Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physicChristison, Robert, Sir
Science
Treatise on Poisons: In relation to medical jurisprudence, physiology, and the practice of physic
Christison, Robert, Sir
Medical jurisprudence; Toxicology
It may be situated on any part of the stomach, but is oftenest seen on
the posterior surface. It is sometimes small, more often as big as a
half-crown, frequently of the size of the palm, and occasionally so
great as to involve an entire half of the stomach. Sometimes there is
more than one aperture. The margin is of all shapes, commonly fringed,
and almost always formed of the peritoneum, the other coats being more
extensively dissolved. In one instance, however, the peritonæal surface
was on the contrary the most extensively destroyed;[202] and in a case
which occurred in the infirmary here, and was pointed out to me by the
late Dr. W. Cullen, the peritonæum alone was extensively softened, and
partly dissolved, so as to lay the muscular coat bare on its outer
surface. The gelatinization therefore sometimes, though very rarely,
begins on the outside of the stomach. Internally the whole is surrounded
by pulpiness of the mucous coat, generally white, occasionally bluish or
blackish, never granulated like an ulcer, very rarely vascular; and when
vascular, the blood may be squeezed out of the loaded and open vessels.
The organs in contact with the hole are also frequently softened. Thus
an excavation is sometimes found in the liver or spleen; or the
diaphragm is pierced through and through. The margins of the latter
holes are without any sign of vascular action, but are generally
besmeared with a dark pulpy mass, the remains of the softened tissue.
The pulp never smells of gangrene; with which, indeed, this species of
softening is wholly unconnected. The edge of the hole in the stomach
never adheres to the adjoining organ; yet, even when the hole is very
large, the contents of the stomach have not always made their escape.
Often the dissolution of the coats is incomplete. John Hunter and
others, indeed, have said that a stomach is rarely seen without more or
less solution of the mucous coat.[203] The best account of the
appearances in this state is given by Jaeger of Stuttgardt.[204]
Public-domain text, read in full here on John Shaqi.
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