. Medical diagnosis for the student and practitioner. bout one fifth of that of the fifth decade. * Recent investigations indicate the existence in the normal stomach of protective anti-enzymes, but under what conditions their activity fails is as yet unknown,t Doubtless the post-pyloric ulcer is a cause of melena neonatorum Stillunknown. go8 MEDICAL DIAGNOSIS Certain Predisposing Factors.—Direct injury, as from blows, tight lac-ing, pressure, the ingestion of corrosive drugs and such occupations as lead toanemia, irregular or hasty eating and the use of improper food, are held to beimportant
. Medical diagnosis for the student and practitioner. bout one fifth of that of the fifth decade. * Recent investigations indicate the existence in the normal stomach of protective anti-enzymes, but under what conditions their activity fails is as yet unknown,t Doubtless the post-pyloric ulcer is a cause of melena neonatorum Stillunknown. go8 MEDICAL DIAGNOSIS Certain Predisposing Factors.—Direct injury, as from blows, tight lac-ing, pressure, the ingestion of corrosive drugs and such occupations as lead toanemia, irregular or hasty eating and the use of improper food, are held to beimportant factors, and at least figure prominently in the statistical statistics are available so far as the author knows, which would bearactuarial criticism. In one clinic, located in the midst of an agrarian population, the farmermay be found to furnish the highest percentage of ulcer cases; in another,the weaver; in yet another, domestics; the results depending chiefly uponthe location of the clinic and the occupational trend of its Fig. 464.—Typical ulcer (penetrating) with spasm of the segments. Note smallprojection toward spine on left side of constriction. (After von Bergmann.) Varieties.—(a) The Acute or acutely relapsing chronic ulcer of pro-nounced and definite symptomatology termed by Welch gastralgic-dys peptic.(b) The latent acute and chronic forms. Single or multiple ulcers may exist foryears and ultimately perforate or spontaneously heal without localized symptoms:probably more than one-half of the cases are unrecognized clinically, (c) Theacute perforating form. In this there is a rapid advance and perforation, (d)The acute hemorrhagic form. In this the symptoms are usually vague, of briefduration or may be entirely absent until profuse hemorrhage occurs. Othertypes occasionally described are relatively unimportant. PATHOLOGY AND MORBID ANATOMY.—The ulcers vary in sizefrom mere erosion to necrotic areas measuring from 4 to 6 inches in diamet
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
