170 THE TREATMENT OF DISEASES. 



stomach. There is no doubt that it may be hereditary. In support of this statement 

 the case is often quoted of the first Napoleon, who died of cancer of the stomach, as did 

 his father and sister. It is a great mistake, however, for people who may have lost 

 one or more near relatives from cancer to suppose that they are doomed to die of the 

 same horrible disorder. It is nothing of the kind ; and it is the opinion of many of 

 the most eminent physicians and surgeons of the day that cancer of the stomach is 

 far less likely than any other form of cancer to be hereditary. Moreover, unless a 

 post-mortem examination was made, it is very difficult to assert positively that the 

 disease was actually cancer. There are several morbid growths which in the 

 symptoms they produce are very like cancer, but a tendency to which it cannot be 

 supposed for one moment is capable of transmission. We recently saw in a hospital 

 an old man who was supposed by everybody to be suffering from cancer of the 

 stomach. He died ; and at the post-mortem examination we found that there 

 was no cancer at all, and that death had resulted from a large ulcer. The poor 

 fellow had no friends, but we can readily imagine that in many cases a knowledge 

 of the fact that the sufferer had died of a non-hereditary complaint would be a great 

 comfort to the survivors. We would earnestly impress upon you the necessity of 

 not attaching too much importance to the existence of a cancerous taint in your 

 family. 



Cancer of the stomach occurs with about equal frequency in men and women. 

 It is very rare under the age of thirty, and the greatest predisposition to the disease 

 is met with in people between the ages of sixty and seventy. Among the exciting 

 causes of cancer of the stomach are usually mentioned errors of diet, brandy- 

 drinking, and mental anxiety ; but their influence is, to say the least of it, very 

 problematic. 



Patients suffering from cancer of the stomach often present a peculiar yellow 

 colour, they become languid and weak, they emaciate, and exhibit other signs 

 of profound constitutional disturbance. It must not be forgotten that these 

 symptoms are common to many diseases, and that to the unpractised eye the 

 pallor of anaemia is readily mistaken for the cachexia of cancer. Pain at the pit of 

 the stomach is absent in very few cases. It is usually a very marked symptom, and 

 is often lancinating in character, but there is nothing peculiar about it which would 

 serve to distinguish it from the pain caused by indigestion or any other disorder. 

 Loss of appetite and vomiting are of constant occurrence in cancer as in many other 

 diseases of the stomach, and the vomited matter is frequently mixed with blood. 

 None of these symptoms will serve to indicate positively the existence of cancer ; in 

 fact, it is the rule with most medical men not to diagnose the existence of cancer of 

 the stomach unless they can detect the presence of a tumour in the abdomen. 



As we have already pointed out. it is often a most difficult matter to distinguish 

 between ulcer of the stomach and cancer. If the patient is under thirty years of 

 age, if he is fairly healthy in aspect, if he is not wasted much after an illness of 

 some duration, if there are marked variations in his condition, he is probably not 

 suffering from cancer. Copious bleeding from the stomach is in favour of ulcer 

 versus cancer. 



Cancer of the stomach is so essentially a disease which must come under the care 



