As we have already treated of the diseases of the peritoneum, we shall now discuss those of the gastric mucous and submucous tissues, and the consecutive affections of the muscular coat of the stomach.

1. Inflammation

A. Catarrh Of The Gastric Mucous Membrane (Gastritis Mucosa)

The opportunity of observing the first stages of the genuine acute catarrh of the gastric mucous membrane, of the gastric-saburral, gastric-bilious, and allied conditions, in the dead subject, is rarely, if ever, offered; we see the blennorrhagic stage, chronic catarrh, and the occasional acute exacerbations of the latter, more frequently.

The latter is developed from repeated active hyperaemia, or from lasting mechanical hyperaemia, and the gastric catarrhs observed in gourmands, and especially in drunkards, and accompanied by ulceration, and by the formation of morbid products in the stomach in chronic heart disease, or in pulmonary phthisis, are particularly remarkable. The latter are generally complicated with catarrh of the entire intestinal tract, and with bronchial catarrh.

The anatomical signs of this condition are, a dark, reddish-brown, or slate-gray, or even blackish-blue discoloration of the mucous membrane, copious secretion of a stone-colored, occasionally glassy pituita, thickening, increased condensation and induration, i. e., hypertrophy of the mucous membrane, which presents itself in various degrees: a. In the lowest degree, the mucous membrane shows simply an increase of thickness and hardness in its tissue;

/B. In a higher degree, it presents, in addition to its increased thickness, an uneven, racemose, or warty surface, a surface mamellonee; r. In a still more advanced degree, it forms prolongations in the shape of permanent, firm folds, or of polypus.

The submucous cellular tissue, and the muscular coat, also participate in this hypertrophy in various degrees - the entire parietes of the stomach presenting unusual thickness, firmness, and hardness.

The pyloric portion is the chief seat of chronic catarrh, and it is there that hypertrophy of the mucous and other membranes is most prominent.

B. Croupy Inflammation

This form never occurs as a primary and substantive affection except in the shape of delicate flocculent exudations in the aphthous process of children, but always, and even that rarely, as a sequela or degeneration of exanthematic processes, in variola, in typhus, in the absorption of pus into the circulation, and particularly in puerperal inflammation of the uterine veins. The false membrane which sometimes invests the entire stomach, presents a very regular areolar surface.

The operation of tartar emetic upon the gastric mucous membrane may produce a similar process, it is however commonly limited to a few streaks.