Case of Cancer of the Pylorus: Undetected during Life

Abstract

The first dose so aggravated her symptoms that I could not persuade her to take a second. I then returned to the acid treatment, in which she persevered for two days, being occasionally better, and then again as bad as ever. The symptoms at length yielded to the following combination:-R. Potass. Chlorat., Soda Sesquicarb., utrq., dr. j.; Tr. Cinchomn Co., dr. iv.; Sp. AEth. Sulph. Co., dr. j.; Infus. Cascarillae, oz. v. M. A fourth part every four hours. A glass of port wine twice a day.In about ten cases out of the fifty entered in my notebook, I first tried the chalk and opium treatment, before resorting to the acid; in only one was perfect relief afforded. The vomiting has been so severe in the prevailing epidemic, that it would seem as if the stomach was unable to bear so nauseous a mixture as that of -chalk and opium. And in most of the cases I have found the best, indeed the only efficacious plan to be, to relieve the intense gastric irritation by cold water, before resorting to the medical treatment. In some cases, if the stomach will bear it, the chalk seems to stop the diarrhoea, but to increase the nausea, and produce most uncomfortable sensations in the bowels on the day after its exhibition. This I have invariably observed in the olden plan of treatment.The conclusions to be drawn from my experience of the sulphuric acid in the treatment of diarrhoea and dysentery, are as follows: 1st. It is more efficaciou8 than alkalies, opiates, and astringents, in a proportion greatly exceeding ten to one.2nd. It is more rapid in its action, (especially in O,hildren,) in a proportion greatly exceeding twenty to one. 3rd. It seems to act in a more rational and (if I may so express myself) scientific manner, by increasing the tone of the mucous membrane of the alimentary canal, rather than by simply astringing its pores.4th. The worse the case, the more rapid and mar-'vellous seems to be the cure,-a most striking feature as compared with the treatment by chalk and opium. I would urge, in conclusion, upon my medical brethren, the desirableness of giving this system a fair trial; and I would, moreover, advise them, instead of giving the acid alone, with water, to combine it with a little sugar and (most rare and excellent of all tinctures,) compound tincture of cardamoms, which seem greatly to relieve the so-frequent distressing flatulence. Unless the character of this autumnal epidemic should greatly alter, they will arrive at the conclusion, after having -tested fairly the acid plan of treatment, that it does not admit of comparison, but only of contrast, with the olden system. P.S. Since writing the above I have seen one case in which the acid failed. Chalk and opium carried the day.