THE ALIMENTARY TRACT 189 
scrubbed and scalded after use. Since that time, infec- 
tious inflammations of the stomach and intestines have 
shown an ever increasing downward incidence, which 
result, there having been no material changes in other 
directions, I do not hesitate to ascribe to the improve- 
ment of butchering and dispensing engineered by Dr. 
W. B. Cadwalader. 
Helminths seem to be of importance in this order both 
by reason of the percentage of autopsies in which they 
presented the most probable or at least most suggestive 
cause and because uncinaria and strongylus have been 
seen attached to the wall and a large bulk of kno\vn irri- 
tative cestodes have occupied the lumen. Physical 
objects, stones, bones, wire, may cause irritation enough 
to activate bacterial action or may actually penetrate the 
wall; the latter action is well known. In so far as prac- 
tical application of this is concerned, it teaches to feed 
whole, unsplintered or ground bone. 
The distribution and character of pathological lesions 
according to the region of the stomach is what might be 
expected from the shape and physiology of its parts. 
True inflammatory processes are best, and in some cases 
only seen in the pyloric half of the viscus, while the 
changes in those few cases believed to be fermentative or 
irritative in nature were largely confined to the fundus. 
Dilatation of the latter part may be understood because 
there the muscular coats are about equal to the mucous in 
thickness and one-half the width of those at the pylorus, 
but why inflammatory processes should not be so 
developed in the fundus is not clear unless the greater 
availability of mucus protects the secreting wall. Not 
only does acute inflammation reach its most definite 
form in the second part of the stomach, but- the irregular 
pigmentation, mammillated overgrowth and atrophy or 
ulceration of chronic disease are likewise best seen in 
this part. 
