To attempt the cure of cancer by internal remedies is hopeless. Such attempts only cause the loss of valuable time during which the cancer might easily have been removed by an operation. When the tumour has become very large, the time for surgical interference has probably passed. The earlier the operation is performed, the bet ter are the prospects of a permanent cure.
Catarrh of the Stomach (Gastritis).—According to the duration of the affection, distinction is made between acute and chronic gastritis. An attack of catarrh lasting longer than four to six weeks must be regarded as a chronic case.
Acute gastritis is usually due to dietary indiscretions, rarely to exposure to cold. Even an excessive meal must be considered a dietary error, and may occasionally give rise to catarrh. Over-feeding may be further com plicated by the ingestion of substances that are not readily digestible, or by inappropriate mixtures of foods, such as a combination of fatty and sour substances. Sour fermentation is one of the most frequent causes of gastric catarrh. This fermentation results from the action of bacteria which either enter the stomach with the food, or else are already present in the stomach and find a suitable soil for their development in the food introduced. The breaking clown of the food leads to the formation of volatile fatty acids (such as lactic acid, butyric acid, acetic acid, etc.), which often may be recog nised by their odour. At the same time gases (such as hydrogen, carbon dioxide, sulphuretted hydrogen, etc.) may develop. These products of fermentation and putrefaction cause irritation and inflammation of the mucous membrane of the stomach, which soon become manifest by an increased secretion, particularly of mucus. The excessive use of alcoholic beverages is also very liable to produce more or less severe gastric catarrh.
The chief symptoms of acute gastritis are : loss of appetite, stomach ache varying in intensity and duration, belching of gas, and vomiting. The tongue is usually dry and coated ; the region of the stomach is sensitive to pressure, sometimes even slightly swollen ; and the bowels are usually con stipated. A severe attack may be accompanied by slight fever (see GAS TRIC FEVER).. The first turbulent symptoms usually disappear in a few days, and are generally followed by rapid recovery. If, however, the patient
fails to exercise proper care, the affection is apt to become protracted, and may persist for several weeks. Involvement of the intestines, which occasionally occurs, is frequently characterised by diarrhoea.
The treatment of acute gastritis does not, as a rule, present any difficulties. The main condition to be met is the removal from the digestive tract of the accumulated and decomposed masses of food by the administration of a purge. The diet should consist of fluids exclusively. It is often necessary to abstain for some time from both eating and drinking, especially when there is a marked inclination to vomit. Beverages must be cool, and should be taken in small quantities. Small pieces of ice may be swallowed in order to overcome the inclination to vomit ; and hot poultices to the abdomen will relieve the stomach-ache. When the condition has improved, the patient should go back to his usual fare by very gradual steps.
Chronic gastritis causes more extensive inflammatory processes in the mucous membrane of the stomach, and, after persisting for some time, these processes may lead to a shrinking, or even to the complete disappearance, of the digestive or mucous glands, thus making the walls of the stomach considerably thinner. In advanced cases the activity of the mucous mem brane of the stomach ceases entirely, the gastric juice containing little or no hydrochloric acid. In spite of this deficiency, however, digestion need not necessarily be seriously impaired, because the healthy intestine may act vicariously for the stomach. The mucous membrane of the stomach, when in a chronic state of inflammatory irritation, secretes large quantities of mucus, and shows a marked tendency to bleed.
The digestive disturbances, as yell as the effects on the general health of the patient, may vary greatly. In some cases the disturbances are scarcely noticeable ; in others they are very conspicuous. Loss of appetite, constant pressure on the stomach (particularly after eating), belching of gas, vomiting, constipation, and (frequently) emaciation are the chief symptoms. Chronic catarrh of the stomach may persist for years, periods of improvement frequently alternating with aggravations. Occasionally, the disease may he arrested for some time.