Definition

A condition in which the gastric mucous membrane becomes the seat of small superficial exfoliations.

General Remarks

As is well known, the term "erosion" signifies a defect of superficial nature. In the stomach erosions are often found at the autopsy. Of late several valuable papers on the pathological anatomy of this subject and on the rare occurrence of erosions associated with typical ulcers of the stomach have been published.

In his excellent article, "Ueber geschwurige Pro-cesse im Magen," D. Gerhardt1 describes erosions of the stomach in the following words: "Sections made of erosions as a rule show that at the base of the ulcerations almost the entire lower half of the mucous membrane is still preserved. In the epithelium of these remaining glands nothing remarkable can be discovered; at the sides the glands become longer; the first ones that are intact usually curve themselves over the defect and partly cover it. The recovery seems to take place by the simple after-growth of the gland remnants".

1 D. Gerhardt: Virchows Archiv, Bd. 127, p. 85.

While the subject in question has been thoroughly discussed and studied in respect to the pathological anatomy by Gerhardt, Virchow,1 Langerhans,2 Hart-tung,3 and Ewald,4 very little has been done clinically. Although erosions of the mucous membrane of the stomach are mentioned in some text-books, there is nowhere defined how these conditions may be recognized during life.

In the Medical Record of June 23d, 1894, I5 have published an article which embodied observations on seven patients in whom small particles of gastric mucous membrane were frequently found in the wash-water of the stomach. These cases resembled each other in so many respects that they appeared as if belonging to one disease. They could best be considered as erosions of the gastric mucous membrane.

The description of "erosions of the stomach" which I shall give in the following is based on the paper just mentioned.

Within the last few years quite a number of authors have written on the same subject. Thus Nau-werk,6 Pariser,7 Sansoni,8 Quintard,9 and Mintz10 have published cases of hemorrhagic erosions of the stomach, and have on the whole corroborated my statements. Mintz suggested the name of "Einhorn's Disease" for this affection.

1 R. Virchow: Virchow's Archiv, Bel. 5, p. 363.

2B. Langerhans: Virchow's Archiv, Bd. 124, p. 373.

3O. Harttung: Deutsche med. Wochenschr., 1890, No. 38. p. 847.

4 C. Ewald: "Diseases of the Stomach," p. 236, 1892.

5 See also Max Einhorn: "Further Remarks on Erosions of the Stomach." The Journal of the American Medical Association, May 20th. 1899.

6Nauwerk: Mt'incheuer med. Wochenschr.. 1897, Nos. 35, 36.

7C, Pariser: Berl. klin. Wochenschr., 1900, No. 43.

8 L. Sansoni: Arch. f. Verdauungskrankheiten, 1900.

9E. Quintard: Arch. f. Verdauungskrankheiten. 1901.

10S. Mintz: "Ueber hjemorrhagischc Erosioncn des Magens." Zeitschr. f. klin. Medicin. Bd. 46. p. 115. 1902.

Etiology

In the vast majority of cases chronic gastric catarrh is probably the cause of the origin of the erosions. In some instances the erosions may, however, be due to some factors vet unknown.

Symptomatology

The subjective symptoms are especially pronounced and consist of pain, emaciation, and a feeling of weakness.

The pains, which are not usually intense, occur immediately after meals, independent of the character of the food of which the patient has partaken. They persist for a variable period of time (one to two hours) and disappear gradually. We have never observed cases characterized by severe attacks of pain. Intervals of complete freedom from pain of variable duration occur, during which the patient is perfectly well. In rare instances the pains are constant and independent of the ingestion of food.