GASTRIC CANCER
As a rule the seat of the gastric cancer is the pylorus. The patient gives evidence of chronic gastritis with continued pain, localized tenderness, vomiting of partially digested food and at times dilatation from extreme fermentation. The hemorrhages are as a rule not large, the blood having changed to a brownish color resembling coffee grounds. Vomiting, in cases where the pylorus is involved, generally occurs several hours after eating, the vomitus being in an advanced state of fermentation. Upon analysis of the stomach contents there is found to be a lack of free HCl.
Dietetic Treatment.—In the dietetic treatment of cancer of the stomach the most digestible forms of foods must be given, milk forming in this, as in other gastric disorders, the chief article of diet. As too much food cannot be tolerated, the meals must be small, even if given more frequently. The patient is often found to evince a distaste for meat, in which case fish may be substituted. When meat is given, it must be simple in form and preparation, such as boiled or broiled sweetbreads or brains, scraped beef or stewed chicken. Rice, farina, cornmeal mush, and other fine cereals, cooked with or without milk, are valuable additions to the diet. Well-cooked and strained spinach, green peas, cauliflower, carrots, and tender string beans and boiled or baked potatoes well mashed may be recommended. Tea, coffee, or cocoa may be used to flavor the milk. These must be given in small portions. The following diet list is recommended by Friedenwald and Ruhräh:
SUMMARY
FACTORS INDUCING GASTRIC DISTURBANCES
1. Errors in Diet.—Over-feeding, under-feeding, improper food, unbalanced diet.
2. Disturbed Secretory Processes.—
(a) Over- or under-secretion of gastric juice.
(b) An excess or deficiency of hydrochloric acid in the juices.
3. Impaired Motility and Tone of the Gastric Organ.—The peristaltic waves and muscular contraction of the stomach walls becoming sluggish prevent the food mass from passing into the intestines at a normal rate of speed, thus giving rise to a fermentation of the food and a consequent dilatation of the organ from the gas thus produced.
Other Factors.—Lack of fresh air and exercise, indoor occupation, bad hygiene, unsanitary surroundings, heredity, certain diseases which are accompanied by gastric disorders.
Diseases of Gastric Organ.—Acute and Chronic Gastritis, Gastric-Ulceration, Gastric Cancer.
Treatment.—Tests—Test meals, X-Ray examinations (pictures and Fluoroscope). Patient is given no breakfast on day of test. In X-Ray laboratory a bismuth or barium meal is given, this meal consists of a pint of fluid, either buttermilk or malted milk, into which a certain amount of bismuth or barium chloride is mixed.
Starvation Period.—A period of abstinence from food is instituted in most of the gastric disorders, (a) to determine the extent and character of the disease, (b) to rest the digestive tract.
Dietetic Treatment.—Diet adjusted to meet the needs of the individual case as determined by the medical examination.
Instruction to Patient.—Individual warned against overeating, drinking and constipation.