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This ebook is for the use of anyone anywhere in the United States and most other parts of the world at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this ebook or online atwww.gutenberg.org. If you are not located in the United States, you will have to check the laws of the country where you are located before using this eBook.
Title: Encyclopaedia Britannica, 11th Edition, "Gassendi, Pierre" to "Geocentric"Author: VariousRelease date: August 31, 2011 [eBook #37282]Most recently updated: January 8, 2021Language: EnglishCredits: Produced by Marius Masi, Don Kretz and the OnlineDistributed Proofreading Team at https://www.pgdp.net
Title: Encyclopaedia Britannica, 11th Edition, "Gassendi, Pierre" to "Geocentric"
Author: Various
Author: Various
Release date: August 31, 2011 [eBook #37282]Most recently updated: January 8, 2021
Language: English
Credits: Produced by Marius Masi, Don Kretz and the OnlineDistributed Proofreading Team at https://www.pgdp.net
*** START OF THE PROJECT GUTENBERG EBOOK ENCYCLOPAEDIA BRITANNICA, 11TH EDITION, "GASSENDI, PIERRE" TO "GEOCENTRIC" ***
Articles in This Slice
GASSENDI1[Gassend],PIERRE(1592-1655), French philosopher, scientist and mathematician, was born of poor parents at Champtercier, near Digne, in Provence, on the 22nd of January 1592. At a very early age he gave indications of remarkable mental powers and was sent to the college at Digne. He showed particular aptitude for languages and mathematics, and it is said that at the age of sixteen he was invited to lecture on rhetoric at the college. Soon afterwards he entered the university of Aix, to study philosophy under P. Fesaye. In 1612 he was called to the college of Digne to lecture on theology. Four years later he received the degree of doctor of theology at Avignon, and in 1617 he took holy orders. In the same year he was called to the chair of philosophy at Aix, and seems gradually to have withdrawn from theology. He lectured principally on the Aristotelian philosophy, conforming as far as possible to the orthodox methods. At the same time, however, he followed with interest the discoveries of Galileo and Kepler, and became more and more dissatisfied with the Peripatetic system. It was the period of revolt against the Aristotelianism of the schools, and Gassendi shared to the full the empirical tendencies of the age. He, too, began to draw up objections to the Aristotelian philosophy, but did not at first venture to publish them. In 1624, however, after he had left Aix for a canonry at Grenoble, he printed the first part of hisExercitationes paradoxicae adversus Aristoteleos. A fragment of the second book was published later at La Haye (1659), but the remaining five were never composed, Gassendi apparently thinking that after theDiscussiones Peripateticaeof Francesco Patrizzi little field was left for his labours.
After 1628 Gassendi travelled in Flanders and Holland. During this time he wrote, at the instance of Mersenne, his examination of the mystical philosophy of Robert Fludd (Epistolica dissertatio in qua praecipua principia philosophiae Ro. Fluddi deteguntur, 1631), an essay on parhelia (Epistola de parheliis), and some valuable observations on the transit of Mercury which had been foretold by Kepler. He returned to France in 1631, and two years later became provost of the cathedral church at Digne. Some years were then spent in travelling through Provence with the duke of Angoulême, governor of the department. The only literary work of this period is theLife of Peiresc, which has been frequently reprinted, and was translated into English. In 1642 he was engaged by Mersenne in controversy with Descartes. His objections to the fundamental propositions of Descartes were published in 1642; they appear as the fifth in the series contained in the works of Descartes. In these objections Gassendi’s tendency towards the empirical school of speculation appears more pronounced than in any of his other writings. In 1645 he accepted the chair of mathematics in the Collège Royal at Paris, and lectured for many years with great success. In addition to controversial writings on physical questions, there appeared during this period the first of the works by which he is known in the history of philosophy. In 1647 he published the treatiseDe vita, moribus, et doctrina Epicuri libri octo. The work was well received, and two years later appeared his commentary on the tenth book of Diogenes Laërtius,De vita, moribus, et placitis Epicuri, seu Animadversiones in X. librum Diog. Laër. (Lyons, 1649; last edition, 1675). In the same year the more importantSyntagma philosophiae Epicuri(Lyons, 1649; Amsterdam, 1684) was published.
In 1648 ill-health compelled him to give up his lectures at the Collège Royal. He travelled in the south of France, spending nearly two years at Toulon, the climate of which suited him. In 1653 he returned to Paris and resumed his literary work, publishing in that year lives of Copernicus and Tycho Brahe. The disease from which he suffered, lung complaint, had, however, established a firm hold on him. His strength gradually failed, and he died at Paris on the 24th of October 1655. A bronze statue of him was erected by subscription at Digne in 1852.
His collected works, of which the most important is theSyntagma philosophicum(Opera, i. and ii.), were published in 1658 by Montmort (6 vols., Lyons). Another edition, also in 6 folio volumes, was published by N. Averanius in 1727. The first two are occupied entirely with hisSyntagma philosophicum; the third contains his critical writings on Epicurus, Aristotle, Descartes, Fludd and Lord Herbert, with some occasional pieces on certain problems of physics; the fourth, hisInstitutio astronomica, and hisCommentarii de rebus celestibus; the fifth, his commentary on the tenth book of Diogenes Laërtius, the biographies of Epicurus, N.C.F. de Peiresc, Tycho Brahe, Copernicus, Georg von Peuerbach, and Regiomontanus, with some tracts on the value of ancient money, on the Roman calendar, and on the theory of music, to all which is appended a large and prolix piece entitledNotitia ecclesiae Diniensis; the sixth volume contains his correspondence. TheLives, especially those of Copernicus, Tycho and Peiresc, have been justly admired. That of Peiresc has been repeatedly printed; it has also been translated into English. Gassendi was one of the first after the revival of letters who treated theliteratureof philosophy in a lively way. His writings of this kind, though too laudatory and somewhat diffuse, have great merit; they abound in those anecdotal details, natural yet not obvious reflections, and vivacious turns of thought, which made Gibbon style him, with some extravagance certainly, though it was true enough up to Gassendi’s time—“le meilleur philosophe des littérateurs, et le meilleur littérateur des philosophes.”
Gassendi holds an honourable place in the history of physical science. He certainly added little to the stock of human knowledge, but the clearness of his exposition and the manner in which he, like Bacon, urged the importance of experimental research, were of inestimable service to the cause of science. To what extent any place can be assigned him in the history of philosophy is more doubtful. TheExercitationeson the whole seem to have excited more attention than they deserved. They contain little or nothing beyond what had been already advanced against Aristotle. The first book expounds clearly, and with much vigour, the evil effects of the blind acceptance of the Aristotelian dicta on physical and philosophical study; but, as is the case with so many of the anti-Aristotelian works of this period, the objections show the usual ignorance of Aristotle’s own writings. The second book, which contains the review of Aristotle’s dialectic or logic, is throughout Ramist in tone and method. The objections to Descartes—one of which at least, through Descartes’s statement of it in the appendix of objections in theMeditationeshas become famous—have no speculative value, and in general are the outcome of the crudest empiricism. His labours on Epicurus have a certain historical value, but the want of consistency inherent in the philosophical system raised on Epicureanism is such as to deprive it of genuine worth. Along with strong expressions of empiricism we find him holding doctrines absolutely irreconcilable with empiricism in any form. For while he maintains constantly his favourite maxim “that there is nothing in the intellect which has not been in the senses” (nihil in intellectu quod non prius fuerit in sensu), while he contends that the imaginative faculty (phantasia) is the counterpart of sense—that, as it has to do with material images, it is itself, like sense, material, and essentially the same both in men and brutes; he at the same time admits that the intellect, which he affirms to be immaterial and immortal—the most characteristic distinction of humanity—attains notions and truths of which no effort of sensation or imagination can give us the slightest apprehension (Op.ii. 383). He instances the capacity of forming “general notions”; the very conception of universality itself (ib.384), to which he says brutes, who partake as truly as men in the faculty calledphantasia, never attain; the notion of God, whom he says we may imagine to be corporeal, but understand to be incorporeal; and lastly, the reflex action by which the mind makes its own phenomena and operations the objects of attention.TheSyntagma philosophicum, in fact, is one of those eclectic systems which unite, or rather place in juxtaposition, irreconcilable dogmas from various schools of thought. It is divided, according to the usual fashion of the Epicureans, into logic (which, with Gassendi as with Epicurus, is trulycanonic), physics and ethics. The logic, which contains at least one praiseworthy portion, a sketch of the history of the science, is divided into theory of right apprehension (bene imaginari), theory of right judgment (bene proponere), theory of right inference (bene colligere), theory of right method (bene ordinare). The first part contains the specially empirical positions which Gassendi afterwards neglects or leaves out of account. The senses, the sole source of knowledge, are supposed to yield us immediately cognition of individual things; phantasy (which Gassenditakes to be material in nature) reproduces these ideas; understanding compares these ideas, which are particular, and frames general ideas. Nevertheless, he at the same time admits that the senses yield knowledge—not of things—but of qualities only, and holds that we arrive at the idea of thing or substance by induction. He holds that the true method of research is the analytic, rising from lower to higher notions; yet he sees clearly, and admits, that inductive reasoning, as conceived by Bacon, rests on a general proposition not itself proved by induction. He ought to hold, and in disputing with Descartes he did apparently hold, that the evidence of the senses is the only convincing evidence; yet he maintains, and from his special mathematical training it was natural he should maintain, that the evidence of reason is absolutely satisfactory. The whole doctrine of judgment, syllogism and method is a mixture of Aristotelian and Ramist notions.In the second part of theSyntagma, the physics, there is more that deserves attention; but here, too, appears in the most glaring manner the inner contradiction between Gassendi’s fundamental principles. While approving of the Epicurean physics, he rejects altogether the Epicurean negation of God and particular providence. He states the various proofs for the existence of an immaterial, infinite, supreme Being, asserts that this Being is the author of the visible universe, and strongly defends the doctrine of the foreknowledge and particular providence of God. At the same time he holds, in opposition to Epicureanism, the doctrine of an immaterial rational soul, endowed with immortality and capable of free determination. It is altogether impossible to assent to the supposition of Lange (Gesch. des Materialismus, 3rd ed., i. 233), that all this portion of Gassendi’s system contains nothing of his own opinions, but is introduced solely from motives of self-defence. The positive exposition of atomism has much that is attractive, but the hypothesis of thecalor vitalis(vital heat), a species ofanima mundi(world-soul) which is introduced as physical explanation of physical phenomena, does not seem to throw much light on the special problems which it is invoked to solve. Nor is his theory of the weight essential to atoms as being due to an inner force impelling them to motion in any way reconcilable with his general doctrine of mechanical causes.In the third part, the ethics, over and above the discussion on freedom, which on the whole is indefinite, there is little beyond a milder statement of the Epicurean moral code. The final end of life is happiness, and happiness is harmony of soul and body (tranquillitas animi et indolentia corporis). Probably, Gassendi thinks, perfect happiness is not attainable in this life, but it may be in the life to come.TheSyntagmais thus an essentially unsystematic work, and clearly exhibits the main characteristics of Gassendi’s genius. He was critical rather than constructive, widely read and trained thoroughly both in languages and in science, but deficient in speculative power and original force. Even in the department of natural science he shows the same inability steadfastly to retain principles and to work from them; he wavers between the systems of Brahe and Copernicus. That his revival of Epicureanism had an important influence on the general thinking of the 17th century may be admitted; that it has any real importance in the history of philosophy cannot be granted.Authorities.—Gassendi’s life is given by Sorbière in the first collected edition of the works, by Bugerel,Vie de Gassendi(1737; 2nd ed., 1770), and by Damiron,Mémoire sur Gassendi(1839). An abridgment of his philosophy was given by his friend, the celebrated traveller, Bernier (Abrégé de la philosophie de Gassendi, 8 vols., 1678; 2nd ed., 7 vols., 1684). The most complete surveys of his work are those of G.S. Brett (Philosophy of Gassendi, London, 1908), Buhle (Geschichte der neuern Philosophie, iii. 1, 87-222), Damiron (Mémoires pour servir à l’histoire de philosophie au XVIIesiècle), and P.F. Thomas (La Philosophie de Gassendi, Paris, 1889). See also Ritter,Geschichte der Philosophie, x. 543-571; Feuerbach,Gesch. d. neu. Phil. von Bacon bis Spinoza, 127-150; F.X. Kiefl,P. Gassendis Erkenntnistheorie und seine Stellung zum Materialismus(1893) and “Gassendi’s Skepticismus” inPhilos. Jahrb.vi. (1893); C. Güttler, “Gassend oder Gassendi?” inArchiv f. Gesch. d. Philos.x. (1897), pp. 238-242.
Gassendi holds an honourable place in the history of physical science. He certainly added little to the stock of human knowledge, but the clearness of his exposition and the manner in which he, like Bacon, urged the importance of experimental research, were of inestimable service to the cause of science. To what extent any place can be assigned him in the history of philosophy is more doubtful. TheExercitationeson the whole seem to have excited more attention than they deserved. They contain little or nothing beyond what had been already advanced against Aristotle. The first book expounds clearly, and with much vigour, the evil effects of the blind acceptance of the Aristotelian dicta on physical and philosophical study; but, as is the case with so many of the anti-Aristotelian works of this period, the objections show the usual ignorance of Aristotle’s own writings. The second book, which contains the review of Aristotle’s dialectic or logic, is throughout Ramist in tone and method. The objections to Descartes—one of which at least, through Descartes’s statement of it in the appendix of objections in theMeditationeshas become famous—have no speculative value, and in general are the outcome of the crudest empiricism. His labours on Epicurus have a certain historical value, but the want of consistency inherent in the philosophical system raised on Epicureanism is such as to deprive it of genuine worth. Along with strong expressions of empiricism we find him holding doctrines absolutely irreconcilable with empiricism in any form. For while he maintains constantly his favourite maxim “that there is nothing in the intellect which has not been in the senses” (nihil in intellectu quod non prius fuerit in sensu), while he contends that the imaginative faculty (phantasia) is the counterpart of sense—that, as it has to do with material images, it is itself, like sense, material, and essentially the same both in men and brutes; he at the same time admits that the intellect, which he affirms to be immaterial and immortal—the most characteristic distinction of humanity—attains notions and truths of which no effort of sensation or imagination can give us the slightest apprehension (Op.ii. 383). He instances the capacity of forming “general notions”; the very conception of universality itself (ib.384), to which he says brutes, who partake as truly as men in the faculty calledphantasia, never attain; the notion of God, whom he says we may imagine to be corporeal, but understand to be incorporeal; and lastly, the reflex action by which the mind makes its own phenomena and operations the objects of attention.
TheSyntagma philosophicum, in fact, is one of those eclectic systems which unite, or rather place in juxtaposition, irreconcilable dogmas from various schools of thought. It is divided, according to the usual fashion of the Epicureans, into logic (which, with Gassendi as with Epicurus, is trulycanonic), physics and ethics. The logic, which contains at least one praiseworthy portion, a sketch of the history of the science, is divided into theory of right apprehension (bene imaginari), theory of right judgment (bene proponere), theory of right inference (bene colligere), theory of right method (bene ordinare). The first part contains the specially empirical positions which Gassendi afterwards neglects or leaves out of account. The senses, the sole source of knowledge, are supposed to yield us immediately cognition of individual things; phantasy (which Gassenditakes to be material in nature) reproduces these ideas; understanding compares these ideas, which are particular, and frames general ideas. Nevertheless, he at the same time admits that the senses yield knowledge—not of things—but of qualities only, and holds that we arrive at the idea of thing or substance by induction. He holds that the true method of research is the analytic, rising from lower to higher notions; yet he sees clearly, and admits, that inductive reasoning, as conceived by Bacon, rests on a general proposition not itself proved by induction. He ought to hold, and in disputing with Descartes he did apparently hold, that the evidence of the senses is the only convincing evidence; yet he maintains, and from his special mathematical training it was natural he should maintain, that the evidence of reason is absolutely satisfactory. The whole doctrine of judgment, syllogism and method is a mixture of Aristotelian and Ramist notions.
In the second part of theSyntagma, the physics, there is more that deserves attention; but here, too, appears in the most glaring manner the inner contradiction between Gassendi’s fundamental principles. While approving of the Epicurean physics, he rejects altogether the Epicurean negation of God and particular providence. He states the various proofs for the existence of an immaterial, infinite, supreme Being, asserts that this Being is the author of the visible universe, and strongly defends the doctrine of the foreknowledge and particular providence of God. At the same time he holds, in opposition to Epicureanism, the doctrine of an immaterial rational soul, endowed with immortality and capable of free determination. It is altogether impossible to assent to the supposition of Lange (Gesch. des Materialismus, 3rd ed., i. 233), that all this portion of Gassendi’s system contains nothing of his own opinions, but is introduced solely from motives of self-defence. The positive exposition of atomism has much that is attractive, but the hypothesis of thecalor vitalis(vital heat), a species ofanima mundi(world-soul) which is introduced as physical explanation of physical phenomena, does not seem to throw much light on the special problems which it is invoked to solve. Nor is his theory of the weight essential to atoms as being due to an inner force impelling them to motion in any way reconcilable with his general doctrine of mechanical causes.
In the third part, the ethics, over and above the discussion on freedom, which on the whole is indefinite, there is little beyond a milder statement of the Epicurean moral code. The final end of life is happiness, and happiness is harmony of soul and body (tranquillitas animi et indolentia corporis). Probably, Gassendi thinks, perfect happiness is not attainable in this life, but it may be in the life to come.
TheSyntagmais thus an essentially unsystematic work, and clearly exhibits the main characteristics of Gassendi’s genius. He was critical rather than constructive, widely read and trained thoroughly both in languages and in science, but deficient in speculative power and original force. Even in the department of natural science he shows the same inability steadfastly to retain principles and to work from them; he wavers between the systems of Brahe and Copernicus. That his revival of Epicureanism had an important influence on the general thinking of the 17th century may be admitted; that it has any real importance in the history of philosophy cannot be granted.
Authorities.—Gassendi’s life is given by Sorbière in the first collected edition of the works, by Bugerel,Vie de Gassendi(1737; 2nd ed., 1770), and by Damiron,Mémoire sur Gassendi(1839). An abridgment of his philosophy was given by his friend, the celebrated traveller, Bernier (Abrégé de la philosophie de Gassendi, 8 vols., 1678; 2nd ed., 7 vols., 1684). The most complete surveys of his work are those of G.S. Brett (Philosophy of Gassendi, London, 1908), Buhle (Geschichte der neuern Philosophie, iii. 1, 87-222), Damiron (Mémoires pour servir à l’histoire de philosophie au XVIIesiècle), and P.F. Thomas (La Philosophie de Gassendi, Paris, 1889). See also Ritter,Geschichte der Philosophie, x. 543-571; Feuerbach,Gesch. d. neu. Phil. von Bacon bis Spinoza, 127-150; F.X. Kiefl,P. Gassendis Erkenntnistheorie und seine Stellung zum Materialismus(1893) and “Gassendi’s Skepticismus” inPhilos. Jahrb.vi. (1893); C. Güttler, “Gassend oder Gassendi?” inArchiv f. Gesch. d. Philos.x. (1897), pp. 238-242.
(R. Ad.; X.)
1It was formerly thought thatGassendiwas really the genitive of the Latin formGassendus. C. Güttler, however, holds that it is a modernized form of the O. Fr.Gassendy(see paper quoted in bibliography).
1It was formerly thought thatGassendiwas really the genitive of the Latin formGassendus. C. Güttler, however, holds that it is a modernized form of the O. Fr.Gassendy(see paper quoted in bibliography).
GASTEIN,in the duchy of Salzburg, Austria, a side valley of the Pongau or Upper Salzach, about 25 m. long and 1¼ m. broad, renowned for its mineral springs. It has an elevation of between 3000 and 3500 ft. Behind it, to the S., tower the mountains Mallnitz or Nassfeld-Tauern (7907 ft.) and Ankogel (10,673 ft.), and from the right and left of these mountains two smaller ranges run northwards forming its two side walls. The river Ache traverses the valley, and near Wildbad-Gastein forms two magnificent waterfalls, the upper, the Kesselfall (196 ft.), and the lower, the Bärenfall (296 ft.). Near these falls is the Schleierfall (250 ft.), formed by the stream which drains the Bockhart-see. The valley is also traversed by the so-called Tauern railway (opened up to Wildbad-Gastein in September 1905), which goes to Mallnitz, piercing the Tauern range by a tunnel 9260 yds. in length. The principal villages of the valley are Hof-Gastein, Wildbad-Gastein and Böckstein.
Hof-Gastein, pop. (1900) 840, the capital of the valley, is also a watering-place, the thermal waters being conveyed here from Wildbad-Gastein by a conduit 5 m. long, constructed in 1828 by the emperor Francis I. of Austria. Hof-Gastein was, after Salzburg, the richest place in the duchy, owing to its gold and silver mines, which were already worked during the Roman period. During the 16th century these mines were yielding annually 1180 ℔ of gold and 9500 ℔ of silver, but since the 17th century they have been much neglected and many of them are now covered by glaciers.
Wildbad-Gastein, commonly calledBad-Gastein, one of the most celebrated watering-places in Europe, is picturesquely situated in the narrow valley of the Gasteiner Ache, at an altitude of 3480 ft. The thermal springs, which issue from the granite mountains, have a temperature of 77°-120° F., and yield about 880,000 gallons of water daily. The water contains only 0.35 to 1000 of mineral ingredients and is used for bathing purposes. The springs are resorted to in cases of nervous affections, senile and general debility, skin diseases, gout and rheumatism. Wildbad-Gastein is annually visited by over 8500 guests. The springs were known as early as the 7th century, but first came into fame by a successful visit paid to them by Duke Frederick of Austria in 1436. Gastein was a favourite resort of William I. of Prussia and of the Austrian imperial family, and it was here that, on the 14th of August 1865, was signed the agreement known as the Gastein Convention, which by dividing the administration of the conquered provinces of Schleswig and Holstein between Austria and Prussia postponed for a while the outbreak of war between the two powers. It was also here (August-September 1879) that Prince Bismarck negotiated with Count Julius Andrássy the Austro-German treaty, which resulted in the formation of the Triple Alliance.
See Pröll,Gastein, Its Springs and Climate(Vienna, 5th ed., 1893).
See Pröll,Gastein, Its Springs and Climate(Vienna, 5th ed., 1893).
GASTRIC ULCER(ulcer of the stomach), a disease of much gravity, commonest in females, and especially in anaemic domestic servants. It is connected in many instances with impairment of the circulation in the stomach and the formation of a clot in a small blood-vessel (thrombosis). It may be due to an impoverished state of the blood (anaemia), but it may also arise from disease of the blood-vessels, the result of long-continued indigestion and gastric catarrh.
When clotting takes place in a blood-vessel the nutrition of that limited area of the stomach is cut off, and the patch undergoes digestion by the unresisted action of the gastric juices, an ulcer being formed. The ulcer is usually of the size of a silver threepence or sixpence, round or oval, and, eating deeply, is apt to make a hole right through the coats of the stomach. Its usual site is upon the posterior wall of the upper curvature, near to the pyloric orifice. It may undergo a healing process at any stage, in which case it may leave but little trace of its existence; while, on the other hand, it may in the course of cicatrizing produce such an amount of contraction as to lead to stricture of the pylorus, or to a peculiar hour-glass deformity of the stomach. Perforation is in most cases quickly fatal, unless previously the stomach has become adherent to some neighbouring organ, by which the dangerous effects of this occurrence may be averted, or unless the condition has been promptly recognized and an operation has been quickly done. Usually there is but one ulcer, but sometimes there are several ulcers.
The symptoms of ulcer of the stomach are often indefinite and obscure, and in some cases the diagnosis has been first made on the occurrence of a fatal perforation. First among the symptoms is pain, which is present at all times, but is markedly increased after food. The pain is situated either at the lower end of the breast-bone or about the middle of the back. Sometimes it is felt in the sides. It is often extremely severe, and is usually accompanied with localized tenderness and also with a sense of oppression, and by an inability to wear tight clothing. The pain is due to the movements of the stomach set up by the presenceof the food, as well as to the irritation of the inflamed nerve filaments in the floor of the ulcer. Vomiting is a usual symptom. It occurs either soon after the food is swallowed or at a later period, and generally relieves the pain and discomfort. Vomiting of blood (haematemesis) is a frequent and important symptom. The blood may show itself in the form of a brown or coffee-like mixture, or as pure blood of dark colour and containing clots. It comes from some vessel or vessels which the ulcerative process has ruptured. Blood is also found mixed with the discharges from the bowels, rendering them dark or tarry-looking. The general condition of the patient with gastric ulcer is, as a rule, that of extreme ill-health, with pallor, emaciation and debility. The tongue is red, and there is usually constipation. In most of the cases the disease is chronic, lasting for months or years; and in those cases where the ulcers are large or multiple, incomplete healing may take place, relapses occurring from time to time. But the ulcers may give rise to no marked symptoms, and there have been instances where fatal perforation suddenly took place, and where post-mortem examination revealed the existence of long-standing ulcers which had given rise to no suggestive symptoms. While gastric ulcer is to be regarded as dangerous, its termination, in the great majority of cases, is in recovery. It frequently, however, leaves the stomach in a delicate condition, necessitating the utmost care as regards diet. Occasionally the disease proves fatal by sudden haemorrhage, but a fatal result is more frequently due to perforation and the escape of the contents of the stomach into the peritoneal cavity, in which case death usually occurs in from twelve to forty-eight hours, either from shock or from peritonitis. Should the stomach become adherent to another organ, and fatal perforation be thus prevented, chronic “indigestion” may persist, owing to interference with the natural movements of the stomach. Stricture of the pylorus and consequent dilatation of the stomach may be caused by the cicatrization of an ulcer.
The patient should at once be sent to bed and kept there, and allowed for a while nothing stronger than milk and water or milk and lime water. But if bleeding has recently taken place no food whatever should be allowed by the stomach, and the feeding should be by nutrient enemata. As the symptoms quiet down, eggs may be given beaten up with milk, and later, bread and milk and home-made broths and soups. Thus the diet advances to chicken and vegetables rubbed through a sieve, to custard pudding and bread and butter. As regards medicines, iron is the most useful, but no pills of any sort should be given. Under the influence of rest and diet most gastric ulcers get well. The presence of healthy-looking scars upon the surface of the stomach, which are constantly found in operating upon the interior of the abdomen, or as revealed in post-mortem examinations, are evidence of the truth of this statement. It is unlikely that under the treatment just described perforation of the stomach will take place, and if the surgeon is called in to assist he will probably advise that operation is inadvisable. Moreover, he knows that if he should open the abdomen to search for an ulcer of the stomach he might fail to find it; more than that, his search might also be in vain if he opened the stomach itself and examined the interior. Serious haemorrhages, however, may make it necessary that a prompt and thorough search should be made in order that the surgeon may endeavour to locate the ulcer, and, having found it, secure the damaged vessel and save the patient from death by bleeding.
Perforation of a gastric ulcer having taken place, the septic germs, which were harmless whilst in the stomach, escape with the rest of the contents of the stomach into the general peritoneal cavity. The immediate effects of this leakage are sudden and severe pain in the upper part of the abdomen and a great shock to the system (collapse). The muscles of the abdominal wall become hard and resisting, and as peritonitis appears and the intestines are distended with gas, the abdomen is distended and becomes greatly increased in size and ceases to move, the respiratory movements being short and quick. At first, most likely, the temperature drops below normal, and the pulse quickens. Later, the temperature rises. If nothing is done, death from the septic poisoning of peritonitis is almost certain.
The treatment of ruptured gastric ulcer demands immediate operation. An incision should be made in the upper part of the middle line of the abdomen, and the perforation should be looked for. There is not, as a rule, much difficulty in finding it, as there are generally deposits of lymph near the spot, and other signs of local inflammation; moreover, the contents of the stomach may be seen escaping from the opening. The ulcer is to be closed by running a “purse-string” suture in the healthy tissue around it, and the place is then buried in the stomach by picking up small folds of the stomach-wall above and below it and fixing them together by suturing. This being done, the surface of the stomach, and the neighbouring viscera which have been soiled by the leakage, are wiped clean and the abdominal wound is closed, provision being made for efficient drainage. A large proportion of cases of perforated gastric ulcer thus treated recover.