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Diseases Stomach

cancer, dyspepsia, symptoms, causes, disease and appetite

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STOMACH, DISEASES OF.—The stomach is liable to a number of acute and chronic affections, which exhibit more or less analogous symptoms.

Under the general term dyspepsia is understood only a symptom of stomach disease. The more common general signs of dyspepsia are : dis comfort or pain, before or after eating ; raising of gas, before or after eating ; constipation or diarrlicea ; loss of appetite, or voracious appetite, etc. Thus it may be seen by the contrasts here presented that dyspepsia is not one thing, but many. It is only a sign that the work of some portion of the gastrointestinal tract is not being performed properly. It may be present in all the various diseases of the stomach and intestines ; or it may be absent even in severe affections. The layman should understand that it is of no value to be told that he has dyspepsia—he knows that ; the important question is, what causes his dyspepsia. Is it an ulcer or a cancer ; is it due to purely nervous causes ; or is it a result of faulty diet, or injudicious modes of masticating, etc. ? These topics are here discussed under their proper headings.

Cancer of the Stomach.—This is a frequent and very malignant disease. It occurs in men as well as in women, mostly between the fortieth and fiftieth years of life. The disease is not, however, limited to this period of life, but may occur both earlier and later, cases being known where it has appeared after the seventieth year. Cancer of the stomach develops so gradually that its onset is usually unnoticed, or not recognised ; and when the physician is called it is often too late to effect a cure. The cancerous growth often develops following an old ulcer ; and careful treatment of the latter condition is, therefore, doubly imperative in all cases. A chronic ulceration of the stomach is always a menace because of the possibility of the development of a cancerous process. It is claimed that injuries to the stomach, caused by falls, blows, kicks, etc., may occasionally give rise to cancer. Whether a chronic catarrh of the stomach may develop into cancer is very doubtful. It is possible that a cancerous growth (in the stomach

as well as in any other part of the body) may be due to infection by a small parasite belonging to the single-cell animal organisms, the protozoa. It is also maintained, and not without reason, that cancer may develop as a result of congenital predisposition.

The onset of cancer is slow and insidious, usually beginning with the symptoms attending an obstinate catarrh of the stomach. When a supposed attack of gastritis proves refractory to all medical treatment, and when emaciation, and loss of strength become manifest, one is always justified in suspecting the presence of a malignant disease of the stomach. Cancer may sometimes be present for many months without causing material disturbances ; in fact, all symptoms may be absent until conspicuous anemia and emaciation gradually become noticeable. In other cases, however, the patients suffer greatly from pains in the stomach (especially after eating), and from vomiting, which often contains blood or masses resembling coffee-grounds.

The appetite is often entirely lost, the tongue heavily coated, and the bowels very constipated. Great physical weakness is usually present. A sure sign of cancer is the appearance of a tumour which, from small begin nings, may grow to the size of a man's head. The largest tumours, however, are not always the most dangerous. Their seat is far more important. Cancer causes the most disagreeable symptoms when situated at the exit of the stomach—at the pylorus. The growth always causes a narrowing at this place, so that food cannot readily pass into the intestine. It therefore accumulates, decomposes, and is constantly vomited. The larger the tumour grows, the more readily can it be felt through the skin. Medical science is, however, able to detect cancer of the stomach before the tumour is palpable. The physician should always test the digestive power of the stomach, and make a chemical examination of its contents in all case of suspected gastric disorder.

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