The prognosis of cancer of the stomach is always hopeless, for there is no authentic case on record in which the disease was ultimately cured. It is true that at one time the discovery of the partial repair that occasionally occurs in a malignant ulcer gave rise to the idea of a ' spontaneous cure of 3ancer; ' but the hope implied has never been realised, owing to the invariable development of secondary growths.
The course of the disease is always so uncertain that it is extremely difficult to foretell, even approximately, the date of bhe fatal issue. In our opinion, the disappearance of the sulphocyanide of potassium from the saliva is one of the most important indications of approaching dissolution, for we have never observed life to be prolonged for more than a month aiter the saliva had become permanently free from the salt. Effusions into the peritoneum and pleurae are always associated with rapid deterioration of strength, and are rarely compatible with the prolongation of life for more than three months. Rapidly increasing anaemia, the constant presence of altered blood in the contents of the stomach, diarrhoea, and a steady diminution in the tension of the pulse, all point to an early termination of the disease. The cause of death in our various cases is shown in the following table.
Cause of death
Perforation (acute peritonitis) ....
Perforation (local abscess).....
Endocarditis (acute and chronic) ....
metastases, coma) ......
Intestinal obstruction ......