Chronic gastritis does not appear to favour the growth of carcinoma, while the alcoholic variety is, if anything, inimical to its development. Functional disturbances are also rarely followed by the disease. Out of 134 of our cases in which details as to the previous health of the patients were noted, only 16 per cent, were mentioned as having suffered from any dyspeptic ailment before the symptoms of malignant disease presented themselves. Of nineteen persons who were the subjects of cancer of the cardia there was a history of dyspepsia in only one, who was said to have been liable to ' bilious attacks.' Out of thirty-One in whom the body of the organ was the seat of the new growth, two had been subject to ' bilious attacks,' in one a simple chronic ulcer was discovered after death, and three, or 9 per cent., had occasionally suffered from some form of indigestion. Among eighty-four cases of cancer of the pylorus, fifteen, or 17 per cent., were recorded as having previously suffered from gastric derangement ; but of these two had only been liable to ' bilious attacks,' in one a chronic ulcer was discovered after death, in three pain after food and hsematernesis pointed to gastric ulcer as the probable cause of the trouble, while two had been liable to biliary colic and biliary calculi were found on post-mortem examination.
From the above facts we conclude that carcinoma rarely affects those who have been the subjects of chronic dyspepsia; that when such is the case the pyloric region is usually the seat of the new growth ; and that the symptoms of the antecedent disorder may often be traced either to simple ulcer or to gallstones.