This section is from the book "Cancer And Other Tumours Of The Stomach", by Samuel Fenwick. Also available from Amazon: Cancer and other tumours of the stomach.
Loss of appetite is an important symptom of gastric cancer. Brinton observed it in 85 per cent, and Lebert in 80 per cent, of their respective cases. In our own series pronounced anorexia existed in 82 per cent., in 11 per cent, the appetite was normal, and in two instances (1.5 per cent.) it was apparently increased. As a rule the distaste to food shows itself after the dyspepsia has persisted for some time ; but in 34 per cent, of our cases it constituted one of the first symptoms of the complaint and persisted throughout its entire course. In the majority of these the growth was found after death to occupy the cardiac or central region of the stomach, and usually belonged to the medullary or cylindrical-celled type. When once it has appeared the anorexia usually increases in severity until it becomes absolute ; but occasionally it varies in degree from time to time, and may even disappear for a few days. At first it may only be meat or some special article of diet, such as fat, butter, or eggs, which proves distasteful, but as the disease progresses, and especially if it is accompanied by frequent vomiting, it becomes more and more difficult to persuade the patient to take any kind of nourishment. It may be noticed that the desire for tobacco and snuff is usually abolished, and that in rare instances a special though temporary craving exists for fruit, herrings, or jam. The way in which the anorexia shows itself varies in different cases. In the majority there is simply no wish for food ; in others constant nausea or difficulty of deglutition seems responsible for the loss of appetite, while occasionally the very sight of food is repugnant. The frequency of the latter phenomenon, however, has been much exaggerated, although when it exists it constitutes a very important and striking symptom. Thus, a lady who came under our care stated that the first indication of illness consisted in such extreme aversion to the sight of meat that she was unable to pass a butcher's shop ; and in another case we were assured by a gentleman that although he often felt inclined for food, the appearance of a joint upon the table at once excited nausea and sometimes made him vomit.
 
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