Gastric carcinoma: mainly in relation to its earlier recognition and consequent radical treatment

In the great fields of Medical and Surgical Diagnosis, there are two subjects which have always appeared to me to present to the ordinary general practitioner, no matter how shilled he may be, almost insuperable difficulty in their early recognition. I refer to Gastric Carcinoma and Acute Suppurative Osteomyelitis. With the former of these, more especially its earlier recognition, it is my intention to deal in this Thesis. The presence of Gastric Carcinoma in the vast majority of cases is only suspected when a palpable epigastric tumour and, unfortunately, in some cases, a visible epigastric tumour is discovered. When one reflects that the common sites for such neoplasms to develop are towards the pylorus and on the lesser curvature (regions in health anatomically impalpable), it can readily be imagined that by the time such tumours are definitely, superficially palpable, not to mention visible, implication of surrounding important structures, glandular invasion, and secondary metastatic deposits, all too plainly account for the deplorable condition of the average patient who is sent to the surgeon for relief. Those "living skeletons", emaciated, sallow, feeble and anaemic, with subnormal temperature, lungs peculiarly susceptible to any chilling effect (the mere giving of an anaesthetic often hastening their end), with hearts enfeebled and tissues devitalised, cannot be expected to stand, and, as can be shown from the results of most surgeons, do not stand, any operation performed with a view to cure and frequently not even one performed merely with a view to palliate their distress.

Grantor dc:publisher

The University of Edinburgh

Year dc:date.issued

1912

Author dc:creator

• Langwill, James

Handle dc:identifier.uri

http://hdl.handle.net/1842/32469

OAI identifier oai:identifier

oai:era.ed.ac.uk:1842/32469