Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: of chronic ulcer of the duodenum which have a clinical significance do not seem, therefore, to be in any way dependent upon these injuries. It is perhaps owing to the interesting and obscure Fig. 8.—Ulcer Of The Duodenum Following A Burn. The first part of the duodenum, shewing a clean-cut oval opening in its posterior wall, the upper limit of which is about half an inch from the pylorus. The ulcer is one and a half inches long, and in the recent state its base was formed by the pancreas, which was eroded. The ulcerative process had exposed and opened the superior pancreatico-duodenal artery. Herbert E., aet. four, was admitted under Mr. Durham for several burns upon the lower extremities and buttocks. The child did well for sixteen days, after which he began to pass blood with his motions. The haemorrhage proved fatal on the nineteenth day after the accident. At the autopsy the intestines were found to contain much black blood. (Guy's Hosp. Museum. No. 740.) nature of these cases that unusual attention has been paid to them, and the impression as to their frequency has unconsciously become exaggerated. It is a fact, however, that acute ulceration of the duodenum doesoccur in cases of burn or scald; and that the surface lesion does bear a definite causal relationship to the lesion of the mucosa of the alimentary canal, especially of the duodenum. In his original paper Curling gave detailed notes of 12 cases, and subsequently recorded another case. Erichsen ("London Medical Gazette," 1843, xxxi, 544), in a study of the pathology of burns, cites 3 cases of ulcer of the first portion of the duodenum occurring on the fourth, seventh, and eighth days after the accident. Wilks ("Guy's Hosp. Rep.," 1856, 3d series, ii, 133), in a short paper, reviewed the 12 fatal cases...