This section is from the book "Cancer And Other Tumours Of The Stomach", by Samuel Fenwick. Also available from Amazon: Cancer and other tumours of the stomach.
Cruveiihier was the first to point out that carcinoma is apt to attack the edge or scar of a simple ulcer, and the subsequent confirmation of this fact by Rokitansky, Dittrich, Brinton, and Hauser has led to the belief that a causal relationship exists between the two complaints. Thus, according to Lebert, 9 per cent, of all gastric cancers originate in this manner ; but Bosenheim is disposed to reduce this estimate to 6 per cent, and Haberlin to 2.3 per cent. The widespread destruction of the tissues that results from a malignant growth usually obliterates every trace of a pre-existent ulcer or scar, and it is therefore necessary to surmise the former presence of such a lesion from a history of severe pain or haematemesis. Out of 134 cases in which special inquiries were directed by us to this question, only four, or 3 per cent., admitted having suffered from symptoms of this kind prior to the onset of the fatal complaint. As this result tallies closely with our experience in private practice, we are inclined to believe that not more than 3 per cent, of all cases of gastric cancer are preceded by simple ulcer. Even this, however, does not necessarily imply that the benign predisposes to the malignant affection, for, inasmuch as nearly 5 per cent, of the entire population suffer at one period or another from ulceration of the stomach, the two diseases must frequently occur in the same individual. It seems to us most probable that a simple ulcer, like any other local injury, merely helps to determine the location of the growth in a cancerous subject; and in support of this view it may be noted that while a healthy stomach rarely becomes the seat of metastatic growths, this immunity largely disappears if the organ happens to present a chronic ulcer.
 
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