Monday, Jun. 23, 1947

Bad Stomachs

The American stomach, A.M.A.'s doctors agreed, is not in very good condition. Ulcers are on the increase, up some 4% since the beginning of the war. Stomach cancer, a closely related horror (many diagnosed "ulcers" turn out to be cancers), now kills 38,000 U.S. citizens a year --or one every 13.8 minutes. The doctors gloomily admitted that they have made small progress with either disease.

For Ulcers, there are two new palliatives: 1) a drug called asymatrine, developed by University of Georgia researchers, which generally stops intestinal spasms and pain; and 2) a synthetic, acid-neutralizing resin called Amberlite IR, which seems to have less disagreeable side-effects than alkalis or gels.

Convention delegates showed plenty of interest in vagotomy, the nerve-cutting operation developed by Chicago's Dr. Lester R. Dragstedt (TIME, Aug. 26), which is currently popular among ulcer specialists. But even that new hope was dampened by Dr. Russell S. Boles of the Philadelphia General Hospital. Said he: "While it is too soon to form conclusions about this operation, it is not too soon to . . . protest against . . . a mass experiment on human beings that is fraught with potentially serious and permanent disabilities." Dr. Boles's warning: the vagus operation, which partially paralyzes the stomach, may produce diarrhea and vomiting, make it hard to get rid of food in the stomach.

Dr. Boles, who takes a dim view of all current treatments, including stomach surgery, suggested that the best ulcer patients can do is to stick to the doctor's prescription as strictly as diabetics and tuberculosis patients. "In the light of our present knowledge," said he, "I believe we should regard ulcer as an incurable disease. It may be held in abeyance, however, by cultivating a new manner of living. With some, this is easy; with others who are involved in a squirrel-cage existence, it is difficult, if not impossible."

For Cancer, there is even less hope: 92 to 98% of patients with known stomach cancer are doomed to die within five years. If caught in time, cancer can be cured by surgery, but by the time stomach cancer is detected, 80% of its victims are beyond the point where an operation will do much good.

The University of Pennsylvania's Dr. Gilson Colby Engel protested that many stomach cancer deaths are unnecessary. X rays and the gastroscope can detect all but 8% of early cancers, said he, but neither patients nor doctors understand the need for such examinations. The average stomach cancer victim does not consult a doctor until 15 to 16 months after his symptoms begin. Anyone who begins to feel weak and tired, to lose his appetite for meat and to have indigestion before or after eating would do well to be examined at once for stomach cancer.

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