In these cases the disease has already made such considerable progress before an accurate diagnosis can be made that any attempt to excise the growth is practically foredoomed to failure. Removal of the entire stomach was performed by Schlatter in 1897, life being prolonged for fourteen months, and has since been successfully done by Brigham, MacDonald, and Richardson; but the operation is such a formidable one that more extended experience is required before any opinion as to its value can be expressed. In certain cases the excessive pain and vomiting arising from a mural growth can be relieved by gastro-enterostomy; but as a rule the results are not more favourable than those achieved by medicinal treatment, while the frequency with which unexpected difficulties are encountered in its performance does not help to commend the operation.