Definition: deep inflammation tending to abscess. Causes: invasion by
pus microbes, infectious diseases, parasitism, traumas. Symptoms:
hyperthermia, colic, tenderness, icterus, coincident disease,
hæmatemesis. Lesions: submucous or subperitoneal abscess, parasites,
peritonitis, exudation, thickening, neoplasm of mucosa, catarrhal
complications. Treatment: careful diet, antiseptics, bitters,
laxatives.
_Definition._ This is a gastric inflammation affecting the membranous
layers, and tending to submucous or subperitoneal abscess. It is much
less frequent than the catarrhal form.
_Causes._ It may be attributed to invasion of the gastric walls by pus
microbes, and appears as secondary abscess in pyæmia and above all in
strangles. The microbes are introduced more directly through the wounds
inflicted by the larvæ of œstrus, or by the burrowing of these (Argus,
Schlieppe, Schortmann), or of spiroptera (Argus). Wounds by sharp
pointed bodies taken in with the food, furnish other infection—atria,
and in their turn ulcers connected with catarrhal or toxic inflammation
may furnish a means of entrance.
_Symptoms._ These resemble those of catarrhal inflammation, but are
usually attended by greater hyperthermia, and the colicy symptoms are
more marked. There is also greater tenderness in the epigastrium and
left hypochondrium, and icterus is more marked. When it occurs as an
extension of strangles or pyæmia the symptoms of these affections
elsewhere are pathognomonic. When the abscess bursts into the stomach
there may be vomiting of bloody mucus (hæmatemesis) which is not
necessarily followed by a fatal result.
_Lesions._ As these are seen only in fatal cases, the presence of an
abscess is the characteristic feature. This is usually submucous, or
less frequently subperitoneal, and may vary in size from a hazelnut
upward. The tendency appears to be to open into the stomach, though it
may burst into the peritoneum and cause general infection of that
membrane. In case of parasites, the spiroptera or œstrus larva may be
found in the abcess cavity having a narrow opening into the stomach. In
certain cases the abscess on the pyloric sac has been found opening into
the duodenum. Congestion, thickening, puckering into rugæ and laceration
of the adjacent mucosæ may be a marked feature, a circumscribed
catarrhal gastritis complicating the local phlegmon.
_Treatment._ This is less hopeful than in catarrhal gastritis, but
should be conducted along the same lines. The same careful diet, with
daily antiseptics and bitters may prove valuable in limiting the
inevitable suppuration, and, if the pus should escape into the stomach,
in healing the lesion. Sulphites of soda, sulphide of calcium,
chamomile, and quinia, are to be commended and pepsin may be added to
secure at once proteid digestion and antisepsis. Laxatives may be
required to counteract constipation or expel irritants, and these may be
combined with the antiseptics already named or with salol, eucalyptol,
sodium salicylate or other non-poisonous agent of this class.