The blood, as a rule, shows the changes found in secondary anaemia. Beyond this the information given by an examination is of doubtful value.
Krokiewicz states that there is no change in the red blood-corpuscles. In thirteen cases digestion leucocytosis was absent. Krokiewicz agrees with Lowitt that this sign is " of equal value with the absence of HCl and the presence of lactic acid." In nearly all cases the alkalinity of the blood was lessened. Osier and Macrae come to the following conclusions :
(1) Neither an increase of the leucocytes nor special variations in the forms appear to be of any moment in the diagnosis of cancer of the stomach.
(2) The presence or absence of digestion leucocytosis is too uncertain to be of much assistance in diagnosis (in twenty-two cases it was present in ten, absent in twelve).
According to Lindner and Kuttner absence of digestion leucocytosis is noticed rather more frequently in malignant than in simple disease. Hartmann and Silhol (5) have recently communicated to the Societe de Chirurgie the results of some researches made on the blood of surgical patients. In the course of these researches they have become convinced that in cancer of the stomach an examination of the blood is more likely to prove useful than a chemical investigation of the gastric contents. The authors made particular investigation on two questions :
(a) The degree of anaemia characterised by diminution of the quantity of haemoglobin, which may depend on the reduction of the number of globules or on the reduced proportion of haemoglobin in their contents.
(h) The existence of leucocytosis. The presence of cancer of the stomach, it is held, is indicated by a well-marked association of decided anaemia with decided leucocytosis. Anaemia is marked less by the diminished number of globules than by (1) a diminished proportion of the haemoglobin in the globules ; (2) by irregularity in the form of the globules, indicating a profound modification of the elasticity and texture of the red globules ; and (3) by inequality in the size of those globules that are not misshapen. The leucocytosis, to have any value as a symptomatic sign, should be very marked, and should affect especially the non-nucleated cells.
1. Dalton and Reid.- Clin. Sac. Trans., 1005, p. 122.
2. Kemp, R. C-Med. News, New York, August 6th, 1904; and Brit. Med. Journ., Supplement.
3. Osier.-Principles and Practice of Medicine, 3rd edit., p. 491.
4. Glaessner, K.-Berlin. Tclin. Woch., July 21st, 1902.
5. Hartmann and Silhol.-Rev. de Chir., 1901, No. 2.