since very simple affections of the stomach may produce similar, and even more severe symptoms. It would be well if this warning were laid to heart. Many people are so con stituted that to tell them they are affected with cancer is to issue their death-warrant. It pro duces such an effect upon them as to lead to their death even suppose they have no cancer, but, perhaps, merely some chronic catarrh.
The parts of the stomach most commonly affected in cancer are, firstly, the neighbour hood of the junction between the stomach and the small intestine (the pylorus); and, secondly, the junction between stomach and gullet. The thickening, which is a result of the disease, is apt to narrow the open ing, so that the passage from stomach to in testine is contracted in the one case and that from gullet to stomach in the other. In the former case the food, which has been digested in the stomach, finds its onward passage ob structed. It is thus retained in the stomach and vomited after a longer or shorter interval, probably an hour or two after being swallowed. The vomit will consist of the partially-digested food, mixed with secretion from the stomach, If the cancer has undergone ulceration and sloughing, the vomit will contain very offen sive matter discharged from it.
From the ulcerated surface also there is likely to be oozing of blood, which will have the " coffee - ground " appearance, because of the action on the blood of the contents of the stomach.
Sometimes obstruction at the pylorus leads to accumulation of food in the stomach for a considerable time. This leads to dilatation of the organ. The accumulated food is at length vomited, and so an enormous quantity may be vomited at one time. (See DILATATION OF THE STOMACH, p. 238.) If the obstruction is at the gullet opening, then food which is swallowed will pass down a considerable way, and then, not able to get into the stomach, will be immediately returned.
Besides such symptoms there will be loss of appetite, pain, and vomiting, which is likely to occur even though no such cause as that of obstruction to the onward passage of the food be present.
No treatment for the cure of the disease is known. The treatment, consequently, is merely palliative—employed, that is, for the relief of pain and such symptoms. Proper nourishment must be given in a form that is easily digestible --milk, if it is well borne, beef-tea, fish, eggs, &c., given in small quantities often, to overcome
irritability. Sooner or later, in most cases, opium is resorted to to relieve pain. The longer this can be delayed the better, since the use of opium grows upon patients. A dose sufficient to induce sleep at first soon becomes too little, and increasingly larger and larger doses require to be administered. Not more than grain of opium should be Piven to begin with.
Whenever cancer of the stomach has reached the stage when it produces obstruction of the outlet and retention of the food, milk usually ceases to be a suitable diet, and beef extract and jellies, and small solid meals of scraped fish or meats with crisp thin toast often suit better.
If the true nature of the affection is deter. mined early (see p. 223 for information as tx methods of determining), and the patient is flu to bear it, an operation may be of immens( value by forming a new outlet to the stomach.
Bleeding from the Stomach (licentatetne may escape from the vessels int( the cavity of the stomach in many kinds o disease. In cases of ulceration, either simpl, or due to cancer, the quantity may be ver: large. Simple congestion, due to disease in th, walls of the stomach itself, or because of oh itruction to the passage of the blood by disease A the liver, for example, or disease of the heart, Bay also occasion it. Hemorrhage from the domach also occurs in scurvy and a disease purpura, to which refer. It must also he noticed that a considerable number of cases have been known of women who had no regular monthly discharges from the womb, but had monthly discharges of blood from the stomach or lungs. Cases also have occurred where sup pression of the monthly flow was followed by discharges of blood from the stomach. If it escape in any quantity it is likely to be vomited, and to be easily recognized. The coffee-ground appearance of the vomit due to altered blood has been referred to under ULCERATION and CANCER OF THE STOMACH. Blood may escape into the stomach, and, not being vomited, will pass on into the bowels, to appear in the stools. It does not then appear in its usual colour, because of the action of the various intestinal juices on it, but makes the faeces black and tarlike. Of course if the presence of blood be evident in the faeces there is nothing to show whether it has come all the way from the stomach or from the intestines only.