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—It is often difficult to differentiate between simple ectasis and other chronic disorders of the stomach, notably dilatation due to stricture of the pylorus from carcinoma. Here much, as regards prognosis, depends upon the differentiation of these two conditions. The diagnosis is rendered tolerably certain by a palpable tumor, pronounced cancerous cachexia, rapid emaciation, etc. There arise cases, however, in which the problem is by no means easy of solution, and hence, in Germany, where dilatation and cancer of the stomach appear to be not very uncommon, the subject of their differential diagnosis possesses great practical interest. In 1879, Dr. Van der Velden announced in the pages of the Centralblatt f. d. Med. Wiss., page 664, that free hydrochloric acid is wanting in the ejecta of stomachs rendered ectatic in consequence of carcinomatous stenosis of the pylorus. The significance of this if found to be a fact, is at once
The Absence of Free Hydrochloric Acid in Stomachs Dilated from Carcinomatous Stenosis of the Pylorus.. JAMA. 1884;III(23):632–633. doi:10.1001/jama.1884.02390720016004