This must be an extremely rare event, since it was not observed in the course of 1,850 necropsies upon cancer of the stomach, nor have we been able to find a single authentic example of it in the literature upon the subject. Its infrequency may be explained partly by the fact that the vicinity of the cardiac orifice, which is the only region of the stomach where the accident could take place, is very seldom the site of perforation, and partly by the rapidity with which disease in this position tends to produce fatal inanition. When the malignant growth extends into the oesophagus, it occasionally perforates the wall of that tube and lays open the left pleural cavity or the posterior mediastinum.