Part 241

Sphincter ani, loss of power in, in ulceration of rectum and anus, 893 paralysis of, in diseases of spinal cord, 907 spasm, in fissure of anus, 888

Sphincterismus, treatment of, 916

Spinal applications, use of, in enteralgia, 664, 665 cord, effects of abnormal condition of, on rectum and anus, 906 and membranes, lesions of, in acute rheumatism, 40 inflammation complicating acute rheumatism, 40 irritation, influence of, on causation of pruritus ani, 909

Spirit-drinking, influence of, on causation of functional dyspepsia, 446

Splashing sound on palpation in dilatation of stomach, 597

Spleen, amyloid degeneration in rachitis, 153 lesions of, in acute intestinal catarrh, 677 in chronic intestinal catarrh, 705 in scurvy, 173 in tabes mesenterica, 1188 in acute yellow atrophy of liver, 1026 enlargement of, in amyloid liver, 1044 in cirrhosis of liver, 994 in hydatids of liver, 1104 in phosphorus-poisoning, 1031 in thrombosis and embolism of portal vein, 1096 in rachitis, 140 in hereditary syphilis, 305

Spondylitis following gonorrhoeal rheumatism, 106

Spontaneous disintegration of biliary calculi, 1066 origin of acute peritonitis, 1136, 1137

Sprays, medicated, use of, in acute pharyngitis, 398 in chronic pharyngitis, 405, 406

Squamous-celled form of cancer of oesophagus, 426

Starchy food, influence on causation of intestinal indigestion, 625

Steam inhalations, use of, in acute pharyngitis, 397, 398

Stenosis, influence on causation of dilatation of stomach, 587 of cardia as a cause of atrophy of stomach, 616 of ductus communis choledochus, 1082 of portal vein, 1095 of oesophagus, as a cause of atrophy of stomach, 616 of orifices of stomach in gastric cancer, 566 of pylorus in carcinoma of stomach, treatment, 578 in simple ulcer of stomach, 503 hypertrophic, 615

Stercoraceous vomit, in acute internal strangulation of intestines, 843 in intussusception, 848, 849 vomiting, in enteralgia, 662 significance of, in intestinal obstruction, 862 in stricture of bowel, 856

Stimulants, use of, in cancrum oris, 344 in cholera morbus, 725 in dysentery, 812 in entero-colitis and cholera infantum, 761 in acute gastritis, 469 in chronic intestinal catarrh, 716 in intestinal obstruction, 865 in abscess of liver, 1021 in aphthous stomatitis, 331 in gangrenous stomatitis, 344

STOMACH, ATROPHY OF, 616 Etiology, 616 General inanition and marasmus, 616 Result of stenosis of oesophagus or cardia, 616 Anæmia, 616 Secondary nature, 616 Acute infectious diseases, 616 Mineral poisoning, 616 Chronic gastric disease, 616 Morbid anatomy, 616 Gastric tubules, degeneration of, 616 atrophy of, 616 Symptoms, 616 Digestive disturbances, 616 Anorexia, 616 Vomiting, 616 Anæmia, 616 Anomalies of Form and Position, 617 Hour-glass contraction, 617 Diverticula, from ingestion of foreign substances, 617 Loop-shaped form, 617 In hernial sacs, 617 In diaphragmatic hernias, 617 umbilical hernias, 617 Displacements, 617 by tumors, 617 by tight-lacing, 617 Twisting of, 617

STOMACH, CANCER OF, 530 Definition, 530 Synonyms, 530 History, 530 Etiology, 531 Frequency, 532 Sex, 533 Age, 534 Geographical distribution, 535 Race, 535 Heredity, 535 Simple ulcer of stomach, 536 Chronic gastritis, 536 Depressing emotions, 536 Individual predisposition, 537 Local predisposition, 537 Symptoms, 537 Course of typical cases, 538 Loss of appetite, 538 Pain, 539 Seat, 539 Effect of food on, 539 Character of, 539 Absence of, 539 Functional disturbance of stomach, 540 Eructations, 540 Breath, fetid, 540 Hiccough, 540 Tongue, appearance, 540 Vomiting, 541 Character, 541 Effect of situation of cancer on, 541 Time of, 541 In pyloric form, 541 cardiac form, 541 Frequency, 542 Cause of, 542 Vomit, characters of, 542 Gastric fluids, detection of cancerous fragments in, 542 absence of free hydrochloric acid in, 543 tests for hydrochloric acid in, 543, 544 Vomit, bloody, 545 detection of blood in, 545 coffee-grounds, 546 Hemorrhages, frequency, 545 Dysphagia, 546 Tumor, presence of, 546 frequency of, 546 method of examining for, 546-549 seat of, 548, 561 size of, 548 consistence of, 548 inflation of stomach with carbonic acid gas in diagnosis of, 549 Constipation, 550 Diarrhoea, 550 Black stools, 550 Urine, state of, 550 Albuminuria, 551 Emaciation, 551 Debility, 551 Depression of spirits, 552, 554 Anæmia, 552 Cachexia, 552 Physiognomy, 552 Oedema, 553 Ascites, 553 Pulse, 553 Epigastric pulsation, 553 Hæmic murmurs, 553 Venous thrombosis, 553 Temperature, 554 Dyspnoea, 554 Headache and vertigo, 554 Intelligence, 554 Coma, 554 dyspnoeic, 555 cause of, 555 Secondary growths, 556 of liver, 556 diagnosis of, 556, 557 growth of peritoneum, 557 Enlargement of supra-clavicular glands, 557 Perforation, 558 frequency of, 558 formation of fistulæ, 558 gastro-colic fistula, 558 Fecal vomiting in gastro-colic fistulæ, 558 Death, cause of, 559 Duration, 559 In early life, 559 Complications, 560 Jaundice, 560 Pylethrombosis, 560 Peritonitis, 560 Catarrhal enteritis, 560 Chronic diffuse nephritis, 560 Pleuritis, 560 Pericarditis, 560 Hydrothorax, 560 Pyo-pneumothorax, 560 Oedema of lung, 560 Pneumonia, 560 Embolism, 560 Aphthæ, 560 Fatty degeneration of heart, 560 Phlegmasia alba dolens, 560 Insanity, 560 Purpura hæmorrhagica, 560 Chronic catarrhal gastritis, 560 Morbid anatomy, 560 Varieties, 561 relative frequency of, 561 Method of growth, 562 Of annular form, 562 Of diffuse form, 562 Relation to coats of stomach, 562 Ulceration, 562 causes of, 562 cicatrization of, 563 Suppuration, 563 Medullary form, 563 peculiarities of, 563 histology of, 563 tendency to metastasis, 563 origin in gastric tubules, 563 Cylindrical-celled epithelioma, 564 histology of, 564 origin from gastric tubules, 564 Scirrhous form, 564 histology of, 564 Colloid form, 564 histology of, 564 Flat-celled epithelioma, 565 Secondary form, 565 peculiarities of, 565 seat of, 565 Changes, secondary, in stomach, 566 Hypertrophy of gastric wall, 566 Obstruction of orifices of stomach, 566 Atrophy of stomach, 566 Dilatation of stomach, 566 Hour-glass contraction of stomach, 566 Adhesions to adjacent organs, 566 Metastasis, 567 relative frequency of, 567 causes of, 568 Wasting of various organs, 568 Pathenogenesis, 568 Theories regarding origin, 569 Diagnosis, 569 Presence of a tumor, value in, 569 Detection of fragments of cancer in vomit, 569 Absence of free hydrochloric acid in gastric fluid, 569 Value of coffee-ground vomit, 569 From gastric ulcer, 569-571 chronic gastric catarrh, 569-571 gastralgia, 571 nervous dyspepsia, 571 fibroid induration of stomach, 571 chronic interstitial gastritis, 571 non-malignant stenosis, 571 non-malignant tumors, 572 tumors of adjacent organs, 572 of liver, 572 cancer of pancreas, 572 tumors of omentum and intestines, 573 aneurism of aorta, 573 spasm of rectus muscle, 573 pernicious anæmia, etc., 574 cirrhosis of liver, 574 of position of growth, 574 of form of growth, 574 Mortality, 574 Prognosis, 575 Treatment, 576 Diet, 576 Pain, 576 Vomiting, 576 Acid eructations and heartburn, 576 Constipation, 577 Diarrhoea, 577 Hæmatemesis, 577 Stenosis of pylorus, 578 Use of condurango, 576 of opium, 576 of ice, 576 of hydrocyanic acid, 576 of bismuth, 576 of oxalate of cerium, 576 of rectal alimentation, 576 of antacids, 576 of charcoal, 576 of washing out of stomach, 577 Surgical measures, 577 Resection, 577 Gastrostomy for stenosis, 578 Non-cancerous Tumors of, 578 Polypi of, 578 Adenomata, 578 Myomata, 578 Myosarcomata, 578 Sarcoma, 578 Miliary aneurisms, 579 Cysts of mucous membrane, 579 Fibromata and lipomata, 579

STOMACH, CIRRHOSIS OF, 611 Definition, 611 Synonyms, 611 History, 611 Etiology, 612 Sex, influence on causation, 612 Age, influence on causation, 612 Alcohol, abuse of, 612 Syphilis, 612 Injury, 612 Chronic catarrhal gastritis, 612 Symptoms, 612 Of chronic dyspepsia, 613 Appetite, impaired, 613 Gastralgia, 613 Inability to ingest large quantities of food, 613 Loss of flesh and strength, 613 Vomiting, 613 Vomit, characters of, 613 Diagnosis, 613 Significance of long duration of dyspepsia, 613 Value of physical examination, 613 Presence of a tumor, 613 Stomach-tube, use of, 613 From cancer, 613 Morbid anatomy, 613 Contraction of stomach, 613 Cavity of stomach, size of, 613 Thickening of gastric walls, 614 Mucous membrane, lesions, 614 Muscular coat, hypertrophy of, 614 Fibrous tissue, increase of, 614 Microscopical appearances of mucous membrane, 614 Gastric tubules, atrophy of, 614 Formation of adhesions, 614 Peritoneum, lesions of, 614 Prognosis, 614 grave nature of, 614 Treatment, 615

Stomach, condition of, in rachitis, 153

STOMACH, DILATATION OF, 586 Definition, 586 Synonyms, 586 History, 586 Etiology, 587 Stenosis of pyloric orifice, 587 Carcinoma, 587 Cicatricial growths from simple ulcer, 587 from corrosive poisons, 587 Hypertrophy of pyloric orifice, 587 Obstruction of pylorus by polypi, 587 Narrowing of pylorus by tumors of adjacent organs, 587 Congenital stenosis, 588 Spasm of pylorus, 588 Obstruction from distortion and displacement, 588 Without obstruction (atonic form), 589 Abnormal gastric contents, 589 Excessive eating and drinking, 589 use of beer, 589 Abuse of condiments, 589 of tobacco, 589 Fermentation of contents of stomach, 589 Impairment of gastric muscular force, 590 Organic changes in muscular coat, 590 Destruction by ulcers and cancers, 590 Chronic catarrhal gastritis, 590 peritonitis, 590 Degenerations (fatty, colloid, and amyloid), 590 Oedema of coats of stomach, 590 Cirrhosis of stomach, 590 Mechanical restraint of gastric movements, 590 Adhesions, 590 Weight of herniæ, 590 Impaired general nutrition, 590 Paresis from neuropathic causes, 590 Frequency of, in its causal relation, 592 Age, 592 Infrequency of atonic form among the poor, 592 Sedentary life, 592 Symptoms, 592 Disturbance of gastric functions, 592 Impaired appetite, 593 Increased appetite (polyphagia), 593 Thirst, 593 Pain, 593 Fulness and weight, 593 Eructations and heartburn, 593 Gases, nature of, 593 inflammability of, 593 Vomiting, 593 time of, 593 Vomited matters, abundance of, 593 amount of, 593 fermentation of, 594 odor of, 594 presence of micro-organisms in, 594 sarcinæ, bacteria, etc. in, 594 absence of free hydrochloric acid in, 594 presence of blood in, 594 Constipation, 594 Diarrhoea, 594 Urine, state of, 594 Dyspnoea and cardiac palpitation, 595 General condition, 595 Tetanic spasms, 595 seat of, 595 muscles of calves and abdomen, 595 of flexors of hand and forearm, 595 Coma, 596 Temperature, 596 Physical signs, 596 Prominence of epigastric region, 596 Peristaltic movements, 596 Splashing sound on palpation, 597 method of producing, 597 Percussion, 598 Auscultation, 598 Displacement of adjacent organs, 599 Morbid anatomy, 599 Degrees of, 599 Capacity, 599 Fundus, size of, 599 Oesophagus, dilatation of, 599 Hypertrophy of gastric walls, 599 Atrophy of gastric walls, 599 Fatty and colloid degeneration of muscular coats, 600 Mucous membrane, state of, 600 Atrophy of abdominal viscera, 600 Diagnosis, 600 Distension of stomach with carbonic acid gas in, 596, 601 Ingestion of water to aid, 598, 602 Stomach-tube, use of, 597, 602 Determination of lower gastric border, 598, 602 From chronic catarrhal gastritis, 603 atonic dyspepsia, 603 Prognosis and course, 603 Death, mode of, 603 Treatment, 603 Prophylactic, 603 Diet, 603, 608 Washing of stomach, 603 object of, 604 modes of, 604 apparatus used in, 604-607 siphon process, 604-606 stomach-pump, 604 frequency of, 607 objections to, 607 contraindications, 608 Of heartburn, 609 Of anæmia, 609 Of constipation, 609 Use of electricity, 608 of nux vomica, 609 of strychnia, 609 of abdominal bandage, 609 of hydrochloric acid, 609 of pepsin, 609 of sodium bicarbonate, 609 of Carlsbad water, 609 of iron and arsenic, 609 of resection of pylorus, 609 of gastrotomy, 609 Acute Dilatation of, 610 Definition, 610 Etiology, 610 Symptoms, 610 Pain, 610 Tympanites, 610 Vomiting, cessation of, 610 Prognosis, 610 Treatment, 610 Use of stomach-tube, 610

Stomach, functional and inflammatory diseases of, 436

STOMACH, HEMORRHAGE FROM, 580 Definition, 580 Synonyms, 580 Etiology, 580 Ulcer of stomach, 580 Cancer, 580 Traumatism, 580 Corrosive poisons, 580 Diseases of gastric vessels, 580 Aneurism of gastric arteries, 580 Varices of veins, 580 Degenerations of vessels, 581 Congestion, active, 581 passive, 581 Portal vein, 581 Pulmonary blood-vessels, 581 Heart disease, 581 Violent vomiting, 581 Acute infectious diseases, 581 Hemorrhagic diathesis, 582 Malaria, 582 Anæmia, 582 Cholæmia, 582 Bright's disease, 582 Neuropathic conditions, 582 Melæna neonatorum, 582 Bursting aneurisms, 582 Idiopathic causes, 582 Hemorrhage from nose, mouth, lungs, etc., 583 Symptoms. See Gastric Ulcer. Morbid anatomy, 583 Source of, 583 From diapedesis, 583 From rupture of blood-vessels (rhexis), 583 Diagnosis, 584 Significance of black stools, 584 Examination of vomit, 584 From hysterical vomiting, 584 Examination of nose and throat, 584 From oesophageal hemorrhage, 584 Use of oesophagoscope in, 584 From hæmoptysis, 584, 585 Of causes, 585 Prognosis, 585 Treatment. See Gastric Ulcer.

Stomach, lesions of, in cholera infantum, 743, 744 in entero-colitis, 739 minor organic changes in, 611 organic diseases of, 480

STOMACH, RUPTURE OF, 618 Etiology, 618 Injury, 618 From over-distension by solids or gas, 618 Symptoms, 618 Prognosis, 618 Treatment, 618

STOMACH, SIMPLE ULCER OF, 480 Definition, 480 Synonyms, 480 History, 480 Etiology, 481 Frequency, 481, 482 Sex, influence on causation, 483 Age, influence on causation, 483 when most frequent, 484, 485 Climate, influence on causation, 485 Geographical distribution, 485 Poverty, 486 Occupation, 486 Needle-women, cooks, and maid-servants, 486 Shoemakers and tailors, 486 Injury, 486 Corrosive poisons, 486 Pulmonary phthisis, influence of, on causation, 487 Menstrual disorders, 487 Chlorosis and anæmia, 487 Diseases of heart and blood-vessels, 487 of kidneys, 487 of stomach, 488 Diabetes mellitus, 488 Intermittent fever, 488 Abuse of alcohol, 488 Burns of skin, 488 Symptoms, 488 Pain, 488 Character, 489 Localized nature of, 489 Seat, 489 Effect of food upon, 489 pressure, 490 rest, 490 mental emotion, 490 Distribution of, 490 Intermittence of, 491 Causes of, 491 Vomiting, 491 Time of, 491 Character of, 491, 492 Causes of, 492 Hemorrhage, 492 Quantity, 492 Voided by bowels, 492 appearance of stools in, 493 Hæmatemesis, 493 Appearance of blood in, 493 Causes, 493 Hemorrhage, effect upon other symptoms, 494 Relief of pain after, 494 Sources of, 494 Of indigestion, 494 Appetite, loss of, 494 Thirst, 494 Constipation, 494, 495 Flatulence, 494 Nausea and vomiting, 494 Headache, dizziness, etc., 494 Tongue, condition, 495 Amenorrhoea, 495 Temperature, 495 General health, 496 Physiognomy, 496 Cachectic dropsy, 496 Physical signs, 496 Perforation, 496 Frequency, 497 in sexes, 497 May occur without symptoms, 497 Cause, 498 Pain in, 498 Collapse in, 498 Physiognomy in, 498 Temperature, 498 Pulse, 498 Vomiting, 498 Constipation, 498 Thirst, 498 Respiration, 498 Suppression of urine, 498 Abdomen, state of, 498 Tympanites, 498 Retraction of testicle, 498 Position of patient, 498 Death in, cause of, 499 Peritonitis in, 499 Peritoneal abscesses, 499 Pyo-pneumothorax subphrenicus of Barlow and Wilks, 499 Into pleural cavities, 500 transverse colon, 500 pericardium, 500 Sequelæ, 500, 503 Gastro-cutaneous fistulæ, 500 Stenosis of pylorus, and dilatation, 503 Complications, 502 Pylephlebitis, 502 Chronic peritonitis, 502 Catarrhal gastritis, 502 Interstitial gastritis, 502 Extension to pleura, 503 Fatty degeneration of heart, 503 Embolic pneumonia, 503 Pulmonary tuberculosis, 503 Bright's disease, 503 Heart disease, 503 Hepatic degenerations, 503 Course, 500 Forms of, 501 Latent, 501 Acute perforating, 501 Hemorrhagic, 501 Gastralgic-dyspeptic, 501 Chronic hemorrhagic, 501 Cachectic, 501 Recurrent, 501 Stenotic, 501 Duration, 501 Terminations, 501 Tendency to recovery, 501 Causes of death, 502 Mortality, 502 Morbid anatomy, 503 Ulcers, number, 503 Position, 503 Size, 504 Shape, 504 tendency to become conical, 504 Tendency to transverse extension, 504 Appearance of edges, 505 floor, 505 Microscopic appearance of surrounding tissue, 505 Cicatrization, 506 method, 506 deformities of stomach from, 506 Peritoneum, lesions of, 506 Perforations, seat, 509 Lesions resulting from, 507 Ulcerations of surrounding viscera, 507 Circumscribed peritoneal abscess, 507 Gastro-cutaneous fistulæ, 508 -colic fistulæ, 508 -duodenal fistulæ, 508 Pneumo-pericardium, 508 Gastro-pleural fistulæ, 508 Emphysema of areolar tissue, 509 time of appearance, 509 nature of the gas, 509 Gas in arteries, 510 Hemorrhage, source of, 510 Changes in blood-vessels, 510 Embolism, 510 Thrombosis of vessels about ulcer, 510 Fatty and waxy degeneration and calcification of gastric vessels, 511 Varicosities of veins, 511 Aneurism of vessels about ulcer, 511 Pathenogenesis, 512 Theories regarding development, 512 Digestive action of gastric juice on development, 512 Inflammatory theory of origin, 512 Neurotic theory of origin, 512 Theory, circumscribed hemorrhagic infiltration, 512 Disease of gastric blood-vessels, 513 Böttcher's view of mycotic origin, 513 Artificial production of, 514 Daettwyler and Cohnheim's experiments, 514 Diagnosis, 514 From nervous gastric disorders, 515 nervous vomiting, 516 gastralgia, 516 gastric crises, 517 cancer. See Stomach, Cancer of. chronic catarrhal gastritis, 517 hepatic colic, 517 Prognosis, 518 Treatment, 519 Removal of sources of irritation, 519 Importance of rest, 519 Diet, 519-522 Use of nutrient enemata, 519 Milk, 519 peptonized, 520 Leube's beef, solution of, 520 Beef-juice, freshly-expressed, 521 Avoidance of coarse food and fruits, 521 Of pain, 524 Of vomiting, 524 Of hemorrhage, 525 Of dyspepsia, 527 Of perforation, 527 Importance of maintaining nutrition, 527 Of anæmia, 528 Of sequelæ, 528 Of convalescence, 529 Carlsbad waters, use of, 522 method of preparing, 522 Use of stomach-tube, 523, 525 method of, 523 of bismuth, 523, 524 of argentum nitratis, 523, 524 of opium, 524 of codeia, 524 of astringents to relieve pain, 524 of tr. ferri-chlor. to relieve pain, 524 of counter-irritation, 524 of subcutaneous injection of milk, oil, and beef-tea, 525 of ice, 525 of antiemetics, 525 of ingluvin, 525 of ergotin in hemorrhage, 525 of dil. sulphuric acid in hemorrhage, 526 of acetate of lead in hemorrhage, 526 of ligature of upper extremities in hemorrhage, 526 of rubber balloon tampon in hemorrhage, 526 of alkalies in dyspepsia, 527 of poultices in perforation, 527 of laparotomy in perforation, 527 of inunctions of oil, 527 of iron in anæmia, 528 hypodermic, 528

Stomach, tubercular ulcers of, 529 typhoid ulcers of, 529 syphilitic ulcers of, 529 necrotic ulcers of, 529 catarrhal ulcers of, 529 follicular ulcers of, 529

Stomach and intestines, lesions of, in acute yellow atrophy of liver, 1026 perforation of, by gall-stones, 1068, 1074

Stomach-pump, use of, in chronic gastritis, 478