e
coats of the stomach and the intestine, the subjects of catarrhal
attacks, closely resemble one another, but differ symptomatically. Acute
catarrh of the stomach is associated with intense hyperaemia of its
lining coats, with visible engorgement and swelling of the mucous
membrane, and an excessive secretion of mucus. The formation of active
gastric juice is arrested, digestion ceases, peristaltic movements are
sluggish or absent, unless so over-stimulated that they act in a
direction the reverse of the normal, and induce expulsion of the gastric
contents by vomiting. The gastric contents, in whatever degree of
dilution or concentration they may have been ingested, when ejected are
of porridge-thick consistency, and often but slightly digested. Such
conditions may succeed a severe alcoholic bout, be caused by irritant
substances taken in by the mouth or arise from fermentative processes in
the stomach contents themselves. Should the irritating material succeed
in passing from the stomach into the bowel, similar physical signs are
present; but as the quickest path offered for the expulsion of the
offending substances from the body is downwards, peristalsis is
increased, the flow of fluid from the intestinal glands is larger in
bulk, though of less potency as regards its normal actions, than in
health, and diarrhoea, with removal of the irritant, follows. As a
general rule, the more marked the involvement of the large bowel, the
severer and more fluid is the resultant diarrhoea. Inflammation of the
stomach may be due to mechanical injury, thermal or chemical irritants
or invasion by micro-organisms. Also all the symptoms of gastric catarrh
may be brought on by any acute emotion. The commonest mechanical injury
is that due to an excess of food, especially when following on a fast;
poisons act as irritants, and also the weevils of cheese and the larvae
of insects.

Inflammatory affections of the caecum and its attached appendix
vermiformis are very common, and give rise to several special symptoms
and signs. Acute inflammatory appendicitis appears to be increasing in
frequency, and is associated by many with the modern deterioration in
the teeth. Constipation certainly predisposes to it, and it appears to
be more prevalent among medical men, commercial travellers, or any
engaged in arduous callings, subjected to irregular meals, fatigue and
exposure. A foreign body is the exciting cause in many cases, though
less commonl