which he noticed the particulars of 3000 cases and 500 dissections, he did not meet with a single instance of fatal primary gastritis. The disease only occurred as a secondary affection or complicating some other disease which was the cause of death.[1] So far as I have hitherto been able to inquire among systematic authors, the descriptions of idiopathic acute gastritis appear to have been taken from the varieties caused by poison.
The following are the only specific accounts I have hitherto met with of an affection of the nature of idiopathic acute gastritis; and the reader will be at no loss to perceive that in each of them it admits of being viewed differently. The first two are the cases of inflammation referred by Haller and Guérard to drinking cold water incautiously [p. 100]. The next is a remarkable incident related by Lecat, and occurring in 1763. A girl, nineteen years old, was attacked while in good health with shivering, faintness, acute pain in the belly, cold extremities and imperceptible pulse; and she died in sixteen hours. The stomach was found red, and checkered with brownish patches and gangrenous pustules (probably warty black extravasation): yet it was supposed to have been ascertained that she had not taken any thing deleterious.[2] This narrative is certainly to appearance pointed. But when it is added, that the girl's mother was attacked about the same time with precisely the same symptoms and died in four hours, I think the reader, when he also considers the imperfect mode in which chemical inquiries were then conducted, will by no means rest satisfied with Lecat's assurance that nothing deleterious was swallowed. The last is an equally singular case given by Dr. Hastings, of Worcester, where poisoning with cantharides was suspected. A young lady, liable to indigestion, but at the moment in better health than usual, was attacked with sickness before breakfast and after it with vomiting. Three days elapsed before she was seen by her medical attendant, who found her sinking under incessant vomiting, severe pain in the loins, strangury, bloody urine, and swelling of the clitoris, attended with red extravasation of the eyes, and a red efflorescence on the skin. Death followed next day amidst convulsions; and there was found in the dead body extravasation of blood between the kidneys and their outer membrane, into the pelvis of each kidney, and into the bladder,—redness of the bronchial membrane, and gorging of the air-cells with blood,—and general redness of the inside of the stomach, with numerous extravasated spots in the submucous coat.[3] It seems to have been clearly proved at the coroner's inquest that poisoning was here out of the question. But the case appears rather to have been one of renal irritation or inflammation than of gastritis, and the affection of the stomach secondarily merely.
- ↑ Recherches sur la Gastro-entérite, ii. 51.
- ↑ Laisné sur les Perforations Spontanées, p. 206, from Recueil des observations des Hopitaux Militaires, i. 375.—This case is also given by MM. Petit and Serres in their treatise entitled "de la Fièvre Entéro-Mésenterique," p. 197, and is considered by them an instance of that particular disease.
- ↑ Trans. of Provinc. Med. and Surg. Association, vol. i.
