The diagnosis and treatment of diseases of the stomach and intestines / by William Fitch Cheney.

  • Cheney, William Fitch, 1866-1941.
Date:
[1936], ©1936
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Licence: Public Domain Mark

Credit: The diagnosis and treatment of diseases of the stomach and intestines / by William Fitch Cheney. Source: Wellcome Collection.

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    been found, later investigations have proved that the case was not anatomically syphilis of the stomach. X-ray examination discloses a peculiar picture of deformity of the stomach, involving usually the pyloric end, but some¬ times the entire organ to a greater or less degree. There is shrinkage and contraction, stiffening and decreased pliability, absence of peristalsis in the area involved, so that the stomach ultimately becomes a firm, tube-like structure with thickened, inelastic walls. Diagnosis Any long-continued disturbance of gastric function may mean syphilis of the stomach, whether the clinical history suggests chronic gastritis or ulcer or cancer, or resembles no type at all. But the chances are all against it being syphilis. If the blood gives a positive Wassermann reaction, this never justifies the assumption that coincident gastric disease is luetic, for syphilis in the blood does not prevent the development of some other pathological condition in the stomach. Physical examination of the abdomen usually is negative. Achlorhydria by itself fails to identify any disease. X-ray examination dem¬ onstrates deformity of the stomach suggesting scirrhus car¬ cinoma, and in any doubtful case the chances are always in favor of cancer because of its much greater frequency. At times, however, certain considerations may justify delay in recommending surgery, until the effects of anti-luetic therapy have been tried. These are the presence of a positive Wasser¬ mann reaction, the age of the patient below that usual for cancer of the stomach, a duration of symptoms over a period longer than malignant disease usually continues before a fatal outcome, a history corresponding perhaps in a certain degree to