Phlegmonous Gastritis.

Synonym.—Acute Suppurative Gastritis.

Definition.—A suppurative inflammation of the submucous and muscular coats of the stomach.

Etiology.—This is an exceedingly rare disease, and nearly always symptomatic, though it has occurred idiopathically as the result of traumatism or intemperance in eating and drinking. It usually follows in the wake of puerperal fever, pyemia, septicemia, and the exanthemata. It is found more frequently among males, and between the ages of twenty-five and fifty years.

Pathology.—The inflammation may be limited, gastric abscess, or diffuse. The seat of the inflammation is the submucous tissue, from which it spreads outward, involving the muscular and serous coats; and inward, invading the mucous membrane, thus giving rise to a honeycombed perforation. The limited form results in an abscess of greater or less proportion, which, rupturing, empties its contents into the stomach, or, perforating the walls of the stomach, empties into the peritoneum. In all cases the mucous and submucous tissues are dusky, softened, infiltrated, and break down during the suppurative process.

Symptoms.—These depend upon the primary lesion to a certain extent, the evidence of sepsis being more or less marked. Usually a chill marks the introduction of the disease, followed by fever, the temperature ranging from 103° to 105°. The tongue is dry, brown, and covered with dirty sordes. There is great pain in the stomach, radiating to all parts of the abdomen. Nausea and vomiting soon follow, the ejected material being dark-brown or black in color, and composed of pus, blood, and bile.

The symptoms, now, are all typical in character; coma, with great prostration, occurs, and the patient dies in a comatose condition. There is usually a jaundiced appearance from the beginning.

Diagnosis.—This is very difficult during life, the symptoms being similar to those of other grave gastric troubles. The positive diagnosis is only made during a post-mortem.

Prognosis.—It is unfavorable, the disease terminating in death in a few days. The limited form may end in recovery, though not often, but runs a longer course before proving fatal.

Treatment.—This would be along the line of antiseptics, such as echinacea, baptisia, sodium sulphite, potassium chlorate, etc. To relieve the intense pain, hypodermic injections of morphia will be necessary.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.