Among the anomalous contents of the stomach, we class, first, the secretions of the mucous membrane, which, both as regards quantity and quality, in various ways depart from their healthy condition; secondly, the products of different morbid processes which occur either in the stomach or external to it; thirdly, foreign bodies which have been introduced into it from without in a variety of ways.

To the first belong large collections of gas, of very acid gastric juice, as we find occurring in chronic gastritis and many other morbid metamorphoses of the gastric membranes, the absence, but more frequently the excess, of a white, milky, opaque, and purulent, or of a transparent, viscid, gelatinous, glassy mucus, such as we find in chronic catarrhs, or in a blennorrhoic condition of the gastric mucous membrane.

To the second belong the products of exudative processes, and of ulcers in the stomach itself, such as plastic, viscid mucous, fibrinous exudation, pus, ichor. The latter may also be introduced from without, from abscesses of contiguous organs, the liver, the spleen, the pancreas, the lymphatic glands, from ulcers of the oesophagus, and even from abscesses of the vertebrae.

Blood occurs in varying quantities; when found to a large amount either in a coagulated or fluid condition, it commonly has its source in rupture of varicose veins of the oesophagus or stomach, in rupture of an aneurism communicating with those cavities, or in corrosion of arteries lying at the base of a perforating gastric or duodenal ulcer. Occasionally, too, the capillary bleedings which accompanying follicular inflammation and erosion, degenerate into such exhausting hemorrhages.

Blood may also occur as a reddish-brown, or black pulverulent substance, either mixed up with the contents of the stomach, and especially with the mucous secretion, in the shape of streaks or flocculi, or attached to the mucous membrane, and more especially to the bleeding portions.

Or it may occur as a chocolate-colored, coffee-ground-like or inky matter, and that will be the case under all circumstances that give rise to gastric hemorrhage, if the blood has been retained in the stomach for a certain period, and submitted to the action of the gastric juice. It is evident that this will chiefly be the case in passive hemorrhages. We gather from the preceding observations that the following are the cases in which the contents of the stomach present this appearance, and in which there will be vomiting of black matter during life: a. In slow hemorrhage from a perforating ulcer of the stomach; b. In capillary hemorrhage accompanying hemorrhagic erosion of the gastric mucous membrane and their follicles; c. In softening; d. In the hemorrhages that accompany cancer of the stomach.

In rare cases we find blood in the stomach without being able to trace a distinct cause of the hemorrhage, either in or out of the organ; the parietes of the stomach are either found to be in a state of complete anaemia, or occasionally single, red, injected portions of the mucous membrane are visible, which bleed on the application of slight pressure from below, by which the congestion is increased. There is no doubt that, in such cases, hyperaemiae of various kinds precede, and blood at once transudes through the vascular coats; the greater the impulse of the blood, the laxer the tissue and the vascular coats, and the thinner the blood itself is, the easier will this be brought about.

The blood which is found in the stomach is not only, as we have remarked, frequently the result of extravasation which has taken place external to the stomach, but it may even have been extravasated external to the oesophagus and intestinal canal. Thus it is often swallowed in large quantities during hemorrhages of the respiratory mucous membrane.

Finally, there may be bile, biliary calculi, fecal matter, and lumbrici, in the stomach.

To the third class belong the most various foreign bodies which have been swallowed accidentally, or in consequence of morbid appetites; in the latter case, chiefly seen in lunatics, they are taken in large quantities, and with evident selection. We may enumerate flints, clay, indigestible vegetables, grass, and straw, waste pieces of clothing; metallic substances, as coins, bullets, iron nails, pins, etc. They give rise to various lesions, to perforation of the stomach, or at least, to irritation and inflammation, with subsequent ulceration of the mucous membrane.