DOI: 10.7925/drs1.ucdlib_280334
title: Ulcer of the stomach

description: Watercolour medical illustration depicting ulcer of the stomach. It has the alternative reference number 1624, 247 and P3A on the front. The Richmond Hospital Museum reference is B.b.30. The entry for this in P263/1 pg. 13 reads 'Ulcer of the stomach, communication with a splenic abscess. Catherine Brady 60. Dr Banks'. The artist's name is in the bottom right corner 'J. Connolly fec.t'. Includes stamp of Bristol Boards papermakers in top right corner. The typescript note on the back begins 'Chronic Ulcer of the Stomach'.
description: Scope and content: The full typescript note on the back reads 'Chronic Ulcer of the Stomach: Communication with Abscess of the Spleen. Dr Banks presented a specimen of ulcer of the stomach, taken from the body of a woman aged 50, who had recently been admitted into the Hardwicke Hospital, in a state of extreme debility and emaciation. She stated that, although her general health was good, she frequently vomited after her meals, but there was nothing remarkable in the matter ejected. Five days before she entered the hospital she had been seized with very severe rigors, which returned each day at the same hour, and were followed by general heat of body. The fits resembled, in some respects, the paroxysms of a quotidian ague, but there was no sweating stage. She complained of pain and tenderness, on pressure, over the whole extent of the abdomen; the tongue was red and dry, and the pulse exceedingly weak; she gradually became more debilitated, and died on the fourth day after her admission. Autopsy. On opening the abdomen, the intestines were found glued together, and copious effusions of lymph existed in the right and left hypochondriac regions. Much sero-purulent fluid had been effused into the general cavity of the abdomen; the spleen adhered firmly to the diaphragm and stomach, and its superior three-fourths were filled with pus of a greyish colour. On opening the stomach, an ulcer of an elliptical form was seen occupying the upper part of the greater curvature, extending from the orifice of the oesophagus downwards; its edges were indurated, and its surface was so thinned at one point that a small opening, not larger than a pin's head, had been formed, which led into the abscess of the spleen. The mucous membrane was perfectly healthy throughout the remainder of the organ; there were a few indurated tubercles in the upper lobe of the left lung. Dr Banks observed, that the age of the patient and the situation of the disease were calculated to lead to the supposition that the ulcer was malignant, but it possessed all the characters of the simple chronic ulcer, or, as it has recently been termed by Rokitansky, the "perforating gastric ulcer". The reports of the Pathological Society afford examples of the chronic ulcer of the stomach, in which adhesion had formed between the stomach and the left lobe of the liver and spleen; but Dr Banks did not remember a case precisely analogous to the one now presented. Professor R.W. Smith had on a former occasion laid before the Society a most interesting specimen of the disease, in which adhesion had taken place between the stomach and the pancreas, and effusion of the contents of the stomach had been prevented by a portion of the pancreas forming a perfect plug in the orifice. It should not be omitted, in the history of the case now detailed, that the vomiting did not afford any aid in determining the true nature of the disease; there was no "vomiting of blood following long-continued pain" a symptom upon which so much reliance has been placed by Dr Seymour. March 29, 1851'.
description: Numbering/sequence: Original reference number: 1624.