There are few diseases which at an early period of their course are more difficult to recognise than cancer of the stomach. The pain, vomiting, and haemorrhage that are usually regarded as especially indicative of the complaint may not only be entirely absent, but occasionally exhibit such individual prominence as to suggest some other and less serious affection of the digestive organs. In other cases the existence of intense ansemia, accompanied by fever and general debility, appears to indicate a disorder of the blood-making viscera; while in not a few the symptoms which arise from secondary implication of the liver or peritoneum completely mask those of the original complaint.
In order to obtain a clear comprehension of the disease in its protean aspects it is necessary not only to study the clinical features of a large number of cases, but to compare the various symptoms presented by each with the nature, location, and distribution of the growth as determined after death. A writer who trusts solely to his own experience, however extensive that may have been, can hardly fail to be biassed by the recollection of certain cases which from some cause or another were unduly impressed upon his mind; while he who formulates his ideas from a series of isolated examples, collected from the periodical literature, courts every error that is inherent in an unverified diagnosis.
In order to avoid, as far as possible, these sources of error, we have based our clinical description of the disease upon the details afforded by 154 cases which were treated and carefully examined after death at the London Hospital and the London Temperance Hospital between 1893 and 1900. It will be readily understood that, owing to the difficulty of securing complete uniformity in the record of the various symptoms, the entire number is not always available for the investigation of every point of interest.