Modern surgery, general and operative . n is to explore suspected cases earlier than has been our custom. I agree with Hemmeter that stenotic symptoms, even when no tumor ispalpable, call for exploratory laparotomy; if the stomach is dilated, if thereis cachexia, if there is no free hydrochloric acid in the gastric jmce, if there isan excess of lactic acid in the gastric juice, if the patient is at or beyond fortyyears of age, when there is vomiting of blood, when the Oppler bacillus ispresent, when blood examination shows a diminution in red corpuscles andhemoglobin, and also shows that there
Modern surgery, general and operative . n is to explore suspected cases earlier than has been our custom. I agree with Hemmeter that stenotic symptoms, even when no tumor ispalpable, call for exploratory laparotomy; if the stomach is dilated, if thereis cachexia, if there is no free hydrochloric acid in the gastric jmce, if there isan excess of lactic acid in the gastric juice, if the patient is at or beyond fortyyears of age, when there is vomiting of blood, when the Oppler bacillus ispresent, when blood examination shows a diminution in red corpuscles andhemoglobin, and also shows that there is no increase in white corpuscles after afuU meal. After the abdomen has been opened the stomach is examined, andif a tvimor exists, the surgeon must decide between the performance of pylo-rectomy and gastro-enterostomy. If the tumor is not very extensive, if thereis no glandular involvement or only involvement which can be removed, and if adhesions are not extensive, pylorec-tomy is chosen; otherwise gastro-enter-ostomy is
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