Haematemesis from gastric ulcer : notes on over two hundred cases / by W. Gilman Thompson.

  • Thompson, W. Gilman (William Gilman), 1856-1927.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Haematemesis from gastric ulcer : notes on over two hundred cases / by W. Gilman Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    •eczema, and the patient, unaware of its baneful effect, had contin- ued its daily use upon his own responsibility. The hemorrhage was the only symptom of ulcer, but it proved fatal during one night and I attributed it to a probable ulcer from this form of metal poisoning. To the above list of 195 cases may be added 6 which occurred in Bellevue Hospital during the past year, of which 3 were males and 3 females. Of these 1 was cured, 1 improved, 1 died of hemorrhage, and 3 were unimproved—All had hsematemesis. The ages of the three males were respectively forty, forty-one, and fifty-one years. In January of this year two more cases oc- curred among males. One patient, thirty-six years of age, was discharged improved after hiematemesis, and one fifty-four years of age died after opera- tion with perforation of pyloric ulcer. He had no hemorrhage at any time (he was a painter). (The 8 cases, added to the previous 195, make a total of 203 hospital cases.) The influence of social status upon the etiology of gastric ulcer is well exemplified in a comparison of the records of Bellevue and the Presbyterian Hospitals for the year 1904. In Bellevue, with 17,765 medical cases treated during that year, there were only 6 cases of gastric ulcer in the entire service, one of the four divisions having none at all—approximately 1 case in 3,000. In the Presby- terian Hospital, with 1218 medical cases treated, there were 15 of gastric ulcer, a proportion of 1 case in 80. In Bellevue, with 7595 surgical cases treated, but one operation was performed for gastric ulcer (which proved to be a complication of carcinoma), against 1925 operated cases in the Presbyterian Hospital, with 4 for gastric ulcer. The majority of gastric ulcers occur among the servant-girl and seamstress class, patients who are more likely to seek private than municipal hospital relief, either from a species of natural selection or because their well-to-do employers are in the habit of contribu- ting to the financial aid of private hospitals; hence they become interested in them and refer their dependents to them. The muni- cipal Bellevue Hospital abounds in cases of alcoholic gastritis, gas- tric carcinoma, syphilis, arteriosclerosis, privation and starvation, yet these prove to be comparatively infrequent etiological factors. There were 144 cases classed as “gastritis” in Bellevue in 1904. What is there in the dietetic or other habits of life of the serving- woman class that predisposes to this definite lesion of the stomach wall? It can hardly be their frequent diet of tea and toast, nor tight lacing (Rasmussen); yet what is it? I raise the question as an interesting one, but cannot answer it. I have examined also the records of cases treated at the Cor- nell Dispensary since its foundation five years ago. There have been in the General Medicine Clinic alone 13,500 cases, with only one of gastric ulcer—a male, a metal polisher, forty-nine years of