The rare occurrence of gastric cancer before the age of thirty has already been noticed (p. 88). Without much trouble we have been able to collect twenty-two cases in which the complaint developed between thirteen and thirty years of age, and to them we have added three of our own. Of these twenty-five examples, twenty-one were males and four females. In most instances the growth was described as encephaloid or scirrhus, and from those where the microscopical features of the disease were recorded it would seem that the cylinder-celled variety is comparatively infrequent.
In sixteen cases the first symptoms appeared quite suddenly, and became pronounced within two or three weeks, while in the rest there was a history of antecedent ill-health which varied in duration from ten days to two months. Pain in the region of the stomach existed in all but three cases, and was usually increased by food, while vomiting occurred in every instance except two, and was often a prominent feature. Anorexia was a less conspicuous symptom, and in fourteen instances did not appear until a late period, while in six a desire for food continued until a few days before death. Fever existed in four cases, and in two continued for several weeks. In every instance there was rapid emaciation and anaemia, and in five ascites developed at an early stage, owing to implication of the liver or peritoneum. An abdominal tumour or enlargement of the liver was detected in nineteen out of the twenty-five cases. It is important to note that carcinoma of the stomach in early life usually runs an acute course, the average duration of the disease in our cases being three months, while in more than one half it did not exceed nine weeks. The conclusions arrived at by Mathieu from an analysis of twenty-seven cases were of a similar nature.