day, such as 

 should be found on the 8th to the 10th day of normal healing ; of 

 I'egenerated glands consisting merely of duct epithelium on the 52nd day, 

 such as should be found on the 16th day; or of almost completely regene- 

 rated glands. Whether eventually in process of time the glands would be 

 always completely reformed has not been determined, but more likely they 

 would not. 



6. The delay in the healing in cases of motor insufficiency is due to a 

 fault in the base of the ulcer, such as may occasionally be seen in normal 

 healing. This fault may be due to necrosis of the base of the ulcer or 

 excessive formation of sclerotic tissue therein, such conditions being the 

 result of the low resistance which the connective tissues possess to digestion 

 by the gastric juice, or possibly in some cases to a secondary bacterial 

 infection. 



7. When pyloric stenosis is present, extensive iilceration may be found 

 around the ulcer, probably due to a bacterial infection. The ulcer actually 

 produced by the serum, however, is no more liable to perforate nor to be 

 more extensive than in the control animal. 



REFERENCES. 



1. Bolton, ' Roy. Soc. Proc.,' vol. 74, p. 135, 1904. 



2. Bolton, ' Roy. Soc. Proc.,' B, vol. 77, p. 426, 1906. 



3. Bolton, ' Roy. Soc. Proc.,' B, vol. 79, p. 533, 1907. 



4. Bolton, ' Roy. Soc. Medicine Proc' (Path. Sect.), vol. 2, No. 2, p. 54, 1903. 



