Very frequent opportunities are presented to us of observing loss of substance accompanied by bleeding, in the mucous membrane of the stomach. There are round or roundish spots of the size of a pin's head or a pea, or narrow, elongated streaks, at which the mucous membrane appears dark red, lax, soft, bleeding, and presenting a depression in consequence of loss of substance or slight erosion.

Commonly a dirty brown coagulum is attached to the point, and the nature of the derangement only becomes evident after the coagulum has been removed. Sometimes this loss of substance involves the entire thickness of the mucous membrane and the submucous cellular tissue, and produces an appearance of small, round, or striated ulcers.

This process is invariably accompanied by hemorrhage; the gastric mucus, which generally is present in considerable quantity, presents streaks of discolored blood, proportionate to the number of diseased points, or it shows a copious admixture of brown flocculi or debris, or we find an accumulation of fluid in the stomach, resembling coffee-grounds. The entire mucous membrane is found in a condition of recent or inveterate blennorrhoea and catarrh, and in the vicinity of the erosions it is often tumefied so as to form a vallated circumference.

The number of these erosions varies; it not unfrequently happens that the stomach, with the exception of the fundus, is closely studded with them, and is marked with red or brown spots, according to the color of the adherent coagula.

They occur at every period of life - they are seen even in the infant, and they are found chiefly at the pyloric portion, i. e. in that part which is the chief seat of the catarrhal process. The follicles, or the glandular apparatus of the gastric mucous membrane (Cruveilhier's gastritis folli-culosa), appear to be their occasional nidus.

This inflammation and erosion undoubtedly occur sometimes as an idiopathic affection. They are more commonly developed consequent, or attendant upon the most diverse, acute, and chronic diseases, so that no definite conclusion as to the real nature of the process, and as to its connection with other affections, has yet been arrived at. An acquaintance with the fact is of considerable importance, though it only serves to assure us that the disease is idiopathic, and in no way allied to the erosion produced by caustic substances.