Gastric ulcer and cancer / by Christopher Graham.

  • Graham, Christopher.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Gastric ulcer and cancer / by Christopher Graham. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    usually intensifies as malignancy creeps on. It is more irregular, longer between attacks, more copious (unless there be a contracted stomach from diffuse infiltration), and gives even more relief; the vomitus is rancid, often foul, acid and obnoxious; all these symptoms vary in intensity according to obstruction and destruction; but the chief characteristic of cancer vomiting is that food taken ^several hours or even days before returns poorly macerated and with undigested masses in it and even this perhaps when pyloric obstruction is slight (cancer paralysis). Vomit- ing is, as a rule, accompanied with less retching in cancer than in ulcer and blood more frequently seen though in small quantities; mucus is, per- haps, oftener seen, while bile is a rarer accom- paniment. If there has been a long period between the ulcer symptoms and the recent cancerous change (Type 1) the diagnosis is usually easier because of the constancy, the rapid approach, and marked character of the symptoms. There may be a short but persistent period of flatulence, bloating, lessened appetite and loss of flesh and then the sudden burst of malignancy so often remarked in the other type (Type 2) that clinicians say attacks the patient in the very height of good health. In these two types we most often meet tumor, and in many other respects are they so similar that we would be led to consider them counterparts — the early symptoms in the one being overlooked or for- gotten by the otherwise healthy individual. Motor power lessens rapidly as cancer pro- gresses and if pyloric obstruction is acute and the other symptoms are intense dilatation advances rapidly; organic acids increase and hydrochloric acid decreases and blood is more often and more easily detected. Finally, it is