The general aspect of a person suffering from carcinoma of the stomach is often highly suggestive of the nature of his complaint. When pain has been a prominent symptom the thin pinched face, the pursed-up mouth, and the permanent furrow at the root of the nose between the eyebrows convey to the mind an impression of constant suffering ; while the sallow skin, the sunken cheeks, and the hollow temples so frequently seen in cases of pyloric stenosis indicate an impairment of nutrition that is rarely met with except in malignant disease of the stomach. Jn addition to this, the briskness of movement, the activity of thought, and the energy of expression usual in a man in the prime of life are replaced by a feeble gait and a listless demeanour, which show that every effort has become a toil, and that a sense of extreme weariness prevents the patient from taking any interest in the daily affairs of life. The despondency and minuteness of detail with which he discusses the most trivial features of his dyspepsia also strike the imagination as being out of proportion to the apparent seriousness of the complaint, and should serve to warn the most careless clinician of the existence of something more grave than a mere functional disturbance of digestion.
Although anaemia is invariably present, certain cases exhibit a curious patch of colour upon either cheek, which stands out in marked contrast to the yellowish pallor of the surrounding skin. This is due to the development of a capillary plexus over the malar bones, which gradually increases in size until it forms a large network of crimson-coloured vessels. According to our experience the phenomenon is chiefly encountered in cases where the malignant growth has involved the glands and tissues behind the stomach, and seldom occurs before the sixth month of the illness. The fact that the semilunar ganglia are frequently embedded in the neoplasm seems to indicate that sympathetic irritation is the cause of the dilatation of the superficial vessels.