Haemorrhage of such severity as to prove immediately fatal is very rare. Brinton estimated its frequency at 1 per cent., and this tallies with our own figures (0.75 per cent.) and those of other writers. In most cases it ensues from rupture of the coronary, splenic, or gastro-epiploic artery, but occasionally the aorta, vena cava, or hepatic vessels are affected. Soft growths of the lesser curvature and of the cardiac end, which have undergone rapid sloughing with destruction of the gastric tissues, are the most common cause of the accident. As a rule the patient is suddenly seized with vertigo, becomes blanched, and loses consciousness. Sometimes convulsions occur. Not infrequently the shock is so great as to paralyse the nervous centres and to prevent vomiting. In such the stomach and intestines are found to be filled with blood after death, or a fluctuating tumour in the epigastrium, due to distension of the stomach with clot, may be detected before life becomes extinct. In other cases profuse haematemesis is followed by immediate and fatal collapse.

(5) Disorders of Digestion. - In addition to pain and vomiting, most of the subjects of gastric carcinoma also suffer from minor symptoms arising from derangement of the digestive organs.

The most important of these are anorexia, dysphagia, flatulence, nausea, pyrosis, and constipation.