PATHOLOGY 
258 
inflammation; but we will venture to fay, that in the 
majority of cafes they do ; and whoever reads Dr. Baron’s 
cafes attentively cannot fail to fee ftrong evidence in fa¬ 
vour of-this notion. In that of Sarah Tandy, “ the com¬ 
plaint is reported to have come on only four weeks ago, 
with tendernefs and fwelling of the belly, naufea, andvo- 
miting.” This patient did not, die for a year, fo that the 
appearances on difieftion could furnifli no evidence as to 
when the tuberculous affe&ion had begun. In the cafe 
of the female, p. 36, the “affeflion began in the pleura;” 
and we do not generally obferve metaftalis in difeafes of 
the abforbent fyftem. Sarah Aldridge (p. 28.) is made 
to ftate, that (he recollefts the pain was “ more fevere at 
the commencement than it has been fince;” her blood 
t oo !< fhowed a flrong buffy coat.” The cafe of Browning 
(p. 41.) affords any thing but evidence of the origin of 
the difeafe from difeafed abforbents ; it came on after an 
operation for ftrangulated hernia, and was clearly con- 
tiefted with the fphacelation of the inteftine which took 
place. 
This difeafe is full of danger, as well from the flow 
infidious progrefs which it makes to undermine of itfelf 
the cpnftitution, as from the accidents to which it ex- 
pofes the patient during the long courfe of management 
required in its treatment. As another caufe of danger, 
alfo, may be added, the want of refolution which we 
have fo often to regret in patients during the cure of a 
chronic difeafe, where the ad vantages of the plan, from 
its gradual operation, are not fo obvious to the fenfes. 
The fymptoms which indicate recovery are, an abatement 
of the pricking pains of the abdomen, and a diminution 
of the frequency of the pulfe to eighty in a minute : but 
even under thefe appearances, however favourable, a re- 
lapfe is always to be dreaded. 
■We have little, and that little unfatisfaftory, to fay 
concerning the treatment of this difeafe. In the firil 
place, bleeding mull be fo far had recourfe to as to keep 
the circulation as much as pofiible below the ftandard of 
health. The bowels mull: be kept open by none but the 
mildeft laxatives. The moll perfect quietude ; cauteriza¬ 
tion by means of continued bliftering on the abdominal 
regions; naufeating medicines fo carefully watched that 
they never may produce a< 5 tual vomiting ; are alfo to be 
refo'rted to. Under thefe meafure we may cure this com¬ 
plaint, when it hasexifted two or three weeks only, if we 
are fortunate enough to be called in fo Toon. After that 
period our tneafures will fomewhat change. We mult 
endeavour to excite the abforbent fyftem to remove the 
morbid productions ; and for this purpofe we fhould 
chiefly trull: to rigid abftinence. We fhould alfo endea¬ 
vour to increafe the fenfations of the fkin, kidneys, See. 
Mercurial medicines feem fuccefsful in advanced ftages 
of the complaint. We fhould try them, however, in the 
early ftage of the difeafe; in the latter, as there is little 
hope of promoting the abforption of a tubercle, we fhould 
naturally be averfe to excite the irritation of fever which 
follows the introduction of mercury. 
10. Eruprefma gaftritis, (Gaftritis, Cullen, fyc.) inflam¬ 
mation of the ftomach: burning pain at the pit of the 
ftomach, increafed by fwallowing; rejection of every 
thing; hiccough ; oppreflion and dejeCtion of mind ; fe¬ 
ver a fynochus. There are two varieties. 
a. Adhsefiva: pain very acute; fever violent. 
£. Erythematica: with an erythematous blufli extend¬ 
ing to and viflble in the fauces; pain more moderate; 
fever lefs violent: pulfe low and quick. 
This fpecies, under one of its two varieties, is found 
alfo as a fymptom, occafionally, in aphtha, mealies, fmall- 
pox, and other exanthems. 
Thefe terms which defignate the varieties we ufe per¬ 
haps fomewhat differently from Dr. Good, in the follow¬ 
ing fenfe. The firft variety will defignate that violent 
form of inflammation in which all the coats of the fto¬ 
mach, and probably its peritoneal covering, are affefted. 
The fecond variety is gaftritis affeCting the mucous mem¬ 
brane only. The firft is alrnoft always acute and violent* 
and is very rarely met with; the latter exhibits both an 
acute and chronic character, and is frequently obferved. 
The firft variety, which has long been known to medical 
authors, is thus deferibed. 
Gaftritis adhefiva is charaClerized by an acute burning 
pain in the region of the ftomach, which is fuddenly in¬ 
creafed, and vomiting at the fame time excited by any 
thing whatever that is fwallowed; it is alfo aggravated 
by external prefture. Thefe fymptoms are accompanied 
by a great degree of general fever ; the pulfe is extremely 
quick and fmall, and commonly hard. There is alfo ex¬ 
treme anxiety, and a greater deprefflon of ftrength, and 
lofs of power in all the functions of the body, than in 
the cafe of alrnoft any other inflammation. In manyin- 
fiances there is a remarkable tendency to fyncope ; and 
there is frequent retching, and often hiccup, indepen¬ 
dently of any thing fwallowed. In fome inftances, other 
fymptoms are fuperadded to thefe. Thus, very early in 
the difeafe, a high delirium has fometimes come on, with 
great giddinefs and lofs of fight, from the fympathetic af¬ 
fection of the brain ; confiderable difficulty of breathing 
has alfo occurred, probably from the impoffibility of de¬ 
pressing the diaphragm without compreffing the ftomach; 
convulfions of the mufcles, and in fome cafes, although 
intenfe third: was prefent, aCtual inability to drink has 
'alfo taken place. 
From the,great fenfibility of the ftomach, and its fym¬ 
pathetic connexion with the other important organs of 
life, it mull be obvious that inflammation of this vifeus, 
by whatever caufes produced, muft occafion a great and 
often fatal derangement of the fyftem. If the difeafe lafts 
long enough to follow the ordinary courfe of other in¬ 
flammations, it may terminate like them by refolution, 
gangrene, or fuppuration. Some writers have mentioned 
feirrhus and cancer of the ftomach as among the lequelae 
of gaftritis ; but Dr. Cullen has correctly ftated that the 
feirrhofities, which are often difeovered afteCting the ftc- 
mach, are feldom known to be the confequences of in¬ 
flammation. 
The prognrjis, as to the tendency of the difeafe to one 
or other of thefe terminations, may be deduced from the 
following appearances and conflderations. The difpofi- 
tion of the inflammation to ceafe, or to terminate by re¬ 
folution, as it is called, may be known by the mild or mo¬ 
derate ftate of the fymptoms ; and by a gradual remiffion 
of them, in confequence of the aftion of the remedies 
employed in the courfe of the firft few days of the .dif¬ 
eafe. For in violent cafes, where the remedies have not 
been applied fuflicientiy early or with fufficient vigour, 
gangrene comes on very rapidly. That a gangrene has 
begun, may be known from the fudden remiffion or cef- 
fation of the pain, while the pulfe continues frequent, 
and at the fame time becomes weaker; while other marks 
of the finking of the powers of life in the whole fyftem 
come on ; fuch as frequent fainting, flatting of the ten¬ 
dons, hiccup, a cadaverous appearance of the counte¬ 
nance, &c. Suppuration is a lefs frequent termination of 
gaftritis, but dtcafionally occurs, and may be expected to 
take place, when the fymptoms have continued, in a mo¬ 
derate degree, for more than one or two weeks ; and el- 
pecially when there is a confiderable remiffion of the 
pain, while a fenfe of weight and anxiety ft ill remain. 
When an abfeefs is formed, the frequency of the pulfe is 
at firft abated; but it foon again increafes, and frequent 
cold ftiiverings, and marked exacerbations of heat and 
feverifhnefs in the afternoon and evening, followed by 
night-fweats, come on ; in other words, a heCtic fever 
enfues. At length the difeafe commonly proves fatal, 
unlefs the abfeefs open into the cavity of the ftomach, the 
pus be difeharged by vomiting, and the ulcer foon heals. 
There are, indeed, fome rare inftances on record, in which 
the impofthume has burft externally, and not only the 
pus, but the alimentary matters fwallowed, have pafled 
out at the opening during the remainder of life. In fuch 
cafesj 
