Obliterative endarteritis affecting the gastric vessels must not be regarded as necessarily an indication of syphilis. It may be observed in the fibrous base of nearly every chronic simple ulcer, and in not a few cases of longstanding perigastritis due to disease of some neighbouring organ. Its pathology is similar to that form of endarteritis which commonly accompanies cirrhosis of the lung and kidney, and in the case of a gastric ulcer its existence is of some value to the organism, since the gradual occlusion of the arteries which lie in the track of the advancing disease tends to prevent haemorrhage. Syphilitic endarteritis, on the other hand, is comparatively rare as a primary complaint, and, as far as our experience goes, is always associated with gummata in the liver, spleen, pancreas, or retro-peritoneal glands. It chiefly affects the smaller branches of the pyloric vessels which ramify in the subserous and submucous connective tissue, and by thus diminishing the blood-supply to the part tends to induce inflammatory thickening of the mucous membrane and to give rise to interstitial haemorrhages and superficial ulcerations. When the arterial disease is especially severe or widely diffused, the nutrition of the gastric wall is so much reduced that the tissues are no longer capable of withstanding the solvent action of the gastric secretion, which consequently erodes the surface and gradually produces an indolent form of ulceration. In other cases the partially obstructed vessel becomes the seat of thrombosis, and the mucous membrane which it supplies, being suddenly deprived of blood, is rapidly digested. In the former case the patient suffers from the symptoms of chronic ulcer of the stomach ; in the latter, from attacks of acute dyspepsia, which are not infrequently followed by haematemesis.