Tubercular ulcers are rare in the stomach, although very frequent in the intestine. They sometimes occur in cases of advanced phthisis pulmonalis. The ulcers are more superficial than those in the intestine, resembling rather those of the urinary bladder, although deeper. They have overhanging edges and granular floors.

The rarity of tubercular ulcers in the stomach as compared with the intestine may be due to two circumstances. In the first place the gastric juice will inhibit the tubercle bacilli in their passage through the stomach, and, in the second place, the stomach is defective in closed follicles, which in the intestine are the primary seats of the tuberculosis. This latter fact may also account for the smaller size and more superficial character of the ulcers.

The author has only met with one case, and in it the patient had been in a state of extreme inanition for some weeks before death.

Syphilis is also excessively rare in the stomach, but Birch-Hirschfeld records two cases' in his Lehrbuch, apparently of congenital origin.

Literature

Coats, Glasg. Med. Jour., xxvi., 1886, p. 53; Kuhl, Ueber tuber-culose Magengeschwiire, 1889; Habershon, Path, trans., 1894, p. 73; Bibch-Hibschfeld, Lehrb., 3rd ed., 1887, ii., 538.