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

  • Cheney, William Fitch, 1866-1941.
Date:
[1936], ©1936
Catalogue details

Licence: Public Domain Mark

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

    137/400 (page 121)
    lena or both. This is a common symptom because of the vascularity of polyps, and it may be the only one. The amount of blood discharged may be considerable, resembling the haemor¬ rhage of gastric ulcer. On the other hand it may be slight but persistent and prolonged and entirely unrecognized unless the stool is tested for occult blood. Thus, an unexplained anaemia may result so extreme at times as to resemble the primary form. Even more important is the tendency of polyps, which in the beginning are benign tumors, to undergo malignant degenera¬ tion, more often in the single but possible also in the multiple growths. Once this change has taken place, the clinical history gradually becomes that of cancer of the stomach. Unless a polyp has become carcinoma and has developed into a tumor large enough to be palpated, nothing definite can be detected by physical examination. Ordinarily even extensive polyposis of the stomach does not produce a mass that can be felt through the abdominal wall. Almost invariably in this disease gastric analysis fails to show any free HC1. Achlorhydria practically is constant. An abun¬ dance of mucus commonly is found in fasting contents and in all extractions after a test meal, and the material obtained is often colored by fresh blood. In a few instances the diagnosis has been made by finding fragments of a polyp in the contents removed from the stomach. For years there was no evidence upon which dependence could be placed for the diagnosis of gastric polyps, and only at autopsy or operation was the condition ever recognized. Their presence in the stomach might be guessed at, even in patients with no previous symptoms at all or with, at most, vague and indefinite gastric discomfort and indigestion, when sudden haematemesis occurred or an obscure anaemia developed, and all