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Cancer of the Stomach.Symptoms.-When the disease has existed for some months, the symptoms are so plain as to admit of but little doubt concerning the nature of the affection. But in the early stages of cancer of the stomach the symptoms do not enable us to distinguish this disease with certainty from several other affections of the stomach, such as ulcer, chronic inflammation, and dyspepsia. For some months previous to the development of marked symptoms the patient usually suffers from an impairment of the appetite, and some of the symptoms of indigestion. There is usually some pain, even at an early stage - a pain which is de scribed as gnawing or cutting. There may be, also, tenderness over the stomach. Even before it becomes possible to detect a tumor in the abdomen, there is usually decided evidence of impair ment of the general health ; there is some loss of strength and of flesh, an unusual pallor of the skin, sometimes fever and derange ment of the bowels. As the disease progresses, vomiting becomes a prominent symptom. The matters ejected are at first merely the partially digested fragments of food which have been swallowed, but later contain also considerable blood and mucus. This blood is at first dark, giving the vomited matter an appearance resembling that of coffee grounds; but later in the disease the blood appears in larger quantities and with a bright red color. After the vomiting becomes frequent the patient's strength fails rapidly, and emaciation becomes a marked feature of the disease. The sufferer's condition now be comes deplorable. All food, even the blandest articles, is rejected by the stomach. The act of vomiting is now accompanied by extreme pain. In the intervals between attempts at eating there is more or less pain, often sharp and shooting. The escape of blood may take place not only during vomiting, but also at other times without apparent provocation. At times the hemorrhage becomes quite severe, the patient expectorating great quantities of bright red blood. In other instances death occurs suddenly from hemor rhage into the stomach. Sooner or later there is usually developed in the abdomen a tumor, situated a little below the breast bone, and ordinarily some what to the right of the middle of the body. This tumor may not be appreciable to the eye, but can be felt by gently pressing upon this locality. This swelling is usually detected by the patient him self, though it may at times escape his observation and be discov erable only upon careful examination. While this is the usual history of cancer of the stomach, yet cases occur in which most of the symptoms detailed above are ab sent. In these cases the patient appears to have merely some dys pepsia. The appetite remains fair. There is no vomiting of blood, perhaps no vomiting at all. The pain is merely of the dull, aching character so often met in simple dyspepsia. In these cases death may occur after a very short illness, the real nature of the difficulty being unsuspected perhaps until a postmortem examination is made. It will be seen from the above description that the symptoms presented by cancer of the stomach are very similar to those of several other diseases ; even the vomiting of blood occurs as regu larly and uniformly in cases of ulcer of the stomach. It is important that this similarity should be remembered, in order that no groundless suspicions may annoy and terrify the patient. It must be stated, that in the early stages of the disease the physi cian himself is often puzzled to decide whether or not the affection is a cancer, though with the lapse of time the diagnosis usually becomes easy. In this connection, a word may be properly said regarding the popular ideas concerning cancer. The prevalent impression at taches entirely too much importance to the hereditary influence of cancer. It is by no means proven that there is any hereditary predisposition for cancer; although physicians generally attach some importance to the fact that a patient's parent has suffered from cancer, yet such a fact carries no weight in deciding a doubt ful case. Many people, some of whose relatives have had cancer, live in constant dread of becoming victims to the disease ; the slightest ailment whose cause is not at once apparent, serves to arouse their slumbering fears that the long-dreaded disease has finally appeared. To all such it cannot be too emphatically asserted, that the previous occurrence of cancer in the family does not warrant the least anxiety as to the safety of the individual. It is, doubtless true, that the children of cancerous parents are some times attacked by the disease; but, while this fact is generally known and appreciated, it is forgotten that the great majority of the children of cancerous parents do not suffer from the disease, while the great majority of cases of cancer are found to occur in individuals whose family history contains no record of the dis ease. Cancer of the stomach rarely occurs before forty years of age, usually after fifty. Males are more frequently attacked than females, the ratio being about two to one. Treatment.-The only hope of relieving a patient from can cer lies in the removal of the tumor. If situated on the skin, or elsewhere within reach of the eye and finger, the nature of the dis- ea*se can be recognized early, and its removal at an early period often relieves the patient permanently of the disease. Within recent years the internal organs of the body have been rendered more accessible to the surgeon's knife ; cancers of the womb, of the rectum, and of the larynx, have been successfully removed with the result not only of relieving the patient from the tumor in ques tion, but also of protecting him from a return of the disease. Within the last three years the same plan has been pursued as to cancers of the stomach. In 1881 Billroth, the celebrated surgeon of Vienna, removed about a third of the stomach of a woman afflicted with cancer. He had, in connection with his assistants, experimented for several years upon dogs, and had found that these animals recovered perfect health after the removal of considerable parts of the stomach. The history of this case showed that the human animal, even when suffering from disease, possesses the same power ; for the woman operated"upon recovered entirely, and was able to consume ordinary diet without any discomfort. Since that time Billroth has performed the same operation on two other patients with the same happy result. One of them is now living, two and a half years after the operation, and enjoys robust health. It is, as yet, too early to affirm, or even hope, that this operation will become a general means for relieving these painful cases of cancer of the stomach ; indeed, there are many difficulties to be overcome besides the performance of the operation itself. Time and experience alone can decide how useful this operation may prove. Aside from this operative procedure, we have absolutely no means for relieving cancer of the stomach. There are, it is true, cases which are falsely called cancer of the stomach, that ultimately recover ; these are generally cases of ulcer of the stomach, in which the symptoms closely resemble those of cancer, as has been already stated. True cancer always results fatally. The duration of the disease appears to be, on the average, about a year ; the patient dies, in most cases, from exhaustion and starvation. The treatment consists merely in an attempt to palliate suffer ing. Foremost in this direction comes opium in some form, prefer ably morphine. In most cases of disease the physician is very reluctant to prescribe morphine habitually, fearing that his patient will acquire the opium habit; in these cases of cancer of the stom ach such an objection has, of course, no weight ; the patient should be supplied with morphine in sufficient quantities to keep him free from pain. The diet should, of course, be unirritating and nutritious, and should be taken in such quantities and at such intervals as the patient finds to be best. Sometimes much comfort can be derived from washing out the stomach through the rubber tube, as already described in discussing dilatation of the stomach. 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